This is a big issue, and you have every right to speak out about it!

If you have (or can find) a good, smart, OB/GYN, schedule ahn appointment and talk the situation over with him/her. I don't remember what RA meds you are on- that would need to be looked at before trying to conceive.

Who has diagnosed your "chronic Lyme" and how was it diagnosed? As you may know, that diagnosis is controversial and there are plenty of alternative types blaming it for everything from joint pain to termites. Does your rheumatologist agree that Lyme is a factor? With a family history of RA and a positive anti-ccp chances are excellent that you do have RA along with anything else.

You and your husband have some talking to do. He is probably scared of having two tiny children AND you to take care of. There are plenty of other scenarios for how this could all work out, too, and he needs to know that chances are good this story could have a happy ending. Pregnancy often sends autoimmune problems into remission for a bit, although they usually do return after delivery.

Miscarriage stinks- been there, done that. I didn't realize how common it was until it happened to me. Women from my age to their 80s started telling me their stories. Your husband shares your grief and disappointment, even if he can't or won't say so. He may be afraid of more unhappiness.

I certainly can't tell you what to do or how to resolve this, but I do feel for you. Big decisions, no easy answers.

My rheumatologist told me that if I did have Lyme, I do not have it anymore and I have early RA. Got a second opinion on that from another Rheumy as well. I tested positive for Lyme Disease (CDC Criteria) the same time I tested positive for Anti-ccp and ANA. I know the chronic lyme is controversial, which is why I am treading with caution and still seeing a rheumatologist. I found the dr by seeking someone to treat me with antibiotics for RA. Which I am on Doxycycline, which is what my goal was. It has seemed to help. Seems too good to be true that there is an end to this.

I imagine you are right on the money about my husband's fears. But I really mean when I say I am functional and there has only been a few times I haven't been able to suck it up and do what I always have done.

For treatment, I actually was started on Plaquenil and got really sick. that rheumy then recommended methotrexate. I told him I want to have another baby and then just say well, mxt is not a good idea then. I then found the dr. continue the doxy I was taking for lyme's and found another rheumatologist. The second rheum told me that the antibiotics helping is just because of the anti-inflammatory properties and that I should give Plaquenil another try. Which I never did, because I want to have another baby and that is category c, so I am not even sure how long I would need be off it, but I figured by the time it would become effective I would want to get off it for preconception. so this is where I am. confused, sad and angry!

Did you know that pregnancy actually kicks in remission for MOST pregnancies - so look past the pregnancy itself. You can be on prednisone alone and be ok. The problem is how you will be after the pregnancy. Can you handle another little one? That's the question. Don't let RA stop your dreams. You are researching adoption - that's still having a child.
Find some relevant information from your doctor on RA and pregnancy.

Just to get you started down the right path. You are worrying about something that you haven't researched. Worry will make your RA worse. Stop worrying.

http://www.webmd.com/rheumatoid-arthritis/features/ra-pregnancy

I'm so sorry about the miscarriage. Heartbreaking.
You sure have every right to be upset. I'm glad you are venting.
Of course we should be grateful for the children we have been blessed with. Still that does not mean you are not entitled to be upset or angry over the situation. It's your life, your future.

I agree with Alto about your husbands fears.
It's hard to understand each other's perspectives at times.
The more he learns the more assured he may be.
As Alto suggested I would find a good OB/GYN, perhaps one specializing in high risk patients.
The thing is this diease is so unpredictable. So in some way I can understand your husbands concern.
My sister had 4 kids, diagnosed with RA in between having them.
Looking back she was one strong women but she managed & for many years on her own (divorced). Family helped but there's only one mom.
I feel for those who are young & planning life. After all life with no huge obstacles like illness is hard enough.
Really hope you & your husband come to some understanding.
After all the family you have here & now are what's most important.
By the way I think adoption is a wonderful gift. To bad they make it so difficult & expensive to give children much needed love & families.
Sammy

Please don't mistake my comments for being negative. I'm trying to say that it will be ok if you have a baby with RA. I absolutely was not trying to treat your situation lightly at all, especially given that you have had a miscarriage.

I am just saying that RA shouldn't stop your dreams. I am positive you can find a good obgyn and specialist.

A friend of mine developed diabetes with her 3rd child. She lost him at 22weeks because the diabetes was not controlled. She went on to have a 4th pregnancy and had a healthy baby girl because she had a specialist and was on insulin for the pregnancy. It was a textbook pregnancy.

