Over the past few weeks, I've really been getting the feeling that the remission I experienced in my second trimester just isn't going to last through my third. I feel like the pain in my hips and hands is only getting worse, and I'm just feeling so stiff and sore and fatigued all of the time. I know that at least some of this discomfort must be due to the pregnancy itself, but the ache is just so familiar that I can't help but feel like my RA is making a comeback.
Since I still have a few weeks of pregnancy to survive and I feel like things are only getting worse, I figured it was time to talk to my doctors. So I shared my concerns with my OB and with my rheumatologist, and I asked them both what my options are.
Unfortunately, neither was a particularly useful conversation. Both vaguely mentioned the possibility of prednisone, but I expressed my general dislike of that option and asked if there were any others. And, in response, both basically said this: talk to the other guy.
Awesome. That's right! My OB said to ask my rheumatologist. My rheumatologist said to ask my OB.
So.....exactly what is it that I'm supposed to do now?
I can't tell you what to do but the only med known not to impact your baby is pregnisone. If your ra doc does mention one of the tnfs: humira, enbrel etc. I would research really carefully (this is me of course). Pregnisone has been used on pregnant woman for years and years and years. And yes, all of these meds have side effects but that one has been used for decades and has the most history out there. So...for me that is what counts. The impact on your baby should be documented vs. say enbrel which just started being used by pregnant woman. They were asking these women to enroll in a study if they were taking it and pregnant and at that time their website still said not for use for pregnant woman...go figure. I say, play it safe. But again this is me. All of these decisions are yours and your hubby's to make. I sure hope you start to feel better soon. I can only imagine how tough this is.
DEB: I am certainly NOT interested in getting on Enbrel while I'm still pregnant. And I'm not actually opposed to prednisone either - it's just that neither doctor has been very specific about how much prednisone they think is appropriate, whether I would do a short dose or stay on it for the remainder of my pregnancy, etc. They both said ask the other guy, which was a bit frustrating. I was also hoping they might have some other pain relief options besides drugs - something topical? PT? Massage therapy? I don't know...anything?!?! I just thought at least one of them could come up with something other than mumbling about prednisone!! Cause I'd like to consider all the options - but apparently there aren't many!!
I would definitely push for some prednisone if you are feeling that cruddy. It is safe for pregnancy and hopefully they can figure out what best benefits you- short course vs. the remainder of your pregnancy. Unfortunately, it doesn't sound like there are a lot of options out there. I honestly think that would be the most effective solution if I were you. I'll ask around see if anyone at work and beyond has any suggestions.
Hope you feel better!!
UNKNOWN: I'm also reluctant to start on a course of prednisone now - while I still have like 7 weeks of my pregnancy to go - because I think it will also be one of the only options while I am trying to breastfeed. And I'm certainly more worried about the post-birth flare (when I'll have an infant to care for) than the amount of discomfort I'm experiencing myself now. Since options while breastfeeding will be limited too, I'm not really interested in using them up until I really, REALLY need them, you know?
In the meantime I've made myself some PT and massage appointments, I'm doing water aerobics and pilates, and the rest of the time I'm trying to rest as much as possible! But if you end up with any other brilliant suggestions I'll take them!!
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