Now that I am growing older and have found someone who is worthy of consideration for having a family with, I find myself more and more contemplating the concerns that come along with such an undertaking. Having children can be trying for healthy parents, much less one who is disabled. The fears that I have will become real in just a few short years, if all goes to plan, and it’s given me pause as I seriously think about the different responsibilities that I will have to face one day soon.

I know the hell I faced during my childhood while growing up with RA, and I would not wish it on my worst enemy, much less my son or daughter.

Throughout my life, Rheumatoid Arthritis has prevented me from doing many things. Playing sports, going to parties, hanging out with girls, and even going to school were all events at which I could not guarantee my attendance. Missing those events gave me many a night of heartache in my young life, as you might imagine. As upsetting as those events were, though, they don’t compare to the arthritis-induced hardships that might face me in the near future. The game of “what if” is a much more sobering affair when you are dealing with the subject of having children.

To have a family, to procreate, is every human being’s evolutionary imperative. It is ingrained in us before we are able to read that boys grow up to play ball with their sons, and girls grow up to marry a nice guy. From a very young age I was taught that having a family and owning a house is the ultimate measure of success. This is all well and good if you are a normal, healthy, man or woman, who has only the run-of-the-mill problems ahead when they are about to having kids. If you aren’t able to perform your duties when you are a normal parent, chances are you can take a nap and get back on the horse. Unfortunately, when you suffer from a chronic ailment, the stakes are much higher.

You have already managed to think of the few of the concerns that me and others must face when the time comes to decide on children, but there are probably a few you didn’t even consider. First and foremost, there is the biggest question of all: am I even medically able to have children?

After years of taking heavy medications and pumping my body full of nasty chemicals, there is a chance that I will not be able to procreate at all. My body’s reproduction function may have been completely destroyed by one of the many medications I have taken during my twenty-five year stint with Rheumatoid Arthritis. Yes, there is a test to determine fertility, but I have been procrastinating in scheduling the test because, frankly, I’m a bit fearful that I won’t like the results. Eventually I’m going to have to bite the bullet and see a physician, but until that point, the possible outcomes weigh on me heavily.

As if that was not a big enough concern, there is also the fear of passing on my disease to any of my potential children. Yes, the doctors are “pretty sure” that my illness is not hereditary, and that there is “not really” any chance of passing R.A. on to my progeny, but no one has told me it’s a one-hundred percent done deal. I know the hell I faced during my childhood while growing up with RA, and I would not wish it on my worst enemy, much less my son or daughter. In addition, trusting in medical science to tell me that there is nothing to worry about seems a bit presumptuous considering the researchers still do not even know exactly how many auto-immune diseases work — including my own. The best the doctors can offer at this point are educated guesses. Sounds like a crap-shoot to me, any way you slice it.

Now, assuming I am able to skirt all of those pitfalls I mentioned above, I still have one major issue that I will have to deal with, should I actually be blessed with children. As most of you know, kids tend to be very active. Children have a healthy social life and a follow a strict regimen of running and playing. You can imagine how difficult a speedy two-year-old would be to keep up with when you have RA. Simply walking up the stairs is a chore at times. Unless you plan to keep your child on one of those humiliating “kid-leashes” at all times, keeping up with your little one is going to be near-impossible. Also, what happens when it comes time to lift up one of your kids? Most of us who have suffered from RA for any prolonged period of time have experienced joint damage and suffer from a loss of range of motion in many areas of the body. Picking up a child who is cooperating is certainly a chore, and lifting up a child who is actively fighting you is just about impossible.

While the physical aspects of taking care of children are certainly an area of great concern, there is one other major issue I’d like to mention. When you have children, most times it is with a partner — someone who has agreed to be your better half. Well, if you love this person, you will never want to make their lives more difficult by forcing them to assume the main role of caring for your young children, but that is exactly what might have to happen. Think about it. When you cannot stay up nights with the newborn baby, or cannot bathe the child safely, or even can’t dress your kid because your hands hurt, then there is no choice but to have the other parent pick up the slack. If that parent also works a full time job, then he or she will be stressed to the breaking point, or maybe even past it. Watching your partner, whom you love, do the extra work in order to help you and raise your family can be taxing on the psyche – it can kill a person inside. Not to mention, it will inevitably lead to martial problems. It’s just another part of parenting that chronic illness makes even harder.

As you can see, I have been thoroughly considering all the different aspects of having children, and all the different fears about what my Rheumatoid Arthritis will prevent me from doing. Will I be able to physically hack it? Will my partner accept and be able to handle the increased responsibility? Who knows. All I do know is that despite all of the forces arrayed against me, I likely will have children, and we will find some way to make do. Or we’ll always make sure grandma and the nannies are around.