December 23, 2013 12:00 PM

It should have been the happiest time of their lives. Dr. Jennifer Arnold and her husband, Bill Klein, were in India on Oct. 13 to bring their daughter Zoey, 2, home from an orphanage. She’d be joining big brother Will, 3, adopted in March from China, and the joyous family would be filmed for their hit TLC reality show The Little Couple, which has chronicled Arnold and Klein’s life since they wed. Then the unimaginable happened. Arnold began bleeding – and it wouldn’t stop. Weakened and faint, she faced a choice: Rush more than 8,000 miles home to Houston, or face the possibility of a blood transfusion in a foreign country, far away from experts who understand the complexities of her skeletal dysplasia, or dwarfism. “My initial thoughts were all about Zoey,” says Arnold, quietly. “But then the bleeding got worse and I was feeling light-headed. It was a hard decision, but I had to go home.”

That decision proved vital. Arnold has now been diagnosed with stage 3 choriocarcinoma, a cancer found only in women who have been pregnant (see box). In fact, Arnold – whose struggle with fertility issues was well-documented on The Little Couple – actually did become pregnant this past August, to her shock. “We had figured, there’s no chance of me getting pregnant,” says Arnold, whose tiny frame could make carrying a child to term risky and unlikely. Arnold admits she wasn’t surprised when an ultrasound soon revealed no heartbeat. A resigned Arnold says, “I had figured it wasn’t going to be viable.”

And yet cells left behind even after the abnormal embryo was removed were enough to trigger the cancer that grew at an alarming rate. Arnold, 39, was started on intensive chemotherapy, while Klein, 39, still in India with Will and Zoey, scrambled to finish their daughter’s visa paperwork. “I wanted to be there,” says Arnold, sitting in a sterilized hotel suite near the Houston hospital where she’s being treated, wrapping herself in a blanket. “But it wasn’t smart for me to stay.”

Arnold and Klein have been no strangers to adversity. Both have different forms of skeletal dysplasia, but each has endured countless surgeries due to the condition. Through the couple’s show, millions of viewers have followed them through the emotionally fraught process of starting a family – a journey that included the pain of selecting a gestational surrogate who later miscarried. Finally, they were overjoyed by the successful adoption of Will, who also has skeletal dysplasia, from China. Approval to adopt Zoey from India followed less than a year later.

But instead of settling in as a mom of two toddlers, Arnold is in a desperate fight against a cancer made more complex by her form of dwarfism. “I felt like I was in another dimension,” says Arnold. “Sometimes I think, ‘Seriously? Really? How can this be happening?’ ”

Arnold soon faced a grim reality when the mass in her uterus initially didn’t respond to chemotherapy; instead it quadrupled in size, and three tumors appeared in her lungs. Doctors were forced to perform a hysterectomy. With any surgery Arnold faces the risk of severe respiratory complications while under general anesthesia, due to her small airway. “We wanted to avoid surgery,” says Dr. Concepcion R. Diaz-Arrastia, director of gynecology oncology at Baylor College of Medicine, who is treating Arnold. “But we felt we had to do it to save her life.” Yet after surgery, Arnold developed pneumonia. “It was rough,” admits Arnold. “If the cancer didn’t kill me, I worried that infections could. I felt terrible.”

With Arnold’s size a major factor in her treatment, doctors made the decision to treat her at Texas Children’s Hospital, where she is on staff as an attending neonatologist. “We needed to have people around us who were experts in pediatric sizes,” says Diaz-Arrastia, adding that cancer in little people is exceedingly rare – and therefore difficult to treat. “You can kill someone by giving them too much chemotherapy, and cancer can kill them if you don’t give them enough.” Arnold’s dosage (an unusually high five-medication cocktail) was upped by 35 percent in hopes that the strong regimen will increase her cure rate. If Arnold can continue without infection or interruption, and if the tumors in her lungs continue to respond to chemotherapy, her prognosis to one day be cancer-free is good. Those are a lot of “ifs,” but despite what Diaz- Arrastia calls a “rocky start,” Arnold and Klein are cautiously optimistic. “The treatment is rough,” says Arnold. “But I have a chance of being cured. I just have to push through it.”

That has meant hair loss and nausea, though Arnold, who now wears a wig, has tried to find humor where possible. (After shaping her remaining strands into a comb-over, Arnold did her best Donald Trump impression and pointed at Klein, declaring, “You’re fired!”) But the new parents have also faced the struggle of getting Zoey acclimated to her new surroundings. Though Zoey has dwarfism, she was never exposed to people of short stature in the orphanage. “She wasn’t used to little people,” Arnold says. “She had a hierarchy in her mind based on who was of normal height. She’d cling to strangers and cry for hours. It was heartbreaking.” (With the bonding process making steady progress at home, the family does not yet want to release photos of Zoey.)

An additional obstacle to family harmony was Arnold’s diminished immune system; Zoey had an ear infection when she arrived home, so Arnold had to stay away until she improved. Klein struggled to console his new daughter alone. “It was torture when she cried,” he says. “You can’t explain to a 2-year-old that you are there to help. I wanted her to be okay and Will to be okay, and I wanted to be there for my wife.” During a particularly low moment, Klein recalls “threatening” God. With his wife in treatment and his family in turmoil, “I said, if He is up there, He will have to deal with me if He tries to take my wife,” Klein recalls, his voice cracking. “I am going to do everything to protect her. She is my life.” Already he’s taken on the role of bodyguard, preventing well-meaning fans who want to hug Arnold from coming too close.

For Arnold, the one possible silver lining of having to take it easy has been enjoying quiet moments with her husband, Will and Zoey. “I don’t feel well a lot of the time, but even if I am lying on the couch and watching them play, at least I am there,” says Arnold, smiling brightly. “I am there, around them, and that is a blessing.”

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