The Story of My Post-Cancer Miracle Baby (And Breastfeeding After a Mastectomy)
This essay was originally published in Wildfire Magazine, Vol 1, Issue 4: Parenting With Cancer, September 2016. Wildfire is a reader-generated, subscription-based digital magazine for young women fighters and survivors of breast cancer.
Interested in learning more about this topic? Join Living Beyond Breast Cancer March 2 for a free webinar that will address how cancer treatment might affect your fertility, tests you can get to assess your fertility after treatment, the impact of pregnancy on risk of recurrence, what to do when pregnancy doesn’t happen easily, and more.
As I lay here watching my one-year-old sleep, I am in awe. For a long time I doubted I would ever have children and on my son's first birthday, I still can't believe he's here – my little piece of heaven. He stirs and rolls over, silently searching for my breast and latches easily; his quiet gulps fill me with pride.
In 2008 I was diagnosed with stage III breast cancer, five days before my 22nd birthday. I was in my second year of university studying nursing, working part time in aged care, living with my parents, and in a new relationship.
When my oncologist, Alison, told me I needed chemotherapy and medication to suppress my hormones, the first thing that came out of my mouth was ‘Will I be able to have kids?’
I'd always wanted children, and wanted to do all I could to increase my chances of being fertile in the future.
I saw Ben, a fertility specialist, but both he and Alison advised against the hormones required to harvest my eggs. It was suggested I try an experimental treatment called goserelin (Zoladex) which would shut down my ovaries, putting me into immediate menopause and thereby making the ovaries less attractive to the chemotherapy, as the chemo drugs attack fast growing cells. Ben also offered to surgically remove and store some of my ovarian tissue for potential use with technological advances in the future.
I had a lumpectomy and axillary clearance which showed the cancer had spread to four lymph nodes and I was told I needed a single mastectomy. During the mastectomy Ben removed my ovarian tissue via laparoscopy, and injected my first Zoladex, all pro bono. A few days later I started going into menopause. I had hot flashes, mood swings and dry skin among other things.
Two days after I finished chemo my boyfriend broke up with me. He told me I needed to focus on myself.
I lost a lot of confidence when I lost my breast and my hair, and I gained weight during treatment. I thought I was damaged goods and nobody would ever want me again. I took out private health coverage in order to have breast reconstruction as the public wait time was five years! (Editor's note: Karlee lives in and had her treatments in Australia.)
I focused on my studies and graduated as a Registered Nurse in July 2010, then started working in oncology – the department in which I received my treatment. I had breast reconstruction the following year, but it didn't do much for my self-confidence. Before the surgery I switched from Zoladex and anastrozole (Arimidex) to tamoxifen.
Fast forward to July 2013. I've been single – and celibate – for four years. I receive a random message on Facebook from an old high school friend, Dan, who I haven't seen in years. We talk a lot and really hit it off.
He was in the army and was almost killed in two separate IED strikes, now suffering from PTSD and depression. We understand each other in ways I didn’t think was possible.
We've both faced the likelihood of our own premature death and dealt with it. We both have issues and we have no trouble accepting each other's issues. Needless to say we get on well and a few months later we moved in together.
The first time we had sex was painful and it took me close to a week to recover. It had been so long I'm fairly sure I was a virgin again! In conjunction with my oncologist I stopped taking tamoxifen, bringing me to a total of 5 years of hormone suppression. Dan and I talked about contraception and my inability to use hormonal methods and our mutual dislike of condoms. We were both STD-free and made a decision to use no contraception as it was extremely unlikely I'd get pregnant after treatment.
Two weeks after ceasing tamoxifen my period returned!
They were very irregular and painful and I needed a D&C due to a buildup of endometrial tissue caused by tamoxifen. This resulted in a complete disappearance of my period pain, thankfully! A new blood test became available called AMH which shows how many eggs you have left. My level was 10. The normal range is about 15-50, which was disappointing. Ben, my fertility specialist, also performed pre-pregnancy blood work on both Dan and I which was all clear, as well as a sperm count for Dan. To this day he still likes to tell people he has super sperm!
In August 2014 on our first anniversary we got engaged! My low self-esteem was virtually gone and we had both healed a lot mentally. As time was not on our side, we decided to start officially trying for a baby – much to my parents delight! I talked to my oncologist, Alison, about fertility treatment and my choices, to which she gave me plenty of information and told me to think about it and make my own decision.
For me personally, there was never a choice. I’ve always wanted to be a mum, breast cancer be damned!
I had a CT, bone scan, mammogram, and ultrasound, all of which were clear, and saw Ben in preparation for fertility treatment.
In September we had a round of intrauterine insemination using hormone injections.
My ovaries took quite a lot of time and hormones to produce an egg (but they did!) and then inseminate me with sperm. I was to return in two weeks time for a pregnancy test. Twelve days later I got my period. As much as we had hoped it would work, we were realistic and not too upset that it didn't. We set the wedding date for February 7th the following year and decided to wait until afterwards to try another round of IUI.
In November I bought a bunch of cheap ovulation and pregnancy tests on eBay.
