Chelsey Perkins

Sept. 30 was a bittersweet day for the Koch family. In the early hours of that Friday morning, Moriah and Tim Koch welcomed 5-pound baby Casey into the world, more than a month before his due date. "He's a tiny little peanut," Moriah said.Casey Koch was born Sept. 30 at 32 weeks. His birth was induced to allow his mother Moriah Koch to begin receiving hormone thera With the beginning of the first chapter of Casey's life came the opening of the next chapter of Moriah's journey to keep hers. Doctors planned the baby's early arrival, a plan that allowed Moriah to receive hormone treatments as soon as possible. The treatments are necessary because three months into pregnancy with her third child, tests revealed 24-year-old Moriah faced breast cancer. "It was really scary at first," Moriah said. "Just the overwhelmedness that I had cancer, and then it hit as, 'What am I going to be able to do? What am I going to take? Is this baby going to be OK, or is he not going to be able to make it? Are they going to have to terminate?'" This is the second time in Moriah's young life she's faced a cancer diagnosis—this time is, in fact, likely a side effect of radiation treatment she received to treat Wilms' tumors that spread to her lungs at age 5. "I could not be any prouder of how upbeat and strong she is," said Julie Johnson, Moriah's mother. "She is a fire. Just like she was when she had cancer when she was little. I'm very proud of her. Everybody is." "She's one of the strongest women I've ever known," said Gregg Benz, Moriah's father. "She's got a great spirit. She's got a good outlook. She loves her children to death. She's a trooper." A Renaissance woman Moriah's two bouts with cancer are not the only life experiences that set the 20-something woman apart from her peers. She excels at drumming, has demolished buildings and once worked in an iron mine. She enjoys fishing, deer hunting and riding four-wheelers and dirt bikes. Tim and Moriah Koch pose during a fishing trip on a paddle boat this summer. Submitted photo As a high schooler in Pequot Lakes, Moriah was a self-described band geek, playing a variety of percussion instruments and was particularly drawn to the drums. "I was famous for playing the song 'Wipeout.' I got nicknamed Sheila E.," Moriah said, referencing the female drummer who notably collaborated with pop musician Prince. A participant in concert, jazz, marching and pep bands, Moriah was the sole recipient of the John Philip Sousa Band Award upon her 2010 graduation. After high school, she worked in various jobs in the service industry before going to school in the Twin Cities to become an ironworker. Even then, she was no stranger to building and tearing down, having worked with her cousin's construction business in Hibbing for a few months one winter. As a member of the Iron Workers Local 512, she worked on constructing large buildings, including a hospital. "I did all the things like tying rebar, shooting studs, climbing up on the iron and putting bolts in, and snapping bolts off," Moriah said. She was transferred to Hibbing to work in the iron mines, where she did work such as cutting down cement in large chunks to be replaced and crawling into tiny ventilator holes to remove and replace bolts. This work situation did not last long, however, as it became difficult for her and her young son Jace without a permanent place to live. She returned to the Brainerd lakes area in 2013 and moved into a home in Jenkins with Tim, whom she'd met while working as a server at Underdogs Bar and Grill. The couple married on a frozen Longville lake in March 2015. "We had someone come out to marry us, and they said, 'Do you want the fast version, or the really, really fast version?' We chose the really, really fast version," Moriah said. The couple's daughter Saddie was born in July 2015, and soon after the family moved to Iowa, where they resided until recently buying a home in Longville. Soon after the Kochs learned their young family would grow once again. But they did not yet know that something else was growing in Moriah's body, too. An evolving diagnosis On a Wednesday afternoon in October, Moriah parked a mobility scooter in a hallway and used a walker to shuffle to a seat in a Cancer Center treatment room at Essentia Health-St. Joseph's Medical Center in Brainerd. She was to sit in that chair for more than four hours as a chemotherapy drug and other medicines streamed into her blood. A 110-mile round trip from her Longville home to sit in this chair will occur weekly for Moriah's foreseeable future. "The chemo will be once a week until he (the oncologist) switches me over to a pill form," Moriah said. "Every third Wednesday will be my hormone therapy. The hormone therapy will be until it stops working. It could be months, it could be years, it could be 10 years." After learning of her pregnancy in March, Moriah went to the doctor in May when she noticed a painful lump in her right breast. After an ultrasound, a biopsy of the lump tested positive for invasive ductal carcinoma, which according to the Susan G. Komen Foundation is one of the more common types of invasive breast cancer. The cancer was considered Stage 1 at that point, and doctors scheduled a double mastectomy for the next month. In June, the mastectomy was performed and a biopsy of a lymph node in Moriah's armpit was positive for cancer, bumping her diagnosis up to Stage 2. A week