I have long been fascinated with the idea of donating oneself to scientific research. Back when I first moved to D.C., I made extra money by participating in blood pressure studies and the like and there was just something so riveting about being a medical "guinea pig." Ever since I became a cancer patient, it's been a dream of mine to one day give back to the scientific community by participating in a clinical trial. Typically, when one hears the words "clinical trial," the image that comes to mind is someone with active and/or advanced disease who's exhausted all available options and is undergoing an experimental treatment, often in an attempt to prolong their own life. So, as someone who was diagnosed with early-stage disease that responded
very well to conventional treatment and carried a low risk of recurrence, I was hard-pressed to think of ways in which I could contribute.
Before I go any further, I should probably talk about something first: One aspect of breast cancer that doesn't get a lot of attention is its effect on a woman's fertility. Not only can chemotherapy ravage the reproductive organs (provided they aren't surgically removed first due to BRCA or other cancer-causing gene mutations), but the long-term treatment for hormone receptor-positive breast cancer is endocrine suppression in order to "starve" the tumor of its primary food source. Because my cancer was nearly 100% hormone-fed, estrogen suppression was an essential tool for staving off a recurrence. For young, pre-menopausal women who wish to retain their fertility post-treatment, Tamoxifen is the gold standard and it's usually prescribed for at least 5-10 years. Pregnancy is strictly contraindicated while undergoing endocrine suppression due to the risk of severe birth defects, which forces many women to postpone if not completely abandon their plans for starting or expanding their families. For this reason, it is often encouraged to see a fertility specialist before beginning treatment in order to discuss your options should you think there's any possibility you'll want children in the future. I didn't touch on this subject in my original post mainly because there simply wasn't time to get into absolutely everything that happened post-diagnosis, but also because it's a very personal thing that I wasn't entirely ready to share, plus it just didn't seem terribly relevant at the time.
Having children hadn't exactly been a priority for me. I'd spent many years going back and forth between "Absolutely never!" and "Maybe someday, if I meet the right person" before finally landing on "I'm not going to let it be a deal breaker either way." Cancer, however, left me with not nearly as much say in the matter. Facing infertility in addition to cancer is definitely a life-altering thing that makes you reevaluate a lot your priorities. During that process, I decided that if I never procreated, I didn't want it to be because cancer made that decision for me. So, on the advice of my breast surgeon, I met with a reproductive endocrinologist shortly after my initial surgical consultation. If I opted to do cryopreservation (a.k.a. "egg freezing"), it would be an expensive, laborious process that would delay the onset of chemo and/or radiation therapy by several months and require specially-timed injections in order to harvest enough eggs for freezing in the hopes that at least one would be viable. Of course, none of this was covered by my insurance. Even though I was eligible for financial assistance via the LiveStrong Foundation, it was still a significant chunk of money at a time when I was saving up to buy my first home (not to mention the $500 yearly storage fee for the frozen eggs that I may or may not ever use). So I decided that I would only proceed with cryopreservation if my Oncotype test came back saying I needed chemo as that would leave me with a roughly 50% chance of never regaining ovarian function. Once the threat of chemo-induced menopause was eliminated thanks to my low Oncotype score, my only real risk factor left was my age and I was OK with leaving that part up to fate. I could always use LiveStrong's assistance in the future if I were to change my mind or need IVF, etc.
One positive thing about 5-10 years of Tamoxifen is that, if I did happen to get hit with baby fever before I was finished with it, I was told I could potentially take a break from it in order to try for a pregnancy. (They call that a "Tamoxifen holiday" in the breast cancer community.) I needed a minimum of 2 years on it before this would be allowed, though, as the first 2 years after diagnosis carry the highest risk of recurrence, which meant I would be 40 before starting a family would even be an option. Again, I was OK with rolling the dice that way so I elected to cross that bridge if and when I came to it.
Fast-forward to June 5, 2019. I was having my regular biannual follow-up with my breast surgeon when she brought up the subject of Tamoxifen and babies (as she is wont to do during these appointments). I was barely 2 months into a new relationship at the time so, needless to say, it wasn't exactly on my radar. When I told her this, she mentioned a national clinical trial currently recruiting patients at specific research hospitals across the U.S. and around the world (the closest being in Georgetown) which she thought I might be a good candidate for. My ears quickly perked up at the words "clinical trial." She said it was called the "POSITIVE" trial, a.k.a. Pregnancy Outcome and Safety of Interrupting Therapy for Women With Endocrine Responsive Breast Cancer. Its main objective is to investigate whether a temporary interruption of endocrine therapy with the goal to permit pregnancy is associated with a higher risk of breast cancer recurrence.
