One woman's story. Hear how she learned she was pregnant.
Your Local Health | Written by BJ Towe
A little over a year ago and on the advice of her doctor, Ashley George of Des Moines began taking supplements to treat iron-deficiency anemia, which affects between 9 and 20 percent of young women. But the level of iron in her blood continued to fall. Then she learned she was pregnant.
About 16 weeks into her pregnancy, George’s iron deficiency became severe. She was referred to a hematologist, who specializes in treating blood disorders. George began making twice-a-week trips to the hospital to receive infusions of liquid iron, which were administered by intravenous (IV) drip.
Up to this point, George chalked up her extreme iron deficiency to her pregnancy. But in February, she began getting odd pains in her right side.
“Each time I would get [the pain], it bothered me more and more. I have two other children and never experienced that feeling [during pregnancy],” George says. “It got really bad. I couldn’t even stand up or walk around. I went to the hospital.” That was February 16.
WAS IT APPENDICITIS?
In the emergency room, blood tests were ordered to determine whether George had an infection, such as appendicitis, that would cause the abdominal pain. Test results came back normal.
Doctors were still concerned about the possibility of appendicitis, which has the potential to be life-threatening. Because the recommended diagnostic test – a CT scan – posed risks to George’s unborn baby, an MRI (magnetic resonance imaging) scan was ordered instead.
Of the results, George says, “It looked like there was [inflammation] in there, but they weren’t sure what it was.” To be safe, Michael Mohan, M.D., a General Surgeon with The Iowa Clinic, was called in. The next morning – on February 17 – Dr. Mohan performed laparoscopic surgery, a procedure that allowed him to view her appendix and surrounding organs. While her appendix turned out to be healthy, Mohan detected an area of her intestines that was severely inflamed.
DIAGNOSTIC COLONOSCOPY ORDERED
“I think Dr. Mohan called me while he was still in the operating room,” says Sue Beckwith, M.D., a Colorectal Surgeon with The Iowa Clinic. “He asked me to see Ashley right away. It’s our goal to never have patients wait for a diagnosis. The sooner they know what they’re dealing with, the sooner they can make a plan and get treated.”
On February 18, George saw Dr. Beckwith for a diagnostic colonoscopy. Again, protecting the health of the fetus necessitated doing things differently: George endured the procedure without anesthesia.
“I remember it all,” George says. “I remember looking at the monitor and seeing bleeding inside there. It was the tumor. It had gotten so big that it attached to my abdominal wall, which is why I felt pain in my right side. It was the reason I was so anemic.”
Should George have surgery now, which could jeopardize her pregnancy? Should she wait until after delivery, which could allow the cancer to grow and threaten her own life?
George says, “Every little thing we did had a possible effect on me or the baby. It was literally life and death. It was a nightmare, but I’ve never experienced a doctor who would explain things more thoroughly and more positively than Dr. Beckwith.
“Everyone was amazing – giving me the risks, the pros and cons, explaining all of the repercussions of every action,” she adds.
While some doctors might have recommended terminating the pregnancy to protect George’s life, no one ever asked her to do so. After weighing the risks, she chose to have surgery right away. In fact, The Iowa Clinic quickly mobilized the surgical team and Beckwith removed the tumor the very next day – less than four days after George arrived in the hospital emergency room.
WOULD SHE NEED CHEMOTHERAPY?
It would be a few days before pathology reports would tell doctors how advanced George’s cancer was. Advanced-stage colon cancer is typically treated with chemotherapy, which – for a woman who is pregnant – poses a whole new set of health risks.
George was relieved to learn the results. She says, “They got all of the cancer out.” And because her cancer was in an early stage, she avoided the need to have chemotherapy.
“My baby was born July 15th, and she is amazing. She went full-term and she’s beautiful,” George says.
George feels good, too, although she has since been diagnosed with Lynch syndrome, an inherited condition that increases the risk of developing colorectal cancer, endometrial cancer, and other types of aggressive cancers.
“I have a long road ahead of me in terms of constant monitoring and trying my best to stay healthy,” she says. “But for now, everything is fine. I’m good.”