6 Weeks Post Delivery
I've made it to the final finish line in the birthing process - six weeks post delivery. For the first 2 weeks home, I had the no heavy lifting, no driving, and no more than once up and down the stairs a day rules. Add the no bath, swimming, or exercise (including intimacy) for the next 3 weeks, and here I am at the post delivery finish line.
I saw my rheumatologist yesterday, and atypical to most post deliveries, I have no flare-ups with my Sjogren's. Thank goodness. I couldn't imagine on top of being sleep deprived to the point that I can't open and close my eyes they are SO dry (and I'm not exaggerating), that I'd also be dealing with physical changes in my body due to the stress from pregnancy and delivery. She did an exam and had some blood work done, but overall didn't find any other changes in my being. I did talk with her about the dryness that I experienced the first few weeks, especially the part about how my mouth kept splitting open and wouldn't heal. Nothing more fun than taking a bit out of something and seeing blood on the food remaining. She said that I could have a vitamin B deficiency, so she added that to my blood panel. After donating 10 tubes (no kidding) of blood, I left there a fairly happy camper.
I saw my OB this morning for my post delivery follow-up. Nothing much new to report there. They have me down a whopping 12 lbs. Not quite what I had yesterday, but then again we had Chinese for dinner and I drank a bottle of water on the way in. I'm less concerned with that number right now. Give me a few more months and then I'll really start dwelling on the fact that I have to tackle the weight issue. My blood pressure was great (110/60), and everything looked a-okay with my incision. The doctor was as surprised as I have been that my steri strips haven't fallen off. I guess I actually listen to the physicians a little too much...I didn't try and speed along the process.
One thing that was discussed at length during my visit was birth control moving forward. This was something the doctors brought up towards the end of my pregnancy. Well, not birth control. Sterilization. That's such a harsh word. At the time, I said I wasn't yet ready to make that decision. My husband asked what was involved. He's two and through. Has been from before we were even pregnant with #1. I've always wanted four children. Everyone I've talked with assumes it's the "I want a girl" thing as we have two lovely boys. It could be, but I've always seen myself having more. Not necessarily with a gender associated.
Before delivering, my husband and I tabled the discussion, with the grounds that after a few months with the baby maybe I'd be ready to make that decision more final. Although I'd like more children, and both my OB and high risk OB have said we could, they and especially my rheumatologist have cautioned me about what the risks are. Obviously, the older I am the higher the risk of issues in general, and the more likely we would be for multiples. Nothing like going for a third and getting a fourth. Know people that's happened to. On top of those normal risks, I also have the increased risk of having a child with fetal heart block or other Sjogren's related complications, I have higher risks of miscarriage (due to Sjogren's), higher risk for flare-ups and other Sjogren's related pregnancy complications. On top of it, to be safe, I should be off of the Plaquenil at least 6 months prior to conceiving, so an subsequent pregnancies would have to be well planned. Finally, the stress on my body of another pregnancy could cause the autoimmune disease to go into overdrive. A risk I had this time around, but luckily avoided (keep your fingers crossed).
So, the conversation today laid out all of my options. There is a pill I could take (progesterone only) that is safe for breastfeeding Moms, I could go the IUD route, or I could have some type of tubal ligation (there's two methods). Things to think about. There are risks with each, and it really depends on what we see in our future. Right now, I can't tell you how I'll feel in 2 years so I'm inclined to take the pill and play it month by month. The doctor also threw out there that my husband could be sterilized...and my response is that we were aware, but that wasn't something that I could discuss with an OB. I'm going to read through all of the literature that the OB provided. Not thrilled about the thought of having the IUD, but then I wouldn't have to remember to take the pill everyday. I've also heard of a few people who have gotten pregnant with the IUD in place. Think I'd rather take the pill and know vs. just hope the IUD doesn't slip!
The thing I didn't tell her or my OB at today's appointment is the pain in my neck and back that I've had since last Thursday. Despite being given the go-ahead for all activities, I won't be doing anything strenuous for at least a few more days since I still can't hold the phone between my ear and my shoulder...nor turn my head to far enough to each side to see over my shoulder. Yeah, probably shouldn't be driving. I keep hoping each day it will be better, and truthfully, beside the blog and when it inconveniences me, I kind of forget that it hurts. Just don't have the time to dwell on it. I'm just thinking one foot forward. Change a diaper, feed a baby, keep toddler occupied while I do both. What's for lunch? Get toddler down for a nap, breathe, update blog, feed a baby, change a baby, feed a baby, and somewhere in between it all figure out and make dinner. Phew.