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Family Planning with Rheumatoid Arthritis

– What if you have the dream of starting a family but fear that if you were to get pregnant it could be a serious risk to your life? Do you have to put your dream on hold? Well, today, medical advances are making it possible for many women with serious chronic diseases to have the baby once thought impossible. So, let’s meet 26 year old Stephanie who is squaring off against Rheumatoid Arthritis and keeping her dream of a baby firmly in sight. – I’ve been living with Rheumatoid Arthritis for almost my entire life. It was mostly in my hands and my wrist to my elbow and then my whole body.

My RA effects me in every day life. From brushing my hair to opening a door knob. On a scale of one to 10, my pain is an 11. It’s unbearable. I’ve been married to my husband, Andres for six years. – Seeing her in pain, it makes me feel helpless. – It’s tough to maintain my equal role. When I see my husband washing dishes, things that I want to do but can’t do. – I would rather do every chore and everything if she didn’t have to suffer. Her health always will come first because without her health, there’s no her, there’s no us. – I would be willing to risk my life to have a child. My husband won’t be happy to hear that.

I just want a piece of the happiness that every mother feels. – Well, Stephanie, thank you so much for being here. And please welcome our very good friend Dr. Freda Lewis-Hall, Chief Medical Advisor of Pfizer. So, thank you for being here. What was it like growing up with Rheumatoid Arthritis? – For a long time I honestly just thought I was completely normal. I thought everybody, all my friends, all the kids on the playground felt the pains that I felt. And it wasn’t until I was 18 that I actually figured out that what I had my whole life was JRA. – And by JRA, of course you mean Juvenile Rheumatoid Arthritis. Dr. Freda, what is Rheumatoid Arthritis? – Rheumatoid Arthritis is a chronic progressive autoimmune disease. Basically that means that our body’s immune system, it has lost the ability to distinguish between our normal healthy cells and cells that might cause disease.

So, the body’s basically turned on itself and starts to attack normal tissue. And over time this can cause irreversible damage to joints and sometimes to other organs like the eyes, the lungs, and the heart. And it also means that some of what you heard Stephanie describe in the video occurs and that is severe, unbearable pain, joints that are swollen, that are tender, and that are stiff. And other symptoms like weakness or fatigue and sometimes weight loss. – Now, isn’t it true that nearly three times as many women have Rheumatoid Arthritis as men? So, Stephanie’s concern about having a baby must be relatively common.

– Absolutely common. And to make matters worse, many times the diagnosis happens during the child bearing years. And it wasn’t so long ago that many doctors were advising women who had Rheumatoid Arthritis and other conditions like it against having children. But over time we’ve gotten a better understanding of the disease, the range of options that are available for treatment have expanded and many women are able to have successful pregnancies. So, the key seems to be, before, during, and after making sure that you have a treatment plan that is coordinated with your health care team. – Well, let’s start with before. What’s a good plan for women like Stephanie who want to start a family? – So, the conversation between your health care team, your partner, and yourself should start before you even try to conceive. Now, Rheumatoid Arthritis, if it’s uncontrolled can make it difficult to conceive or to have a normal pregnancy. The first priority is to get Rheumatoid Arthritis symptoms under control. And then to understand what the risk would be. Putting goals and a plan together becomes important and making sure that those plans had the understanding of what would be safe for you as the mother and what would be safe for the baby in utero.

– Once your pregnant, let’s talk about during the pregnancy. – So, now it’s a matter of three things. Making sure that your Rheumatoid Arthritis symptoms remain under control so that the Rheumatoid is under control, making sure that your baby is safe in utero and then also monitoring the other risks that might come in the pregnancy. An example of that would be, some women with Rheumatoid Arthritis are at higher risk for developing high blood pressure and high blood sugar during pregnancy. High blood pressure can then go on to become a disorder called preeclampsia, which can be serious for the mother and the baby. – Well, let’s say they get through the pregnancy and had the delivery, what challenges and what management needs to take place then? – Plan for after before.

So, get some of your concerns out of the way. Safe breastfeeding, managing your Rheumatoid Arthritis symptoms, you wanna do that before you’ve had the baby. One of the reasons that’s important, for example, is that many women with Rheumatoid Arthritis report that they’re symptoms are dampened during pregnancy, but guess what, in many of them there’s a flair up after the pregnancy, so you wanna be ready for that. I see that you’re very independent. But it’s really important to get your network, your support network in place during planning, pregnancy, and after. Don’t be afraid or embarrassed to ask for help and never hesitate to call your doctor if you have any concerns or questions. – My advice to you in having worked with so many patients with Rheumatoid Arthritis is to not forget about balancing physical and emotional health. Look, if you know someone who has a chronic illness and wants to know more about the possibilities of pregnancy, then you must check out because you just might find out that you got old information and is the most cutting edge medical site I’ve ever been on.

– While you’re there, you can find really important information on other health topics and of course while you’re there you can also sign up for the monthly newsletter so that important information comes to you. – And that’s a great newsletter, Robin loves it. So, I wanna thank all of my guests today, especially Dr. Freda Lewis-Hall..

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