With two toddlers and a private midwifery and lactation consultancy business to run, Kate Visser’s life was just about as busy as can be.
It’s no wonder she was caught by surprise when one day, her aunty pointed out a large thyroid nodule sticking out on her neck.
“I had had a miscarriage the month before and believed I’d had basic thyroid levels checked but wasn’t certain. I hopped up and went to our room with floor-to-ceiling mirrors. How had I not noticed this lump before? It was significant. I extended my neck and the lump extended its hands as if to welcome itself into my life,” Kate, from the NSW Central Coast, shares.
“I saw my GP a couple of weeks later who agreed that it was abnormal and referred me for an ultrasound. There was no concern with this but suggested it was a reasonable size, around 4cm x 5cm. With this information at hand, my GP suggested a biopsy. It must be the health professional in me but I thoroughly enjoyed watching the ultrasound screen showing a needle being repeatedly poked all over the nodule in my neck. Again, everything seemed fine. My GP wanted a second opinion and referred me to a surgeon.”
A surprise pregnancy
Kate was quickly booked in for a hemithyroidectomy – a surgery that removes half of the thyroid gland and nodule.
“He wasn’t concerned by either my ultrasound or biopsy but discussed that the size of it wasn’t a positive marker. That, and the fact it was affecting my breathing and swallowing were signs that it was better out than in. It wasn’t going to get smaller and I could probably function well, without medication, with half a thyroid.
“Surgery was nonchalant. Some moderate swelling which lengthened my stay in recovery due to risks to your airway but otherwise ok. I was reunited with my hubby and breastfeeding 12-month-old soon enough. Before discharge my surgeon’s registrar informed me that all had gone well, there were no complications or concerns. The nodule appeared non-malignant but was sent to pathology regardless.”
Two weeks after her surgery, Kate came down with cold-like symptoms and felt kind of off. She immediately knew she was pregnant with her rainbow baby.
“The two lines on the stick just confirmed it. This baby was in the forefront of my mind. Nothing else could compete with it. When my surgeon’s receptionist phoned and requested my follow-up appointment be brought forward by a week I politely agreed, as if I was doing them a favour, and felt exasperated that I’d need to bring my daughters with me as I had no one to care for them.
“It’s a total ride taking kids to appointments at doctors’ rooms – climbing chairs, moving hanging paintings, pulling out fake flowers. Why can’t we speed up specific moments in motherhood? We are taught we should be grateful for every specific moment but that is rubbish.
“Finally! In we all went. The rest is much of a blur. Something about surgery all went well. Balloon blown up for one kid. Something about scar looks good. Something about you have cancer. Balloon blown up for second kid. Something about it’s the best kind of cancer to get and if you can choose one, this one is the one you want. Someone’s balloon pops. I can’t help but think no cancer is good and I don’t want to choose one. Something about surgery to remove the remainder of my thyroid, lifelong replacement medication and radioactive iodine treatment in Sydney. I interject — ‘I’m six weeks pregnant’.”
Treatment ‘incompatible’ with pregnancy
After being congratulated on her pregnancy, Kate was told her surgery to remove the slow-growing thyroid cancer would be delayed until two weeks after her due date — unless she gave birth sooner.
What was supposed to be a simple check-up appointment, had quickly turned into a nightmare.
“The tears flow. I’m a 29-year-old mother of two, six weeks pregnant, recently had surgery and now with a cancer diagnosis. Shit.
“The most magical secrets I’ve ever kept have been my children in early pregnancy. It’s hard to describe how incredible it is looking at the world around you, still spinning, yet no one knowing that you hold the world inside of you. This day, however, was miserable, not magical. With one kid asleep and the other occupied by ABC kids, but acutely aware that mama was crying, I did a quick Google of radioactive iodine treatment. Incompatible with pregnancy. Incompatible with breastfeeding. The tears flooded. I was ‘still’ breastfeeding my 2.5 and 1-year-old daughters. It is a critical element in how I anticipated mothering my children.”
Still reeling from her diagnosis, Kate tried to imagine what her future would look like once her third baby entered the world.
“I couldn’t even breastfeed for the first week or so, I needed to fully wean 4-6 weeks before treatment. That meant never breastfeeding this baby. I thought about donor milk and if I’d be able to ever avoid formula for my baby. Neither daughter ever had a bottle but I’d have to navigate motherhood bottle feeding. So much of breastfeeding is about much more than feeding. I have no idea how to parent without boobs.
“I learn that I’d need to be away from my children for at least a week or two, and potentially not hold my newborn due to radioactivity that could permanently damage their thyroid or give them cancer.”
Later that day, Kate broke the awful news to her husband and mother — who were understandably both devastated.
Determined to breastfeed
She then began desperately searching for alternative treatment solutions that would allow her to breastfeed her third child.
“I first met with the oncologist’s registrar… I had a horrendous experience in that room and felt truly worthless at the hands of a fellow health professional. I felt bullied, coerced and criticised. I was asked if my only objection to radioactive iodine was so that I could breastfeed. I heard ‘You’ve breastfed your other children, this one will be fine’, ‘What are you trying to achieve here?’, ‘Do you want to be here for your kids long term?’, or my favourite one, a question posed to my husband when I disagreed with a comment she made: ‘So what do you think about all of this?’. If looks could kill she would’ve been in smithereens!