While many young breast cancer survivors do opt to temporarily interrupt endocrine suppression for the purpose of achieving pregnancy, there's not a lot of data available on whether that puts them at an increased risk of recurrence down the road. While the current data suggest that a post-cancer pregnancy after treatment is finished poses no increased risk, less is known about a temporary interruption in hormone therapy before resuming after delivery. This study is looking to evaluate that more deeply. The basic criteria for enrollment was fairly specific: you had to be between 18 and 42 years of age at the time of enrollment, able to bear children at the time of your original diagnosis, have a history of hormone-positive, early stage invasive breast cancer, and have undergone at least 18 but no more than 30 months of endocrine suppression therapy. And of course, you had to be willing to get pregnant. While having children wasn't necessarily paramount for me, the idea of doing it as part of a clinical trial was quite appealing. I fit the bill for everything they were looking for in a participant. The main issue was timing. In June of 2019, I was nearing the end of my 22nd month on Tamoxifen. If I had to stop taking it after no more than 30 months in order to be eligible for the study, then that put February 2020 as the latest I could enroll. But (as I soon learned) the trial was only open to 500 participants worldwide and would likely fill up before then. Sure, I could always take a break later and try on my own. But I knew that if I were to go down that road at all, this was the way I wanted to do it. Because not only would I be monitored extra closely by the research team all throughout pregnancy and for 10 years beyond, but I would be contributing to science! That itself was a pretty strong selling point. My only worry was: could we really do this? My relationship was too new to seriously consider such a life-changing step.
I told my surgeon I would think about it and talk it over with my partner. I also didn't want to do anything without first discussing it with my oncologist since he was the one in charge of my Tamoxifen regimen. Meanwhile, I contacted the research coordinator at Georgetown just to inquire about what all the study would entail. She said the first step would be to bring me in for a consultation. So I set that up, figuring I could just see what it's all about but with no obligation to enroll. My partner (Brian) and I discussed it later that night. Even though we both agreed it was crazy soon to even be talking about it, it couldn't hurt to have the consultation, and he said he fully supported whatever I ended up deciding. He even offered to take the afternoon off work to go to the appointment with me. (Yes, this man was actually entertaining the idea of having a child with me despite only dating me for 2 months and already having 3 teenage children of his own. That's just how awesome he is!)
Two weeks later, we were in Georgetown meeting with the research coordinator and oncologist in charge of the study there. I learned that, in order to enroll in the trial, I would have to stop taking Tamoxifen anywhere from 1 day up to 1 month before enrolling. Then I would have to wait 3-5 months for the "wash-out" period before the drugs were completely cleared out of my system and it would be considered safe to start trying. At that point, I would have a 2-year window to get pregnant, deliver, and get back on hormone suppression (obviously the sooner the better). Participation would require regular visits to Georgetown for blood work and exams from the time of enrollment all throughout pregnancy and for several years after delivery in order to monitor my progress. The study was extremely intriguing but there were quite a few logistics to figure out if we were serious about doing it. They anticipated the trial filling up in early 2020, which still gave me 6 months of leeway. A lot could happen in that amount of time but I felt reassured knowing it wasn't a now-or-never ultimatum. I told them I was definitely interested but I wanted to meet with my oncologist before making a final decision, which I had an appointment to do in mid-August. So I said I would get back with them after discussing it with him then.
Two months later, on August 14, I had my biannual appointment with my oncologist. When I told him I was considering doing this study, he was on board to say the least. In fact, his words were: "Not only are you an ideal candidate but I think you definitely should do it!" By his reasoning, it would accomplish two things: it would get me off Tamoxifen for a while (the side effects of which were becoming more and more unbearable and I was so ready for a break!), and it would allow me the chance to try to have a baby. The fact that I'd be doing it in the name of science made it a triple whammy! His giving me the green light made me feel much more confident about participating, however it was still way too soon and way too much needed to happen first. I had about 2 weeks left of my current 90-day Tamoxifen supply. I decided I would refill it one more time, which would put my last day on it as December 14. One month later, I would officially enroll, wait out the 3-5 month wash-out period, then just kind of see what happens. Knowing it could be nearly a year before we even started trying made it seem much less daunting. I even called my mom to get her opinion on the matter. She agreed this was not the ideal timeline or chronology of events, but loved the idea of me doing a clinical trial--in addition to giving her and Dad their first grandchild!--and they were both very excited about the whole concept.
