Monday, June 27, 2011

and it's in the form of postpartum depression

Aside from the fact that I HAVE been meaning to update this blog, the impetus to write tonight is my diagnosis of postpartum depression.

A switch flipped last week. Why last week? Anders is 19 weeks old in two days. We made it past the difficult first two weeks of breastfeeding and no sleep, six weeks with a touch of colic, returning to work at 10 weeks, pumping around the clock for the last four months. Why now?

I didn't want to go home. I was at work with a pit in my stomach because I didn't want to go home. I knew that wasn't normal, though I take normal with a grain of salt. I looked at my beautiful baby and felt nothing.  Except guilt that I didn't feel anything. I knew. Paul knew. And I called my psychiatrist the next morning.

Two months ago, I dropped Lexapro from my med list. I wasn't anxious anymore. I didn't need it. One month ago I decreased my Wellbutrin dose. It took two weeks before I felt like I lost my edge at work, but that was it. I was going to give it a month before calling to schedule an appointment. I didn't make it that far. Last week I wanted little to do with my baby. I didn't want to pump anymore. I suggested we just take out the disposable diapers instead of doing the cloth laundry. This wasn't like me. I knew it and I hated it.

So here I am. Back in the hole not knowing how to get out. Standing still while everything spins around me. I'm sad and angry and frustrated and embarrassed. And trying to figure out how to push these aside to love and care for my baby who needs me.

We caught it early. My Wellbutrin is back up and I'm seeing my pysch weekly until this levels out. Then biweekly. Then monthly. With my history, I'll be on meds for a year and with any future pregnancies/babies. I've had good days in the last week, but today was particularly bad. I don't think I managed to complete anything at work today.

But I did tell my coworker, who is both a very close friend, second mother and mental health ally. She'd been waiting for this. Not in a pessimistic way, but in a watch my back way. She's the same friend who sat with us at the ER with my first miscarriage, when we had no idea what to do or think.

This isn't me. It's my body, brain, chemicals, hormones. An illness. I didn't do anything wrong. It just is. So we're dealing with it. This much I know, though it's hard to feel. I don't want to tell people what is going on with me because I'm afraid they'll ask why. Why when I finally have the baby I've been wanting? [That's so loaded, I don't even want to go there. I don't know why. I wanted the other babies, too. Yes, Anders is a good baby. I don't know what's wrong.] And I spin...

I always knew this was a possibility given my history. My doctors have been vigilant and so has Paul. So have I, for that matter. But I wanted to be okay. To not have to deal with something on my very long list of concerns/complications. I wanted SOMEthing to go right.

Anders is right, so very right. That's what I have to remember. I need to take care of myself so I can take care of him. I don't want Anders to EVER wonder where his mom is or why she isn't hugging him. That thought breaks my heart.

So here it is. Back on this journey. I don't know how to navigate PPD. It's different than the depression I struggled with earlier. It's scarier.

But this is temporary. I'm doing what I need to do. Paul is the best dad and can pick up what I can't give at the moment. Anders is well-cared for. And I'm doing the best I can at this moment, with what I have to give.

But it's hard accepting that. Maybe writing it will help.

four months of Anders in photos

The quickest way to catch up...share a few of the MANY photos we have take of this sweet baby. My goodness, how we love our little boy. I can't believe he is already four-and-a-half months old. I miss the tiny baby snuggles, but the bigger babies snuggles are just as good, if not better. I hear it just keeps getting better. Are you ready for some cuteness??

Daddy read If You Give a Moose a Muffin when Anders was 1.5 hours old.
An early family picture

Red hair!

Anders' first hockey game...still in the hospital.

I cried when I packed away this sweet grey outfit. It was the first I picked out just for my baby.

The upside to early bottle feeding - Daddy gets in on the action!

Milk drunk.

My friend Vicky took these photos of Anders when he was nine days old. Her little girl V was born just two-and-a-half weeks before Anders.

This little outfit has a dinosaur on the shirt. And dinosaur feet! [I'm still new to uploading photos. I'll figure out how to rotate in the future. Until then, sorry.]

First bath - success! Now we love baths. 

I rather like to dress him like a little old man. This particular sweater has elbow patches.

Baptism April 3
Anders at six weeks.

The snow finally melted (in mid-April), so we went for our first walk!

 A typical maternity leave day, though mascara didn't start happening until he was about eight weeks old. There is likely a Diet Coke to my right. 

My happy (future?) Cobber!

April 25, my birthday

One of my favorite photos...eight weeks.

We LOVE cloth diapers!

I think I got the best present in my Easter basket.

First Mother's Day with Anders.

Of course one needs a ducky bathrobe.

