Recently I’ve received feedback from a few readers that “they used to like my blog, but now that it’s been so focused on my training instead of RA they can no longer relate” – or something to that effect. And that’s a valid criticism. I’ve been so focused on creating content for Health Central, that I’ve slacked on writing here, and training journals are an easy way of just getting something posted every week.
Writing about my training isn’t about RA, but it is a place to hide from it. I shared an amazing article from Women’s Running this week written by a woman with Ulcerative Colitis. Her reflection on running with an autoimmune disease moved me to tears on the train – “…I remember that I am not here to live with my disease and everything it might throw my way. I am here to live outside of it.” Training and racing is very much the same for me. It’s a place to retreat far away from my RA and focus on form, reps, sets and interval times, and as the progression of my disease threatens to encroach upon that safe place, I throw myself in deeper further chasing that escape.
Lately, my disease has felt so all-consuming that the escape is increasingly harder to come by. Back in January, I went to see my OBGYN for my annual exam with Dr. B. As she ran down my updated meds list she was shocked to see that I was on Norvasc for my high blood pressure. My cardiologist knew I was on oral birth control which contraindicates BP meds, and prescribed them anyway despite me asking that very question. Dr. B was pissed but more focused on finding a new birth control method ASAP as the combination of Orencia, Methotrexate and Doxcycline are Categories C, X, and D respectively when it comes to use in pregnancy.
With the pill no longer an option we quickly ruled out the patch, the ring, and Depo Provera too, and Dr. B encouraged me to consider an IUD. And then, out of nowhere, I started crying. Getting an IUD at 32 felt so permanent I explained, even though the logical, educated, medically savvy defender of reproductive rights in me knew that wasn’t true at all. I cried harder telling Dr. B that having children feels so far out of reach right now because every time one part of my health stabilizes another falls apart. The NP student in the room handed me a tissue and gently, reassuringly put her hand on my back while Dr. B grabbed a pen and a piece of paper and said, “Anna, you have time.” She drew me a bell curve of reproductive aging and assured me again that I had time.
I laughed weakly and thanked her for knowing me well enough to know that I needed a diagram to get me off the ledge I was teetering on. She continued “I think what you need is a plan – or at least an approximation of one so that if pregnancy is a goal, the rest of your treatment can be line with that eventual goal.” And she’s right. My current treatment plan (like most patients’) is reactive – responding to symptoms, lab results, pain, and progressive joint damage, but this is a long-term goal that needs a proactive approach.
She let me know that because I was so high risk she’d need another doctor to partner with her. We agreed that the next step was a consult with Maternal and Fetal Medicine (MFM) who could better counsel me on high-risk pregnancy, the genetic testing/counseling we’d need and how to coordinate the small village that it would take to make this a reality – if ever. Her office even made the appointment for me – which I rescheduled for last week… And then canceled completely.
As much as I want to make a plan (or an approximation of one) there’s one thing that remains looming that no plan will mitigate – that all of the consults, testing, etc. will lead us to one place… The place where we decide not to have children because the risks to my health are just too big to gamble with. This is one of my greatest fears in life second only to something terrible happening to someone I love, and, if I’m being honest, I really feel like that is the inevitable conclusion of trying to formulate a plan.
So I’m putting it off for at least a little longer. I’m trying to find comfort in the fact that Dr. B is adamant that I have way more time than I thought, and I’m trying to find hope, safety, and clarity in throwing myself deeper into my training. Because maybe, just maybe, if I can find or build my strongest self through every rep, set or interval, maybe I can get to a place where I’m strong enough to weather whatever the outcome of trying to plan may be. That if I can build a body strong enough to be a Spartan, maybe someday it will be strong enough to be a mother too.