The Root of My Evil

Dear Pfizer:

I am the poster child for better living through chemistry.  My OCD is controlled with Prozac, my child was conceived with the use of multiple injectible drugs, my pregnancy with him was made easier with Zantac and Flonase and he was delivered quite comfortably once I had a fabulous epidural.  So, I obviously have no problem with drugs.

What I do have a problem with, however, is your drug, Zoloft, which I went on because I was breastfeeding. Only now, after finishing up my course of it and switching back to my beloved Prozac do I realize just what a wretched drug Zoloft is for me.  Let me tell you what happened.

Four weeks post-partum, I began having stomach issues.  Constant, uncomfortable and rather embarrassing stomach issues.  They didn’t go away.

My head was surrounded by a giant fog that refused to lift. I’d sit down to read a book and wouldn’t be able to concentrate.

Also starting around the four week mark, there was not a day that went by that I didn’t think about suicide.  I envied dead people. I would think about what a release from the grind of it all it would be.  I would be able to sleep.  Finally and consistently sleep.  I wouldn’t have the anxiety and uncertainty of anticipating the needs of a newborn.  I fought it, though. I fought it hard. I reminded myself that suicide is a permanent solution to a temporary problem.  I would look at my son and will myself to hold on for another day on the promise that it would get better.  I reminded myself what a terrible impact it would have on him. I thought about how Mr. X would be alone and how much I would miss him.  I thought about how angry everyone would be with me for being selfish and taking the easy way out.  But, the thoughts were still there.

I finished the pills a week and a half ago.  Within days, the stomach issues improved, the thoughts began to go away and the fog lifted.  I began to feel like myself again.

The only conclusion that I can reach is that your drug screwed up my digestive system, put me in a fog and made me want to kill myself. Way to go.

Smooches,

Mrs. X.

image: K’vitsh

Point of Origin

Ferreting out the root causes of my PPD has helped me immensely in dealing with the thoughts and feelings that I’ve had.  I got the idea from Brooke Shields of all people.  I read most of her biography, Down Came the Rain, and despite not being a model, Princeton grad or Hollywood actress myself, I found that Brooke and I have a lot in common: we both suffered through infertility, miscarriage and PPD.  So, I found her book very helpful, particularly the process that she went through to identify the root causes of her PPD.

I’ve thought long and hard about what caused my PPD, particularly in the middle of the night while rocking Rex back to sleep and being half asleep myself.  Here is what I have discovered.  Some of it will sound very familiar, other parts not so much.

1) The Mother of All Hormone Hangovers: I vaguely remember hearing in Childbirth 101 class about the sudden drop in the hormone cocktail once you give birth, and frankly I think I was actually relieved because I was pretty tired of the hormones at that point. They wreaked havoc on my joints, my head, my GI tract, and my emotions.  I was one cranky lady toward the end, and lot of it had to do with those wonderful hormones.

So, how is it that I could still feel like crap after they had gone? How is that fair?

2) Ch-Ch-Ch-Changes:  Nature abhors a vacuum. I abhor change.  Both are constants.  And, what does having a baby do to one’s life in literally an instant? Change it. Big time. Like every conceivable (ha!) facet of said life.  Intellectually, I knew this.  Emotionally, I really thought that people were making it sound a lot more awful than it really was.  They were right.

Here I was with an 8lb ball of Change and I was struggling mightily against his current.  I wanted something – anything – of my old life back because this new one was completely alien to me.  At one point, I wasn’t even sure I was in my own home – everything looked the same, but it was completely unfamiliar.  Being the geek that I am, I also couldn’t help but feel like I was in that episode of Star Trek where Kirk is in an alternate universe and they are all bad – including fabulous Evil Spock!  I was waiting for Mr. X to sprout a goatee overnight. He didn’t shave for a few days, but there were no goatees.

While I hate big life changes with every fiber of my being, I do eventually grow to accept them.  With this one, it was a matter of just plodding through each day and recognizing that I was still there, this was still happening and I had better get used to it. Who knows, maybe I would even begin to enjoy it. The shock of the change has worn off and there is enough now of my old life interspersed with this new one that I no longer feel like a stranger in my home.

