For the past two weeks, I've had a pregnancy scare. The only times in my life that my menstrual cycle wasn't totally reliable were when I was pregnant, breastfeeding, or when my cycle was re-regulating itself naturally after coming off of hormonal birth control. I'm 32, and I've had regular cycles for what amounts to 20 years at this point (holy crap!). And then this month happened...
As my period was later and later, I got more and more stressed (despite the negative home pregnancy tests - and one at the doctor as well). I'm 32 and married and have two awesome kids. So what is the big deal? I'm on a pregnancy Category D medication.
I've been diagnosed with migraines since I was 22. They were intense but infrequent for the first two years I had them, and then miraculously, they went away. But it was a temporary reprieve. 2 years ago they started coming back. I was breastfeeding my son at the time, so my medication choices were (super) limited. They were infrequent though, so while it sucked, it was manageable. And then about a year ago, they got out of control. At that time, I had 28 migraine days in a single month. It sounds crazy, but it is 100% accurate. I obviously went to the doctor, and was in absolute tears the entire visit (I'm pretty sure they diagnosed me with mild depression at the time, but who the hell wouldn't be completely depressed and worn out after a month like that!). They put me on a medication that seemed to work alright...for a time.
But then April happened.
I had the worst migraine of my life. It is a vague memory for me, the crushing pain. The worst of it lasted about 15 minutes, if my guessing is right (time was truly warped during those moments though). It felt like total blackness. I was in the living room sitting on the couch and it came out of nowhere. When it let up a bit, I remember sitting with my head between my knees and my face resting in my hands...and realizing that I couldn't feel my face. My face had gone numb. I tried to talk to my husband to tell him what was wrong, but my words wouldn't come out right. I knew I had to go to the ER to get an evaluation for stroke.
I didn't believe I was having a stroke, I believed it was a complex migraine. But given what was happening, it would have been neglectful *not* to get checked out. I went to the ER, the Dr. confirmed what was going on (complex migraine) my CT brain scan was negative for bleeding or stroke, and I had a follow-up with my Dr. the next day. I was referred to a neurologist. And it was about time.
All of this to say, now I am on Topamax - a serious migraine prevention drug that is also an anti-seizure medication. It is a category D medication. It is known to cause birth defects, low birth weights, and miscarriages. Every time I see my neuro, she reiterates how important it is not to become pregnant. But here's the catch: She also took me off birth control pills. For two reasons. One, the kind of migraine I was having can be associated with a higher stroke risk, so hormonal bc pills are more dangerous for me than the normal (healthier) woman. Two, Topamax itself reduces the effectiveness of the birth control, so it's kind of like, what's the point?
So my husband and I are relying on condoms and calendars while we decide what to do longer term. And in the meantime, I'm scared to death of becoming pregnant and accidentally (for lack of a better way of expressing it) poisoning a baby in my womb. But I have to be a Mom to my existing kids. Having a migraine 28/30 days a month is not being a mother. And what if one of those complex stroke-like migraines happen when I'm out driving? I've resolved myself to the fact that I *need* to take the preventative medication. Even if it means my childbearing days are over because of it (and I had never intended to only have 2, my husband and I always wanted a large family).
Do any of you have any experience with Category D medications? Did anyone become pregnant while on a Cat D medication?image source
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Comments (25)
Remember the reporter who appeared to have a stroke on TV last year, she had a complex migraine aural event (similar to what happened to me) - not a stroke. http://www.YOUTUBE.com/watch?v=IG7NuH5QTdE
I couldn't stay on topamax for more than 8 weeks. My side effects were horrible and it didn't help my migraines at all.
@bittersweetjaded@xanga - Luckily it has been very tolerable for me (all I get is a tingly feeling in my hands or feet every once in a while, and that doesn't happen if I remember to take my vitamins), and once we adjusted the dose, has controlled my migraines amazingly well. I'm sorry it didn't work for you.
Migraines like that are the one thing that can cause the most heartfelt sympathy in me. I only ever had to deal with them when I was pregnant and even then I only had four or five for each pregnancy, but it was a nightmare each time even though I knew what was happening. I was lucky that every time one occurred, I was by myself or have a family member nearby that could watch the child. I cannot imagine having to deal with those types of migraines on a regular basis especially with children. I am so sorry.
I was actually on a similar medication for seizures when I was younger. I remember my mother becoming so offended when the neurologist wanted to put me on birth control even though I was only twelve because of how serious the effects were on pregnancy for the mother and child. Of course it was easy to avoid pregnancy then, but it would be devastating now if they were to kick back in and I was actually forced to choose to not have any more children.