I'd been trying to be more in tune with my body in order to determine when I was ovulating. On a day when I suspected I was close, I took an ovulation test and it was positive! You can imagine what the days following looked like and I won't go into detail! Two weeks from that date was December 24th and I was starting to suspect I was pregnant. My nipple was extremely sensitive, I had some mild abdominal cramps and a general feeling of something being different with my body.
I took a pregnancy test, but it was negative. I wasn't deterred and thought it was just too early to test.
On Boxing Day I tested again and I swore there was a very faint line on the test! Dan and Mum were excited, but weren't convinced it was positive. The following day another test had a slightly darker line and I couldn't take the uncertainty anymore. I went in to work and had a blood test. A few hours later a colleague called me with the results. It was positive: I was pregnant, naturally!
To say I was excited is an understatement! I visited my GP and went for a dating scan a couple of weeks later where we saw a tiny flickering heartbeat. My obstetrician, Ben, couldn't believe I was pregnant naturally and along with my oncologist, Alison, I was closely monitored. My twelve-week scan showed the baby was perfectly healthy.
Alison came to visit me one day at work and told me she was pregnant too. She'd seen Ben after I recommended him and we were due only three days apart!
The pregnancy continued uneventfully, and at 19 weeks we discovered we were having a boy! At 28 weeks I was diagnosed with gestational diabetes. I tried to control it by improving my diet, but to no avail. Metformin tablets worked well and my blood sugars were well-controlled.
By 34 weeks I was exhausted. I finished up at work and started on maternity leave. My belly was so tight and stretched from the TRAM flap reconstruction, I started to get some stretch marks. My back was constantly aching, my legs were swollen, and I hardly slept because I had to use the bathroom constantly overnight.
During my pregnancy I had been reading about breastfeeding, but couldn’t find any information on feeding with one breast.
I saw a lactation consultant who assured me it was very possible and told me they'd provide breastfeeding support in the postpartum period.
At our 37 week appointment I was very over being pregnant and having trouble walking at times due to bad pelvic pain. Ben attempted a stretch and sweep, but my cervix was fully closed, so we scheduled an induction. The receptionist called the hospital and we booked in the earliest date they had, very keen to meet our little man.
On Tuesday the 18th of August we presented at the hospital at 8:15 p.m. for induction. The plan was to insert prostaglandin gel onto my cervix that night, then see Ben at 7 a.m. the following morning. He would attempt to break my waters, then hook me up to the syntocin drip. If I wasn’t dilated enough, it would be another dose of gel, wait six hours and try again. I could have up to three doses of gel.
The gel was inserted at 9 p.m. and at 12:30 a.m. I woke with cramps. They increased in intensity until 6 a.m. when I had my first contraction and my waters broke all over the carpet! During labor, the baby kept dropping his heart rate unless I was lying on my right side. Being confined to the bed made the pain impossible to manage, and at 8:20 a.m. I had an epidural.
Several times I almost went to the operating room for an emergency C-section due to baby's low heart rate, and at 9:30 a.m. Ben said he'd check me one last time and if I hadn't progressed I'd be going for surgery immediately. Thankfully I was 9 cm dilated! After Ben set up, I was 10 cm and started pushing. The epidural was weak and I could still feel the contractions as pressure and could push easily. The baby had other ideas though, and due to distress needed to be vacuumed out.
The cord was wrapped so tightly around his neck that Ben struggled to get it off.
Eli Edison Excell was born at 9:46 a.m.
They held him up to me and he was all stiff and after a few seconds let out a little cry which was the most beautiful sound I've ever heard. He was perfect at 6lb 10oz (3.014kg) and 51 cm long, with a head circumference of 35.5 cm.
He had his first breastfeed at 10:20 a.m. and we had skin-to-skin until 11 a.m. when I got up to shower and he had skin-to-skin with Dan and then snuggles with Mum. I had no issues after the birth and my period returned at six weeks postpartum – much to my dismay!
Breastfeeding has been an incredibly easy and rewarding journey for Eli and me. In the first week I had a cracked nipple and my milk didn't come in until day 5, but this was nothing in the long run. Eli is a natural on the boob, and I have a 'go with the flow' attitude, which has helped a lot. He is 13 months old today and still breastfeeding with no end in sight.
Having one breast has made absolutely no difference in being able to breastfeed, in fact I think it was easier because I’ve never had to worry about switching sides!
Two months after Eli was born I had a copper IUD inserted. As my breast cancer was ER+/PR+ I'm unable to use hormonal contraception. The first two periods were very heavy and painful, but are now trouble-free.
Motherhood has been the most incredible healing experience and I thank my lucky stars every day. Eli is absolutely perfect and I feel my world is now complete.
Eight years ago I thought my life was over, but now I realize it has just begun.
Karlee Excell, of Australia, was diagnosed with stage III hormone receptor-positive, HER2-positive breast cancer in 2008, at age 21. She is now an oncology nurse working where she was treated. Karlee is the mother of a naturally conceived post-cancer baby and is breastfeeding her son with one breast until he naturally weans. Karlee's husband suffers from PTSD after being injured in Afghanistan while on deployment with the Australian army. Together, they are navigating life and love after both going through traumatic experiences.