Within minutes, Northwest Side woman has C-section and cancer surgery
By Stefano Esposito | Staff Reporter October 18, 2013 5:06PM
Updated: November 21, 2013 6:08AM
As the anesthetic fog lifted, Robin Garren awoke with an empty womb and a dead man’s bone in her leg.
“Where am I?! Where’s my baby?!” she cried out from her bed at Northwestern Memorial Hospital on that June 2012 evening.
The series of events that led Garren — a bubbly, tell-it-like-it-is waitress from the Northwest Side — to be in that hospital giving birth and having life-saving cancer surgery on the same day began in an emergency room in another hospital about five months earlier.
Garren had slipped on a patch of ice in a mall parking lot on the South Side. Just to be safe — she was three months pregnant at the time — her family called an ambulance. The doctors in the emergency room at Advocate Christ Medical Center in Oak Lawn told her the baby was fine.
“But I kept telling them, ‘my knee, it hurts so bad,’ ” Garren recalled this month — telling her story on the one-year anniversary of being cancer-free.
A doctor entered her hospital room. He’d just seen Garren’s X-rays. He looked anxious. He wouldn’t meet Garren’s eyes.
“There’s a shadowing on your bone,” he said.
About two weeks later, Garren got the worst kind of news: She had cancer — a rare and very aggressive kind that had broken out of her femur and had begun eating into her muscle.
Early on, Garren had a lot of decisions to make. Her first: refusing to end the pregnancy.
“I said absolutely not.” The doctors told her there could be risks to the baby, including the possibility of heart muscle damage, because of the chemotherapy.
“I said, ‘It’s my baby,’ ” Garren said. “I looked at my boyfriend and said, ‘We’ll love it no matter what.’ ”
How Garren survived the next few months is as much about perseverance, humor and love as it is about modern medicine.
“I just blinked and looked at [the doctor] and said, ‘OK, what do we do?’ ” said Garren, whose words are punctuated every few minutes by a burst of nervous giggles. “Never once was the thought, ‘Oh my God, I have cancer.’ ”
She began chemotherapy in March 2012 at Northwestern Memorial. Garren then had three choices: Doctors could amputate her leg, replace the femur with metal pieces fashioned into a bone-like structure, or use a cadaver bone.
Replacing cancerous bone with pieces from a corpse isn’t new — it’s been around since the mid-1980s — but the hardware that holds it all together has improved dramatically, said Garren’s surgeon, Dr. Terrance Peabody.
Garren’s tumor was at the lower end of her femur, just above the knee joint. A decade ago, the metal plates, screws and rods connecting the donor bone to the knee routinely couldn’t hold up to the stresses of human motion.
“With the old technology, things would move, rotate and flex, and things would not heal. They would fall apart,” Peabody said.
And unlike a donor heart or kidney, the cadaver bone is kept frozen, which kills a lot of the antigens — substances that can stimulate an immune response, Peabody said. So Garren wouldn’t need to take anti-rejection medication.
At first, Garren considered the cadaver bone option a little macabre.
“I was like, as long as they’re not coming back from the dead to claim it, it will be OK,” she joked.
She was told the metal bone structure would likely fail within a decade.
She ruled out losing her leg: “I wanted to be able to paint my toes, wiggle them.”
Garren got a small break during her long ordeal: Her morning sickness stopped after week 16. Otherwise, she was dealing with sheer exhaustion as her belly expanded and chemo sessions took their toll. Late into her pregnancy, she moved from crutches into a wheelchair.
Her long, dark-brown hair fell out.
“Oh my God, I look like Danny DeVito,” Garren recalled thinking.
What helped was the steadfast support of her family, particularly her two sisters who, one after another, moved into Garren’s apartment to help her with daily life.
“I don’t think I could have done it without my family,” Garren said.
As the delivery date got closer, Garren learned that because of her particular condition, the birth would be anything but ordinary. She would need a Caesarean section because she couldn’t bend her legs for a vaginal birth. The cancer was too aggressive to delay surgery, and it was safer to have her lose consciousness just once. So doctors decided she’d have both surgeries on the same day.
Garren could choose to be awake for the birth or sleep right through a near-full day of surgeries. She chose the latter.
“Because my consolation prize will be when I wake up to see my baby,” she said.
Garren’s memories from June 15, 2012, are fuzzy.
She remembers her father, sisters, boyfriend and her boyfriend’s mother clustered around her hospital bed. And she recalls her boyfriend’s mother, a devout Catholic, kissing the hands of her surgeon.
She went under about 8 a.m.
It was an extraordinary scene in the operating room: Peabody and his team, the surgeon who would perform the C-section, a pediatrician to treat the baby if there were complications, an anesthesia team, nurses and others.
It was a risky operation for a number of reasons, including the challenge of removing the tumor completely while not damaging delicate arteries, nerves and veins; if that happened, “You might as well have done an amputation,” Peabody said.
The C-section and leg operation lasted eight hours, including 90 minutes to fashion the 6-inch-long cadaver bone so that it precisely fit into Garren’s leg. In the operating room, Peabody is part surgeon, part sculptor — and a little bit carpenter.
“We put a man’s bone into Robin because it looked stronger and the dimensions fit better,” Peabody said.
The sun had begun to set when Garren finally awoke.
She came to, frantic and with a breathing tube in her nose.
She didn’t know where she was, but she wanted to know her baby had survived.
Garren quickly got the good news: A healthy Sophia Marie was born shortly before 9 a.m., weighing 6 pounds, 8 ounces with strawberry-blond hair — and the leg surgery had been a success.
Garren had to wait two days to hold her baby because each patient was in a different part of the hospital campus and too fragile to move.
The hospital gave her an iPad, which let her watch Sophia’s movements in the intensive care unit. Sophia, who was born three weeks early, needed temporary help breathing.
“Seeing her made me want her that much more,” Garren said. “I didn’t want to hold an iPad, I wanted to hold her.”
On June 17, two nurses finally brought Sophia into her mother’s room. Coincidentally, Garren’s older daughter, Lexi, arrived at the same time.
It was an extraordinary moment for a mother who had endured so much.
“Having my two daughters there, it was wonderful,” Garren said. “I let Lexi hold her. . . . It was just absolutely amazing.”
A year and a half later, Sophia toddles around her mother’s cluttered living room in a pale pink dress, seizing her mother’s cellphone and dropping it into a laundry basket stuffed with toys.
“What are you doing, silly girl?” Garren said.
The cadaver bone has finally fused to Garren’s bones. She walks with a limp but says she’s planning to start physical therapy for that. She said she feels great.
A long, slender scar runs from the top of her hip to just below her knee.
“I call it my Frankenstein leg,” Garren said.
She has not asked about the person whose bone is now inside of her.
“Does that make me insensitive?” she wondered.
One day, she plans to tell Sophia about the months before her arrival.
“We’ve been through a lot together,” Garren said. “I want her to know how much I love her. . . . I would do anything for her — for both my kids. They’re my whole world.”