roller coaster up!
dr. #1 visit #1 go ahead with the future-baby making! first, take this pill so you can ovulate. then, take an ovulation test every day for a week. next, come in for blood work so we can check to see if you ovulated. don't forget your prenatal vitamin and talk to your psychiatrist about your medications because three are class c. (class c drugs have animal studies that had adverse effect on the fetus and/or there are no adequate and well-controlled studies in humans.)
roller coaster down!
dr.#2 - visit #1: you haven't had a period in five weeks? take a pregnancy test. in the meantime, here's an rx for folic acid. now let's talk about your medications. here are your options:
- stop all three medications. this is the safest for future-baby. this is not safe for you because you can have withdrawal and/or a relapse
- stay on all three medications. this is risky during pregnancy for the baby and he/she will experience withdrawal after birth.
- stop trazodone, my sleeping medication. it should be the easiest to come off of.
- stop an additional drug but stay on at least one
-
- stop lamictal and stay on cymbalta. (the most recent study with lamictal had cases of birth defects like cleft palate or lip.)
- stop cymbalta and stay on lamictal. (cymbalta is a very new drug and there are no studies.)
roller coaster down down down!
hubby + wifey convo #1: wean me off lamictal and stay on cymbalta. monitor my condition. post-pone future baby-making until i am off the drug. i love you, i love you too.
roller coaster up!
dr. #3 - visit #1: you haven't had a period in six weeks? take a pregnancy test. your bloodwork is good. you are only deficient in vitamin d. here are drops to take every day. yes, you should see a specialist about your hand and head tremors.
roller coaster up!
dr. #4 - visit #1: you haven't had a pregnancy test in seven weeks? take a pregnancy test. i am diagnosing you with essential tremor. this will more likely get better rather than worse while you are pregnant. after your pregnancy, there are medications you can take if you continue to have trouble with this. i have prescribed lamictal for epilepsy and my patients have had very successful pregnancies. i strongly urge you to stay on lamictal and try going off cymbalta. i have seen too many cases where unknown drugs have caused problems. also, do you have a doctor who will monitor your blood sugar during pregnancy? you are a high risk for gestational diabetes. [at which point i express, given everything from depression to fibromyalgia to diabetes, "i feel like the worst person to get pregnant..." at which point she tells me, "don't even think that. not for one second. you are healthy and young and you are perfect for being pregnant." at which point (as i am recounting the conversation to dan) dan tears up.]
roller coaster up! roller coaster down!
hubby + wifey convo #2: wean me off cymbalta and stay on lamictal. monitor my condition. post-pone future baby-making until i am off the drug. i love you, i love you too.
dr. #2 - phone call #1: i am glad you got a second opinion with the neurologist regarding lamictal. i want to see you in a week. you still haven't had a period? take a pregnancy test.
roller coaster up! roller coaster down!
dr. #1 - phone call #1: you haven't had a period? take a pregnancy test. if it is negative, take this pill to induce a period. then take this pill to ovulate. repeat ovulation kit and appointment for bloodwork.
roller coaster down!
dr. #2 - visit #2: glad to hear you have no withdrawal symptoms! monitor your mood and as soon as you feel like you might be slipping back into a depressive state, we'll talk. if that happens, we can try a class A medication. it is safe to stay on trazodone at a low dose since you are activated at night without it. here's an rx for more, and for the new dissoluble lamictal tablets. let's meet again in six weeks.
roller coaster up!
hubby + wifey convo #3: one more week and we're good to go!!! except the getting the period thing! so now we wait for that in exciting anticipation. ironic. i love you, i love you too.
roller coaster up! roller coaster down! roller coaster up!
* gosh darnit. blogging is such a good way to vent. i guess there will be future-baby making posts.
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