I had my daughter with RA. When the ligaments loosened up, mine really loosened and that was the only difficulty I had. Physical therapy helped a lot.

Best wishes and I'm sorry if my note above reads poorly.

I was diagnosed with RA after my first was born. Started with symptoms about 6 weeks after I had him (c-section), but didn't realize that all the little flares (feet, shoulders, etc.) were linked to 1 disease until he was about 5 months old when I had nodules all over my fingers. Rheumatologist also wanted to start me on methotrexate, which I refused because I, too, wanted another pregnancy. When my son was a year, we started trying again and got pregnant in about 3 months. I went into remission during that pregnancy and only took a little prednisone for the first trimester. After my second was born, I breast fed for about 6 months and then they insisted I start on some RA meds. They put me on Humira which led me to another remission for about 5 years. The course of the disease is different for everyone, and management is the key. My boys are 11 and 10 (today's my 10 year olds birthday!), and I struggle trying to keep my RA under control to this day. I wish you much luck in fulfilling your dreams and don't let this disease run you. If Drs think it's a safe choice, get your husband involved in the learning process and go for it! Hang in there!

you are only 32 and want more than one child. seems desirable and awesome and like the doctors should be there for you.

it seems like the OB and the rheum can talk together and pull for you to get another pregnancy off the ground. who knows like everyone said maybe it will kick the symptoms to the curb for the 9 months. I am rooting for you. keep asking and keep investigating. I held a newborn for my friend this morning for an hour while she did chores and the baby happened to be napping after nursing. I thought I had died and gone to heaven. Babies are a just reward for this disease any day. get the support and plan in place that you need. it's good you posted. shout it to the highest mountain until they come up with a road map for you. the 30's are a good time for the biological clock to roar.

i had three miscarriages, one uterine and two tubal, my thoughts are with you on that one.

keep us posted

depot

Hi Pitt - I can relate to a lot in your story. I've had RA for 14 years and I have three children. I was pg with my first when I was dx'ed with RA. The first rheumy I saw was well-meaning, but terrible. Her recommendation to me was to start on gold salts (!) which I refused to take bc not only did I want more children, I wanted to breastfeed the one I already had. My response was to say "thanks but no thanks" on the meds. Lucky for me, I went into a six-month remission after I delivered my son. The bad news was that I developed more intense and difficult RA symptoms when I came out of that remission.

Because I knew I wanted another child, I continued to forego meds until I found rheumy #2, who said "your symptoms can't continue like this. You need to at least be on prednisone while you're trying to get pregnant." I started taking prednisone daily and experienced about 80% relief.

Meanwhile, trying to get pg again was not going well. I tried for a year on my own with no success (DS took 4 months to conceive, so something seemed to be wrong). Because of my age at the time (38) I decided to try fertility treatment. I also found Rheumy #3 who was closer to my home and recommended adding Enbrel to my treatment (his comment: "Have you ever considered that you're having trouble getting and staying pg *because* of the RA?"

Fast forward 3 years, 2 m/cs and 10 fertility treatments, including 4 rounds of IVF, and finally, I delivered my beautiful twin girls about 2 months shy of my 41st birthday. Completely worth it.

After 2 m/cs and 3 failed IVF attempts, I started looking at adoption. I started the process without talking with my husband much about it, because he too wanted another child, and two of his three siblings were adopted. Wouldn't he want to adopt too? To my shock, he said no - that if we couldn't conceive on his own, he wasn't interested. However, within a few months, he said he'd had time to think about it and had changed his mind - yes, he'd be willing to adopt. Elated, I put us on a list for overseas adoption, and was just scheduling our home visit when my pg test from IVF round #4 came back positive.

Let me tell you that it's not all been good news. The babies are fine, healthy and marvelous 8-year-olds today, but the RA got kicked up several notches after I came out of a four-month remission after their birth. I've never been able to get the RA under control since, despite throwing every biologic, NSAID, herb and fish oil I can at it. I have significant deformities now in my feet and hands, and I flare on a weekly basis. Was it worth it to me? Yes. I, like you, knew I wanted to parent another child, and that was going to happen come hell or high water. I still work, I still do many activities I did before, but with a lot more pain and less mobility. Would other women make this choice? Maybe not.

I'm also lucky that my DH supported my desire to have another child. It's possible that with a little time, your DH will come around. If not, talk to him and see how you can work this out. For me, not choosing to have more children due to my RA was simply unacceptable. Only you can decide how much you're willing to fight for this. Best of luck no matter what you decide!