Starting a family with brittle asthma

Hi

Me and my husband would like to start a family but I have brittle asthma and Addison's.

The consultants are being really helpful but have asked me to stop some meds as they are not licensed during pregnancy. This includes the antibiotic (amriymicin) and spiriva/tiatropiam (both spelt wrong). They also tried to stop singlair but that put me straight into ICU for a few days.

My questions are has anyone taken singulair through pregnancy as it looks like I can't stop that one?

Does anyone have experience of a young baby and brittle asthma with hospitals and HDU/ICU?

I have also been asked to stop ammatriptalaian (spelt wrong), I take it at the lowest level for possible VCD (never confirmed) but I'm so twitchy from stopping the drugs above I'm scared of stopping another. Has anyone taken this in pregnancy?

My husband is really scared that A - I will get worse during pregnancy and B - what will happen afterwards if I do end up in HDU or hospital once the baby is born will he get left holding the baby?

Thanks for your help

Amanda

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Hi, when we were looking at having a family, the obstetrician I saw before concieving liaised closely with respiratory specialist consultant about treatments. Some peoples asthma improves during pregnancy due to hormonal changes - but equally some gets much worse. I would suggest getting a specialist respiratory opinion regarding both pregnancy and your specific medications - they should liaise and discuss directly with the obstetrician who would be managing your care (they should have obstetricians who specifically manage high risk pregnancies).

At the end of our duscussions it was agreed that pregnancy was simply too dangerous and would ultimately lead to loss of life - but I have additional lung issues. If we hadnt have had those multidisciplinary discussions, it would have had a terrible outcome. Shared Knowledge = planning = greater chance of a good outcome

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HI Amanda,

No expert at all on this, definitely agree you should get some expert advice.

But just as a preliminary idea: everything I have seen in passing while reading about montelukast (on it though not starting a family or thinking about it) seems to say you can't start it during pregnancy but if you are already on it beforehand there's no reason to stop. So perhaps look up that info and then take it to discuss with the drs? Again though this isn't currently relevant to me, my impression is it's always better for the baby if the mother is as controlled as possible, so if it is feasible for you then taking meds which aren't definitely toxic for a foetus is preferable to stopping them 'just in case' and you becoming more uncontrolled than before.

I will stop there as out of my depth...but thought I might say that in case it helps - good luck!

[Skee-skee]

Hi

I can answer one of your questions- I've carried on taking Singulair even though pregnant (it was due last Sunday but still no sign, but it will have to come out soon as I'm being induced on Thursday). My consultant advised trying to stop Singulair (it was started during an admission years ago so we had no idea if it worked anyway). I found my asthma got worse so decided to keep taking it.

I thought the advice on Singulair was DON'T start it during pregnancy but if someone is on it and it works then continue with it.

I've always been told that the most important thing is that your asthma is controlled as possible and oxygen deprivation to your baby would be far worse. I'm sure your consultant has also talked about the rule of 3rds (i.e. a 3rd get better, a 3rd get worse and a 3rd stay the same). Is your asthma steroid resistant because that might give you a clue which group you might fall into? On a positive note mine has been better.

The idea about liaising with both your respiratory consultant and an obstetrician is a great one- then at least you will be fully informed.

If you do decide to go for it, you will be really closely monitored and have lots of scans. The later scans are great as you can see the face so clearly and everyone likes to look at the pics as they aren't used to seeing them. Our baby had a right frown during the whole 38 week scan. Also prepare yourself that while other people get to decide where they have the baby/ what pain relief they might want, you will get absolutely no choice!

Sorry I can't help with any of the other questions.

Bryony