I have never had to deal with this, neither taking a Category D drug nor migraine medicines. I think that I would have to go on the pill or some other form of birth control in order to prevent pregnancy or I would talk to my doctor about ways I can control the migraines while trying to get pregnant or while pregnant. It's a tough decision especially when you want a big family.
@Erika_Steele@xanga - Birth control pills are contraindicated, since they have recently discovered that the medication itself (Topamax) reduces the effectiveness of (oral) hormonal contraception. But, like I said, even besides that, other means of hormonal birth control are contraindicated because of stroke risk.
The birth control choices are barrier, calendar, and sterilization. We're not ready to jump into sterilization. It's a conversation and is on the table, but you can't just jump into that. I think I've accepted it more than my husband has at this point, but it's only been since April/May.
@sarahsmurfette@xanga - have you considered a copper IUD. It's hormone free and from what I see on-line, others who are on Topomax use it. You may have already considered it. There are health issues are contraindicated for using the copper IUD. The link is probably not the best link, but everything I've found suggest the copper IUD.
@Erika_Steele@xanga - I have considered it, yes. It's really the only other option out there that is effective. For me personally, it isn't a match. That's because I spent a lot of years as a CT tech and I scanned plenty of young women looking for their IUD because it was "misplaced," had migrated, or had perforated their uterus and was somewhere in their abdominal cavity where it shouldn't be. A friend of mine works at an Ob/Gyn and she said it happens more often than people discuss as well, and that none of the female employees (at least where she is) would ever consider an IUD of any type because of the risks.
I feel like I can get close to 100% contraceptive effectiveness with condoms and calendar methods together combined (it just sucks long term, and leads to scares like the one I had this week when my period is late for other reasons). We always use a condom and avoid sex altogether during my fertile time. I feel like for us, it's the best choice.
But that doesn't mean I'm totally comfy with it. Ya know? Probably because I know my husband and I are extremely fertile (became pregnant the first time we had sex together, and after she was born, as soon as I came off birth control, two months later I was pregnant again without trying). TMI?
I can most definitely relate. Three years ago I had severe migraines every day for about 6 months. My neuro finally did an MRI and found that I had a pituitary tumor that was causing bleeding around it. This was the cause of my migraines. I was on all sorts of migraine meds before they finally removed it. I was on Topamax for a while until they thought I had a pulmonary embolism (I didn't but, they decided to get me off Topamax since I have a high blood clotting risk.) Since the surgery 2 years ago, I rarely get migraines anymore. But, I do panic if I have a headache lasting for more than a day.
@misslei11@xanga - That must have been scary. I would get super nervous every time I got a headache too, in your position. Anyone would.
I also had an MRI as well as an MRA (MR Angiogram to look at the blood vessels in and around the brain). Mine was normal, which I am very relieved by. But I was pretty scared while getting the MRI/MRA. Partly because I was listening to the little radio thing they have in the headphones, and during the exam, the Kelly Clarkson song that says "what doesn't kill you makes you stronger," played twice. And I thought God must be trying to send me a message. And it freaked me out. HAHAHA!
@sarahsmurfette@xanga - I would've freaked out if that song was playing twice too, haha.
It was definitely scary and I wouldn't wish that surgery on my worst enemy (they went through my nose then I had to have cotton packed into my sinuses for over a week.. I thought I looked like Shrek) But, I'm so happy that they found out what was causing the migraines because I had to see several different doctors and they all thought I was looking for pain meds. =\ "How do you have migraines every day?" All those types of questions.I have to get follow up MRI's every February or so, and see an Endocrinologist every 6 months to get blood work to check up on my hormones.
So I know where you are coming from. I sincerely hope that they get your migraines under control because, it's not "just a headache" and you can't "just take some motrin and deal with it". They are debilitating!
Feel better!
Having had migraines in the past, I can both imagine how horrible your life can be, but at the same, I can't imagine the extent as mine weren't as frequent.
One thing that has GREATLY reduced my migraines is a low carb, high fat diet. This is also used to treat seizures, epilepsy, bi-polar disorders and prevent Alzheimers. I know some people that have gotten off seizure meds by following a strict low carb/high fat diet. Modern grains are pretty much posioning our brains (not to mention the amount of sugar we now eat---even naturally ocurring sugar can be too much for some peopl). Sounds extreme, but it's true...modern wheat was hybrid without ever testing on animals or humans. "Wheat Belly" by Dr William Davis is a phenomenal book. There are also many websites devoted to LCHF lifestyle.