Tragedy struck, however, exactly two weeks later on August 28, 2019. My dad was rushed to the hospital that evening where he suddenly and unexpectedly passed away, leaving my whole family shocked and devastated with grief. He'd been dealing with several illnesses for the last few years and had
spent more time in the hospital than out since March of that year, but
he always managed to pull through and we all figured this time was no exception. He and Mom had just flown down to D.C. less than 3 weeks earlier to see me perform in an opera at Wolf Trap and he'd seemed sickly but nowhere near the end, so it was a devastating blow to everyone. Dealing with his passing left very little bandwidth for much else, but it also gave me a newfound purpose. My mom was so completely shattered that I wondered if I would ever see her smile or feel the slightest twinge of joy ever again. She said horrifying things like she wished she could die so she could be with Dad, and that the only thing that made her happy was thinking about dying. I longed desperately for something that would give her a reason to live and bring her some semblance of happiness in a world where half of her heart was now gone forever. She'd told me once that she only ever had 2 real dreams in life: to be a mother and to be a grandmother. I'm pretty sure she and Dad had abandoned all hope of attaining the latter many years ago since my brothers and I were never terribly motivated in that area. The thought of seeing her holding her grandbaby and finally crying tears of joy instead of sorrow was the final straw that made me determined to see this study through to the very end.
My plan had been to enroll in the trial in January 2020 but, once the dust started to settle after Dad's funeral and I finally got around to following up with the research team, I learned that it was filling up a lot more quickly than expected. They thought it would be better to enroll me sooner, like mid-December, since it would likely close by the end of the year. So my appointment was scheduled for Monday, December 16, which meant I could still finish out my current Tamoxifen supply before enrolling. However, I got another call from them two months later on November 13 stating that the trial was now projected to fill up by the end of that same month, so I needed to be seen as soon as possible. So my appointment was moved up again to the following Monday, November 18 at 8:30 a.m. Interestingly enough, I had originally been scheduled for my next biannual follow-up with my breast surgeon at that exact same time that same morning, but her office had called a few days before and moved my appointment to Tuesday the 19th instead. It was like the path forward was paving itself!
On Sunday, November 17, I took my last Tamoxifen. The next morning, Brian and I got in his car and headed up to Georgetown. I was both apprehensive and eager. Despite looking forward to relief from the side effects, being off hormone suppression made me feel extremely vulnerable, like I was walking a tightrope without a safety net. Brian expressed concern over how quickly this was happening, but I reassured him (and myself) that it would be at least 3 more months before the wash-out period would be over, and even then we had up to 2 years. Besides, I trusted the process and had faith that everything would happen exactly when--and if--it was supposed to happen.
The appointment was mostly for me to sign a bunch of consent forms (including giving them permission to store my blood and tissue samples at a special facility in Milan!), have an exam with the doctor, and get some basic blood work. I was told I would need to come back a few weeks later for more blood work since they couldn't do it all that same day. They explained this was because it would be drawn at a special research lab in the facility, so they had to officially enroll me and give me a participant number before they could take my blood for the study, which would take a couple of days. And because it was a special research lab, it would be paid for by grant funds rather than billed to my insurance, so I would never see the results of that or any other blood work that was drawn there. I would also have to come back every three months for periodic blood draws, with possible additional visits in between depending on my pregnancy status and how it was progressing. I had to provide them copies of my breast surgery and pathology reports, my radiation treatment summary, and fill out several psychological questionnaires. I also had to start keeping a menstrual diary so they could gather as much data about my cycles as possible. It was going to be a lot of extra work and I was committing to it for at least the next 10 years. But something inside me just felt unequivocally that this was meant to be part of my path in life. And if that wasn't enough, I found out the following week that the study had actually filled up literally the same day I was enrolled. It had been open to 500 participants worldwide. I was number 500. It was all the proof I needed that fate's hands were at work.
