Last year, my then-four-year-old son had a terrible cold/flu season that extended through May. In the course of six months, he had a stomach virus, strep throat, various colds, three ear infections, and two different strains of flu. Having a child who was sick so often would be hard for anyone, as he was miserable, he missed a lot of school, and I had to miss a lot of work and had many sleepless nights taking his temperature and dispensing medication. However, because he’s my son, an additional concern burned in my brain.
Is his immune system okay?
As a person with rheumatoid arthritis/rheumatoid disease (RA/RD), I know what it’s like not to be able to count on my immune system. Instead of focusing its firepower solely on germs and viruses, my immune system gets confused and attacks my joints (tendons, muscles, and organs are potential targets as well). My immune system, designed to keep me healthy, actually causes damage and pain to my body.
Having a malfunctioning immune system, I faced a challenging decision of whether to have biological children. As my husband and I decided whether to attempt pregnancy or adoption, I weighed the potential risks of pregnancy and stopping my biologic drugs, the physical demands of caring for a baby, and the possibility of passing on my genetics to my children.
While researchers are still far from a full understanding of the causes of RA/RD, it has been determined that genetics are one causal component. Studies have shown that an individual is up to three times more likely to develop RA/RD when a first-degree relative (parent, sibling, child) also has the disease.1 Furthermore, when a family member has an autoimmune disease, his/her close relatives are more likely to develop an autoimmune disease, though not necessarily the same one.2 Therefore, given that I have multiple autoimmune conditions, as do my sister and my mom, deciding whether to have biological children required a lot of consideration.
I did choose to become pregnant, and now that my children are here I can’t imagine the world without them. I do not regret my decision for a moment, and I am so grateful they exist. However, that doesn’t fend off the guilt and worry that creep in whenever either of my children has health problems.
Unfortunately, this cold and flu season was nearly as bad for my son as last year’s, with two rounds of strep, a stomach bug, two ear infections, and the flu. As I worry, I also remind myself, “Five-year-olds get sick.” Of course, everyone gets sick once in a while, but any kindergarten teacher will tell you that five-year-olds get ill more frequently than most. I keep this in mind each time my son gets sick, and his pediatrician reminds me of this when I ask if I need to be concerned about his immune system. And yet, the worry persists.
The pediatrician does keep the family history of autoimmune disease on his radar as well, and he has said he would be more concerned if my son’s frequent illnesses weren’t the run of the mill sicknesses that five-year-olds tend to get. The fact that he isn’t picking up rare infections is reassuring to the doctor, and I try to let this reassure me as well.
Still, I worry.
When I shared my concerns with my aunt, she told me not to worry. I responded that I don’t know how not to. Yes, it is true that kids get sick. Everyone knows that. However, I also know some things that many people don’t: I know what it’s like to grow up with a sister with Type I Diabetes who was frequently hospitalized; I know what it’s like to be a child with chronic, undiagnosed symptoms; I know what it’s like to be diagnosed with a degenerative, autoimmune disease without a cure. In my family of origin, when it came to health problems the worst case scenario often came to bear. Therefore, I don’t know how to assume that all will be well.
I spoke to a therapist about my concerns. He validated that yes, I do know what the worst case scenario looks like. However, understanding that is a possible reality doesn’t mean it will become our reality. The statistics about the genetic propensity for autoimmune disease does mean that I should be vigilant about my children’s health, tracking symptoms and illnesses and consulting doctors when I’m concerned. All the while, I must balance this with what doctors share with me, that so far they don’t see evidence of an autoimmune condition. I must balance the worry with hope, as no one, including myself as a mother, can be sure of what the future will bring.