3) What Does this Nipple Do Again?:  One of the quickest ways for me to get really upset is to be put in a situation where I have to accomplish something and I have no freaking clue about how to do it.  Add screaming infant who depends upon you for his very life and the pressure is really, really high.  We took Baby 101, and practiced swaddling and changing the diaper – on a plastic, non-moving, non-screaming baby.  In the hospital, all of a sudden we were expected to do this on a squirming, screaming, red-faced little infant who did not care that you had no prior experience.

That was just the tip of the iceberg.  We didn’t know how much he should eat or how often he should poop or even how much he should sleep.  We were clueless to the highest degree possible.  We overstimulated that child for a week easily before someone explained to us that babies get overstimulated super quick and once they do, you have an easier time getting an active volcano to stop than a screaming overstimulated, tired baby.

What is amazing is that I am usually extremely well informed about just about every major thing in my life.  I research and read anything I can get my hands on, but up until we brought Rex home you would not find a single tome about parenting in my house.  Why? My infertility.  I refused to allow myself to even look at parenting books let alone read one lest something terrible happen and we have no baby.  So of course, when it came time to deal with the real thing, I didn’t know which end was up (well, almost. I could tell one end from the other, even though liquids came out of both ends sometimes).  Mr. X was equally clueless.  I was shocked that they let us take Rex home from the hospital.  Didn’t my look of utter panic give them any clue?

4) The Power Struggle: I hesitate to add this one, but I know that it played a part.  Since both Mr. X and I were clueless, it meant that we had to learn the quick and dirty way with on-the job training and boot camp.  I assumed that we would be doing this equally.  It became pretty clear rather quickly that Mr. X was very uncomfortable with holding, handling and doing pretty much anything with Rex.  It was not for lack of desire – it was because he had never done this kind of thing before and didn’t know what to do.  My inclination in those situations is to just do it and see what happens.   His inclination is to opt out.  Unfortunately, with an infant, you can’t opt out (much as you’d like to sometimes).  So, I would ask if he could do some task just because I really needed a break and he would get this look of combined panic, pain and general discomfort which would make me feel even worse.

This became a real problem when he went back to work and I stayed home with Rex.  I was of the opinion that if I had to be home with an infant who demanded constant attention, the least I could expect would be a break when Mr. X got home.  He didn’t really see it that way, mainly because he was still rather clueless when it came to infant care and had spent the whole day at work.  A whole day at work then sounded like a day at the beach to me – no infant to be constantly on the watch for, no mind-numbing television, and no stealing food on the sly before said infant wakes up.  I would have killed to be at work.  But, the balance of power for getting a break was not in my favor since I could sleep during the day (rather difficult when you are on pins and needles waiting for the baby to wake up and you have no idea what you are going to do in that situation) and was not expected to be conversant with adults on complex topics in a work environment.

We both underestimated what the other was doing and this contributed to the feeling on both sides that the other was not fully appreciating what each had gone through.  All he wanted when he got home was a break and all I wanted when he got home was a break. Unfortunately, we couldn’t both have our way at the same time.

In the end, we both gave a little – he became more comfortable with Rex, I wasn’t as on edge at the end of the day (thanks to Grandma who would come over for a few hours each day).  Rex, for his part, also helped by getting a little more predictable and helpful in letting us know what he needed and when.  But, I was disappointed by him and that really saddened me and added more to my overall difficulties.

Knowing now what I do, I can see that it was a perfect storm a-brewing when we brought Rex home that would cause me to have PPD.   I’m just so glad that others saw it, talked about it and helped me through it.  I’ll still have little moments, but they are just that – moments.  And, every day, I have more moments snuggling with Rex where my heart swells with love and I want to just breathe him in for as long as possible.

Let There Be Light

I cannot begin to express my thanks to all of you who took the time to comment on my last post – all of you helped me see that I am not alone, crazy or ungrateful because of these thoughts that I’ve been having.  Once again, the IF community has been a source of get comfort and support. Thank you, thank you.

Since Rex* was born, I have been seeing my therapist and taking Zoloft, since it is approved for nursing mothers.  But, the sadness, the feelings, all of it was still there.  So, I dug a little deeper after I made that post.  I began to read accounts of other women who have suffered PPD and found myself nodding vigorously at the thoughts that other women were having.  It felt so good to hear other women vocalizing what I had been thinking and to know that those thoughts are classic manifestations of PPD.  I finally realized the extent to which I having problems and I began to look for ways to help myself feel better.

