TTC with chronic pain and meds

[Lucysmama]

A little background...I have two kids, and had a set of surrogate twins.  I haven't posted here in a long time. But I need some advice from smart and educated women. I currently have a brain disorder (for which I had brain surgery last year) and several spinal cysts. This causes me daily pain, sometimes debilitating pain, as well as a whole other slew of issues. My husband and I have been wanting another child, but we were kind of waiting to see if my neuro issues were going to be surgically resolved. Apparently, they are not going to resolve, at least not anytime soon. We've decided we'd like to proceed with having another baby. Frankly, I don't want to waste my life waiting to get better, because it might not ever happen. My neurosurgeon has given his blessing and said I should remain stable.

But we're left facing another decision: do we have another child, knowing I will need to take prescription pain medication for the duration of my pregnancy and nursing? The baby will have exposure to my meds. I also will have to have the child via cesarean, and probably under general (due to my cysts, epidural/spinal is not advised). I feel okay about the surgical birth...I can handle that. I am really unsure about the meds, though. Would you TTC knowing the child will be exposed prenatally to opiates? I would of course try to keep it to a minimum (I always do). But minimum does not mean none. I could not function with none, I'd be in way too much pain.

Please be kind with your responses, ladies. Keep in mind that I do NOT want to take Rx pain medication. I have to. I have been on them for quite some time, and I have kept it to an impressively low level by using complimentary medicine, laying down a lot, using water/swimming, and listening to my body. I intend to use the same mindfulness in pregnancy. I just want to be responsible in my decision making, so I am looking for input. I am hoping I can find some sweet spot between mainstream "Just take whatever the doctors prescribe you!" and "No, don't take any pills whatsoever while pregnant, treat it all-naturally." I would like some informed opinions! So, would you TTC if you needed to take pain meds long-term? I know there are some chronic pain moms out there who might have some advice for me, and I'd love to hear from them, especially.

Thanks!

[katelove]

Do you have a pain clinic or chronic pain specialist who you see? They might be able to offer some suggestions for altering your medication while you're TTC/pregnant.

If you have access to Hale's Medicines and Mother's Milk you could look at alternatives there. He usually includes a recommendation for use in pregnancy.

As I don't know what sort of pain you experience I can't really offer specific suggestions. General things which immediately spring to mind are TENS machine and accupuncture. Bear in mind to that pregnancy may increase your pain medication requirement.

If you take opiates then I'd probably also speak to someone experienced in managing neonates with opiate withdrawal to see if they have any suggestions. And maybe a maternal foetal medicine specialist to see if there are certain times when you should avoid certain drugs to reduce the risk of developmental damage.

My feeling is that it's potentially doable but complex and input from some specialists during the planning stages would be valuable.

[pokeyAC]

I would also recommend acupuncture and other similar treatments.  There is no definitive answer on whether using a TENS unit is safe during pregnancy, but it could provide some relief.  I second what katelove said.  Try to find drugs that are safer and talk to someone who knows about caring for babies exposed to those drugs.  Someone told me the other day that they are thinking of taking a class for foster parents who will care for drug-exposed babies, and she said that methadone is one of the better drugs for babies to handle.  Perhaps that is true.  It seems like babies may have a rough start and have higher needs at first, but they turn out just fine.  You may want to get some advice on how the baby would behave and what special needs it may have.

[Lucysmama]

I know I *can* do it with the meds - as in, people do. And people who take WAY more than I do. I currently take about 15 mg of vicodin a day, which is not very much. I've been able to keep it at that level for over a year. I'm sure I can work with my doctors (primary, pain, and OB) to come up with a workable plan. With complimentary medicine, I may be able to keep it to 10 mg per day, but I doubt I could get it lower. It's possible I could taper and forgo the medication for a week or so before delivery to help stave off withdrawal -- though my doctor said that there shouldn't be any major withdrawal at that level of medication. He's not an OB though. But my question is more...am I comfortable with it? I don't know. I didn't even take Tylenol with my other pregnancies. So obviously it's a pretty big leap to a pregnancy/nursing where I'd have to be on prescription pain meds. I am just curious if there are other moms who have been in this position. I feel super guilty having to take anything during pregnancy.

[SassyLime9]

I don't know if anyone is still checking this thread; or maybe the original writer went ahead and got pregnant!

I just thought I'd mention that I'm in a similar situation & met with a high-risk OB who does pre-pregnancy appointments for those with medical issues. It was helpful not only to talk through what difficulties I might face with my medical issues, but also talk about which medications are in which classifications to take (or not) during pregnancy. He also mentioned several different options for those in my situation, including surrogates, adoption, etc. 

Best of luck to you!