Help needed, decision on medication and long term risks, please

I’m a trying to make a decision regarding the medication I am / I should be taking and wondered if anyone has advice or could talk some sense into me.

 

I have had UC for over 15 years, mainly controlled with 5ASA and steroids (when flaring up). I had a baby boy in June 2009 and 6 weeks postpartum went into a severe flare which took 4 courses of steroids and finally 6 mp to get under control. I was in remission for a year and we decided to try for a second baby.

Stubborn as I am, I decided and with my GI approval, to go off 6MP and hope that my UC would stay in remission. Unfortunately I have been flaring again, just barely getting by. I had blood tests done and to no surprise I am severely anaemic, with ferretin levels at 9. I also had a very early miscarriage in June, which contributed to even bigger blood loss and my doctor hinted that the miscarriage might have been caused as I am so run done L

 

I am on iron therapy and probably will need to get iron infusions again to pick me up again, but what I am unsure about is if I should go back on 6pm.

 

I am worried that the longer I am in this moderate flare, the bigger the cancer risks and other long term risks are. So should I just go back to 6mp, build up my strength and then try for another baby?

 

Or should I still try to control my flare with 5ASA and suppositories and diet and hope that when I get pregnant (if that ever happens again), I will go into natural remission like I did last time ?

 

Sorry this is so long, I am just so confused and fed up, I hate this darn UC and the way nothing can be just straight forward.

Edited to add signature

Sorry to hear you are having such a hard time. I had a similar situation in which I very stressed about meds and my UC returning and worked really hard to stay healthy before getting pregnant with my second child. Honestly, do whatever you can do to get as healthy as possible before getting pregnant, as it is such a strain on one's body, and that is without considering being very anemic(in the same boat with you there) and the UC. You don't want to be flaring when pregnant, its such a nightmare.

I agree with Red_34, maybe try the strong meds, 6mp, and then try the rectal meds to get you through. I was not personally comfortable with taking an immune suppressant while pregnant(and was lucky I didn't need one), but I know many pregnant women have done so and been fine. I'd suggest having a long talk with your GI and OB/Gyn about that, because if you can't stay healthy without the 6mp or something similar, that may be the only way to stay healthy while pregnant.

Its hard to mediate between taking meds now to get you better and then looking at the long term risks and weighing the two..I believe the cancer risks for immune suppressants aren't really all that higher than for those with UC, versus those without UC, but that sounds like another conversation to have with your doctor. I am at the point where I want to live my life as normal as possible while I can, which includes being with my kids and family as much as I can, and for me that means Humira and prednisone as well as diet.

I wish you the best and hope you have a happy, healthy pregnancy whenever that time is right for you.

Thanks so much to take the time to reply ! All of it makes sense and I know I am the only who can make the decision what to do 

I am keen to get pregnant, but as you said, it’s probably not wise when I am so run down. On the other hand, I am wondering if I could just manage without going back on 6mp for now and once we have the second baby (god help it all will happen and go well) then I have no problems going back on 6mp.

In all fairness, I am not worried about the long term risks of being on 6mp, I am more worried that the constant low-grade inflammation may cause bigger risks.

Thanks so much for your input, I have another appointment with my Dr next week, so I will have a lengthy discussion on this.

Thanks !!!