Once I was officially enrolled, the waiting game began and, as I've mentioned before, patience was never my strong suit. On one hand, it was nice knowing there was no rush. But on the other hand, I found myself growing more and more anxious to "just see what happens." I'd never been pregnant or even tried to get pregnant before. In fact, I'd spent my entire life avoiding it! So the whole thing was completely uncharted territory to me. I'd always expected that if I ever got to a point in my life where I felt children were a possibility, then my partner and I would simply stop using birth control and leave the rest up to fate. Unfortunately, I no longer had the luxury of being casual about it. Because of the risks of getting pregnant while on Tamoxifen and the risk of my cancer coming back while off, I either had to be deliberately trying or deliberately NOT trying. Well, I quickly learned that to be deliberately trying was a completely different animal from just seeing what happened. So I joined a couple of Facebook groups for women of "advanced maternal age" who were TTC ("Trying To Conceive") and one called Babies After Breast Cancer where I connected with several other women who were also enrolled in the POSITIVE trial. These groups ended up being tremendous resources for me as someone who was brand new to the TTC community. I'd essentially had to learn a whole new vocabulary once I became a cancer patient. The same can be said of TTC. The acronyms they used were numerous and ranged from purely technical (LH = "Leutenizing Hormone" and DPO = "Days Post-Ovulation") to downright humorous (AF = "Aunt Flo" and BD = "Baby Dance," i.e. sex).
I figured, at my age and with only a 2-year window, I had little time to waste. So in early January, just before the 2-month mark of the wash-out period, I made 2 phone calls: one to my reproductive endocrinologist to ask if there were any specific vitamins or supplements I should be taking to increase my chances, and one to my OB/GYN for some blood work and family planning counseling. My endocrinologist recommended some preconception supplements that were specially formulated for older women (and rather pricey at $140 for a 3-month supply), which I started on right away. My OB/GYN recommended some labs to be taken on day 3 of my next cycle to check my hormone levels, ovarian reserve, etc. She also gave me an order for a procedure I could have done called an HSG (Hysterosalpingography) which would check my uterus and fallopian tubes for any abnormalities plus clear them of any blockages if found. Typically they wait to do those until at least 6-12 months of trying without success but, since I was about to turn 41 and had a 2-year time limit, she figured I should probably be a bit more aggressive.
The next 2 months were a flurry of activity. On February 1, I began a 6-week class at George Mason University to earn my paralegal certificate, something I'd been thinking about doing for several years but always put off for various reasons. I figured, with everything going on, it was now or never. I originally registered for the 12-week course at the Loudoun campus but 2 days before the first class, they emailed to inform me that the course had been cancelled due to low enrollment. They offered me either a full refund, a transfer to the online course already in progress, or a transfer to the 6-week course at the Arlington campus. I chose to do the 6-week course in Arlington since I needed to get this done ASAP and knew I would do better with live classroom instruction. But I was freaking out about how I would ever juggle a full-time job Monday through Friday, all-day lectures on Saturday and Sunday, plus studying and completing 5 major writing assignments for 6 full weeks. I got it done, though, and even finished with the highest grade in the class! In retrospect, I'm extremely glad it happened that way because I finished in half the time, and the 12-week class likely would have been cancelled halfway through anyway since that's when COVID-19 was declared a pandemic and social distancing measures were being put into place. It's funny how fate works sometimes, isn't it?
Not everything that happened during those 2 months was good, though. I had my Day 3 labs drawn on February 11 and the following week, a nurse called me with the results. Without giving me the specific numbers, she told me they indicated "increased difficulty conceiving" and their recommendation was to follow up with a fertility specialist to discuss IVF. I was crushed. Had all of this been for nothing? I doubted Brian would agree to such aggressive measures and I wasn't sure how I felt about it, either. I'd told myself that if it didn't happen naturally then I would just accept that it wasn't meant to be, but suddenly I was wondering if I could really accept that so easily. I scheduled an appointment with my OB/GYN to discuss the results more in-depth and, in the meantime, tried to come to terms with the disappointment that this might not happen for us after all.
