Archive for the ‘Pregnancy’ Category

New Article re: Thyroid Autoantibodies and Pregnancy

Those who have HE are all too familiar with the significance of thyroid antibody levels. This newly published article discusses the clinical relevance of thyroid antibodies in pregnancy:

Thyroid Autoantibodies in Pregnancy: Their Role, Regulation and Clinical Relevance

Francis S. Balucan, Syed A. Morshed, and Terry F. Davies
Journal of Thyroid Research: v.2013; PMC3652173, published online April 2013. doi:  10.1155/2013/182472

Pregnancy with HE

August 16, 2012 5 comments

11/14/13 – Announcing the birth of my son, James!  Born Tuesday, 10/29/13 at 7:23pm EST. 8 pounds 3 ounces, 20 inches long.  This has been an incredibly emotional and scary ride, but it is over and I have a very healthy, big, strong boy.  I could write a book about the birth and my emotions, but I’ll keep it short and pointed.  The birth was induced at 39 weeks.  The baby was fully developed and large (via the ultrasounds) and I had been having terrible pain, specifically the common nerve pain associated with a baby that has dropped for birth.  So the decision to induce was for my health and to prevent any possible HE complications.  My water was broken and I was given a low starting dose of pitocin.  I immediately went into very strong labor.  They halved the dose of pitocin and gave me demerol to help me get through the contractions.  About 5 hours later, I gave birth and held a screaming baby boy.  I didn’t need a doctor to tell me his lungs were fine, but that had been a concern due to the HE drugs. His lungs and birth weight were better than average, despite the 100mg azathioprine, 20mg hydrocortisone and 4mg clonazepam daily.  He passed all his tests and measurements perfectly.  Despite the medications, I had eaten well, taken prenatal vitamins and exercised.  A healthy lifestyle helped to beat the high odds of complications.  The hospital recommended I do not breastfeed due to the clonazepam, but I had gone to a specialist and also looked up the risks myself and I decided to breastfeed.  He has been breastfeeding for a bit over 2 weeks now and he is gaining weight normally and has no respiratory issues.  I do supplement with formula when I cannot breastfeed to give him the proper amount for feedings. So baby is wonderful and healthy.  I did have one complication of hemorraging very badly one week after birth. There was a bit of placenta left over after birth and I had to have a D&C to remove  it.  I lost A LOT of blood so I was admitted to the hospital overnight, and it has been just over a week and I’m still working on the postpartum anemia.  My new doctor now wants to wean me off the hydrocortisone AND clonazepam, which is terrifying since my cocktail has worked so well for so long, but that is the new struggle now that I’m back to being a single person in this body.  This will be the end of this post.  The birth was normal, only one non-HE related complication afterward.  I’m thrilled I’m finally a mother, and I’m beyond relieved my baby boy is happy and healthy.

07/13/13 – Wow, what an amazing ride this has been!  I am almost 24 weeks pregnant, approaching my third trimester!  I had the genetic consultation which included an in depth research of the medications I am taking and how it could affect the baby.  I’m taking 20mg hydrocortisone, 4mg clonazepam, and 100mg azathioprine daily, plus the prenatals and the occasional vicodin for severe headaches.  The specialist decided these medications at these levels are not of a big enough risk to my baby to be concerned. 🙂  I also had the anatomy scan ultrasound, and my baby is very healthy.  His organs are the right size and functioning normally, his bones are well formed, his skin and neck are the right size.  He does not appear to have any problems.  He’s VERY active.  He kicks all the time! He’s also much BIGGER than average.  The doctor said “He’s long, tall and thin, just like his Mom.”  His length can’t be measured anymore, but his long leg and arm bones show he is very tall.  He is also estimated to be almost half a pound heavier than most babies at this stage.  What’s interesting is that azathioprine use during pregnancy results in low birth weight 50% of the time.  Though my baby appears to be very big.  The doctors are monitoring the pregnancy to see if he gets too big that I may not be able to deliver him naturally.  I eat an all organic, gluten-free diet.  Lots of fruits and vegetables and drink lots of water.  I do believe all this is helping.  I have not gained extra fat.  I am gaining the recommended weight for pregnancy.  I have not failed any of the blood pressure tests or sugar tests.  For the past several weeks, the pregnancy has been going normally.  So I hope to be unlabeled “high risk”.  And yes, if you noticed I kept saying “him”, IT’S A BOY!! I’m so excited to soon have my son in my arms.  His official due date is 11/4/13, but the doctors all expect him to be early, at the end of October.

05/11/13 – I’m about 14 weeks pregnant now. First trimester is over, but the calm that is supposed to come with the second trimester has not come. I am still labeled high risk and I frequently have pregnancy emergencies like severe pain and bleeding. Through all of this so far, the baby appears to be growing and developing normally, and he or she is VERY active. I’ve heard so many people say how beautiful and delightful pregnancy is… Well it sure hasn’t been for me. I haven’t been able to work, I’m frequently on bed rest, and the “pregnancy symptoms” seem to be magnified in me. Although I’m ecstatic to have a child, pregnancy has been awful. And I still have so long to go! I’m getting a scan next month to include checking on genetic defects and defects due to the medications I take. I feel confident that the baby is fine, just a gut feeling. But I have been told by others with HE that pregnancy is difficult any typically ends in miscarriage. I took the chance because I had exhausted options like adoption and surrogacy. I don’t regret my decision to get pregnant, but I still certainly didn’t expect it to be this difficult and painful. The good news is the baby is still doing well. And I have not relapsed. I’ll update again when the genetic consult is done.

