Hopeful and Positive

I am very close to delivering my fourth child – a baby girl who in all tests and ultrasounds has proved to be healthy and developing well. I am excited and not unaware of how very fortunate I am. I know autoimmune diseases can make conception and pregnancy challenging. I also know that being fearful of potentially negative outcomes can make pregnancy – and parenthood, for that matter – equally challenging.

I received a comment to one of my recent blog posts that said, "I truly do not comprehend why a woman would choose to give birth or raise children when she knows she has arthritis, a lifelong chronic disabling disease. It baffles me, and I wonder WHY as well as HOW one plans to physically be available for a baby, then a toddler, and then a youngster, etc."

Frankly, I was shocked at that one, and I'm sure many you will be, too. (I look forward to reading your comments!) The quick and simple answer to that comment is that I have hope and a positive attitude. Working here at the Arthritis Foundation, I hear about and see people who range from mildly affected to severely affected. I know what they go through and how they cope. I also know they never give up – and neither do I. To prepare each issue of Arthritis Today and write or edit each article, I continually read about the research going on in the field of arthritis. I know what's being studied, and I talk to those doing the studies. I know geneticists are very close to finding all of the genes involved in autoimmunity. I know tissue engineers are on track to growing cartilage for transplantation into bad joints. I know researchers keep finding markers of inflammation that can be potential targets for new medications. Because of all of that, I have hope that with continued research, treatment of arthritis will improve dramatically in coming years. I know that although it is lifelong and chronic, it does not have to be disabling.

I know treatment certainly has improved since my own grandmother was physically disabled back in the 60s. Being told to stay in bed to take pressure off her joints and being injected with gold didn't do much to help her RA improve. Her body weakened, and she died in her mid-50s with eroded joints and a damaged heart and lungs. When I'm in my mid-50s, I know for a fact I will be in much better health. Rheumatologists have learned alot since then, and I follow my rheumatologist's advice. I eat right. I exercise. I don't smoke. I drink alcohol, when not pregnant, in moderation – maybe one glass of red wine at night and maybe two on a weekend night with friends. I take my medications as directed. I make sleep a priority. I take time -- if only a few minutes when I get home from work or before I go to bed -- to relax. I have a great relationship with my husband, kids, mom, sister and extended family. I have supportive coworkers and friends. I have hobbies. I'm involved in my community. I enjoy life. And because of all that, I never questioned having kids or raising them. I have alot to offer society, and a chronic disease doesn't change that.

I think my three other children would say that I've always been available to them – both physically and emotionally. I had all three of them before being diagnosed with RA, but slowly and surely, the symptoms were making themselves known throughout the past decade. Still, I play ball with them; we walk, bike or swim together; my oldest son and I workout at the gym together, and my younger two can't wait until they're old enough to join us. We talk about anything and everything under the sun. We laugh – alot. We draw pictures, play cards and games, build with Legos or pretend with dolls. We watch movies, go miniature golfing, hike and camp. I help with homework and school projects. All three kids are involved in sports, and my husband coaches one of the teams. We're always at practices or games. Afterward, some nights we go home and cook together. Other nights, we run errands and get takeout. On weekends, we put on music and clean the house; during the week, the kids help out with chores after school so I can spend time with them all at night. My husband works from home full time, so he does the laundry. Our life is full and busy, but it works. We all make it work. And therefore, my having a chronic condition does not preclude both my husband and I from having a family and a full, happy life. I can't – and don't – imagine it any other way. And I truly believe that in life you get what you give. If I thought I could do nothing more than sit on the couch or take to my bed, I would be completely unhappy. If I get up, feel productive at work, contribute to society, engage in helping others and take care of my body, life gives alot back to me. Yes, I have a chronic disease, but I also am able to live. And that's the ultimate "why" and "how" for being available to my children, regardless of their age.

This fourth child coming in a matter of days or weeks will be delivered from my 41-year-old body that has been diagnosed with RA. I don't feel any different than I did when I delivered my last child 8 years ago. Actually, I feel better. Honestly. I feel stronger and healthier now. Perhaps it's because my diagnosis made me make my health a priority. When I got pregnant, my level of inflammation was down, I was exercising regularly, counting calories to keep my weight down and taking time to rest. Eight years ago, I knew my wrists hurt when I held my babies, but I was told I had tendinitis and that carpal tunnel syndrome was common in moms with young children who are constantly picking up kids or car seats. I knew my hips hurt, but was told it was because I held the kids on the same side and threw my back out of alignment. I knew my ankles hurt, but was told I sprained them. My doctor, although he knew my family history included RA, never tested me. I very well could have had RA back then, but didn't know it. So this time around, I'm ahead of the game. I know what I need to do now to keep the inflammation down. I'll go back on my DMARD after delivering the baby and nursing for a few weeks. I'll be coming back to work. I'll continue to be involved with my family, friends and community. I'll continue to take care of myself. And I'll still be happy and hopeful that I'll be controlling my arthritis. It will not control me or my decisions about how to live my life.