When my appointment came, I told my doctor that I wasn't interested in hearing the odds or percentages of my chances to conceive naturally. I just wanted to know what all I needed to do to maximize them. Then, I learned that my lab results weren't quite the kiss of death the nurse had made them out to be. My AMH (Anti-Müllerian Hormone) was low, indicating diminished ovarian reserve, but it was on par for my age. And my FSH (Follicle Stimulating Hormone) was high, indicating my body has to work harder to get me to ovulate, but it was just barely over the threshold and also typical for women my age. Everything else was normal. My doctor explained that at my age, with those numbers, and a confirmed history of endometriosis, my quickest window to pregnancy would be IVF. However, she reassured me that I was taking all the right steps to maximize my chances of natural conception. Obviously my odds of that happening at 41 were decidedly less than they were in my 20s, but that wasn't to say it was impossible, and I was doing everything right to increase those odds. The primary concern at my age is egg quality, and I was already taking doctor-recommended supplements to help improve that, in addition to maintaining a healthy weight through diet and regular exercise, being physically active, plus avoiding tobacco and recreational drugs, all of which can help turn back the hands of time. When I read my labs to my mom later, she said they honestly sounded fine to her. Then she reminded me that her office had just delivered a 44-year-old patient that week who had conceived naturally. I posted my results in some of my TTC groups and received several responses from women who said their numbers were way worse yet they still conceived on their own and carried to term. So it appeared that the rumors of my ovarian demise had been greatly exaggerated. (Mark Twain reference - look it up!) Besides, regardless how few good eggs I had left, all I needed was one. With that in mind, I decided to be as proactive as possible for the next 6 months, then reevaluate from there.
The oncologist at Georgetown had given me the business card for an acupuncturist in Dupont who specializes in both cancer and fertility patients, so I made an appointment with her for late March. I bought a bulk supply of ovulation predictor kits and downloaded the accompanying fertility tracker app where I could upload the results, track my cycles, and calculate my optimal days for conception. I added some probiotics and Omega-3 supplements to my daily regimen, all of which were on the list of recommendations for older women who were TTC. I also decided I would schedule the HSG sometime in April or May, once my paralegal class was over and I had some time to relax and get back into my normal routine. On February 18, I hit the 3-month mark of the wash-out period, which meant it was now safe to start trying. But, as the saying goes, it was out of the frying pan and into the fire.
My class concluded on March 15, just days after coronavirus was declared a global pandemic and life ground to a halt. My acupuncture appointment was canceled since the office had to close indefinitely. And although I still went in to work every day since my firm was considered an essential service, they had to furlough a few people in order to cut costs, which made it nearly impossible for me to be out of the office for any reason, especially an elective procedure (i.e. the HSG). Further, my 41st birthday present from Brian was a trip to New York City the weekend of April 3 (our first anniversary) which of course had to be postponed to a date as yet unknown. I did my best to deal with the disappointment of all of this while maintaining as much normalcy as possible, and prayed for no more setbacks or disruptions.
On Saturday, March 28, I woke up experiencing mild cramping, which I chalked up to my cycle getting ready to start even though it wasn't due for 5 more days. That was actually quite discouraging because my ovulation predictor kit had shown a surge on the 18th, meaning I likely ovulated 12-24 hours later, which made me only 9 or 10 days post-ovulation. If my cycle started too early, it could mean I had a short luteal phase, which would make it even more difficult to conceive. Treating a luteal phase defect is fairly easy but usually requires progesterone supplements, which I wasn't certain would be safe for me to take since it was one of the hormones that had fueled my cancer. I'd been told after my diagnosis that I would never again be permitted to use any medications containing additional hormones, no matter how minuscule the dosage. The clinical trial had given us permission to get pregnant "using whatever means necessary" but I'm sure my oncologist would have an opinion on it, too. When I brought this up with Brian, he very firmly stated that me being off Tamoxifen for a short while was the farthest he was willing to go for this to happen. He said, "You're too important to me to do anything else that could put you in danger. The last thing I want is for you to end up with cancer all over your body." So I crossed my fingers and prayed that "Aunt Flo" would hold off a few more days so it wouldn't come to that.
The following night (Sunday, March 29), quarantine boredom and a couple glasses of wine convinced me that it would be fun to take a pregnancy test since I had so many of them stashed up and they were so inexpensive. So I did. The control line appeared right away but I didn't see a second line. When I looked closely, there appeared to be a faint indentation (also called an evaporation or "evap" line) where the second line was supposed to be. I'd seen many women in the TTC groups on Facebook post pictures of similar results asking "Do you see it?" and people would reply, "I see it! Congrats!" while others would say, "I see nothing." I remember in that moment thinking that I now understood how easy it was to confuse an evap line with a faint positive and why it caused so many women to get their hopes up. So I chucked the test aside and thought, "Oh, well. Try again next month." On Tuesday morning (March 31), the cramps were still ongoing but my cycle still hadn't started. I decided to test again right after I woke up since that's the best time of day for the most accurate result. Again, it was more or less just for fun since AF still wasn't due for another 2 days. I mainly just wanted to see if I could expect it to start soon so the cramps would finally go away. Immediately, the first line appeared on the strip. Then the second one.
