- 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 gethealthystayhealthy.com
because you just might find out
that you got old information
and gethealthystayhealthy.com
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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