Partner or not…. “Diseases the problem”

Marriage-Infographic-2

Hello  everyone,

my post  today is regarding us with rheumatic diseases but even regarding all the people with  rheumatic diseases, they can be women or men doesn’t matter.

I read  in a lot of  forum that couple  broke up after one of the partner get sick and need help or just need  to be understood. This is  so bad and of course upset us so much….

But at the same time  we can realize that the person we have  chosen is not the right one, rather you got married  in a church or not  the sentence “for better or for worse in health and disease”  is completely forgot from who in the couple is not sick unless the love is  REAL and  DEEP.

So what to  do ?

be focus on us  try to be better as we can and let him or her go we do not  deserve more pain!

Another advise ? I’ve got married this year at 42  years old, and my love  took  me and my pain in one  shot, he knows it can  worst but he knows i’m a warrior.

Be a  warrior be focus on you and  if your partner is not  good to be next to you, just CHANGE IT !

Waiting for your comments…

Wish you a flare free week.

 

Pregnancy with Ankylosing Spondylitis

 

Does ankylosing spondylitis (AS) worsen with pregnancy?

Pregnancy tends to improve AS in 20-30%, worsen AS in 20-30% while it remains unchanged in 50-60%. In general, spinal disease remains unchanged during pregnancy while peripheral arthritis and uveitis are suppressed during gestation and tend to exacerbate after delivery. Women carrying a female foetus fare better than those carrying a male foetus. Those with active spinal disease are advised not to plan pregnancy unless the disease is controlled.

When can one plan pregnancy with ankylosing spondylitis?

Your arthritis must be reasonably controlled for a period of at least 3-4 months before planning pregnancy. You should not have had any flare during these months.
Always speak to your Rheumatologist before planning pregnancy as he may have to make changes in your medicines. He would be the best person to guide you regarding the timing of your decision. Please speak to him well in advance as Methotrexate has to be stopped at least 3 months prior to planning to conceive.Those with active spinal disease are advised not to plan pregnancy unless the disease is controlled.

Is the pregnancy outcome different in patients with ankylosing spondylitis?

No. Ankylosing spondylitis doe not affect the course of pregnancy or the fetal well-being. The risk of fetal loss, prematurity or low birth weight does not increase with AS. Women with Ankylosing spondylitis are more likely to require a cesarean section as inflammed/ ankylosed sacroiliac joint is a mechanical hindrance to childbirth.

What to expect after delivery?

50-80% of the AS patients experience aggravation of symptoms 4 to 12 weeks after delivery. Episodes of uveitis & peripheral arthritis are more common after delivery.

Does Ankylosing spondylitis impair fertility?

No. Ankylosing spondylitis does not impair fertility. Sulfasalazine can impair the maturation of sperm cells and thereby impair the fertility of men. However, this generally settles after stopping the medicine (after an average of 2 ½ months). Sulphasalazine does not affect fertility in women.

Does Ankylosing Spondylitis start during pregnancy?

Ostenson & colleagues studied 939 patients & found that AS starts during pregnancy in about 21% patients.

What is the risk of your child inheriting AS?

The risk of your child inheriting AS is higher if you are HLA-B27 positive. If you are HLA-B27 positive & your partner negative; the chance of your child being positive is 50%. However that does not mean that he/ she has to develop AS. The chances of developing AS are even lower; probably 5- 20%. The chances are higher If you have any other family members affected by AS.

Family Planning and Rheumatoid Arthritis

Although anyone can get rheumatoid arthritis, women with RA outnumber men by about three to one. Many women with rheumatoid arthritis are diagnosed in their 20s and 30s, just when marriage and family start to take life’s center stage.

With pain, fatigue, and medication side effects to consider, there’s no question rheumatoid arthritis makes family planning more complicated. But RA doesn’t have to put your dreams of having a family out of reach. If you’re thinking about starting a family while living with rheumatoid arthritis, consider these tips.