One of the first things I did was wean myself off of pumping.  Rex has been having formula from day one, but I was also breastfeeding.  Once it became clear that he was a grazer and I would likely spend up to 12 hours a day with him attached to my boob (2, 3, even 4 would be fine, but not 12 – that would really send me off the edge), I switched to pumping so that he could still get all of the benefits but I would be tethered to a machine for 20 minutes and not to a baby for hours on end.  I realized that one of the big factors that was causing me problems was the feeling that my body still wasn’t mine – it belonged to Rex since I found out I was pregnant and it was still his even after he was born.  Stopping pumping let me get control of my body again letting me eat, drink, etc. whatever I wanted and it felt so good.  Rex got a good four weeks straight of breast milk which under the circumstances was the best I could do.

I also have talked with my OB and she has turned out to be a great resource for help and support.  I had my 5-week post-partum visit with her last Wednesday and she prescribed me progesterone cream to help and ordered blood work to test my thyroid and Vitamin D levels.  Both could be a potential aggravating factor.  The results should be in next week.

Perhaps the greatest help she gave me, though, was to tell me that I needed to go back to work sooner than I had planned.  And she is absolutely right.  I need that intellectual pursuit right now to help me feel more normal – because that is what is most difficult for me about this whole process. I don’t feel like myself yet.  But, getting back into things I did and enjoyed before I had Rex has really been helping me get back to that feeling of normal.  I really think that going back to work will help move this along. Rex will head into daycare at a wonderful facility on site at Mr. X’s office.  He will be well taken care of and I will be able to have the time and distraction that I need to be a better mother to him.

I don’t know when I will be free of my PPD, but I’m taking it one day at a time.  Still.

* Rex is the name I have chosen for our little one on this blog.  He truly is king in our household.

Rude Awakenings

What I am about to say will likely either resonate with you or really piss you off.  Either way, I have to say it:

Right now, I do not like being a mother.

This makes me feel terrible – not only because it seems as if I should love it from the beginning but also because I went through so much to get here.  I’m not a 16 year old who got knocked up by accident.  I pursued motherhood the way many people approach climbing Mt. Everest. How could I go through so much to get something and then not want it when I got it?

Unfortunately,  I never spent much time while we were trying to get and stay pregnant thinking about the details of what would happen if we actually had a child.  I mean, it just seemed so distant, so alien, so … not going to ever happen that I did not want to torture myself with thoughts of what we would do with an infant.  Then, once I was pregnant this last time and it looked like it was actually going to stick, I didn’t want to jinx myself by thinking about the future for fear that something terrible would happen.

So I was seriously unprepared for the utter shock and awe of the introduction of a newborn into the household.  I knew that there would be disruption and sleep deprivation, but I didn’t know that taking care of an infant day in and day out would be such a soul-sucking endeavor.  Because, right now I have a baby that does what any almost 4-week old does: eats, cries, sleeps, poops, pees, and repeats.  No smiles, no giggles, no cooing.  It’s just not in the developmental milestones yet.  Which means that I am a janitor, waitress, chef, and nanny all rolled into one with not even a little smile to break the monotony.

There is at least one moment, each day, when I want my old life back or when I fantasize about getting a full-time nanny to whom I can give him whenever he cries or when I want to sleep.  Whenever I get out of the house by myself, I feel as if I am on parole but still required to return to the prison after a few hours.  Everyone tells me that it will get better, but that was like telling me that I would eventually get pregnant when we were dealing with infertility – it did nothing to help me at the time. I’m also afraid that these feelings mean that my dad was right all along: I’m too selfish to be a mother because I do want my time, my sleep and my freedom, still.

That being said, I am slowly accepting that this is my new life.  And, I still look forward to those little milestones – longer sleep, the first smile, the first day we can put him in daycare.  I’m also trying to find some enjoyment in this period – I don’t want to look back and regret that I didn’t enjoy it more.

Between Heaven and Hell

When we went for our nuchal translucency test a few weeks ago, the maternal fetal medicine specialist gave us several options for the blood test portion of the screening. We chose the sequential integrated test which would require blood work a few weeks after the initial scan to be able to get a more accurate result.  I went for that bloodwork on a Monday when I was 15w4d and was advised that we would have results by the end of that week.  The next day, we left for our long-planned vacation in the northeast.

Mira (on the wall)I wasn’t particularly concerned about the screening results.  The nuchal measurement was above the median, but still well below the 95th percentile and the initial bloodwork came back ‘normal’, although they didn’t give me a discussion of what normal meant.  I wasn’t going to press for it either since it was normal.

