Our Decision for a Small Family
Starting a family when I was only 21 wasn’t exactly how I thought my life would play out. Medications and health problems not related to psoriatic disease decreased my chances of getting pregnant in the first place. At that time in my life, I had no signs my immune system would go haywire within a decade. I was trying to juggle a full load of college classes, writing for the college newspaper, work, and pregnancy. All of this chaos didn’t mean my husband and I regretted being young parents. It just meant things were going to be different.
Despite the odds of starting a family so young, we’ve been doing pretty well.
Expanding our family to four
Many times over the years, I’ve been asked about turning our trio into a quartet, and that would have happened if it weren’t for a miscarriage. But honestly, I’m okay with that. Three is a great number for us.
When my son was 4, he was diagnosed with psoriasis. I can remember his dermatologist so clearly asking, “Who in your family has psoriasis?” And, no matter how many times he asked, my answer was still no one.
Within a year, he was diagnosed with juvenile psoriatic arthritis. His pediatric rheumatologist at the time also asked about family history, but I told her no one had autoimmune arthritis.
I found out that I was the family link about three years later. My body was just waiting in the shadows for a trigger to start both psoriasis and psoriatic arthritis. I also learned that psoriatic disease is prevalent on my biological father’s side of the family, but because he died very early in my life, I wasn’t knowledgeable about it.
The blame game
The genes seemed stacked against us, and it was hard seeing my little boy have such a hard time managing both diseases with little in the way of helpful treatments that worked longer than six months at a time. It was then that I decided that our family would stay at three.
Other factors did play into the decision, but honestly, I don’t think I could live with the guilt if I knowingly passed on my genes a second time. It took years for me to get past blaming myself for what I passed down to my son. I just don’t think I could go through that again.
Today, I know that blaming myself only made the situation worse. There is nothing I could have done to prevent this outcome. No parent likes to see a child in pain. Yes, my son had a rough go and still does on occasion, but here’s the really great part: He’s a smart, funny, and super independent young adult. He loves people, animals and life, and he makes me so proud. And, if I could go back and change history, I wouldn’t. I can’t imagine life without this kid.
Genes and statistics
According to the National Psoriasis Foundation’s article “Genes and Psoriasis,” there are about 25 genetic variants that scientists believe are more likely for a person to develop psoriasis or psoriatic arthritis. Scientists also believe that at least 10 percent of the general population will inherit genes that create a predisposition to having psoriasis. Still, it is thought that there has to be the right mix of these genes and only two to three percent of people have that mix. In addition, it is usually an environmental trigger that is needed to actually activate psoriatic disease.
So, how does this translate into passing your genes on to your children? NPF’s article, “About psoriasis and psoriatic arthritis in children,” explains that if one parent has psoriasis, then there is a 10 percent chance your child will get the disease. This jumps to 50 percent if both parents have psoriasis.
Linda J. Brown wrote an article for the Arthritis Foundation titled “Juvenile Idiopathic Arthritis: All in the Family?” which reports on a study conducted by Dr. Sampath Prahalad, MD, associate professor of Pediatrics and Human Genetics at Emory University in Atlanta. Dr. Prahalad explained that if one identical twin has juvenile idiopathic arthritis (JIA) – which includes juvenile psoriatic arthritis – there is a 25 percent chance that the other twin will also get JIA.
Dr. Prahalad’s study shows that siblings have an estimated 12 times greater risk of getting JIA. This may sound like a lot, but because the general population only has a 1 in 1,000 prevalence of JIA, the chance of both siblings having JIA only equates to 1.2 percent. That means there is a 98 percent chance that you would not pass on your genes to another child.
Some mom advice
My advice to those with psoriasis and psoriatic arthritis who want to start a family: Follow your heart, and if that leads to having children, enjoy every smile and giggle from those little ones because they do grow up fast. And if you pass on your genes, remember your children will get far more good ones than bad ones from you. Psoriatic disease will only be one small part of your child. You will be amazed as to what your mini-me can accomplish, despite having a chronic health condition.
It’s also important to note that research and medical treatments are expanding and evolving quickly. The cutting-edge medications available to my son when he was 4 are now the norm.
If you decide to have no children of your own, then that’s okay, too. Starting a family or growing the one you already have is a personal decision. Just as one medication works well for one patient but not another, so does this family decision.
Adoption and foster care are other options which allow you to be become a parent and may be great alternatives for you. You may also find that being the most wonderful aunt or uncle is very rewarding, too.
For me, my family of three is perfect, and I wouldn’t change a thing.