the last time

*Disclaimer: This blog is in no way meant to judge any mother's choice to breastfeed or not.

Two days ago, I left my little family to drive to Brampton Civic Hospital for an appointment with a rheumatologist.  I listened to the entire Mumford & Sons 'Babel' album, singing happily all the way.  I walked into the hospital, registered, and surfed through Facebook while I sat in a large waiting room - completely and blissfully unaware that my entire life was about to change.

Let me back up a bit.  About 8 years ago, I started noticing some discomfort in the joint of my thumb on my right hand and the toes on my right foot.  Nothing too serious, just couldn't hand-write anything for a long period of time or wear heels for longer than a couple of hours.  Fast forward to 2010 when my son Mateo was born.  I started noticing that changing his diaper would cause some pretty bad pain in my thumb that would sometimes radiate up my arm.  I went to my family doctor, who sent me to an orthopaedic surgeon who insisted it was an "old sports injury" that I must have "forgotten about".  Let's be clear - aside from pretending to play second base on a softball team when I was 12 and hiding in the showers while on the swim team in high school, I've never played a sport in my life.  He coerced me into getting a cortisone injection, and sent me on my way.  That worked for a while, but then the pain returned.

I continued to endure this extremely uncomfortable pain in my thumb and my right toes, and then the joint of my middle finger on my right hand started to hurt.  I went through a similar process, this time with a different doctor who again coerced me into cortisone in both my thumb and my middle finger.  I continued on with this pain until Mateo was about 15 months old.  At the time, I didn't notice that this coincided with when he weaned himself from breastfeeding.  I went on with my life, and aside from the occasional discomfort that I treated with physiotherapy, I didn't think any more of it.

My husband and I discussed having another child, and so after 5 months of trying and one early miscarriage, we got pregnant with our daughter Violet, who was born this past October.  It was around Christmastime that I started noticing the old pain coming back in my fingers and toes, but this time more fingers hurt too.  I started seeing my physiotherapist again, and the more I saw him, the more he became visibly concerned that I had a condition that was far more serious than my family doctor or any other doctor I'd seen realized.  He kept mentioning things like gout and lupus and arthritis, but in complete denial, I failed to ask my doctor for a blood test.  I tried giving up gluten and dairy, I continued my physio, I tried acupuncture and massage therapy.  But nothing worked.  In fact, by March, the pain had spread through my entire right hand, part of my left hand, both knees, all ten toes, and my spine.  By April, I had to heave myself out of bed every time Violet cried for me in the middle of the night, and literally limp to her nursery - often times unable to pick her up and forced to wake my husband to help me.

Finally, at the advice of my physiotherapist, I went to my family doctor and asked to be tested for rheumatoid arthritis.  "It's not RA, but I'll do the test if you want," she said.  I used my connections through a surgeon at Brampton Civic, and got myself referred to a rheumatologist despite my blood test coming back negative (yay!! relief!!).  I wanted to see this doctor to see if she could give me some answers about all of this pain and inflammation.  Maybe she'd prescribe me some naproxen and wish me the best.

And so here we are, back in the waiting room.  I wrote a note to some girlfriends on Facebook that I was nervous to hear what the doctor would say, based on information another friend had given me that morning (this friend is a doctor and had indicated that I'd likely be put on  meds that I couldn't breastfeed on, to which I replied, "I will never compromise the health of my daughter.  I don't care what the doctor says").  Blissfully.  Unaware.

About 40 minutes past my appointment time, I was called in.  The doctor came into the room and asked me to explain my story.  She asked me how long I planned to nurse my baby, and I said "as long as she wants me to".  "Hmmm" she said.  She did a full body assessment of my joints, writing on her chart as she went.  At one point I noticed she had to start a second page of notes.  "Hmmm. This isn't good" she said.

I sat on the table and listened to the words coming out of her mouth, but I wasn't really hearing her.  She isn't saying this to me.  She isn't telling me that even though my blood test was negative, I actually do have RA. She isn't telling me that I have 17 affected joints, and that more than 5 is cause for immediate and aggressive treatment.  She isn't telling me that the drug I have to go on is so severe and dangerous that I will no longer be able to provide nourishment for my baby.  That I will be in constant danger of getting sick because the drug will completely suppress my immune system to attack this awful disease that's taken over my body.

Then I suddenly heard her.  I started to cry and begged her for another solution so that I could keep nursing Violet.  "There must be something," I cried. "No, Erin.  You need to start this treatment, and you need to start this soon.  Do you want to feed Violet for another few months or do you want to be able to play with her in the park when you're 35?".  No more bliss.

I left with a prescription for Methotrexate, and two sheets of blood test requisitions.  She said, "please make an appointment soon, Erin.  I will see you soon.  It's going to be ok."  Is it?  Is it really?  How will I explain to my 6-month-old that "Mommy can't bring you close enough to soothe you when you're scared or sad, instead I have to shove a fake nipple in your mouth attached to a bottle filled with something that tastes nothing like breastmilk"?  I'm walking down the hall of the hospital, fogging up my sunglasses with tears thinking, "I've failed her.  I've failed my daughter. NO! This isn't happening.  It's not".

I got to my car and lost it.  Completely and utterly lost it.  Couldn't see past the tears, and started whaling.  Why me?  Why now?  Breastfeeding Violet is one of my most cherished things about being her mother.  I know these moments we share will eventually phase out, but I am not ready.  I am not ready to give this up!  Will she look at me differently?  Will she feel rejected?  Will she be at risk?  Will she love me less?

I know what the logical answers are.  I know that the right thing to do is wean Violet and start these meds.  I know I have to take this risk and give up something I love in order to salvage a life I want to live with my family; to be the mother and wife they need me to be.  I know.  I KNOW.  But the pain I've dealt with in my joints is nothing compared to the pain I am feeling in my heart.  NOTHING.  This just isn't fair.

Then, I realize this pity party I'm hosting is what's unfair.  People are being diagnosed with cancer while I'm being told there's a chance to nip this thing in the bud before it's too late.  And there are mothers who never had 6 minutes let alone 6 months of nursing with their babies.  I get it.  But nonetheless, I'm grieving.  I'm struggling with this shitty hand of cards I've been dealt.  And I will be struggling with it for the rest of my life.

And so now, I have to make the right decision and get this show on the road.  I have to put a timeline on when I will nurse my baby for the last time.  The last time I'll feel her tiny hand grab my chest as she latches to my breast.  The last time I will feel her drinking the milk my body has made for her.  The last time I'll see her little eyes looking up at me and feel her hand reach for my face while she nurses.  And when I think about this, my body shakes.  I feel lost and devastated and completely and utterly defeated.  My body has betrayed me.  My life has changed.  And I am dreading the last time.