JOURNAL OF THE SURGEON: The miracle pregnancy of women

Our daughter and our son both made us wait for a moment before giving us our first grandchild. Of course, Marie was worried and often complained about it.

Irritated by her persistent lament, one day when she raised the subject again, I told her: "If you want children, I can help you, but for the grandchildren, I feel helpless and we have to wait until they decide to produce one! "

This spontaneous remark reminded me obliquely that Phyllis, my patient, said when I told her that chemotherapy, indicated for her lymphoma of Hodgkin, was likely to knock out her ovaries and make her infertile. when she replied, "It will be a bigger blow to my parents because I am their only child, and they are looking forward to a family of grandchildren."

Phyllis came to see me a few years ago with a small lump Above her left collar, she said, "Being painless, I do not care about it until I my mother noticed it and insisted that I immediately consult our family doctor. I work as a marketing manager for an international travel agency, Phyllis continued, and I had to go to Germany to strengthen our tourism business. I told Mom that I would see our doctor when I returned, but she insisted I see her before I fly to Berlin. Just as well, I listened to my mother for once, "Phyllis added with a smile on her face," because as soon as Dr. Waswa saw this bump, her face dropped. She diagnosed him as an enlarged gland and advised me to see you mara moja. When I told him that I had to catch a plane to Berlin, to make sure I saw you before taking the plane, I took a urgent appointment so that I can see you. "

" Sage, "I noticed feeling the hump after getting Phyllis' relevant story." It's a long shot but this gland looks clinically similar to Hodgkin's lymphoma. "

"What's that?" Phyllis asked, and added afterwards, "Be frank, because I can take it."

I had already heard this so-called false accusation but I decided to be frank with this 25-year-old girl. "It's a primary cancer of the lymph nodes." I responded. "I insist on the term "primary" because, as you know, the lymph nodes are secondarily involved in various cancers. "

Looking at his puzzled face at unsolicited additional information, I continued:" To give you a common example, cancer of the bad, often the glands in the armpits are involved and enlarged. "

" How can we prove your clinical diagnosis? "She asked." By removing the gland and sending it for histology. "

Phyllis willingly accepted and removed the gland under local anesthesia in the" minor "theater and sent it to the histology." The pathologist usually takes four days ", I said writing a prescription for painkillers, "So, can you make an appointment with my secretary to see me in a week when you go out?"

On her next visit, Phyllis was accompanied by her parents, provoking me to say, "I see that you have brought your moral support with you this time, just as well, because the pathologist's report confirms my clinical diagnosis."

After a long period of questions and answers, during of which the parents mainly spoke, we started the discussion about the treatment. "As a generalized disease, it requires a widespread treatment, that is to say the administration of chemotherapy drugs. Looking at their raised eyebrows, I worked out.

"As you know, we have glands in various parts of the body, such as the armpits, groin, neck, including above the clavicle, also inside the chest and the abdomen.I am almost sure that Phyllis has Hodgkin in some or all of these glands, a fact that I will check by CT scan of these areas.Phyllis lamented. "

" I heard things horrible about chemotherapy. "" We can avoid most of them by giving you additional medications, but in your case, the serious one: /// C: / Users / anini / Download / SURGE08-07 The consequence will be that the chemotherapy drugs will hit your ovaries and make you infertile. "I gave this warning because the idea of ​​removing the ovaries before chemotherapy and relocating them after their harmful effects occurred. have dissipated had not been studied yet ied.

That's when Phyllis said while looking at her parents: "It's indeed a shock to me but a bigger shock for me. my parents, who are looking forward to a family of grandchildren, since I am their only child. "

" Regardless of the grandchildren, what is the perspective of our only daughter? Phyllis' mother asked

"The prognosis is pretty good because we have now developed more effective drugs. "I replied, everyone was in agreement that Phyllis was going to start her first chemotherapy clbad upon her return from Berlin, a trip of up to a week.

Dr. Okach She gave six new chemotherapies to Phyllis and declared her in remission.When she came to see me after the end of the clbad, she looked very happy and her opening remarks were. fly to New York next week because we will soon be starting direct flights from the United States to Nairobi and my job is to develop a market there so that Americans can enjoy our beautiful beaches and unique playgrounds. " "I said after checking that she was free of any illness.

"I also want to tell you that I met a nice young man and that I started a relationship with him." She added with a blush on her face. "Given what you've said about chemo that makes me infertile, should we take precautions?" I took a little time to respond to this surprise announcement and a frank and unusual investigation. "19659005 I think you should take precautions until you are ready for a commitment."

A fortnight later I was woken up in the middle of the night by a shrill ring of my mobile. "Excuse me for disturbing you at any time, at home." I recognized Phyllis' anxious voice. "I'm a little disoriented because I just got out of the office of the oncologist and he told me that I had a recurrence of my illness in my chest.He wants me to start a treatment of chemotherapy to subject the glands in my chest. "

" Please take your bearings and tell me how you ended up with an oncologist. "I said, still in a state of stupor. week after my arrival here, I developed a cough for which I saw our company doctor. When he heard my story, he referred me to an oncologist, who after seeing the scan of my chest broke the shocking news. He told me that I could have chemo in Nairobi. "

" Take the first flight home and let us solve your problem. "I advised him."

Upon his return, Dr. Okach and I saw Phyllis together and the CT scan of his chest taken in New York.We agree with the diagnosis and Dr. Okach said. "A little unusual so soon after the end of the CT but I agree with the oncologist that you need a different chemotherapy, especially on the thoracic glands." [19659005"It'badactlywhatDrWilkinson"Phyllishasreported

My contribution to this consultation was to repeat my warning to Phyllis. "I'm sorry that if your ovaries have not been flogged by the first chemo course, the second course makes motherhood in your case a chimera."

Despite this warning, which I had to give for medico-legal reasons, I was happy to see that Phyllis started her second course without delay. I've received regular reports on her progress but halfway through the course, Dr. Okach told me in the coffee room.

"Phyllis complains of low abdominal pain and I thought you would send her for a review." [19659005"Jevousenprie"repliedwithnonchalance

I put a single question to Phyllis when she came for the review. "When was your last period?"

She replied. "They disappeared after the first chemotherapy treatment and seeing what you said, I'm not worried about it."

"I can not find anything to explain your pain, but do an ultrasound and I see what it shows." I suspected glands in the pelvis.

I called the radiologist and she m & # 39; said, "Send her right away.

"I will bring it myself and have a coffee with you. I answered him

While the radiologist was applying cream on Phyllis' abdomen, she murmured. "There are no hypertrophied glands as you suspect." Then she added with enthusiasm. "But I see a three-month pregnancy in this basin."

"It's a miracle!" I say with equal excitement. "I have not seen pregnancy after two cycles of chemotherapy." I turned to Phyllis, who was lying on the ultra-sound sofa that I had asked. "Is it possible?"

"Not possible but very likely," she replied. "After what you told me before starting the second course of chemo, we decided to throw condoms and pills."

"Just as well you said," I replied, "because I was going to label it immaculate design and a miracle."

The last word came from the radiologist who after looking at his desk calendar said. "Judging by the length of the pregnancy, it will always be a miracle and a Christmas baby!"