Posts Tagged ‘ genes ’

Antidepressants While Pregnant–Follow Up

Thursday, August 25th, 2011

Fi and me on beach

It was so reassuring to know I’m not alone in my conflict of staying on meds while pregnant. And even though I know I’m making the right decision for myself, I do worry at times. How could I not? Someone who read my blog recommended a Reproductive Psychiatrist at NYU. This is an extremely specialized department on the cutting edge of research.

I saw the psychiatrist this week and I wanted to pass along what she told me. Knowledge is power, right? I’m going to take another leap here and even include the actual meds and dosages I’m on. Here goes:

At conception, if you’re taking antidepressants, then the baby is exposed. As she put it, “Exposure is exposure.” Meaning, going off at 3, 6, 9 months etc. is not going to make a difference. It’s the first couple months that are the big development stages.

I asked her about the studies that say there’s a 1-2% chance of cardiovascular/pulmonary issues in your baby if you take an SSRI (like Lexapro, Zoloft, Prozac, etc.). She said there is no conclusive evidence that those drugs cause higher risk under certain dosages. For example, the recommended maximum dosage for Lexapro while pregnant is 20-milligrams. (I’m currently on 5 mg, which I went down to on about the 3rd month of my pregnancy). She explained that those same risk percentages (1-2%) exist in the general population of pregnant women. Factors such as age, smoking, diet, etc can potentially elevate those risks. But not necessarily SSRI’s taken at the recommended dosages.

She also said to stay the course with what works mentally. You want to avoid huge ups and downs and being a human yoyo. It is better for you, but more importantly—the baby.

I’m also on Wellbutrin. The studies show there are no known or proven higher risks when taking while pregnant at the recommended maximum dosage. It is 300 milligrams or less on the extended release tablets. I’m on 150 milligrams.

Having said all this, studies have shown that the more drugs you’re on, the greater risk for some sort of issue/problem. That kind of follows logic, right? If she had met me before I got pregnant, she probably would have increased my Lexapro and taken me off Wellbutrin entirely. That way, I’d only be on one drug. But she assured me it’s really nothing to be concerned about. She’s had women with far more complicated drug combos than mine who have had beautiful babies.

When it comes to breastfeeding, the risks go down even more. The breasts act as a secondary filter (the body/blood being the first filter). She said tests were done with breastfeeding moms at a 20 mg dose of Lexapro and 300 mg of Wellbutrin. Those tests showed zero trace of the drugs in the baby.

And finally, bottom line: healthy, happy, anxiety-free mom = chances for the best baby. All the evidence supports that.

I thought this was some great information to have. If any of you have other information, I’d love to hear it.

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I’m Having A…..

Thursday, August 25th, 2011

BOY. Working titles: Little Leroy.  Wayne Sanchez Junior. Baby Oops. Found out at 11 weeks when we got the CVS results back.

Fia Gets a Brother

Fia Gets a Brother

I knew from the moment I got pregnant that it was an XY. I am usually not one of those people with a second sense for this sort of thing. But somehow I just knew.

When the genetic counselor called to tell us that the chromosomes looked normal (whew), she asked if we wanted to know the sex. Yes!  I had rehearsed this moment for the past 2 days. I know she is going to say boy, but maybe just maybe, she’ll say girl.

Nope. My instincts were right. Boy. Oh boy.

If I’m being honest, there was a moment of disappointment, of mourning. Maybe it’s because I think we have a better chance of another great baby if it’s the same sex as Fia. Maybe it’s because I wanted her to have a sister. And maybe it’s because I am already so familiar with her.  Change is scary.

There’s also a nagging fear with a boy: the most modern of medicine still can’t test for Autism and the rates are so much higher with boys. My husband’s nephew is severely autistic, which I know adds to my worry. But I know there is nothing I can do about it, so just like this “unexpected” pregnancy, I am going with it. I have to. I’m grateful for the tests we could do. And if something is wrong, we’ll deal.