Perhaps after a period of being on these drugs/diet, your brain will "settle down" and heal itself and you can re-evalutate your pregnancy options then. If not, what about surrogates or adoption?
I take 3 category 4 meds. But I'm an old lady, so pregnancy isn't an issue. It sounds like you plan to have more children, otherwise something permanent would have been done. If that's the case, get serious and make a plan for having another one. If you are simply vacillating, there are other forms of birth control available as well, but I'm in your camp when you stated you needed to be there for your two children. I had a hysterectomy at age 29, with two small children, and I never looked back, because I knew those precious babies needed me, and it wasn't about me making more, even though I was in a religious group where some women thought I was selfish. It wasn't done for birth control, by the way. It was needed for health reasons. And over the years, I've been grateful to be there for my children. Oh, and I do take topomax for migraines as well, and the quality of life is definitely worth it. Maybe two or three times a year I take a Frova, a migraine pill as well. You are of infinite worth and importance to your husband and your children, and how blessed they are to have you in their lives. God bless.
@TracyKVM - My husband wants to adopt, particularly if we don't have any more biological children. I'm not all that open to pursuing that and I think that's because my two close experiences with it (my Aunt and Uncle, and my best friend) were bad. My Aunt and Uncle adopted a 3 year old (state adoption) and his younger brother - there were a lot of abuse issues and actual physical brain issues due to alcohol (and drugs?) during pregnancy. It was a nightmare for 15 years, pretty much every single day. And my best friend did an international adoption of a baby...and didn't get him 'til he was 3 (after over 100,000K spent - did you ever see the Dateline story about the "Teddy Bear" adoption lady? They were one of her victims).
Time will tell. I'm just not there yet.
@Pollypinks@xanga - I've accepted that there won't be any more children. It wasn't "my plan" but I'm OK with it. My husband has been slower to acceptance, and I can't really blame him, he isn't in my shoes and frankly, he wasn't around to see a lot of the migraine problem (military). His slower acceptance is why permanent measures haven't been taken yet (vasectomy).
@misslei11@xanga - That has always been one of the harder things for me, SO many people don't understand what migraines are. They really do, the majority of people, think it's "just a bad headache" and that you can take Motrin or Excedrine "migraine" (what a joke - how do they even get to make that claim?). I can't even tell you how many people, when I tell them my story reply with, "yeah, I get migraines sometimes too. I usually just take Motrin and lie down in the dark. I usually just nap it off."
And I don't say anything because they're my friends and I don't want to offend them. But wtf?!
So, I now love you for *getting it*.
I mean good lord, after the one I had in April (with the stroke-like symptoms), I couldn't walk in a straight line for 3 days, and it took 8 weeks for me to regain the ability to stand on my left leg (on one foot). It's like getting a brain bruise.
I guess from an older person's perspective, your husband's reluctance and inability to see a health problem hits me square in between my eyes. You don't exactly get married with the assumption that everything will always be perfect. What does he do for you and the family when you've had migraines, and why is he not on board 100% where his mate's health is concerned? I guess from my perspective from living with 3 auto immune disorders as well as bipolar, all I've ever seen from my husband is complete support and willingness to do whatever extreme measures are necessary at any given time. A mate and two beautiful children are what many people call perfect.
@Pollypinks@xanga - It's a combination of things. And it's not that he doesn't grasp that there is a health problem, it's that he sees me a such a pillar of strength (not really a bad thing). I guess you'd have to know me better in real life to fully see his perspective. But for me? No matter what it is, it gets done. I have a migraine? Whatever still needs to be done gets done. I go into robot mode, and push through it for the sake of my kids and to hold my house together while my husband is gone.
I have to be that equal pillar of strength with my husband. Not only because of his job and the way it dictates our family dynamic, but also because it's just who I am. I come from a long line of very strong women, it's who we all are. Davis women get it done, period. So from my husband's perspective, it isn't debilitating because I've been able to "handle" it (and from the outside, you might think that, but on the inside, it's probably why the migraines wouldn't go away and kept coming back without reprieve).
So it would be hard, from his perspective to see that I need help when I don't ask for it (and that's on me, not him). It would be hard to see the difference this medication has made for me because of that - I didn't display "weakness" when I was feeling bad. It's stubbornness, really. So to him, it might not seem like it's a medication I will always need to take. It might seem like it's a temporary thing until I'm better. So why take permanent measures for what might be a temporary problem?
He supports me. He just has to play catch up to get to the same page of acceptance. That's because of the way I portrayed strength when I was ill. It was more of a shocker to him than it was to me.
