I tried to post this yesterday. But I just couldn't figure out how I felt, so I couldn't really think of what to say. Honestly I'm still not sure.
Yesterday the baby and I went to see my rheumatologist. While I'm definitely doing better than I was at this point postpartum with either of the boys, there's simply no denying the all too familiar twinge in my toes, the ache in my knees, the whole-body morning stiffness, the nightly anxiety dreams that always seem to accompany the onset of a really bad flare...
Cimzia is a wonderful pregnancy- and breastfeeding-friendly treatment option, and I'm so grateful for how much easier things have been this time around on it. But the reality is that it just isn't enough to control my RA indefinitely by itself. I've know that was the case from the start. But Rituxan, which is by far the best treatment I've ever been on, isn't breastfeeding-friendly. So my option if I want to keep breastfeeding is daily prednisone until I wean and switch to something stronger. And we all know how I feel about regular prednisone. And, in any event, there's no guarantee that the prednisone will even be enough to keep things under control.
For some reason, I can't really seem to figure out how I feel about the whole situation. On the one hand, I'm really doing a lot better than the last two postpartum periods, so I can probably afford to push it a bit more. On the other hand, with three kids to care for now, it's even more important for me to be functioning as well as possible.
Perhaps most importantly, I can't seem to figure out what I actually want. On the one hand, breastfeeding is so much easier and I really love the bond it gives me with my baby girl. And even if things get worse than they are now for me physically, it luckily doesn't look like we're on track for it to be nearly as bad as my last two postpartum experiences. On the other hand, not breastfeeding would be so much easier, and I know full well that I can have an equally strong bond with my daughter without it. And, since I've done so well physically in the past year or two, even a small flare feels unnecessary since I know there's a treatment out there that could potentially make it stop. Each option feels easier than the other. Each option feels harder than the other.
All these unknowns have been causing me some serious anxiety. It feels almost like having PTSD - based on pain and struggle I've experienced in the past I'm worrying about pain and struggle that hasn't even happened yet and might never even happen at all. And logically I know that doesn't remotely make sense. Logically I know I'm doing a lot better this time, I have more options than I've had in the past, not breastfeeding is perfectly fine, and mostly everything is going ok. But somehow my subconscious is having a difficult time remembering that, especially in the middle of the night.
So for now I'll take the prednisone. I'll take the anxiety meds. I'll talk to the therapist. I'll take it one day at a time and see how it goes. I'll try to give myself space to figure out what I want. I'll try to give myself time to figure out the best decision for me. And I'll try not to beat myself up about any of it.
After all, my little girl is here. She's two months old and healthy and her brothers adore her. My family is whole. And that's most import of all.