Woman Goes From Pediatric Cancer Patient to a New Mom at P/SL | by Debra Melani

Dr. Cindy Kelly

Posted on Wed, Apr 3, 2013

Mostly, she remembers waking up from the morphine and seeing her doctor and parents crying. Shock prevented tears, as her local doctor explained the bad leg break during her basketball game was not a normal fracture; it was caused by an aggressive bone cancer. At 15, she didn’t know what to think. “I don’t think I really cried until I got to Denver and met Dr. Kelly,” says Amanda Dschaak, who still lives in her small hometown of Craig. That’s when the questions and tears suddenly hit: “Oh my god, am I going to die? Am I going to lose my leg? Will I ever play basketball again?”

The only thing Dr. Cindy Kelly of Presbyterian/St. Luke’s Medical Center didn’t deliver on was returning the avid athlete to the basketball court. The threat of another break was just too great. But today, Dschaak is 27, still has her leg, and has the answer to the one big question she and her mom later asked: Can she ever have a baby? With the help of P/SL, Dschaak did overcome the obstacles and give birth to a baby girl years later.

Amanda Dschaak

Amanda Dschaak with her daughter Rylie at North Park in Craig, Colorado.

Delivering life and limb

Immediately after being diagnosed with osteosarcoma, Dschaak was started on chemotherapy, three highly-potent infusions that shrunk the tumor beyond detection. A 12-hour surgery followed, replacing her femur and knee with prosthetic parts. Then she underwent four more chemotherapy treatments. “I went in probably weighing about 130 pounds. I came out two weeks later weighing 102 with a 10-pound cast on.”

By choosing The Denver Clinic for Extremities at Risk at P/SL, Dschaak boosted her chances of survival. “We have a unique protocol for osteosarcoma treatment, and we have the highest pediatric survival rate in the country,” says Dr. Kelly, who is a board certified orthopedic surgeon.

Technological advancements have also dramatically reduced the number of amputations once required. “All of the technology has come a long way, from the big prostheses that we put in to ones that we can make grow,” Dr. Kelly says. Years ago, younger patients were not candidates for limb salvage because their bones were still growing, and the technology was not available.

Once Dschaak and her family were confident her life and leg would be saved, other questions arose, such as Dschaak’s chances of one day having a baby of her own. Chemotherapy can affect fertility, they were told, but they would just have to wait and see.

Delivering baby

Six years ago, Dschaak did give birth to a baby girl. And she delivered at P/SL, where the nurses and doctors who shared in her dramatic fight against osteosarcoma came to visit her and to welcome little Rylie into the world. “I wouldn’t have it any other way,” Dschaak says of her decision to stay with P/SL. “I love all my doctors and nurses. They’ve always been very supportive of me.” But Rylie didn’t come easy. Dschaak went into labor 10 weeks early. “My liver and kidney shut down. My lung collapsed. I was in the ICU on a ventilator when I had my daughter.” Doctors stabilized Dschaak and delivered Rylie via caesarean section, weighing 2 pounds, 6 ounces.

Within 24 hours, Dschaak was fine. Although what happened remains unclear to her, Dschaak says she knew she and Rylie, released from the Neonatal Intensive Care Unit in just five weeks, were in good hands, with doctors and radiologists involved in her cancer care by her side again. “The girls (oncology nurses) came and saw me every day. They brought blankets for Rylie and for me.”

Dr. Kelly says she sees Dschaak’s level of loyalty often at P/SL. “I think patients develop a certain level of trust and faith in all of the caregivers here, from the nurses to the physical therapists on up to the doctors. They just feel secure, especially when they have survived a disease.” And there’s no question that continuity results in better care, she says. “It’s a collaborative team here at all levels, and so, if the OB/GYN has a question about something; we’re right here.”

Today, Dschaak says her experiences have shaped who she is in many ways. She recently lost her father to melanoma, but believes her empathy from her experience comforted them both. “It was hard, but I know what he was going through, and I was there by his side the whole time. My dad used to always tell me ‘attitude is everything, and there is a reason things happen’.” She believes her cancer kept her in her hometown, near her dad and her family. “I would have never met my husband, and I would have never had my daughter. And Rylie’s my rock. She’s just awesome.”

Did you know?

Menstrual periods may become irregular or stop completely during chemotherapy, and they might not come back afterward. Menopause might start at an earlier age.

Infertility can occur with chemotherapy, but whether it happens and how long it lasts depends on many factors, including type of drug, doses given, and patient age.

Although most common in teenagers, osteosarcoma (a bone cancer) can strike any time, particularlybetween the ages of 10 and 30. Possible symptoms include:

  • Swelling or a lump at the location of the tumor (usually affects longer bones)
  • Pain at the tumor location
  • Difficulty moving the affected limb
  • Limping
  • Deep bone pain severe enough to wake up your child
  • Bone fractures (rarely)

With typical intravenous chemotherapy treatments, the 5-year survival rate for osteosarcoma falls within the 60- to 80-percent range. At Presbyterian/St. Luke’s, where intra-arterial chemotherapy is used, patients have a 5-year survival rate of 93.2 percent.

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