Early Tuesday morning, OZL wanted to nurse at about 3:00am. Twenty minutes later he was full and contentedly back to sleep. I knew that I needed to get back to sleep too, because I had to get up early for a rheumatologist appointment. But, yet again, I couldn't fall back to sleep. I tried laying still and paying attention to my breathing. I tried reading for a little while. I went downstairs and cuddled on the couch with River. I tried going back to bed. But it was no use.
By 6:00am I was still awake but totally exhausted. And, as APL was getting ready for work, I started crying like a little girl about how much I didn't want to go to see my rheumatologist. Because I already knew exactly what he was going to tell me. And I just didn't want it to be true.
But it is true. My rheumatologist confirmed that my joints are getting worse (in fact my pilates instructor gently told me the same thing on Monday). And, unfortunately, we're pretty much out of breastfeeding-safe medication options. (While RA medications that are safe for breastfeeding do exist - i.e. I think plaquenil may be one of them - my rheumatologist says they would take 3 to 6 months to have any effect, and, considering the severity of my RA, are unlikely to work for me anyhow.)
So what am I to do about breastfeeding? My options are basically stick it out or give it up (though luckily my rheumatologist did not put it quite so bluntly).
For now I'm opting to stick it out, which means staying on the prednisone. I had been taking the full 10mg of prednisone in the morning in an attempt to keep it from messing with my sleep, but clearly that isn't working anyhow. So my rheumatologist recommended taking 5mg in the morning and 5mg at night to put me on a more constant dose, instead of a peak-and-valley dose. So I'm going to try that. And, as backup, the only other real option for me is to increase the dose of prednisone. Of course, that would only make my sleeping issues worse. Not to mention making it even more difficult for me to lose weight, which is already extremely difficult since my joints hurt too much for me to do any serious amount of exercise.
If things don't go downhill any faster, my rheumatologist actually thought it might be reasonable for me to try to stick to breastfeeding until OZL is five or six months - which I think would be a pretty amazing accomplishment. But, when I'm honest with myself, another three months with no additional medication seems pretty daunting at the rate things have been declining.
For the time being I'm just going to try to stick it out another three weeks through my trip to California. From September 9th to 16th, APL will be riding his bike from San Francisco to Los Anglels in the California Coast Classic - a total of 525 miles - to help raise money and awareness for the Arthritis Foundation. (Check out his website to learn more about the ride - and also see more cute pictures of OZL!) OZL and I will be spending the week in Los Angeles with my dad and APL's parents so that we can all be at the finish line. Seeing as breastfeeding is currently going well, I think traveling with an infant will be easier if I can just, ahem, whip out the boob any time OZL is hungry (or crying on the airplane!)
And after that? We'll just have to wait and see. But the hard truth is that it might be time to give it up.