This past weekend was one of mild heartbreak - I must admit, I'm probably a bit worse-off with my depression currently from the news we received.
The end of June marks 2.5 years of trying for our second miracle; however, that trying has been harder to manage with my body lately. I have chronic conditions that are being investigated, including constant pain, fatigue, mental health concerns and an increase in the amount of debilitating migraines I've been getting.
Fatigue
It took us over a year to complete a myriad of sleep studies to determine what is happening with my fatigue, as it has become intrusive and a risk for doing normal tasks. It has definitely impacted my ability to work and learn, and especially my ability to engage and interact with my son. After several sleep clinic sessions, the specialist I was seeing told me "there's nothing I can do for you", as the clinical tests resulted in normal readings. I have very slight (and by slight I mean one point away from normal) sleep apnea, so I'm using a CPAP machine at night to assist my sleep, but otherwise I'm fine (clinically). He suggested that I shoe out thousands of dollars into tests and evaluations that are not covered by medical, and we're just not in a place financially to do that.
Mental Health
The next step in my investigation - and a step that is ongoing - is that I asked for a re-referral to a psychiatrist to evaluate my current mental state. 8+ years ago I was diagnosed with bipolar type 2 and previously medicated - but I stopped medication before getting pregnant with my son, and then again during this fertility journey. It turns out, after a secondary evaluation with a new psychiatrist, I may never have had bipolar and instead generalized anxiety and severe depression, with a possibility of ADHD. So now I'm going through the motions to try Cognitive Behavioural Therapy (CBT) before they entertain medication in August.
Migraines
This has become the most concerning issue. I've had migraines since I was a teen, but I've always pushed through. I had a CT scan in 2018 to see what was causing the issues, but those scans came back clear. Now that I'm dealing with a lot more stressors, my migraines have become absolutely debilitating. They are affecting my work performance, the involvement with my family, concentration and ability at school, and my mental health status. I have been referred for an MRI for additional imaging, but in the meantime, my doctor has put me on two medications: Topiramate (daily preventative) and Almotriptan (taken at onset of migraine symptoms). Here's the thing: Topiramate is a Category D medication. What is a Category D medication? If I get pregnant while using it, I am 3-4 times more likely to have a child with birth defects (ie cleft lip and palate).
What Does This Mean?
When I was on Lithium (also a Category D) in 2018, I had a co-requisite of birth control because of the risk of birth defects. I spoke with my fertility specialist and pharmacist about the risks associated with Topiramate and it is highly discouraged to entertain pregnancy at the same time - in fact, there are screening questions asked by doctors before prescribing the medication, including if an individual is pregnant; therefore, I will be putting myself back on birth control for the duration of my time on this medication
As much as it breaks my heart, I can not ethically continue our fertility journey while treating my migraines. That would be irresponsible and selfish. There is no guarantee that Topiramate will help - and if it doesn't we can go back to trying for a second child. If it does? Well, we'll cross that bridge when we get there. It's a hard choice. A lot of tears have been shed. It feels like a part of me has died a little bit - the part that has been anxiously awaiting the feeling of being pregnant again. I have to remind myself that we have such an amazing ray of sunshine already and that right now I need to care for myself so that I can help my family. It's a different taste of grief - but grief all the same.
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