Friday, December 18, 2009
The absolute good news from all of this is the morning sickness has eased, I'm over the flu and sinus infection and the fever blisters are gone AND... I am optimistically thinking that I am finally in remission! Best Christmas gift ever!
The last time I was in remission it lasted eleven months...but I had gone completely off all of my medications. This time my GI doctor wants me to stay on the Asacol three pills a day, three times a day. That's a lot of pills.
And things are complicated because I'm pregnant now. If Asacol was completely known to be safe during pregnancy it would be classified as Category A. It is classified as Category B. I talked to my GI doctor, he said he thought it would be better for me to take the Asacol to keep my health up and there are not any known risks from that medication.
I talked to the pharmacist. He said that he felt completely comfortable telling me to take it while pregnant. He said he has known several women that have taken it while pregnant with no ill effects and that Category B means there are no adequate and well-controlled studies in pregnant women. He said this is mostly because the drug companies don't feel it is ethical to do drug studies on pregnant women and not necessarily because the drug is unsafe.
Then I tried to call my obstetrician. I couldn't reach her over phone, I'd have to wait for my first appointment, but I did talk to her nurse who looked it up in a book and said it was fine to take.
I was at that point unsure what to do... This is a personal decision and each individual facing this circumstance has to make their own choice. These were the things I thought about:
- If I'm already in remission, and know that if I am careful could be in remission for a long time, why would I risk taking any drug at all if I didn't have to.
- Not exposing myself to chemicals and drugs is one way to keep my baby safe, but I also need to be healthy to keep the baby safe.
- I was in a flare-up during my entire first pregnancy. I was induced three weeks early because of intrauterine growth restriction (IUGR). This means my son was below the 10th percentile for his gestational age at that point. He weighed 5 lbs 11 ozs at birth and the doctor was concerned about him having serious problems (he's absolutely perfect now). While the doctor said the cause of this was unknown, I can't help but wonder if it was related to my flare and my body just being so depleted.
- Why would I risk going having another flare-up if the medicine can help prevent it.
- How will I have the energy to care for a toddler and a new baby if I am sick
I felt like everyone was saying I should stay on the medicine and if I wasn't pregnant I knew I would for sure. I finally made up my mind when I talked to my Ob/Gyn.
I told her my concerns and asked if I should try to get off the medicine or at least try to cut back the number of pills. She told me that in her opinion Asacol was completely fine. She said she has many patients on it and that she has seen studies involving pregnant women that indicate their is no harm. I know that she isn't one of those doctors that say anything is fine because with my first pregnancy I wanted to take Probiotics to see if that could help with the flare and she would not let me because she said it was unstudied and the risks weren't known.
So, ultimately I decided to stay on the medicine FOR the health of my unborn baby. Having enough energy, getting enough nutrients, feeling well, getting good rest, etc. is just as important as avoiding things. I am sure there are people that disagree with this decision or think I should take non-medicinal approaches, but I feel this is what fits best for me, my lifestyle, and my family right now. I'm feeling good and I got to see the ultrasound of my baby and hear his/her heartbeat. Life is good.
I'll keep you updated!