“A few weeks later I saw a radiation oncologist because frankly, I was willing to put myself through anything to better my child. He was incredibly kind and politely said at 29 years of age he wouldn’t touch me. External beam radiation increases your risk of cancer by 1% every year. All I wanted throughout it all was a discussion and an exploration of my options, but it seemed like I had none.”
Finally, Kate met with an endocrinologist – a doctor specialising in hormone disorders – who offered her a glimmer of hope. She was told that depending on pathology results after her surgery, she might be able to delay the radioactive treatment by up to 12 months.
It was now a waiting game as Kate eagerly planned for a home birth.
“I’d always wanted a home birth but it hasn’t been an option previously. Having had 2 physiological births before, I was an ideal candidate. More than that, I felt that home birth was the best way to celebrate the end of my birthing days, and the ideal way to reclaim my body as I birthed outside the system I was being dragged into for other reasons,” she explains.
A magical home birth
As her due date finally arrived, Kate noticed the first signs of labour.
“I laid down to feed my second daughter to sleep, it was 8pm, and then it started, the first real waves that would bring my baby to me.
“My babies have a habit of turning from left occiput transverse (the perfect position) to LOP (posterior and not so ideal) during labour. This meant that for a third time, I was faced with a long early labour and continued to have contractions every 15-20 minutes for 24 hours.
“The next evening I tried to feed my daughter to sleep again, but it was different this time. Breastfeeding suddenly brought on the most intense tightenings yet. I was able to breathe through the first two before tapping out. I kissed her forehead and passed bedtime onto my hubby. I knew this was the beginning of the end.”
Within a couple of hours, Kate’s contractions had ramped up to five minutes apart.
“At 12:30am I called my midwife Helen to let her know it was baby day. The midwife in me wanted her to sleep as long as possible. There is nothing harder than lying down in bed and having a phone call from a labouring woman just as you close your eyes. In my words, I’d started “moo-ing”. I knew I’d gone from a place of being able to breathe through my tightenings to needing to now vocalising. A promising place.”
Kate hopped into the birthing pool as she prepared to meet her baby. But after examining herself, she felt a cervical lip — when part of the cervix becomes swollen and gets in the way of baby’s head.
“My midwife suggested sitting on the toilet. I did everything in my power to avoid sitting on the ‘dilation station’ because there was no way I was sitting on the damn toilet unless I was desperate. Contractions were always unbearable there and I wouldn’t have the comfort of water. I got desperate though and my unravelling truly began.
“The clenching, the roaring, the anger, the sailor swearing, the truly primal birthing woman emerged with a force.”
When the pain became too much to handle, Kate made her way back into the birthing pool.
“After what felt like an eternity and more gusto than I knew I had, I felt his head emerge and was surprised when I couldn’t feel his face, half expecting him to come out posterior due to the intensity of it all. Little did I know I had just birthed a 38cm head in a transverse position.
“On the 20th November 2021, I birthed our son Tommy at home in what was one of the most challenging days of my entire life, but one that was a true catalyst of metamorphosis.”
Surgery a success
Twelve days after Tommy was born, Kate had surgery to remove the cancer.
“Recovering from the first surgery was hard with a 2.5 and 1 year old at the time. Now I had a 3.5, almost 2 year old and very fresh newborn. There’s no opportunity to put a movie on and sleep through the recovery phase. Fortunately, in the complete opposite scenario to my initial follow up appointment with my surgeon, the pathology from my remaining thyroid tissue was boringly normal.
“What this meant was that I had the option to delay treatment for around 12 months, potentially a little bit longer. I knew that I wasn’t able to breastfeed long enough that Tommy could naturally wean, but 12 months is remarkably longer than not breastfeeding at all which I was originally told.”
Determined to provide Tommy breastmilk until he naturally weaned, Kate pumped everyday for around 9 months to build up a freezer stash. She weaned him just before his first birthday, and received the radioactive iodine treatment in March.
A donor breastmilk journey
“I spent a week away from my hubby and three kids but my scan looks like it was successful, so I can move to six monthly monitoring for the next five years.
“However, days before his final breastfeed I realised that my breastmilk, once defrosted, was high in lipase. While safe to drink the milk tastes horrific and rancid. So I ended up donating my entire chest freezer of milk to families whom their baby drank high lipase milk, and instead relied upon donor milk for us.
“Let me tell you what it’s like to be on the receiving end. Awe filled, humbling, inspiring, gratuitous and thankful beyond comprehension. Breastmilk donors are living legends.”
Now a 16 month old toddler, Tommy has continued to receive donor breastmilk since his 1st birthday.
“I am actually planning on relactating over the next month, so aiming to regenerate some of my own milk supply to be able to give him that and wean off donor milk.
“He doesn’t have much milk per day so this should be simple enough. I want all my children to have the same opportunity and receive the same benefits of breastfeeding past infancy.”
We wish Kate and her family all the best for their future and know she’ll have an incredible story of courage and determination to tell her three children when they’re older.
Read next…
- Birth Story: Mum sent home from hospital, gives birth at home
- ‘I felt absolutely nothing’: Why having a baby isn’t always love at first sight
- Birth Story: “A home visit from our midwife saved my baby’s life”
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