• Sati Rampersad

Taking A Risk?

Too Soon?

There are times in our lives when something is important enough that, despite the odds and potential risks, we decide to go for it anyway. So, true our short-memoried human nature, as time went by, the trials and tribulations of the two previous, harrowing, pain-filled, miserable years faded, became a distant memory. At this moment in time, I'd never felt better and the optimist in me believed that I was invincible, that all things were possible. This was my mindset when I had my first post-surgery appointment with my GI (subsequent to my follow-up visit with the surgeon who performed my bowel resection). It was about three months after my surgery, and my GI had by then received the report from the surgeon, indicating that I was healing and recovering on schedule. After going through the motions - the physical examination, how have you been feeling? any lingering pain/discomfort? how's your relationship with food going? how many times you're going to the bathroom? etc. etc. He then asks me if I had any questions or concerns about anything, and since he'd come to know me fairly well by then, he fully expected me have some kind of question because, well, that's just me, I always did. What can I say, I like to keep on top of things. Nevertheless, my next question clearly caught him off-guard and left him momentarily speechless, understandably I guess, as it was my first post-op visit with him, and it usually takes just as long (sometimes longer) to recover from the mental effects of major surgery as it does the physical. So, the timing for such a question was unexpected, for him anyway but it was something that was weighing on my mind., Doc, I've been thinking that since this is as good as it's going to get for me, and it's really good right now, what are your thoughts about me expanding my family, you know, having another child? Seeing his obvious shock, I hastened to add, not right away of course, but in the not too distant future. I rambled on that my son was now four years old, so I figured it was worth giving it some thought because tick-tock, the biological clock and all that. I was thirty-three years old, and back then, that was “getting old” for having children without complications (how times have changed, thank goodness!). I could tell that the poor man was having some internal struggles, and trying to figure out what to say to the obviously deranged woman sitting in front of him. Seriously, I could just “hear” him thinking, this woman is nuts! She’s still recovering from major surgery after more than two years in constant pain, in and out of hospital countless times, is able, for the first time in forever, to enjoy life, and she wants to do this NOW! After clearing his throat and regaining his composure, at least outwardly, he said, well, my dear, that's your decision, of course. However, from a medical standpoint, despite the healing you see on the outside, it can take up to a year to fully heal internally. He went on to add that, even more importantly, I'd been on all manner of heavy duty drugs consistently for a very long time, none of which had been tested on the possible effects on a fetus. There was also the very real possibility of me having a premature flare-up due to hormonal and overall changes in the body during pregnancy. Damn! Anything else? Despite knowing the doctor was doing his due diligence, it was still quite a buzz-kill. Seeing my obvious disappointment, he told me that if this was something I was seriously considering, since three months had already gone by, his best advice would be wait at least six more months (ideally nine) for the drugs to clear out of my system before trying to get pregnant. He also said that he would be remiss in his duty if he didn't point out that I might face some challenges in my ability to even conceive. Some of the reasons for that being the nature of the disease itself, the aggressive treatments, and the surgery, also, as my body had been through significant trauma, it resulted in my monthly cycle being quite erratic, some months not making an appearance at all. (Sorry guys if that’s TMI, but we’re all grown-ups here, right?). All things considered, it usually takes some time for the body’s functions to get back to normal (hopefully). Intellectually, I knew that I may have to face some challenges, but hearing it spelled out like that, made it a reality, a very daunting one. I felt profoundly disappointed and extremely discouraged.

Bad Timing

In the weeks and months that followed this visit, I moved on with my life, went back to work, spent quality time with my family, was eating and drinking anything and everything I wanted; I felt “normal”, something I hadn’t done in a very, very long time. Life was good and I had decided to not worry and obsess about anything, I would let nature take its course, whatever was meant to be will be, you know, que sera blah blah. I felt that I had so much to be grateful for, a wonderful, supportive family, a job (still), a good life. But it seemed that nature liked to mess with me, throw me off-course, challenge me at every turn because five months after that sobering doctor’s visit, I started feeling unwell- nausea, vomiting, dizziness, headaches, fatigue. All things that I was very familiar with, expert at, in fact. I’m thinking, No! No! this cannot be happening!! They told me I should be disease- free for at least two years after the surgery, with the possibility of recurrence increasing as more time went by. There were no guarantees, of course, but ... WHAT THE HELL!! I made the dreaded doctor’s appointment (with my family physician), and he ran the regular preliminary tests (blood /urine), checked blood pressure, heart rate etc. etc. It took a week for all the results to come in and I was summoned to the doctor’s office to discuss them. You can well imagine what that week was like for me, especially since I was feeling even worse than when I had gone in the previous week. He looked me dead in the eye and said “you’re pregnant”; my jaw dropped. WHAAAT!!! That’s impossible!! I barely even get my period! While I’m still trying to wrap my head around that, I realize that the doctor was still talking; I’m sorry, what? He repeated “there is no sign of any active Crohn’s, there has been no recurrence, all your symptoms are no-doubt pregnancy related”. To be perfectly honest, I didn’t quite know how to feel, I was overwhelmed with all kinds of emotions - joy, confusion, doubt, gratitude, anticipation, you name it! My mind was racing; of course I was very happy, but I was just as terrified because it was too soon! It wasn’t supposed to happen before (at least) six months, and it was only five! What if those evil drugs were still in my system?! How will I know? My doctor told me that I needed to see my GI as soon as possible to discuss the situation regarding my overall care, and what would potentially be a high-risk pregnancy. Is this really happening?!

Don’t Worry Too Much. Really?

My GI took the news better than expected, but then he’d had time to process it because my GP had forwarded my blood results prior to my visit. He offered the customary congratulations, and assured me that although the timing was not ideal ( no sh**, Sherlock!), he would manage my care meticulously and monitor things every step of the way. He told me he would do whatever it took to ensure a positive outcome, and to that end, the very first thing I needed to do was get an OB-GYN who was experienced in handling pregnancies of women will IBD. He explained that such a specialist would be more aware of what to look for if there was any sign of a flare-up of my Crohn’s, and have a better knowledge of how to handle any type of complication. Yeah, that didn’t sound scary at all. He promised he would liaise closely with this doctor. I was fortunate that there was such a specialist a few floors up from my GI’s office (at Mount Sinai Hospital), someone he knew quite well in fact. He made the appointment for me right away, and I was able to see him a couple weeks later. When I met this OB-GYN, to be perfectly honest, I was not overly impressed because, one, he seemed very nonchalant about my concerns, “Oh, don’t worry, everything will be just fine”, and secondly (okay, this was being judgy on my part and had no bearing on the man’s capabilities), he was a little rumpled/unkempt, plus he had a lazy way about him. However, since my GI spoke so highly of him, I thought I would give him a chance. Best decision I ever made, he was very thorough, patient, accessible, reassuring about my concerns about the drugs in my system as well as having a flare-up. Also, new worries took hold which were yet more unknowns: if my Crohn’s did flare-up, how would it impact the baby? Would the baby be afflicted by this dreadful disease? Feelings of guilt joined those of terror because, despite the reassurances, proposed constant monitoring, and ongoing tests, no one will know for certain how this baby will be affected until it’s actually born. Could I endure this kind of stress and tension for the rest of this pregnancy, eight more months, without something going wrong?