know there were threads on this before, but since we don't have access to the old threads, can we start a new one?

I'm 39 years old...my son is 15...and I'm soooooo missing that second baby that I always wanted and never had. Now that I'm with someone that I really feel I will be with forever, who also wants a child, I am seriously considering it....if not for this danged disease.

I know there is the possibility of having a child while having rsd...and also the possibility of it bringing on remission. But what if it doesn't? And what about the pain meds? I've been reading up on it, and reading that some people stay on the duragesic with no harm to the baby.

Any opinions? Any advice? Anyone want to yell at me for even THINKING about it?

Hugs
LisaM

Hi Lisa and welcome. Just so everyone knows let me introduce you to Lisa. Lisa is from Braintalk 1. Diamond Lil and I seen Lisa's post on Braintalk 1 today and told her to come over here to ask this question because we knew Kate was here and posting.

I also have been in touch with Lisa during the down time of Braintalk so its good to see she found her way over to this site. I didn't know how to send her over here at first but today I figured it out, sorry Lisa its those damn drugs.

Once again welcome. Jewells

I really can't help you with the pregnancy thing but personally it never was a issue for me. I think the blue, red, green, yellow, pink, orange and purple pills are all kicking in at the same time. WOW! look at all the pretty colors!

LOL! Just kidding! Seriously, make sure you check with your doc before you ever consider doing anything sexually! Chin Up!!!!

Mark

Welcome Lisa, and well done J and DL for bringing you here. Our resident preggers gal will, I'm certain, be able to give you some advice, she pops in often, Kate on the OBT, Cake on this.

Yes, if memory serves, she has 4 small children and got through the pregnancies very well except for the last, recent one. Kate is also our resident ketamine expert having been through a few 5-day continuous treatments. So, she's a mine of information....but I'll clear off and make way for others who *do* know something about it!

BTW, although I never had kids (not planned, bad timing and the pill!) I completely understand the ticking clock thing. I finally gave pregnancy a chance at the age of 39 and guess what? Nothing happened No regrets!

Anyway, great to see you here,
all the best.

hopefully the pros will be along soon.

But they are all grown, and I think I am the wrong particapant lol. Just wanted to jump on and say hi!

Hi Lisa,

I'm a mom of two, and certainly understand how strong those maternal urges are.

I did a little quick searching, and found only generic warnings about fentanyl (Duragesic) risk during pregnancy. Sounds like the usual warnings for other narcotic pain relievers. Here's what WebMD said:

"Fentanyl should be used during pregnancy only if the benefits to the mother outweigh the risks to the fetus. Talk with your doctor before using fentanyl if you are or may be pregnant. This drug can pass through your body in breast milk and should not be used while you are breast-feeding."

Reading between the lines, this probably means that there probably hasn't been many incidents of problems due to fetal exposure, but that they probably don't have enough data to rule it out, either. My guess is that the animal toxicology studies during initial drug testing probably didn't show a lot of teratogenicity (i.e. causing mutations to fetuses) either. Usually the pregnancy risk description for drugs that cause significant problems to animal fetuses at relatively low doses (i.e. the doses humans would use) are very strongly worded.

I remember reading that many anticonvulsants DO have a history of causing significant problems with human fetuses when taken by pregnant moms. I don't have that data on hand (although I know that Tegretol is one that is potentially a problem).

I did a quick search at PubMed, and couldn't find any papers about the worsening or improving of existing RSD during pregnancy. However, I did find a reference to one review paper that summarized data about RSD diagnosed during pregnancy. Here's the reference and abstract:

Eur J Obstet Gynecol Reprod Biol. 1999 Sep;86(1):55-63.
Reflex sympathetic dystrophy in pregnancy: nine cases and a review of the literature.

"OBJECTIVE: To better understand the diagnosis of reflex sympathetic dystrophy of the lower extremities in pregnant women. SUBJECT: Disease analysis using a retrospective series of nine cases and a review of the literature (57 patients and 159 sites of reflex sympathetic dystrophy). RESULTS: This disorder should be considered in any painful pelvic girdle syndrome or lower extremity pain. The hip is involved in 88% of cases. Symptoms develop in the third trimester of pregnancy, between the 26th and the 34th weeks. Magnetic resonance imaging (MRI) provides an early, accurate, and very specific diagnosis, although standard radiography continues to be the first-line diagnostic tool. Fracture occurs in 19% of patients. The etiology and pathophysiology remain unclear, although pregnancy itself appears to play a significant role in this disease. Although locoregional mechanical factors partly explain reflex sympathetic dystrophy. Hypertriglyceridemia appears to be a risk factor. This disorder develops independently, but the conclusion of pregnancy appears to be necessary for cure. Reflex sympathetic dystrophy does not appear to affect the course of the pregnancy. Indications for cesarean delivery remain obstetrical and should be discussed when a fracture is involved. Simple therapeutic management using gentle physical therapy provides rapid and complete recovery in 2-3 months. CONCLUSION: Reflex sympathetic dystrophy during pregnancy remains poorly understood and underestimated. Only joints of the inferior limbs are involved. MRI appears to be the best diagnostic tool. Pathogenesis remains unclear. Fractures are not rare. Treatment should be non-aggressive"

I have the whole paper on a PDF file if you're interested.

Hope this is helpful, and good luck!
Annie

Pregnancy—Although studies on birth defects with fentanyl have not been done in pregnant women, it has not been reported to cause birth defects

Pregnancy—Although studies on birth defects with fentanyl have not been done in pregnant women, it has not been reported to cause birth defects. However, using any narcotic regularly during pregnancy may cause physical dependence in the fetus. This may lead to withdrawal side effects after birth. Also, use of this medicine near the end of pregnancy may cause drowsiness and breathing problems in newborn babies.

Neurology. 2006 Aug 8;67(3):E6-7.
In utero antiepileptic drug exposure: fetal death and malformations.

BACKGROUND: Pregnancy outcomes following in utero exposure to antiepileptic drugs (AEDs) are uncertain, limiting an evidenced-based approach. OBJECTIVE: To determine if fetal outcomes vary as a function of different in utero AED exposures. METHODS: This ongoing prospective observational study across 25 epilepsy centers in the USA and UK enrolled pregnant women with epilepsy from October 1999 to February 2004 to determine if differential long-term cognitive and behavioral neurodevelopmental effects exist across the four most commonly used AEDs. This initial report focuses on the incidence of serious adverse outcomes including major congenital malformations (which could be attributable to AEDs) or fetal death. A total of 333 mother/child pairs were analyzed for monotherapy exposures: carbamazepine (n = 110), lamotrigine (n = 98), phenytoin (n = 56), and valproate (n = 69). RESULTS: Response frequencies of pregnancies resulting in serious adverse outcomes for each AED were as follows: carbamazepine 8.2%, lamotrigine 1.0%, phenytoin 10.7%, and valproate 20.3%. Distribution of serious adverse outcomes differed significantly across AEDs and was not explained by factors other than in utero AED exposure. Valproate exhibited a dose-dependent effect. CONCLUSIONS: More adverse outcomes were observed in pregnancies with in utero valproate exposure vs the other antiepileptic drugs (AEDs). These results combined with several recent studies provide strong evidence that valproate poses the highest risk to the fetus. For women who fail other AEDs and require valproate, the dose should be limited if possible.