The first three months of Matilda Tristram's first pregnancy – unplanned but welcomed by her and her partner Tom – passed without incident. Then, at 13 weeks, she began vomiting. The cause, she eventually discovered, was bowel cancer.
Matilda, a lecturer, children's TV writer (Abney and Teal and Dip Dap being her biggest hits) and illustrator faced not only the ordeal of cancer treatment, but also the terror of undergoing it whilst carrying her unborn baby.
Now, 18 months after that shocking diagnosis, Matilda has just celebrated her son James' first birthday, and also the publication of her book, Probably Nothing: A Diary of Not Your Average Nine Months. She is feeling well and has recently had a second clear scan since her treatment ended.
The book, at first glance a cheerful looking hardback 'comic', documents - through simple cartoon illustrations with hand-written captions - the extreme highs and lows of a year in which Matilda and her loved ones sought to deal with a life-threatening illness, a pregnancy full of uncertainties, the birth of a baby and the exhausting realities of new parenthood.
It was born from an online comic Matilda started in the weeks after her diagnosis, serving as a way of sorting through her own torrent of emotions, regaining perhaps some control over a situation in which she felt she had very little, and of keeping people updated without constantly having to engage in awkward and occasionally unwelcome conversations.
One drawing captures the excruciating discomfort of having to catch up with people who knew about the pregnancy but not the cancer.
The online diary soon developed a following far wider than her circle of acquaintance, and Matilda found herself the subject of a publishing house bidding war.
The result is a deeply moving, thought-provoking book which immediately draws the reader in, its colourful illustrated format – a pleasure to look at - making it very easy to identify with the key characters.
The tone flits effortlessly between funny, sad, trying to be normal and frightened but - while Matilda is perfectly open about her fear, her occasional anger – it is never self-pitying.
Despite the intimacy of the diary, with Matilda and Tom pictured in the darkest moments as well as the happiest, the medium – more immediate than words, less intrusive than photos - means the reader doesn't feel they are prying or being mawkish.
The reader knows from the start that the story has a happy ending (though Matilda, like other cancer patients, will continue to be monitored and doctors generally avoid talking about definitive cures).
There is no desire to build any tasteless suspense. We start with Matilda cheerfully attending a cancer patient's makeover day before cycling home to her waiting partner and baby.
The book then rewinds to the diagnosis, and the anxious weeks leading up to that point when doctors tried to convince an increasingly anxious Matilda that her symptoms – vomiting, constipation, severe stomach pain – were the result of some vicious pregnancy hormones and perhaps an unfortunately timed dose of norovirus.
It was only when Matilda refused to go home from hospital and insisted on an MRI scan to discover the cause of her agony that doctors discovered a total blockage of her colon.
The resulting emergency surgery to remove part of her bowel showed the obstruction to be a cancerous tumour and that cancer cells had invaded 5 of the 25 lymph nodes which were removed.
Matilda was by then 18 weeks pregnant, and the horror of being given this news – with no certainty of what it might mean for either herself of her baby – is captured in her drawings: Matilda, Tom and her parents are pictured from behind, left to have 'a bit of space' in a tiny windowless room. There is no text.
The oncologist is straight-talking and to the point. The couple have three options- start chemotherapy immediately accepting that there may be risks to the baby, terminate the pregnancy and begin treatment, or delay treatment until after delivery. There are no guarantees in any scenario and the treatment might cause infertility.
The feeling of helplessness, the lack of any certainty are captured in the pictures where Matilda and Tom try to reach a decision, their heads floating with no body, ground or security to tether them.
They decide to begin treatment and continue with the pregnancy, their research having reassured them that the chemotherapy which will attack the cancer cells should leave their baby unharmed.
The treatment is gruelling and the emotional rollercoaster travelled by Matilda and those close to her is clearly utterly exhausting. The surreal juxtaposition of baby scans, knitting baby cardigans and talking about names with chemotherapy wards, colostomy bags and intrusive thoughts about funerals is sobering.
The couple try to ready themselves for the healthy baby they long for as well as they can, but snippets of conversations overheard from other expectant mums – their woes necessarily so trivial in comparison – drive home the extent to which their situation is so utterly different.
The effort to assimilate such huge life-changing events simultaneously is sometimes overwhelming. In these moments the deep love and support of Tom and of her parents radiates from the page. There are hugs, shoulders to cry on, plates of food and shopping trips.
The dedication in the book confirms that it is for her 'tremendous family and friends'. Most of all, she writes, it is for Tom and James. "As well as being quite unlucky, I am very, very lucky."
There are many deeply moving moments. The time she first feels the baby kick, his birth, seeing him smile, watching meteors together in the night sky and learning that her scan has come back clear.
Matilda has perhaps unwittingly become something of a campaigner about a form of cancer which is little discussed and yet which is the 4th most common form of the disease in the UK (after breast, lung and prostate). Around 41,600 people are diagnosed with bowel (or colorectal) cancer each year.
Tweeting as @colonclast she describes herself as 'replacing Sharon Osbourne as the glamorous young face of colon cancer'.This book, exquisitely drawn, emotionally open, deeply moving and genuinely unique should do much to help raise the awareness so clearly needed.
Probably Nothing: A Diary of Not Your Average Nine Months by Matilda Tristram (Penguin Viking, £16.99).
For more from Matilda Tristram see @colonoclast or www.mmaattiillddaa.com. For information on bowel cancer see www.macmillan.org.uk