"Holy f**k!" I gasped. Was I seeing this correctly? Although a false negative early on is possible, there's no such thing as a false positive. And this was very clearly a Big Fat Positive. I fished out Sunday's test to compare. Suddenly, that little evap line looked like it may have been a very, very faint positive after all. "No freaking way!" I thought. To say I was shocked was an understatement. But even more than shocked, I was freaked out. I hadn't expected it to happen so quickly, especially without some sort of medical intervention. Plus, I always thought I'd be one of those people who could tell the minute she became pregnant, but I felt absolutely no different except for the cramping. Then I began to wonder if those were implantation cramps, or an indication of early miscarriage. I called my doctor as soon as their office opened. They said they usually don't see OB patients until 8 or 9 weeks, but advised me to make an appointment ASAP because of the cramping. So I went the next day over my lunch hour. Brian picked me up at work and drove me even though it was right down the street. But because of the pandemic, he wasn't allowed in the exam room with me or even in the waiting area. He had to wait outside by the elevators.
When I'd made the appointment, I learned that due to scheduling changes caused by the pandemic, my usual doctor was only seeing patients at their other location for the time being, so I had to see someone new. Fortunately, I liked her a lot (and in a quirk of fate, she was 8 months pregnant herself!). She did a quick exam and said everything seemed normal, then drew some blood to check my progesterone and HCG levels. I expressed my concern to her about being a high-risk pregnancy due to being 41, the fact that this was my first pregnancy ever, and my history of hormone-positive breast cancer, endometriosis, type II diabetes, and hypertension. My blood pressure had actually gotten so high while I was on the pill that I had to stop and switch to a progesterone-only birth control method. And since I was about to have more estrogen coursing through my body than ever before, obviously my biggest fear was pre-eclampsia. The anxiety of that was fresh on my mind since my cousin's girlfriend had just had an emergency c-section 2 weeks earlier after developing that, and a friend of mine had died from it a few years ago at age 34. I felt that, with all my risk factors, it was practically a given and I didn't want to even think about how that would affect my mom. While my cousin's girlfriend was in the hospital trying to get her blood pressure to come down, Mom was pacing the floor and saying that she wouldn't be able to relax until she knew the baby was out. In her words, she's "seen and knows too much." Imagine how much worse it would be if it were her own daughter. If anything happened to me the same year she lost Dad, it would almost certainly kill her, too.
My OB assured me I did the right thing by coming in when I did. She said it was too early to do an ultrasound but they would let me know the results of my blood work and based on that, likely have me come back in 2 weeks for some imaging. She also advised me to schedule an appointment with my primary doctor to discuss blood pressure meds that were pregnancy-friendly as neither of the ones I'd been prescribed were recommended, and to monitor my BP twice a day and keep a log of it. Although my BP was fine at the time, the increased estrogen would likely change that once those levels started to climb, but she said there were some preventative measures I could take which we would deal with once I was a little further along. Then she gave me a written pregnancy confirmation to send to the research team at Georgetown since they required proof for the study. Seeing my own name next to the words "currently pregnant" was the most surreal thing ever. It felt like I was watching it in a movie. My due date was calculated as December 9th based on the date of my last period, which meant, assuming all went as planned, I'd already had my last childless Christmas. (Talk about your mind being blown!)
Still, I wanted to stay cautiously optimistic since my age carried a higher risk of early miscarriage. I wanted so badly to tell my mom because not only would she be overjoyed but her expertise would help me with any questions or concerns I didn't want to bother my doctor with. I'd asked her a few months earlier if she would want to know the second I got a positive pregnancy test or if I should wait until I was out of the danger zone. She said I could tell her right away since, after 40 years in the industry, she understood how these things can go, so she could handle the disappointment if it didn't stick. But I didn't want to get her hopes up only for it not to stick and just compound her existing grief. Plus I felt a text message telling her she was going to be a grandma was so inherently wrong, all things considered. I asked Brian his opinion and he felt we should hold off telling her for a while for those exact reasons. I knew it would be extremely hard to wait and I'd have to be very careful not to let it slip, but this way I could tell her on Mother's Day, hopefully in person if the shelter-in-place order is lifted by then and I can travel to Ohio. But Mother's Day was 6 weeks away and I was already bursting with the news.
With that, I will conclude 2019 B.C. (Before Conception). Stay tuned for 2020 A.D. (After Delivery)!