03/19/13 – I know I’m not supposed to announce anything until 14-16 weeks, but I am pregnant, about 6 weeks!  Seeing the baby’s heartbeat on the ultrasound was the happiest moment of my life.  I am (as I expected) a VERY high risk pregnancy.  I’ve already been put on bedrest twice and had to go to the hospital.  I get weekly ultrasounds and blood tests, and I have to give myself daily hormone injections because my adrenal gland and thyroid aren’t working properly to support my uterine lining.  I can’t continue to work at my current job (due to the strain on my abdomen), so I’ll have to figure out an alternative.  Of course I fear every moment of losing the baby, which is why I am hesitant to tell anyone.  But I’ve shared my ups and downs with HE on this site, so I might as well share my ups and downs as a pregnant woman with HE.  Right now, I’m certainly in a very UP mood!  I’ve wanted a baby for so long.  So please pray or keep me in your thoughts that I will have a smoother pregnancy and a healthy baby!

10/17/12 – I’ve been attempting pregnancy for 8 months.  I’ve been taking the fertility medications, ovulating 3+ eggs per month.  Last month, I felt a lot of cramping at the time an egg should’ve implanted.  I had an ultrasound and blood test to check hormone levels, and we were fairly sure I had conceived.  Unfortunately, I developed a sinus infection, and my job switched my shifts, all causing a lot of stress.  I got terrible headaches, very bad cramping, followed by a heavy period.  Very possibly I had a very early term miscarriage.  After that, I decided to do in vitro fertilization, to increase my chances of getting pregnant to a drastic 60%.

Unfortunately, my sinus issues were further investigated and showed I have a deviated septum and other issues.  I have to do some allergy tests for the rest of this month, hopefully to avoid surgery.  So no trying to get pregnant at this moment.  Funny thing is I didn’t take any fertility drugs and I still ovulated multiple eggs from both ovaries (not typical).

So in order to avoid an emotional and costly miscarriage after IVF, I need to destress.  I’m changing jobs (within the same company) and I’m going to put school on hold after this semester.

I’m doing too much for a “normal” person, let alone a person with HE… and one trying to get pregnant.

I need to significantly reduce my stress levels.  I’m in nursing school and we finished a section on the immune system, and it just hit home about how much stress leads to disease.

So I’ll wait a couple more months for my life to settle down.  Then I’ll share how IVF goes!  Wish me luck!

8/16/12 – I’ll probably keep updates in this one post to avoid cluttering up the site.

Prior to starting Imuran, I had no idea what it would do to my body, so I decided to begin the in vitro fertilization process by harvesting my mature eggs.  Many people and a few doctors told me this was a bad idea to go through the hormone injections and the toll it takes on my body, but I wanted to have eggs just in case I needed them for the future, so I went ahead and did it.

It sure wasn’t an easy process.  But it wasn’t because of the HE.  I produced 3 times the amount of eggs an average woman does in this process.  I went into hyper ovarian stimulation syndrome, and my ovaries swelled to the size of grapefruits.  Terribly painful.  Harvesting was the biggest nightmare (I’ll spare the details), but I’ve got 35 good eggs in the freezer just in case I need them. 🙂

I saw several doctors about pregnancy.  The docs were split 50/50 if it was safe to do it (for me and the baby).  They were both concerned about the drugs I was taking (mostly the azathioprine) as well as some evidence that autoimmune diseases usually flare up during pregnancy.  My sister’s Chrohn’s flares up badly when she is pregnant, so I was disappointed thinking I could never safely get pregnant, but I still wanted desperately to be a mother.  I tried adoption and surrogacy and ended up heartbroken each time it didn’t work out.

I decided to start trying to get pregnant after I happened to find research on women taking azathioprine (the one drug the docs worried about, and the one I was too scared to stop taking).  Aside from a high increase in pre-term birth, the statistics for azathioprine babies were quite close to average statistics for birth defects (my biggest concern).

So I was trying the old fashioned way for 6 months.  This month I started the fertility drug, Clomid. Tomorrow I get my blood checked to predict ovulation so fingers crossed I get pregnant this month!!

Here’s some brain food I used to make my decision:

Safety of immunosuppressants (2012)

Early pregnancy azathioprine use and pregnancy outcomes. (2009)

Autoimmune disorders complicate pregnancy (2007)

Birth outcome in women treated with azathioprine or mercaptopurine during pregnancy: A Danish nationwide cohort study. (2007)

Azathioprine Pregnancy and Breastfeeding Warnings

Categories: Pregnancy