Linda had her chemo infusion on Thursday and it went well. She did have some minor side effects and a slight elevated temperature on Saturday. But, she is overall doing well, continuing to exercise and be her social self. Ava and I sat with her during the infusion, and Ava even slept on her for awhile while Linda got her meds. An interesting fact (I sound like Cliff Claven) is Linda did best with her first round of chemo while Ava was "with" her (not yet born) and the worst ones were without Ava. So, now Ava is back with her and I think they share a special bond that makes the process smoother.
Chicken or Egg? We have one of those Chicken or Egg quandaries that I've thought about for some time and the mystery will forever remain unsolved. Here it is for the curious: Linda's chemo regimen included a standard protocol of pre-meds to help with nausea. Of those, one was dexamethasone. This is a steroid to help with nausea control and is standard with many types of chemo. It is also (coincidentally) used to develop lungs on preterm babies when doctors know the baby will be delivered early (it passes through the placenta). So, Linda was given these premeds (after heavy consultation with our OBGYN and Oncologist, and countless hours of research I did on effects of all this during pregnancy). Thus, Ava received (via her mom) 3 doses of these steroids during chemo. They certainly helped her very premature lungs develop slightly faster which helped her 3 month early delivery. We didn't have time for the full dosing of steroids when Ava was delivered because it was so sudden. So, this chemo dosing was it. And, I think it helped Ava's lung development. But, the Chicken or Egg question is this: Did the Chemo cause the premature birth? Or, was the prematurity just going to happen regardless and the steroids actually helped? I talked to a doctor on the east coast who is an expert in pregnancy with cancer cases. She said prematurity is not usually a factor of chemo but couldn't say so with certainty in our case. So, we'll never know. But, we're just thankful that Ava is doing well, and our doctors had studied every angle of the whole regimen and knew the steroid would likely help both mom and baby in our situation.
Rob.
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2 comments:
Interesting about the steroids. I got two shots of steroids before Solomon was born at 33 weeks; they had to speed up the usual protocol and give me two shots 12 hours apart b/c it happened so fast to. I'm so glad Linda is bearing the chemo well, and I can imagine that having Ava there makes all the difference to her tolerating it.
Steroids, steroids, we live our lives by steroids. When I was 28 weeks pregnant, we decided it was time to do the prophylactic steroids for Mason (beclomethasone). Then, after being on the CPAP for 6 weeks, we did a long course of dexamethasone. I truly believe this is what turned the corner for him and allowed us to eventually bring him home.
Like you said, you will never know what "caused" the prematurity, but perhaps you can know that the Chemo pre-course did help save Ava's lungs and help her to do as well as she did in the NICU and since being home! I know Mason wouldn't be at home or on as little oxygen as he is without the steroids.
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