1. Don’t Worry That Rheumatoid Arthritis Could Hurt Your Baby

Rheumatoid arthritis itself doesn’t seem to harm the developing baby, even if RA is active during pregnancy. In fact, 70% to 80% of women with RA have improvement of their symptoms during pregnancy. Although some women with RA may have a slight risk of miscarriage or low-birth-weight babies, the vast majority of women have normal pregnancies without complications.

However, many drugs for rheumatoid arthritis — including methotrexate and leflunomide — can cause birth defects. These same medications may also cause birth defects if they are taken by men who father children. Therefore, it’s important to talk to your doctor about altering treatment several months before you or your spouse try to get pregnant.

With the right treatment and prenatal care, babies born to moms with rheumatoid arthritis are as healthy and happy as any.

2. Have Patience As You Try to Get Pregnant

Experts disagree whether rheumatoid arthritis reduces fertility in women or men. It’s true that many women with RA take longer to conceive than women without rheumatoid arthritis. Inconsistent ovulation, decreased sex drive, or having sex less often due to pain and fatigue are possible explanations.

For men, acute flares of rheumatoid arthritis temporarily reduce sperm count and function, and can cause erection problems and decreased libido. For both men and women, effective treatment for RA improves sexual symptoms and function. In well-treated rheumatoid arthritis, fertility in most men and women is probably normal.

3. Know That the Future Looks Bright for Rheumatoid Arthritis Treatment

New biologic drugs for RA have created a new era of treatment for rheumatoid arthritis, according to rheumatologists. With early and aggressive treatment, most people with RA can avoid joint deformities and major disability.

For most women, that means being present and active throughout your children’s years at home. While bad days from RA symptoms may be unavoidable, doctors believe most women will keep their independence for decades, and possibly their lifetimes.

4. Alter Rheumatoid Arthritis Treatment Well Ahead of Your Pregnancy

As soon as you’re considering starting a family, see your rheumatologist. Some drugs need a months-long “washout” period before trying to conceive. And that goes for men as well as women; although unproven, methotrexate might result in sperm problems that could cause birth defects.

If you’re taking leflunomide for RA, even more advance planning is necessary. Due to its long half-life, leflunomide needs to be stopped two years before trying to conceive a baby, although there are ways to “wash” it out of your system quicker.

5. Work With Your Doctor on Rheumatoid Arthritis Treatment During Pregnancy

Your rheumatologist will help you decide on a treatment plan that includes both control of your RA symptoms and safety for your baby.

Low-dose prednisone, for example, is generally considered safe during pregnancy. Hydroxychloroquine (Plaquenil) and sulfasalazine are also considered safe. While evidence is limited for biologic medicines like Enbrel and Remicade, many rheumatologists are confident in their relative safety during pregnancy.

One way to avoid the risk of pregnancy problems from RA medications is to simply not take any. Under a doctor’s supervision, some women quit RA drugs “cold turkey” when they begin trying to conceive, through delivery and breastfeeding.

This method has its own risk, of course: possible progression of joint damage from flares during the time when you are off treatment. In certain women, though, some rheumatologists endorse the approach, with close monitoring for disease activity.

6. Expect Improvement in Rheumatoid Arthritis Symptoms During Pregnancy

Interestingly, pregnancy usually has a positive effect on rheumatoid arthritis symptoms, albeit temporary. About 70% to 80% of women experience improvement in their RA symptoms during pregnancy.

In many of these women, drugs for RA may be safely reduced or even eliminated during pregnancy. For about one-quarter of women, though, rheumatoid arthritis activity continues during pregnancy, or gets worse.

Unfortunately, the respite from RA symptoms during pregnancy is short-lived. Most women relapse after delivering their babies.

7. Until You’re Ready to Get Pregnant, Use Contraception

Again, remembering the potentially harmful effects of some rheumatoid arthritis drugs on the fetus, it’s essential to avoid pregnancy until you’re ready. Experts say that used properly, a variety of methods are appropriate and effective, such as:

  • Condoms
  • Oral contraceptives
  • Vaginal ring
  • Intrauterine device (IUD)

Although controversial studies have suggested oral contraceptives might prevent rheumatoid arthritis in some women, there is no evidence that they help control RA symptoms.

Thanks to webmed