Six months pregnant with her second child, Casey Sullivan figured that all of her discomfort, bulging neck veins, coughing and back pain were a result of her pregnancy. So she didn't bring it to her doctor's attention until she couldn't breathe.
That's when doctors realized that the 26-year-old wife and mother had Hodgkin's disease.
An X-ray revealed that a large tissue mass had spread from one side of her chest to the other, pressing against her aortic artery and her lungs. That caused veins from her head to her chest to bulge and restricted her breathing.
The cancer had taken over a third of her chest cavity.
An oncologist wanted to start chemotherapy immediately, while the obstetrician recommended giving Sullivan's unborn baby more time to develop.
Today, members of both sides of the family will gather to give thanks for two miracles.
"We're extremely thankful. I mean it couldn't be a better Thanksgiving," said Melody Fletcher, Sullivan's mother.
But seven months ago, despair reigned. No choice was good. Wait too long to begin treatment and the implications for Sullivan could be dire. Act too soon and the baby could be at risk.
Sullivan had been experiencing symptoms for at least three months -- coughing and back pain.
The pain eventually got so bad she couldn't even lie in bed. She started sleeping in a recliner.
When that didn't work and the cough got worse, she went to the doctor.
By that time her resting heart rate was 135, twice as fast as it should be.
Dr. Kirk Brody, Sullivan's obstetrician, recommended she see a pulmonologist. He discovered the mass and brought in an oncologist.
The cancer specialist pushed for immediate and aggressive treatment of Sullivan's mass. Brody argued they should wait for the sake of the baby.
At 27 weeks, he was concerned that the baby's lungs would not be developed enough for the baby to breathe on his own. The oncologist agreed to give the baby another week to develop before attacking the cancer.
Brody gave Sullivan steroids to speed the baby's development.
The cancer didn't put the baby at risk, Brody said. Prematurity was the concern.
They had to weigh getting Casey treated as soon as possible against the chances of delivering the baby too early, he said.
"The chances that the baby would die or that there would be long-term complications."
Baby Keller came at 28 weeks and spent the next two months in the Neonatal Intensive Care Unit at Erlanger hospital. He had a head full of hair, but at 3.5 pounds he was so thin that his arms looked like bat wings, said Sullivan.
For her first child, 2-year-old Cadence, Sullivan didn't even have an epidural. Her water broke. She was in labor for five hours and the baby came.
But Keller was delivered by Cesarean section, and Sullivan was sedated.
After she woke, nurses told her she had a baby boy.
A week later doctors started Sullivan's chemotherapy. For the next six months she went through a cycle of intense pain, despair and joy.
The pain caused her to cry. It didn't just hurt, it was debilitating. And the fatigue from the chemotherapy disabled her, keeping her from working full time or even assisting her husband with the kids and the household.
Because her immune system was weakened and Keller's hadn't fully developed, mom and newborn spent hardly any time together.
Too exhausted from chemo to do anything, Sullivan had to rely on others for a great deal. That made her feel worthless and depressed.
Today she cries tears of joy when she thinks about her support system.
Ryan, her husband of five years, paid the bills, took Cadence back and forth to day care, sat with Keller in NICU and comforted her, all while maintaining a full-time job.
"Without him the house would have fallen apart," Sullivan said.
Fletcher, her mother, came up from Texas to help care for Cadence. And her mother-in-law, Joan Sullivan, of East Ridge, started a prayer group at her church and sat with Keller in the hospital.
A nurse at Erlanger insisted on sitting with Sullivan during her chemotherapy. Sullivan said she felt just fine, yet the nurse stayed nearby. And when the discomfort and despair came -- just when Sullivan thought she was going to break -- the nurse was there.
Then there was her job at Camping World. She wanted to work, but was too tired from the chemo. Her boss allowed her to work at will, to come in when she felt like it and leave when she felt sick. Co-workers and customers took up a donation for her.
Sullivan's church, Gracepoint in Fort Oglethorpe collected meal bars and food that her husband could eat while running back and forth from his job to the hospital. The church arranged the food in a basket and at the bottom was a layer of $1 bills and coins so that he never had to pay out of pocket for parking at the hospital.
Church members also cooked a hot dinner for the family once a week for about five months, until Sullivan finished chemotherapy. They also mailed her more than 100 cards for her 27th birthday.
One church member, Jan Morrow, organized biweekly prayer meetings for her on Tuesday nights. Word of her battle spread, and whether she was just leaving her Ringgold, Ga., home or shopping for groceries, people told her how they were praying for her.
Churches in Denver City and Lubbock, Texas, attended by extended family, sent cards once a week and told her that prayers were coming from churches as far away as New Mexico.
Sullivan compares her baby to John the Baptist. Like he made the way for Jesus Christ, Keller made way for her. If she had not been pregnant with Keller, she said, she might not have known she was sick until it was too late.
Today, doctors say Sullivan's cancer is in remission, but they won't say she's cancer-free until she has been without cancer for five years. She received 12 rounds of chemotherapy and is scheduled to start four weeks of radiation in December to eradicate any remaining cancer cells.
Baby Keller is healthy at 6 months of age and developing on schedule.
Today, the whole family will celebrate Thanksgiving together in Sullivan's mother-in-law's home in East Ridge. More than a dozen members from both sides of the family will be here from West Texas and West Florida to celebrate.
"They're coming," Sullivan said, "because they're thankful that I am alive, that Keller is alive and healthy."
Contact staff writer Yolanda Putman at email@example.com or 423-757-6431.