I'm in no way ready to have a child or anything, but I'm on a crap load of antidepressants and mood stabilizers for anxiety and depression. Though they're not category D, they're category C and the formula I'm on right now is the first thing that has helped everything I've been through. I'm scared to death to ever have a child of my own because of the potential risks. There's even law suites for my Zoloft causing birth defects. And if I go off of them I know that I wouldn't be a fit parent. I've had to come to terms that adoption or surrogacy is the best option for me. II guess in a way it's good to know that before I want to have children, so I can find a potential mate that's okay with it but I'm bummed to know that there's a huge chance that I'll never have my own baby.
Sara, God bless for having the strength to push through a get done what you need to. I was like that when I was in my 20's and 30's as well. The health didn't get better, it got worse, and because I hadn't shared the inner most problems with my mate, by the time things got so bad that I couldn't handle them, there was huge resentment on his part. Not because he had to step in, but, because I hadn't been intimate enough with him to share all aspects of my life with him. So, maybe the migraines wouldn't last as long, come back whenever they do, any number of things on the spectrum, were he included in doing what needed to be done to allow you to lie down and do what needs to be done to take care of the pain. Have you been told this will go away? Has your mate been to the doctor with you? It seems he has been treated "less than" because of a work horse mentality, rather than being included in a plan that keeps you from suffering. And if the meds keep you from suffering then perfect! If I don't take the topomax daily, I'm gonna pay for it down the line. I have 3 autoimmune disorders, pay $1000.00 per month after insurance for 13 meds, and there's not one my husband is not familiar with. Not one. I lost my pride years ago, and now we just work together to take care of each other, but, and I say this sincerely, if I forget to tell him about a change one of my doctors has made, he is not pleased with me.
@Pollypinks@xanga - Here's the thing we can't forget - my husband is in the military. No he never went to a dr appointment with me. This is all stuff I have to handle on my own, he know about it, but it isn't stuff he goes to with me. You can't just tell the government, "My wife has a dr appointment" and expect to get relief from duty unless it's an emergency, and that's something we have only done when it was 100% necessary.
He's in the Coast Guard, his job is to be the boat driver, and there are only couple of those at his station at any given time. They have to be there because they are first responders for Search and Rescue as well as any Homeland Security issue that comes along. That's why he can't just leave unless there's an emergency here.
This is the life of a military wife. When I married him I knew that there were time expectations that would take him away from us. It's my duty, then, to hold the fort down while he's gone serving the country and protecting the people in the water. He can't come home for routine Dr appointments. I inform him of them and what was said or done. Things have come a long way toward understanding, I'm sure you know that the majority of people don't even understand what migraines are (not just a bad headache). He gets that now (but it didn't start that way). Especially with the complex migraine he witnessed, and how seriously the drs treated it, he got it.
You make a good point about not withholding information from your spouse.
Thanks for the info on your husband, and all he does for his country. I actually worked as a nurse for the V.A. for 14 years, and learned to respect so very many of our country's finest. And I was there to see the day when women returned from combat in the Gulf War, with conditions attributed to mustard gas and the like. For many years the government refused to acknowledge that their conditions had to do with that, much like the vietnam soldiers fighting for their lives after exposure to agent orange. My brother in law was in the Marines during those years, and now, in his late 60's, is suffering leukemia. They have compensated him for it, but it doesn't remove the illness. So I do understand that military life is very trying and lonesome, frequently for long periods of time, and you hate to squander any time with your spouse once he's home by bringing up headaches. God bless, and have a good day.
I'm on Botox for migraine, which causes birth defects. Hormonal birth control causes migraine for me, so I got Paragard, the non-hormonal IUD. It actually kind of sucks, but better that than take the risk.
Topamax was miserable, I couldn't think hardly at all when I was on it, I finally had to stop because I was afraid I was going to get into a car accident. I could see red lights, but I couldn't process that it meant I needed to stop, things like that. Plus my work was really suffering. My neurologist knew someone who was fired because it caused them to be so bad at their job. Botox is a godsend.
@sarahsmurfette@xanga - this may make me sound ignorant but if your husband were to get a vasectomy, aren't those reversible? Mind you I'm getting my knowledge from the sitcom Reba.
No, don't have experience with those kinds of medications or your experience, obviously, but I have to tell you about a phrase in a novel that really stuck with me. I think it's applicable here.
It's Camelot-era fiction, and the heroine goes to a wise woman because she doesn't want to get pregnant. While she's there, she hesitates and pictures a child who looks like her lover, and the wise woman says that she needs to choose for her current need. When you said that your kids that you already have need their mom, that's what I thought of. You're doing the right thing. It does suck though. :(