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