Monthly Archives: September 2012

Weigh those risks carefully

The German drug company Gruenenthal, which came to notoriety in the 1960s for producing the anti-morning-sickness drug thalidomide, this week issued an “apology” to the thousands of babies around the world who suffered birth defects as a result of its use.

According to a Sept. 2, 2012, story published by the Reuters news service, thalidomide was marketed internationally to pregnant women in the late 1950s and early 1960s as a treatment for morning sickness. About 10,000 babies were born around the world with defects caused by the drug, mostly malformed limbs or missing arms or legs.

Why take the chance in the first place?

While I have to agree with the families who dismiss the apology as “too little, too late and riddled with further deceit,” coming more than 50 years as it does after the fact, for me the story carries much wider implications. It’s a sobering reminder to moms-to-be everywhere not to take anything other than prenatal vitamins when pregnant, no matter who tells you it’s safe. Will your doctor be there to help you raise a child who has been damaged by the drug s/he said you could take? Will the drug company?

I speak from experience. For years I have suffered from chronic, debilitating migraines that require powerful drugs to control them. Ironically, one of those drugs is manufactured by an American pharmaceutical company that was responsible for the widespread distribution of thalidomide here in the United States.

Out of compassion for my constant misery, my physicians had said I could “probably” take those medications while pregnant and nursing, because there was no “empirical” evidence they caused birth defects. Well, an absence of empirical evidence might simply mean the drug hasn’t been tested for those specific conditions.

So while I appreciated my doctors’ sensitivity, I did not take my prescription medications — nor even over-the-counter painkillers (which never worked anyway) — during the eight or so years when I was either pregnant, nursing or thinking about it. That was back in the 1990s, and I have never regretted a single second of the sheer torment I went through as a result. I somehow managed to muddle through the worst days, and I can assure you it wasn’t pretty.

My daughters, however, are pretty. Very pretty. In fact, they’re perfect.

Fraught with risk

This takes on special significance for me, since I gave birth to a son in between those two perfect girls whom the medical community had written off as “hopeless,” because he had the great misfortune of being that one in 12,000 babies for whom something goes catastrophically wrong somewhere in the developmental process for no discernible reason.

It had nothing to do with drugs. I followed the same strict no-drug policy with him that I had with the other two pregnancies. In fact, it had nothing to do with anything I did or didn’t do. It was something that Nature herself had decreed, for reasons that to this day remain unknown to medical science. And it was completely out of my hands from the very earliest hours after he was conceived, when that first cell division went disastrously, tragically awry.

So why, when the very process itself of bringing a new life into the world is already fraught with risk, would anyone consciously add to the risk to her unborn child?

Weighing the risks

Thalidomide was prescribed for millions of pregnant women to treat morning sickness. Like migraine, morning sickness does eventually go away. But unlike chronic migraine, it does not come back day after day, week after week, month after month, year after year. So I truly wonder why anyone wouldn’t reasonably conclude that the best course of action in all but the most severe cases (and maybe even then) would be to simply tough it out, learn to tolerate some discomfort, and wait for it to be over.

I have heard it said that severe morning sickness itself can pose a threat to the unborn child by making the mother dangerously ill or depriving the developing baby of important nutrients. And I can certainly understand the importance of reducing the risks of a potentially life-threatening condition.

But my chronic migraines were and are an ever-present life-threatening condition. They are severe enough to pose the risk of death by migraine-induced stroke. It’s a threat that hovers every day a migraine looms. In my case, that’s about 15 days out of every month. My neurologist charts the progress of my migraines with considerable concern, because the risks of the condition itself are at least equal to those of the medications he prescribes.

During the course of my childbearing years, there certainly was no question in his mind that the death of a pregnant or nursing mother would be cataclysmic for the infant.

Toughing it out isn’t pretty

Ultimately, he left the choice up to me. So even with those very real risks in mind, I chose to tough it out while I was pregnant and nursing.

And as I said, it wasn’t pretty.  When my first child was an infant, it was easy enough to bring her into bed with me on severe migraine days to cuddle and nurse all day long. But when she grew more mobile, and certainly when I had two active little ones to look after, things got much more complicated.

There were days when I crawled around the house on my hands and knees just to get them something to eat. I would read and sing to them through streaming, bloodshot eyes while lying on the floor. When I drove them to the pediatrician’s office, I always kept a stash of plastic bags in the front seat next to me, in case I had to pull over suddenly to throw up.

The guilt alone was crushing. Would this be all they would remember of their childhoods? Despite the fact that I made the most of days when I felt well enough to take them hunting for flower fairies or invite their friends over for sleepovers and beach play dates, I was haunted by the fear that the overriding memories they would have of their childhoods would be of their mother lying prostrate on the floor, too immobilized and incapacitated by illness even to get up and lie on the couch.

Strong and compassionate

But instead, something wonderful happened. My daughters have grown up strong and confident, full of happy memories of trips to the park and tea parties on the front porch. One vividly remembers how I staunchly defended her over the course of two difficult years when she was being bullied at school and her principal refused to protect her. The other shares in common with me a love of dance and movement, and has occasionally joined me in my ballet workout sessions.

They don’t remember my being ill. Ever.

And they are compassionate far beyond their years. They have an uncanny ability to sense when someone they love needs an encouraging word or a kind gesture, and they always seem to know exactly what to do.

I knew for certain that I had triumphed over my condition several years ago when, within days of one another, each one confided to me that she had figured out she was my favorite daughter.  Each one had specific examples she could cite that had demonstrated to her that I clearly favored her over her sister.

“Don’t tell your sister,” I told each one. “This will be our secret.”

And the great thing was, they were both right. Each one is special, and each one has shared special moments with me that are unique just to her.

No regrets

As for my son, he is never far from my thoughts. Every year at Christmas time, we hang a pair of small blue booties near the top of the tree, a visible reminder that he is still very much a part of our lives together as a family.

But I am not haunted by regrets. I do not awaken in the night to phantom cries from an infant I somehow failed to save. The things that keep me awake, when they do, are the things that keep most adults awake: unpaid bills, looming deadlines, job performance reviews.

I am grateful that I never have to look back and ask myself if there was something – anything – I might have done differently to help my little son. There was not. I did everything I could. I gave him life to the extent that I was able, I celebrated and loved him for the painfully brief time that he was here, and I remember him always.

No better promise than this

This is truly all that life promises. We are given no guarantees that motherhood will be free of pain, discomfort, and heartache, along with its indescribable joys.

But we should be able to live with a clear conscience. That is something that is well within anyone’s power to control. That is what I would wish for any mother.



Filed under Chronic migraine, Essays