Hi Christina,
What a tragic situation... :-(
Why is she in the Netherlands? Is she Bulgarian and is that how she got in
touch with you? Does she have a social network?
Knowing where she lives would surely be helpful. Maybe I can give
suggestions for someone really experienced (not me, with these kind of
problems... :-s ...) in her vicinity.
We could maybe find out who could be there for her for emotional support as
far as lactation goes and help speak to the people in the hospital where she
will deliver.
I don't know... I would think that it would be useful to provide her hcp's
with relevant information.
If you can let me know more, on or off list, I can put her info through to
those who could help her.
Warmly,
Marianne Vanderveen IBCLC, Netherlands
----- Original Message -----
From: "Christina Yaneva" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, January 18, 2010 8:32 AM
Subject: [LACTNET] pregnant mom of twins with Hodgkin's, wants to bf
I seem to be getting predominantly complicated cases in the new year and
once again I need help from the knowledge and experience on Lactnet. I have
permission to post.
A pregnant mother of twins, currently 35 weeks and living in Netherlands,
contacted me some days ago with difficult questions. She was diagnosed with
Hodgkin's lymphoma around 9-10 weeks. Mom underwent 4 courses of chemo so
far, standart ABVD protocol, the last one finished early in December. The
doctors told her they will wait for the babies to be born and start
radiation therapy after the birth (5 days a week, 15 min, above the
diafragm, so breasts would be directly exposed). No more rounds of chemo for
now and no scheduled delivery, they will wait for the birth to happen on its
own. There is a PET scan to be done too after the babies are born.
Mom wants to know if it will be possible to bf the babies - the ultrasound
shows no problems with them, but she feels guilty for the chemo and wants to
bf for as long as possible in her situation. She has other 3 sons, all of
them bf for various lenght of time (had enormous oversupply with the first)
and wants to bf the twins too. She got breast implants 3 years ago, placed
"under the gland", as mom described it.
I researched the information available about the drugs and was able to find
Dr. Hale's answer to a similar question 3 years ago too. He states perhaps
it will be ok to bf 2-3 weeks after the last round of chemo because of the
short half lives of the drugs, so that's good news for the mother. Her
doctors told her radiation wouldn't affect the breasts or the milk and as
far as the PET scan goes, I was able to find information about the drug
commonly used in situations like hers and it will require only 24 hours of
pumping and dumping - she will ask the radiologist what drug exactly will be
used to be sure.
We talked about how important it is to be open and flexible in her goals
because of the possible changes in her situation, her exaustion from the
chemo and the twin pregnancy and her other children she has to care for too,
so she is prepared it won't be easy.
It will be very helpful if you can point me out to any resources about bf
after chemo - esp if there is an online group for pregnant and bf moms with
cancer or more information about the problems she faces.
And I wanted to ask if anyone of the LC's in Netherlands is willing to take
over her care - it goes far beyond my knowledge and skills, not to speak
about how far I am, and she will need competent help in her challenging
situation. I don't know where exactly she lives, but I will ask. She doesn's
speak Dutch, but she speaks English.
TIA,
Christina Yaneva
BF Peer Councellor
Bulgaria
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