A Blessing and a Curse

In all the business of our lives, it's easy to look over the little things. We complain about petty stuff, getting stuck in traffic, who said what on TV or in politics... It sometimes takes a life changing event to put things into a different perspective where we can forget the pettiness and really appreciate the little things for what they are: miracles.

A few months ago, I was laying in bed on my side with my shoulders twisted around toward the ceiling and just happened to feel a golf ball sized lump under my right rib cage. I didn't think it belonged but put off asking any questions for another month or so thinking that it was just something normal I'd never noticed before or maybe having a baby recently had shifted some things around. Our health insurance had just changed and I had not yet found new doctors to replace the previous ones. I finally decided to call a local doctor who had openings for new patients. He was a bit baffled by this lump...we could only feel it when I lay in this particular position. If I turned over to my back, it would sink down out of reach. He ordered a CT scan for the following week and I mentioned there might be a chance I'm pregnant. I did a test in the office that day and to my great relief it was negative. I really wasn't ready for another child yet. I was on day 28 of my cycle so I played it safe and did a home test the day before the CT scan on day 32...positive. I couldn't believe it! I had an 11 month old baby I was still breastfeeding, I was scared out of my mind about what this lump could be and...I was now pregnant! I sat at home and sobbed for hours. My last two pregnancies were welcome and joyous...this one was a big wrench in the works. I immediately canceled the CT scan and scheduled an ultrasound for a week later.

The results of the ultrasound were a bit inconclusive but things were narrowed down to: a highly vascular 4cm mass on the mid pole of my right kidney that wasn't a fluid filled cyst. Possibilities were angiomyolipoma, a rare type of benign tumor made up of blood vessels and fatty tissue, or renal cell carcinoma. My doctor referred me to a urologist, who ordered an MRI. The hospital refused to do the MRI (even without contrast) until I had reached my second trimester. I had to wait two months for this. With as little information about my condition that I had to go by, this was a very stressful time to say the least. Not to mention, I didn't really like my urologist, who didn't seem to have good communication skills or an ounce of sensitivity. I was quickly sinking into depression. I finally had my MRI one day after the start of my second trimester. When he first ordered the MRI, the urologist confidently proclaimed that I "couldn't" have cancer because I was too young and healthy. I felt like I was being shrugged off.

The MRI results as relayed from the urologist were scary...he didn't use layman's terms and seemed to want to get me off the phone. It was a week after my MRI and I had finally called to ask what was going on. The doctor had just returned from vacation. The conversation was awkward and when we spoke, I heard the words "bleeding" and "hemorrhage" and he finally said that it was "suspicious" and "worrisome for cancer". I had to drag even that much out of him. He then referred me to the head of the urological oncology department at UCSF. He wasn't feeling qualified for my case because I was pregnant. I had no problems with this. As one last virtual slap in the face, the previous doctor's office took forever getting my records transferred because, I suppose, I needed more time to worry.

I finally had my appointment with Dr. Carroll at UCSF five days ago. Needless to say, he was MUCH better at letting me know what's going on and gave me the whole picture. He hadn't seen the actual MRI scans yet but from the written report, he kindly assured me that this is not going to be a problem for his team to deal with. Even if it were cancer, the location of the tumor and the fact that it's contained within a "meaty" portion of the kidney allows for an easy removal. No other therapy would be needed. No chemo, no radiation. I also wouldn't have to lose the whole kidney. Despite not knowing if it was benign or cancerous, he felt it needed to come out soon. This was such a relief to hear, it took a massive amount of control not to cry right there in his office.

He took the next two days to view the scans with other doctors at UCSF so that they could verify what the report said. I received a call from him Friday afternoon explaining that they could find no signs that the tumor is benign (no fatty tissue). So basically, I most likely have a malignant tumor... the "c" word. The big question at this point is when is it going to be removed. I will either have to have open surgery at around 24 weeks in my pregnancy -or- wait and monitor the tumor through the pregnancy and have it removed laparoscopically a couple weeks after delivery. He is currently trying to contact my OBGYN to see what she's comfortable with. We don't know how long this tumor has been there and we don't know how fast it's growing. If I have the open surgery, recovery will be long, difficult and simultaneous with the third trimester. Reading others' stories of recovery from open kidney surgery is scary...and they aren't even doing this while pregnant. Laparoscopic surgery is a much easier recovery but we have no idea how things will go in the next five months.

This last phone call has really put me on edge again despite my efforts to prepare myself. I'm only 31, do not fall under any of the risk factors, and do not have any family whatsoever who has had ANY type of cancer. I have always been very active and healthy. It's simply a freak occurrence. I just can't help but think about how easily I could have missed that lump and how much worse things could have been. Apparently, a mass that small can almost never be felt from the outside. Given more time to spread, it may have become terminal. You can call it luck but I'd like to believe it was divine intervention.

On the bright side, I get to find out on October 6th if I'm having a boy or a girl. I have two boys already and am really hoping for a girl this time. I'll be happy, though, just to have a healthy baby at all. I'll be even happier to be a mother of three for a very long time. This was all so unexpected and I don't know what the heck I'm going to do with three kids or how I'll fit them all into my car and house! Regardless, this baby will be my little survivor and I'm forever going to be grateful. The road ahead is going to be rough but it really is good to be alive.