The best way to underscore Elizabeth Edsall Kromm's incredible journey might be to pose a question that reads like a brainteaser: How does a woman whose reproductive health was compromised long ago become a biological mother, in the same month, of two newborn girls who aren't twins?
Though she had beaten a rare kidney cancer as a young girl, she had known she might face another struggle one day, when she decided to try for a baby.
And after an uphill battle to conceive caused by the very treatment that saved her, Kromm got the shock of a lifetime last summer, just months after landing on a clear path to motherhood.
The answer to that brainteaser? Caroline "Linny" Kromm was delivered full-term via surrogate on November 1, while 11 days later, Edsall Kromm delivered Amelia "Millie" Kromm on November 12, after just 27 weeks of pregnancy.
But the story of how this transpired has more twists and turns than one might imagine.
Beyond the incredible timing of the two births, Edsall Kromm, 37, had become pregnant naturally after multiple failed attempts at intrauterine insemination and in vitro fertilization.
The odds are stacked against a cancer survivor like Edsall Kromm becoming pregnant and delivering a baby, says Dr Donna Neale, one of her physicians.
"It is a miracle when something like this happens," says Dr Neale, director of the Center for Maternal and Fetal Medicine at Howard County General Hospital, which works with high-risk patients. She says that in her 21 years of working with at least 10,000 women, she can only think of three patients who overcame similar health histories.
"This does not happen often, and it's important for women to realise that. But women should hold on to hope. There's always hope."
Edsall Kromm says she couldn't have been more surprised to discover that pregnancy - to her, the last possible cause for her persistent tiredness - was the reason she'd been feeling so run-down.
"When I learnt I was expecting last June I said, 'Oh my God! This is ridiculous,'" she recalls, considering all that she and her husband, Jonathan Kromm, had gone through. "We were both joyous, but also a little freaked out. It seemed so incredibly random. We were beyond dumbfounded."
This story has its beginnings in 1981, when Edsall Kromm was three and growing up in Annapolis. She was diagnosed with Wilms' tumor, a kidney cancer that primarily occurs in young children. Doctors removed her left kidney and diagnosed her cancer as stage 4. She underwent two more surgeries, along with outpatient chemotherapy and radiation, between the ages of three and six.
She went on to lead a normal, healthy life. She met her husband when they both worked for the American Cancer Society, and they married in 2006.
By 2014, the couple had arranged to have a child through a surrogate after exhausting other methods. In June of last year, when their surrogate was about halfway through her pregnancy, Edsall Kromm finally acknowledged that she hadn't been feeling well for a few weeks. She had been busy volunteering and attending doctor's appointments with the surrogate, and she had initially chalked up her fatigue to long hours.
Because of her childhood illness, Edsall Kromm's doctor ordered a nuclear scan, which required a negative pregnancy test before they could proceed. That's when two pink lines brought the couple's world to a standstill.
The home pregnancy test was positive, and a different type of testing was in order.
"When we saw the baby's heartbeat, I lost it. Jon lost it," she says of her first ultrasound exam. "We had spent all of our time, money and energy working with our surrogate, who is a very important person in our lives. It was a total psychological investment that we were already happy with."
They began facing uncertainties they'd never anticipated, such as how to handle Edsall Kromm's maternity leave when their babies' due dates were within months of one another.
"We knew we could prepare for a second baby and that we could take care of me," she said. "Everything else we figured we would face when it happened."
Baby Linny weighed 3.26kg at birth and had no complications. But Millie weighed just 907 grams and had health issues, including a dislocated hip and leg, underdeveloped lungs, and a hole between the chambers of the heart. She stayed in the neonatal intensive care unit for three months.
While physicians continue to closely monitor Millie, Edsall Kromm says the couple was told that "within a year we won't know the difference" in the girls' development, despite the wide disparity in their gestational ages at birth.
"Jon and I are both goal-oriented, and we knew we would figure out a way to have a family," she says. "But Millie came home feisty and determined, and we know we are very, very lucky."
Jonathan Kromm says the couple's road to parenthood was "physically and emotionally taxing at times", though they'd done their research beforehand. "We went into this with our eyes wide open and with doctors who helped us learn what to expect and how to assess each situation."
Despite that, there was one thing they couldn't predict, he says. "How do you emotionally prepare for something like this? You don't. Elizabeth is so strong and so capable, and that made it that much easier.
"Every morning I wake up now and look at the girls, and I'm like, "Wow. All the puzzle pieces actually came together,'" he says.
Now that she's on the other side of the experience, Edsall Kromm has some advice for others hoping to start a family: Remember how much is beyond anyone's control.
"Give yourself the opportunity to feel bad, but plan for what you can and be grateful," she says.
"It may not be elegant and it may not be pretty, but there's no one way to make a family. Believe you're going to get there somehow."
The Baltimore Sun