In the weeks since the CVS I have wrapped my head around “boy” much more. Boys love their mammas. They are big snugglers. And puberty will probably be easier to deal with.

But in the meantime, do I really have to look forward to a penis peeing on me when I change his diapers? That doesn’t sound like very much fun.

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Taking Antidepressants When Pregnant

Wednesday, August 17th, 2011

Enjoying the beach with my baby

Enjoying the beach with my baby

Full disclosure:

I take antidepressants.

I will continue to take them through my pregnancy.

I took them while pregnant with Fia.

Internal conversation:

I can’t believe what you just revealed. Hurry. Duck and run for cover!!

No. I’m not going to. It’s time to get this conversation on the table.

You sure? You will be nailed to the cross on this one. Judged and deemed unfit for motherhood.

I don’t believe that. I think women are terrified of talking about this. I think many will feel relief that I’m admitting my own dirty little secret. They may carry the same secret. And it’s okay.

Do what you will but don’t say I didn’t warn you…..

Alright, it’s out there.  And I’m not shying away from it. It is my truth.

In my post about my dying mother, I mentioned her bipolar disorder. I breathe a deep sigh of relief that I don’t have that. But I do struggle with depression. And anxiety. For years I just “dealt” with it. With herbs and holistic medicine; with therapy and exercise; with meditation and yoga. Didn’t matter. Nothing changed how my chemical brain worked. I still do all those things, but now I take a small white pill everyday.

When I began taking it I felt this huge cloud lift. I felt less anxious. And far happier. I didn’t become an emotionless zombie. I became much more present in life–not in my head.

I went off of them a few times to see if perhaps I was “cured.” It can happen. Not me. That familiar dark cloud would start to drift into my periphery and I knew the storm was coming.

When I got pregnant with Fia, I struggled with my decision to stay on my meds. I even tried to wean off again. I felt the pit coming almost immediately. So I made my decision and stuck to it. I had to stop googling all the horrible things people talked about. I know it’s a risk. So is breathing the polluted air of NYC. So is going through the x-ray machine at the airport. So is my secret love of Taco Bell’s #3 with a diet Pepsi.

What I will say is more studies need to be done so women can have the facts. For a variety of reasons, there is just not a lot of conclusive data out there on taking antidepressants while pregnant. As an article in the NYT points out, pregnant women often aren’t part of drug studies. Therefore, a lot of the data is inferred, not proven. And even the most ardent studies have holes in them. I have an excellent OB and psychiatrist, both of whom agree: going through my pregnancy depressed and dark is far more dangerous than sticking to what works. (Also, during my pregnancy with Fia, we moved to LA for a bit. I saw 3 different OB’s/specialists. They all had the same unanimous opinion.)

What is proven is that some people have chemical imbalances. It’s in their genetic makeup.  And sometimes medicine is the only thing that works. Yet when taking those meds, the judgment from others can be severe. I guess that’s why women like me don’t disclose this. But today I’m feeling brave.

So there you have it.  Anyone else out there who wants to talk? I’m here.

Side note: I was recently informed about a study being conducted at Columbia University Medical Center exploring some of the issues around antidepressant use during pregnancy. If you are interested, and live in the NYC area, you can contact the study coordinator, Michelle Gilchrist at (212) 851-5175 OR mag2241@columbia.edu.

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Ruling Out Genetic Disorders When Pregnant And More…

Friday, August 12th, 2011

I don’t want any surprises with my pregnancy. Didn’t with Fia either. I want to know the sex, I want genetic defects ruled out, I want to know how and when I will labor (and that includes drugs). For Fia I didn’t have a crystal ball for this one. But for baby #2, I know how it’s going to happen. Or at least what we’re planning for. Will save that for another blog.

For those who don’t find out the sex because “it is one of life’s few surprises” I say a) you’re much braver than, b) much more patient than I, and c) it’s still a surprise when you find out! I just get to find out 30 weeks earlier and get my plan in place.