So, we enjoyed a few days in the Big Apple, seeing the sights, doing Broadway, and just being on vacation.  That Friday, we headed to the next portion of our trip – a cruise through New England.  We were giddy as newlyweds to get on the boat and enjoy the cruise.  First, of course, was the life boat drill that involved lovely dayglo orange life preservers and a demonstration of how to jump into the water if required.  We got back to our cabin and my cell phone was ringing.  It was the MFM with the results of our screening.  That’s where the nightmare began.

Our screening for Down Syndrome, aka Trisomy 21 was 1:20, meaning that there was a 5% chance of Downs, with all other results normal.  Unfortunately, it took several tries for me to understand what he was saying as the cell reception on a ship with tons of steel is not exactly ideal.  What was worse was that I had to go on the balcony to get any reception at all and so I was attempting to disguise the topic of conversation while also taking in what he was telling me.  Mr. X began to swear which frightened me more than what the doctor was telling me since he rarely ever swears out of anger.  He rarely gets angry period.

I was surprisingly calm as the doctor was doing his spiel.   I understood that it was not a final answer and I felt pretty certain that it would turn out just fine.  It was until he started throwing out the terms ‘terminate’ and ‘special needs’ that I began to really get worried.  It’s one thing to be told that you have a 5% chance that your unborn child has a chromosomal abnormality that could mean profound disability and quite another to be told that you can terminate the pregnancy you have worked for four years to bring to fruition or have a child who is labeled from birth as ‘special needs’.  In hindsight, I would have preferred him to simply leave it to what our options were for further testing rather than bringing up what to do in the event that the 5% chance came true.  That particular bell, however, could not be unrung.

So, there we are at the beginning of the cruise that we had been looking forward to as the ultimate escape and we are brought back to reality with one five minute phone call.  The first thing to do was to decide what further testing we wanted.  We both agreed at the time that we were not willing to undergo an amnio because the ultimate worst case scenario has always been having a perfectly normal baby that is miscarried due to a botched amnio.  The other options were an enhanced scan or do nothing.  We chose the enhanced scan which I called for and scheduled for a few days after our return.

Unfortunately, that was all that we could do at that point.  It was either stew or put it aside and go on with our cruise.  I am a stewer by nature and I was in fine stewing form after this.  Dinner was a blur as was conversation with our table mates. I could barely eat and wanted nothing more than to go back to our cabin and stare at a wall or Google.  I did neither, and had a terrible night’s sleep.  Everytime I fell asleep, I would wake up in terror at the thought of terminating if it came to that.

It wasn’t until the next night that matters came to a head and I was finally able to process all of the feelings that I had regarding the information we had not twenty-four hours earlier.  Mr. X and I were on our bed as we sailed away from our first port and I just started bawling.  I let it all out – my fears, my anxieties – and we talked it through.  We came to the conclusion that we needed to know and that there would be an end to this particular nightmare, even if it was not meant to be at that particular moment.  We talked about all of our options and what we would do if we had to make a decision.  Most of all, we talked about the 95% chance that everything was fine and that we would not let this ruin our vacation.  From that moment on, it did not.

We had a lovely trip and I was able to really enjoy myself.  For that, I am so proud and thankful and that is enough for me for now.

image: Mira (on the wall)

The Hurt in My Heart

My heart has been hurting today. A lot.

It started in the morning as the twinge in the nose and progressed to a dull thud behind the breastbone by this afternoon.  As usual, the hurt was internal.  No one came at me with a dagger or intentionally tried to bruise me.  My heart was just overwhelmed with seemingly innocuous things that really turned out to be little poisonous darts, each a minor annoyance, but collectively fatal:  Mother’s Day ads.  More Mother’s Day ads.  Participating in the dangerous game of comparing oneself to other infertiles, and pretty much everytime coming up short (meaning, still not pregnant).  Reading email from best friend with a near one-year old and trying to decipher whether we have entered into the game of one upsmanship.   Receiving drugs for the next cycle and being reminded – again – at what I must do to get pregnant that many others do not.  Remembering the joy of those moments when I was pregnant and genuinely believed that it was going to work, that we had finally defeated the monster.  

In other words, it was a bad day.

