I had my pre-pregnancy appointment today. I went with my list of questions, my list of "Can I....", my medication list, and my health conditions.
First of all, I absolutely love my doctor. He started out by giving me general information about how things usually progress as far as office visits, sonograms, genetic testing, etc. are concerned. He confirmed he liked the prenatal I was taking and liked that I am charting and tracking my cycles.
Anxiety and OCD: I addressed the fact that I have generalized anxiety d/o and OCD. My doctor approved the Buspar for my anxiety, stating it was a class B drug and he felt confident that the benefits to my health (i.e. IBS, sickness due to anxiety) far outweighed any associated risks. However, the Zoloft was a different story. He totally empathized with my health-related/focused OCD and agreed that it would likely worsen during pregnancy as I would then have someone (more important than myself!) else to worry about, as well. He told me he prefers his patient's not take medications if they don't need to and that there is a small risk of heart defects when SSRI's are taken during the first trimester. He also discussed possible withdrawal symptoms in baby at birth.
Overall, he told me that he has not personally seen any lasting complications in women taking much higher dosages of Zoloft than me, but knows that it has happened specifically with Paxil. He told me that if he were to have to recommend an SSRI for a pregnant women it would be Zoloft and that 50mg is not a high dose at all. He also told me he would send me to a high risk doctor to do a scan of baby's heart at 20-24 weeks to check for any complications so they can be anticipated at birth. I felt good about that, but am still torn! I worry about my health off of Zoloft, but I worry about baby's on it! I have some thinking to do.
Other health concerns: The only two conditions my doctor was concerned with are related to my connective tissue. I have also been "loose" jointed and have a history of dislocations. He suggested I see a rheumatologist to get tested for connective tissue disorders so that we can anticipate any possible associated risks, though he does not feel I am a "typical" Marfan's or Ehler Danlos patient.
We also discussed my hips. I had two open bilateral hip reductions at birth and several surgeries following. I was in body casts until I was almost 3. The doctor brought up a good point - I have some lack of flexiblity and rotation in my hip sockets and if, delivering vaginally, I were to have an epidural, I may allow my hips to be moved by staff in a way that could cause fracture or long-term damage as I wouldn't be able to feel it. Therefore, he also wants me to see an ortho. doctor to consult as to whether I should be able to deliver vaginally or if I'd be a better elective c-section.
If you made it through all that, congratulations! I only spent the time typing all of this up because these are the types of things I have been searching for in discussion boards and hoped maybe it would help someone else. :)