When it comes to genetic testing, all I can say is thank god for modern medicine. If I had lived in any other time period I would have worn a chastity belt to make sure I never got pregnant. Or joined the convent, though I’m not sure I would have been a very good nun….

For the above reasons, at 10 weeks, 5 days I had a CVS. Also had one with Fia. It’s as accurate as an amnio but you do it much earlier and the results come much faster—within 48 hours. It tests for the major genetic disorders, like Down Syndrome. The specialist (and you should go to a highly trained specialist if you have this done. I went to the dude who basically invented the technique) takes a needle and aspirates some cells in your placenta. Apparently when you get pregnant, half your cells go to form the baby, the other half go into the placenta. It is 99.99% accurate. It doesn’t test for neural tube defects, but a blood test at 18 weeks does that.

Yes, there is a small risk of miscarriage involved. 1-2%. But it’s almost always operator error. That’s why I feel very strongly about going to a specialist for something as important as this. You don’t want to mess around.

At any rate, I am now relieved to know that based on what they can genetically test for, Baby Oops is a-okay. What am I having? Did I say what I want to have? Stay tuned!

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Losing My Mom–With a Second Chance

Monday, July 11th, 2011

As she lay dying, I spoke to her on the phone. I told her that it was okay to go. That she would live on through me and Fi.

I told my mom’s sister how much Fia loves sautéed spinach.“Your mom loved that growing up. We’d call her Popeye,” she said. I cringed. Dear lord, please give Fia the good genes from her. Like love of spinach and not crack.

It’s not that my mom didn’t have some amazing traits. In her early years she was smart and beautiful. Kind and colorful. But that was then. In her darkest days her childhood friends would shake their heads and tell me, “Everyone in high school wanted to be Suzy Newlon. Such a shame.” We’d all look down and mumble awkwardly in agreement.

My Mom

My Mom

Five decades of alcohol and drug abuse—including picking up a crack habit when she was 62-years-old—a few suicide attempts and a clear-cut diagnosis of bipolar—didn’t really give her a fighting chance.

One recent Christmas she went around her Florida condo complex with a 20-foot ladder. She climbed up the trees and spray-painted the coconuts red.  It was an instant hit. On another Christmas she tried to kill herself by jumping off a parking garage.

I truly believe some people are born to conquer addiction while others are just born to stay addicts.

Last year at 64, her life had become desperately depressing and tragic. I rarely spoke to her. Neither did my siblings. But then a miracle occurred.

She had an intestinal rupture and went septic. Almost died. Ended up on life support. And while her health slowly deteriorated, her life got surprisingly better.

For the next 11 months she was mostly confined to a hospital bed. She had psychiatrists who tweaked and tweaked her mental meds. She had hot meals and an entire staff at her beck and call. She was the queen bee and basked in her royal treatment.

“I love it here. I can order a milkshake at 3 in the afternoon,” she’d tell me in her southern drawl.

The next day she would complain that the chicken was dry.

“Mom, this is a hospital, not the Four Seasons,” I’d remind her on the phone.

“I know that, but how hard is it to cook chicken right?”

I’d roll my eyes; secretly glad she was even complaining. In the past, depressive days meant curling up “in the ball” on her couch and refusing to speak to anyone.

At least now we knew where she was and that she was safe. It was also finally safe to bring Fi down to meet her. A hospital—germs and all– is far more sterile than her living conditions had become over the years.  And I knew what I was getting: glimpses of the mom I had in childhood; when she was a superstar. Cool, fun, unconditionally loving.

Over this past year almost every trip down she was alert and attentive. She couldn’t get enough of Fi. This is a woman who had missed so much of my life. My wedding, my pregnancy, the birth of my daughter. We were both getting a second chance.

She would tell me how much Fia reminded her of me when I was little. I’d relish the stories. And feel relief that (so far) it seems Fia has much more of me in her genes than her grandmother.  I can only pray the ones she does have from either of us are the good ones.

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