later, a surgeon placing a port noticed a lymph node in Moriah's neck appeared diseased. An ultrasound revealed three suspicious lymph nodes and biopsies shows they were malignant. Moriah's cancer was then considered Stage 4, meaning it had spread beyond the immediate region of her breasts. Moriah's pregnancy with Casey presented challenges to her treatment. She received adriamycin and cyclophosphamide, or AC, chemotherapy every three weeks—a treatment safe for the fetus. Hormone therapy doctors knew Moriah needed to treat her triple-positive breast cancer was not possible, however, until after the baby's birth. To make matters even more complex, the estrogen surging through her pregnant body excelled the growth and spread of the cancer. Moriah traveled to the Mayo Clinic five days after receiving the Stage 4 diagnosis for further testing. Chest X-rays and a liver ultrasound both revealed additional lesions. "When we went down to the Mayo we were pretty clueless on everything," Moriah said. "The first couple visits with my oncologist, I think we kept him in the room for over an hour, just bombarding him with questions, until we really learned what was going on." Doctors decided to schedule Casey's induction at 34 weeks to introduce hormone therapy to Moriah's treatments as soon as possible. After a relatively short labor, Casey was born and was placed on a feeding tube. Four days later, Moriah received a full-body CT scan, revealing cancer in several of her bones—her shoulders, pelvis, spine, ribs and jaw. No way but forward For some, such a diagnosis would understandably lead to despair. Moriah, however, remains infectiously upbeat. A Brainerd Dispatch article published nearly 20 years ago on Moriah's childhood cancer diagnosis made clear this attitude is nothing new. "Through all of this, her teachers and her mother said Moriah has remained a cheerful and optimistic girl who loves school and likes to ride her bike on the Paul Bunyan Trail," wrote former Dispatch reporter Jodie Tweed. "I've always had a positive outlook, because if you don't, it makes it scarier," Moriah said. "It doesn't help your ability to live every day." Moriah is comforted by the positive outcomes other patients have experienced with the same therapies she's been prescribed and is knowledgeable about the side effects she will experience. "I wanted to know, so that I could plan ahead eating-wise and with my medicine. If you don't know what you're facing, you're not going to be able to face it," she said. As the mother to an infant and two other children under 5 years old, challenges abound for Moriah. It's too difficult for her to care for the children on her own, so a family member or Tim are always there to help. This includes her mother Julie, mother-in-law Missy Walton and her father Gregg, who travels from Hibbing a couple times a week to visit his daughter and grandchildren. "It's been pretty tough," Gregg said. "She's my little girl, and I can't do nothing about it. ... I have to stay strong for her, too." "Trying to get around is difficult," Moriah said. "It's like a constant pain, ache in my shoulder, my leg and my back. I'm just always usually in some kind of pain. It's gotten better since Casey was born, because I can be on a lot of different medicines." She faced postpartum depression following Casey's birth, and despite her optimism, isn't immune to having bad days. "It was hard at first to get bonded with the new baby, because of everything that happened with him while I was pregnant with him. The cancer spread really fast," Moriah said. "Now, it's easier. ... Then I sit there, and I look at Saddie or him or Jace, and I think, Oh gosh. Am I going to get to see them grow up? And graduate? Am I going to be around, or am I not going to be around?" When she once would have taken her dirt bike for a spin to boost her mood, Moriah now looks to the bathtub to provide both mental and physical relief. "I'll take baths all the time," she said. "It's probably my favorite thing to do during all this. It helps the pain and I can go hide in the bathtub." In less than two weeks, friends and family from near and far will descend on Jenkins for a benefit to raise funds for Moriah's medical costs—an event Moriah said she looks forward to. "There has been a lot of wonderful support this time, from the community and everyone," Julie said. Moriah is excited to see people important in her life, but what she doesn't want is for anyone to feel bad for her. "I know a lot of people hear my story and they feel super, super bad for me. I'd like people to know not to feel so bad for me. There's nothing I can do about it now, other than go through all of this," Moriah said. "Everybody always says, 'She's so young, she shouldn't have to go through it.' When they say that to me, it makes it almost worse. I am young, and I am going through it, and there's nothing else I can do besides go through it." How to help the Koch family A benefit in honor of Moriah (Benz) Koch will be at 5 p.m. Nov. 19 at the Jenkins VFW Post 3839, 3341 Veterans St., Jenkins. Tickets are $10 each and $5 for children age 10 and younger. The ticket includes spaghetti with meatballs, French bread, Caesar salad, a beverage and dessert. A silent auction will take place at the event as well. Monetary donations may be sent to American National Bank of Minnesota, 31279 Brunes St., Pequot Lakes, MN, 56472. For more information, call 218-568-4999.