Fibromyalgia and Pregnancy
You may be in the place I was a couple of years ago when I was first diagnosed with fibromyalgia and Sjögren’s Syndrome, an autoimmune disease that attacks my glands. I was still considered a newlywed and my husband and I were planning to start a family, and the first thing that I wanted to know was how this news would affect pregnancy. Although I was told that I should have no problems, I decided to do some research of my own. I spoke to each of my specialists about the risks, the difficulties, changing medications, and what to expect.
Like many FM patients, I took a myriad of medications to treat my various symptoms. I learned which medications are safe to take during pregnancy and stopped taking those that are not. What a change! Prior to pregnancy, I had added each medication and increased the dosage so gradually that I did not realize just how much they controlled my pain until I was no longer using them.
Sleep disruption and muscle pain were the bi-product of discontinuing a nightly muscle relaxant. The most noticeable difference was when I stopped taking my non-steroidal anti-inflammatory, which is unsafe during pregnancy because it prevents implantation of an embryo. I began having difficulty getting out of bed in the morning, and even getting up from a sitting position, because I was so stiff. Taking a hot shower first thing in the morning helps relieve some of the stiffness, as does regular stretching. Talk to your doctor about exercises that will relieve some of the discomfort caused by FM.
Be prepared for these changes and allow yourself and your partner some time to adjust. More warm baths, hot tea and massages will be in order. A major consideration before becoming pregnant is whether or not you will be able to tolerate changes in your treatment reduction in your medications. Through this experience I have learned what a high tolerance for pain is possible when something as important as a baby is at stake.
Despite all of the research that I had done, I was not fully prepared for what I would encounter. Sjögren’s Syndrome causes my immune system to attack anything that might be considered foreign, including fertilized eggs that are trying to become embryos. After two and half years and several failed infertility treatments, I finally heard the words from my doctor’s nurse regarding my blood work, "Melanie, you are very pregnant!"
After only six weeks of pregnancy, you might think that I would not have noticed any real changes yet. Not true. I started noticing changes right away, some good and some less than pleasant.
For the first time since I can remember, I actually started feeling rested when I woke up in the morning. Sure, I wake up at 3:00 every morning to use the restroom now, but I actually feel like I am sleeping soundly. The flip side of this is that I am even more tired in the afternoons than I already was thanks to FM. I have learned to do whatever it takes to get a nap in the afternoon.
In my research I have read that autoimmune patients often feel better during pregnancy, and I would have to say that so far in my experience, I agree. Many expectant mothers experience nausea and hot flashes. However, I definitely notice fewer symptoms of FM. With the exception of the afternoon exhaustion and some hormonal headaches, I actually feel better pregnant than I did before. I have more energy in the mornings and evenings than I have had since I first began noticing the symptoms of FM. I also no longer wake up with leg and foot pain, which could at times feel like a dagger was shooting through my bones.
The biggest and most positive change for me has been a reduction in headaches. This is my primary symptom and has included tension and daily migraine headaches with no real relief. Over the past few weeks, I have noticed a huge reduction in migraine headaches and the frequency and intensity of tension headaches.
There are a lot of changes and considerations to look forward to when planning your pregnancy as a FM patient. First and foremost, give yourself a break and allow yourself to have down time. Pregnancy takes a lot out of any woman. Add chronic pain to the mix and you are looking at one strong mama! Enjoy this time and remember that you won’t have quiet time like this for quite a while after your baby is born, so take advantage of it. I am looking forward to all of the wonderful changes that the rest of my pregnancy will bring and will try to enjoy myself; I hope that you do the same. Happy pregnancies to you all!
Some pregnancy tips for fibromyalgia patients:
Medications:
- Be sure to talk to your doctors about which medications are safe to continue during pregnancy and what alternatives might be available, such as physical therapy or herbal remedies. (Editor’s Note: A comprehensive list of medications commonly used to treat fibromyalgia, and their safety during pregnancy, is included in "The Blessed Event," an article by Catharine L. Shaner, MD, in vol. 6 of Fibromyalgia AWARE)
Doctors:
- Find an obstetrician that is familiar with FM and its symptoms and do not be shy about interviewing doctors until you find one that is right for you.
- Keep your rheumatologist informed about how you are feeling, any new symptoms and pain management needs that you have. Ask him or her to coordinate with your obstetrician to ensure more continuity in your care.
Work:
- Talk to your doctor about disability. Even part-time disability is an option if you just can’t do 40 hours/week but feel well enough to continue working. Information about short-term disability is available through your doctor or your human resources department.
Naps:
- Take your lunch break in your car and bring a kitchen timer to wake you when it’s time to go back to work.
- Work from home and schedule an hour for a nap by extending your work day by one hour.
- Talk to your boss about changing your schedule to fewer hours per week during pregnancy.
Daily duties:
- Decide that it’s okay not to get everything done. If ever there was a time to slack off a little in our chores, pregnancy is it. You should spend this time focusing on yourself and your health for the health of your baby. Give yourself a break if you don’t get everything done within the timelines that you have set.
- Talk to your partner about what help you need including grocery shopping, paying bills, running errands, house keeping, etc.
- Ask for help. Talk to family and friends about helping you out by making dinner once a week, helping with laundry on Saturday, etc.
- Consider hiring a house cleaning service to come in once or twice per month to help stay on top of the deep cleaning. This is an area that can become overwhelming if it gets out of control and having a service take over can be quite a relief.
- Switch to a dry cleaner that delivers and do your grocery shopping online. By simply eliminating some of the mundane daily chores that you have, you will have more energy to get other things done.
