The pre-surgery week

The week before my surgery, the appointments really went into overdrive.

Monday

We saw our obstetrician. This appointment pre-dated the cancer. My pregnancy was being monitored quite closely because I had high blood pressure and eventually developed pre-eclampsia while I was pregnant with Joseph. But so far, my blood pressure had been fine, and things had changed, so we spent a good hour with her talking about the cancer treatment.

It was the first time we’d met this doctor, and I didn’t warm to her straight away. But it didn’t take long. She called me ‘dear’ and had a motherly air, but she got things done, too. At one point, she left the room to see if she could get me an appointment for a growth scan, and five minutes later, I was lying on my back with the ultrasound gel being spread over my belly.

Although surgery under general anaesthetic and chemotherapy are both possible during pregnancy, the timing of the birth was going to be quite critical, because it had to be between chemo treatments. I’d be induced. If the baby was breech or there were any problems with the induction, I’d have a C-section. Nearer the time of delivery, I’d have two steroid injections to boost the baby’s lungs. The growth scan put the baby at an estimated 2lb 12oz, which was about right for the stage of the pregnancy. It also showed that she was breech, but she had a good few weeks to turn.

Wednesday

We were back with the breast surgeon to get the results of the fine needle aspiration. No mischief. She thought the swelling detected on the MRI was probably a result of the biopsy. We followed this appointment up with my pre-surgery assessment. A nurse took us through what to expect on the day of the surgery: what time to arrive, what to do and not do beforehand, what to bring.

She told me I couldn’t eat anything from midnight the previous day until after the surgery. Several times, she said ‘I’m sure they’ll put you first because you’re pregnant. Has nobody told you you’ll be first?’ Nobody had. But I hoped she was right. Every morning, I woke up starving.

We also saw a breast care nurse, who took me through the exercises I needed to do after the surgery and explained a bit more about the procedure. She gave me that look that everyone gives me, now. A bit incredulous, and sorry.

Thursday

The obstetrician had phoned me and said that, because there was a small risk of the surgery kick-starting labour, she thought we should do the steroid injections that week. I had the first one on Thursday afternoon. When I told the midwife that I was due to have my anti-D injection (given at 28 weeks of pregnancy, depending on the mother’s blood type) the following day, she offered to do that too, so it was ‘one more thing out of the way’.

Friday

On Friday morning, I was supposed to have my whooping cough injection, but I ended up having to cancel it. I just couldn’t fit everything in. Instead, I had the second steroid injection, and then we waited around for a while because our obstetrician wanted us to talk to a paediatrician while we were there. My bum was numb from the injection, so I paced up and down the room a bit. I had my book but I couldn’t settle down to reading.

When the paediatrician arrived, he talked us through what would happen if my surgery did send me into labour. The hospital where I was going for the surgery doesn’t have a baby unit, so he said I’d be taken by ambulance to the right hospital. Unless it all happened really quickly. He told us that she would need to go on a ventilator, that she’d be fed by tube for several weeks.

As we talked it all through, it started to seem like something that was really going to happen. I had to keep reminding myself that the chance of it was small. I asked what the survival rate was for babies born at 28 weeks, and Paul told me later that he hadn’t wanted to hear the answer. But we were told it was about 95%, which was higher than either of us expected.

During the conversation, our obstetrician arrived. Like magic, she produced a midwife and an anaesthetist to talk to us. She gave us her mobile number, asked Paul to call her when I went in for the surgery, so that she could arrange for a midwife to come to that hospital to check the baby afterwards.

The things we were talking about were terrifying, but I felt so lucky to be being looked after this well. I couldn’t believe how various teams and individuals were communicating and coordinating my care so seamlessly. It was the week of the junior doctors’ strike, and I genuinely don’t think I could have been better taken care of.

Everyone wished us luck, shook our hands. I had an appointment to see the obstetrician again in a couple of weeks. I told her I hoped to make it and to still be pregnant, and she smiled kindly. It felt momentous, somehow. None of us knew how the next few days were going to go. But next time we saw each other, things would have shifted.