Thursday, September 27, 2012

Got Guts: Colitis, Pregnancy & a Happy Ending

When I was first diagnosed with colitis, getting pregnant was the last thing on my mind. I was 20 years old, sick as can be and just wanted an answer to why I felt so crappy (literally) and how I could start feeling better.

Though it took awhile to answer the latter, I finally was able to achieve remission after a few years of trying different drug regimens. At this point, I had just finished grad school and was moving down to North Carolina to be with my boyfriend (hi, husband!) and still wasn't really thinking about how my guts would affect my ability to get pregnant or have a healthy baby.

It wasn't really until 2009, about 6 years after I had been diagnosed and 2 years of marriage in the books, that Matt and I first started to talk about our timeline for having kids and the issue of my colitis really came to the surface. I was fortunate enough to have been under the care of the same doctor for 3 years now - the longest stretch I had had so far - and we both really liked and trusted him. We weren't really ready to have a baby quite yet, but we figured we should broach the subject with my doctor sooner rather than later.

Given that I hadn't put much thought into how my disease could affect my fertility, pregnancy or having a healthy baby, I started to get a little nervous and scared when we first started discussing it. In the literature (which is where science nerds like Matt and I turn to), there are studies that show that women with colitis have higher risk for miscarriage, pre-term babies, low birth weight babies and birth defects, like cleft palates. To make matters even more complicated, the type of medication that I had been on for years - and that I had finally achieved remission with - was an immunosuppressant with fairly little research to either support or deny use during pregnancy. Even if I did stay on it during pregnancy, I wouldn't be able to breastfeed on it which was disappointing and upsetting to me.

To keep a long story (relatively) short, the next couple of years brought some frustrating setbacks. First, I tried to taper down and then eventually go off my immunosuppressant. It didn't work. I had my first flare in over 4 years and it took two rounds of prednisone to get me back under control again. My doctor was supportive of my "experiment" but when all was said and done, we both agreed it was pretty obvious I needed to stay on the medication. I also ended up changing OBs after this when, despite the obvious setback from my health, the doctor I was currently seeing sent me to a high risk specialist and both of them basically spent the entirety of every appointment reading all the risk factors of colitis and pregnancy to me and never offering any support.

When I met my new OB and explained my situation and her response was a very reassuring "So you'll stay on the drugs, we'll monitor you, we'll monitor baby and it will all be okay" I could have cried from relief. In fact, I probably did. Once I had my OB and GI on the same page and my drug regime established, we finally felt like we were in a good place, medically, to have a baby.

I was healthy when we got pregnant, and my GI had told me anecdotally that people tended to stay in the same state they were when they got pregnant. Healthy women stayed healthy, women who were flaring tended to stay in a flare. I hoped he was right.

I had an amazingly easy pregnancy and felt great throughout most of it, minus a 2-day bout with morning sickness around week 4 and the normal discomfort and some nausea at the end. Around Memorial Day, I started having symptoms of a flare and panicked... but they went away within a day or two. A normal GI bug, my doctor concluded, or maybe just one of those random inexplicable symptoms of pregnancy. There are lots of weird ones, so I'm told.

Despite my easy and healthy pregnancy, the worries lurked in the back of my head about pre-term and low birth weight babies. I refused to let my mind think about anything worse. When I passed the end of the first trimester, I breathed an initial sigh of relief. When I passed the 37 week mark, I breathed another sigh of relief.

When my early baby showed up and weighed a whopping 8 lbs 1 oz and had all ten fingers and toes and a perfect little face, my sighs of relief became tears of joy.

It's easy to take health for granted, and even I can do that when I've had years of being in remission. It's easy to take a healthy baby for granted, after the initial exams confirm that everything is perfect and you're home and in the midst of sleepless nights, making bottles and changing diapers.

Yesterday I went to my routine quarterly GI visit, with my healthy 12.5 lb baby in tow with me. As soon as I was checked in to get my vitals done, I had about six different nurses flock over to me and cluck and cuddle Bo. They tucked us into our room to wait for the doctor and as I sat there in the quiet room waiting for my appointment - the kind that I happily refer to as the "good boring" appointments - I suddenly felt very reflective. I thought about reading all those research studies 3 years ago, tampering with all my medication doses and the 9 months of the quiet low-intensity worry that was always present - and how quickly it all disappeared the moment I laid my eyes on my son.

And I thought about how I hope, never ever, to lose sight of the gratitude that I have for his health and mine and for the journey it took for us to get to this "routine, boring" appointment.


Allison the Meep said...

I didn't realize colitis affected pregnancy like that, but it makes so much sense. It's probably a huge issue of inflammation and malnutrition, and the fetus not getting enough because of the condition? Or am I way wrong? Celiac is like that, and I sometimes think what a miracle it is that I didn't miscarry with Julian and he was born absolutely perfect, despite me being at almost my absolute worst with celiac and not knowing what was wrong with me.

Ameyer said...

This one made me teary eyed. So glad that your GI visits are on the boring side. Here is to many more happy moments in your life ( I am actually toasting you with my glass of vino)!

Unknown said...

I'd never thought about colitis affecting pregnancy either. My middle schooler's best friend was diagnosed with colitis last year, and hers isn't under control yet. I feel so bad for her. She's missed so much school with flare-ups and it's making a rough time in life even harder! I'm glad to hear yours is under control and didn't negatively impact your pregnancy!

Jamie said...

Such an amazing story and thanks for sharing it with the Internets. So thankful that you had a "boring" pregnancy, healthy baby boy, and more "boring" dr appointments!

Jamie said...

Such an amazing story and thanks for sharing it with the Internets. So thankful that you had a "boring" pregnancy, healthy baby boy, and more "boring" dr appointments!