So, I took my hurting heart and went to the most peaceful place that I know of, my backporch, and stretched out on a chair.  I listened to the birds and the wind. I tried pleading with my heart to stop hurting, telling it that we are so lucky to have what we do. But, my heart was being churlish and refused to stop hurting.  “I don’t hurt less because everything else in life is rosy,” it said.

I knew I needed something or someone more compelling. I decided to summon Mr. X.  Never mind that he’s working and doesn’t know that I am summoning him in my mind. I closed my eyes and called across the miles to him. The door to the porch closed, I stretched out my hand and there he was sitting next to me, holding my hand.

“What’s the matter, my love?”, he said.

“My heart hurts, ” I said.

“Why does it hurt?”, he asked.

“Because it is afraid that it will never have that special joy of knowing that your dreams are finally coming true.  It sees others finding this joy and it wants to know when it will be its turn.”

“Ah, I understand why that would hurt. Can I have your heart for a moment?”

I reached inside and gave him my poor, shriveled damaged little heart. I watched as he cupped it in his hands like water and began to speak to it: “There is no reason to hurt, little one. This joy that you seek is not the only joy in the world. You can still seek this joy, but this can’t be the only joy that you seek or you will continue to hurt. You know this. I love you, little heart. No matter what happens or doesn’t happen, I love you and will love you.”

My hurt began to ease as I felt his love and as I realized that I can be happy without this joy, even if I still seek it.  I took my heart back and tucked it safely away.  I promised to take better care of it, to be kind to it and to try to shield it from those things that hurts it the most.  

And for now, my heart has stopped hurting.

Vignettes

I cried yesterday.  It’s been a while since I did that.  But, it was a full-on bawl fest complete with heaving and gulping, but no fist pounding.  It had been a stressful week, what with the dog-eating-poo incident, work, not being to sit comfortably on my toosh due to the butt shots each night, and an unusual number of reminders recently of how hopeful we had been when we got pregnant the first time. 

All of a sudden, it hit me that I missed my babies.  And I cried for them, again.  I cried for me, for Mr. X, for our parents, but mostly for those babies who we will never meet.  I cried because we had so much hope, we thought we had finally escaped the bonds of infertility and rejoined the normal world, and we were so wrong. I cried because so many babies do survive, where ours did not.  I still hurt.

I think I needed the catharsis, but it came on very suddenly.  One minute I was petting the dog and the next I was bawling.  But, better out than in and luckily I had forgotten to put on mascara that morning, so I had no tell-tale raccoon eyes when Mr. X came home about 30 minutes later.

                                                                                                                                                                           

I was driving today behind a Nissan Pathfinder with a Baby on Board sign thingy hanging in the back window.  I remember when these first became popular when I was still a kid and even then I thought they were rather ridiculous.  My opinion hasn’t changed, although now I amuse myself by trying to figure out what the practical purpose is to having one of those on there.  Is it like the handicap placard that you pull out when you want to use the handicap space (which I saw yesterday)? Is it to tell people to be extra careful not to rear-end you? Is it to brag about your fertility? I purposely chose not to give much stock to that last one because it would just make my blood boil if it was true. 

I just read the Wikipedia entry and it turns out my second guess was correct.  It also quotes George Carlin, who departed this world way too soon, as opining that the phrase was made up of “the three most puke-inducing words that man has yet come up with”.  Jumbo shrimp, George!

                                                                                                                                                                           

My maternal grandmother was one of four sisters.  Three of the sisters married (including my grandmother), one did not.  The one who did not lead a very interesting life before she died in the 1990s.  Of all of her nieces and nephews, the spawn of her sisters, I’m pretty certain that she liked my mother and my uncle the best.  Many of her amazing possessions that she amassed from her travels and living abroad made into our family after her death.  I never saw the full inventory as I was in high school and So Important that I could not bother to look at everything.  But, every now and then my mother shows me something, usually jewelry, with the statement, “Oh, that belonged to Aunt D”. 

One item that I don’t think I had seen before was a lovely gold pendant in the Chinese symbol “Double Happiness” – my mother was about to auction it off to the highest bidder on eBay, but asked if I was interested.  This was pretty soon after my second miscarriage and I knew immediately, that it was the perfect reminder of the now two babies we have lost – double happiness.  It was double happiness to hear their little hearts beating away and to think that maybe they would join our world.  

I haven’t worn it yet, though, because I don’t have a chain for it and I keep forgetting to measure what length I want.  The sooner I do, though, the sooner I can have them close to my heart.