Happy Flag Day!

Overwhelmed by developmental milestones...sitting, grabbing, hands to mouth, teething...

Trying out the new hiking backpack!

Strong enough for the Johnny Jump Up!

We went to visit Vicky and her babies and have some three-month photos taken.

My current favorite photo of my boy. Big blue eyes, blue diaper, hint of red hair. :)

happy birthday, anders

I last posted at 37 weeks, and I was anxiously counting down the days. From the beginning, I felt that my baby should come at 38 weeks. That given my Factor V Leiden and history, that would be safest. But my OB wouldn't schedule an induction before 39 weeks. So an induction date was set for February 21.

Since 32 weeks, I had been seeing my OB weekly and had biophysical profiles and nonstress tests performed weekly. Work just knew that every Monday, I wouldn't be in until after noon, and on Thursdays, I needed to leave at 2.30 for the day. I loved not having to wait more than four days until hearing or seeing the heartbeat again. Even though baby was rather stubborn up to the very end and would make my NSTs last over an hour EACH time, I loved it. My only job at that moment was to be there.

On February 14, 38 weeks, 1 day, I went in for my regular OB appointment and BPP. Baby didn't pass the BPP. Sleeping was apparently more important than showing off breathing or moving. So after the regular check (dilated 1 cm, 50% effaced), I drank lots of orange juice and hooked up for the NST. Baby BARELY passed. My OB consulted another OB and determined all was good for that day, but I needed to go home, rest, and repeat on the next day. So home I went, with the email to work saying I'm not in labor yet, but...

Tuesday, February 15. Not only did baby pass the BPP with flying colors, the NST showed I was having regular contractions (could have told them that) every five to seven minutes, lasting 30 seconds. My OB checked and I was still only 1 cm. She said that if I had progressed at all, she would have admitted me. Instead she told me to go home and call her later, since she was on call. So home I went, with the email to work saying I'm not in labor yet, but...

I went to the grocery store to by snacks for the hospital. And took the long way around. I bounced on my yoga ball all afternoon. Paul and I decided nothing was happening so we went out to dinner at the mall, and then walked down to baby Gap to admire cute little clothes. I debated about doing my heparin injection, but had pretty much decided nothing was going to be happening, so I did it at 8.30pm.

So my water broke at 11.15pm. Lying in bed, reading. I didn't even get to fall asleep. So for an hour I monitored the fluid and contractions. I mean I didn't think I wet my pants, but, well...yeah. Contractions were four-six minutes, and the fluid kept running clear. I woke Paul up with the cliched "I think it's time." Actually I just said my water broke. He grew alert rather quickly! We called the hospital, explained my water broke and that I tested positive Group B Strep, and predictably, they said to come in.  So off we went, but not before taking a couple pictures.

February 16 started, and we were wide awake. Being admitted was rather boring. Check - dilated to 1.5, 80% effaced, -2 station. But tests confirmed my water had broken, so they started the antibiotics. I reminded the nurses like clockwork that I needed my new bag hung every four hours. After having our niece die of a GBS infection, I wasn't protesting one bit. L&D was very busy, so they pretty much just filled the tub for me, and left us alone most of the night. The plan was to start pitocin at 6 am.

Well, the pit started at 9 am instead, because again, they were busy. When 7am rolled around, I got my very own nurse, whom we loved. So nice. Contractions were uncomfortable, but not unmanageable, and I had progressed to 2.5. I spent more time in the tub; Paul left to get himself some lunch.

Around noon or so, the contractions were getting to me, so we tried Nubain. Love Nubain. I'm a happy drunk, so I was mostly pleasant. I was having such bad back labor, that each time a contraction hit, all I could say was "back" and Paul would start the counter pressure while I helpfully told him that's not where it hurt. But I was able to rest between.

Until the nurse decided we needed to go to internal monitoring. The monitors weren't staying on well enough, and they couldn't get a good read on my contractions, which was important because of the pit. And then they decided to also place the scalp electrode on baby's head. I just chose not to think about that one too much. At the time they were placing these, I was completely unmedicated. They had to place the scalp one not once or twice, but three times. At one point, two were connected. Throughout the course of the day, I went through five IUPCs to monitor contractions. Not so pleasant. They actually had to call in the SWAT team at one point because three different nurses couldn't get it placed correctly. Fun for me.

pitocin, I was ready. It was going to be awhile.

I love the anesthesiologist. Here I am after that wonderful relief, happily reading some Martha Stewart Living. That was 3pm - 14 hours after my water broke.
Hours, naps, and lemon Italian ices later, I hadn't progressed past 5.5...maybe. So around 8 pm, my night nurse and student (LOVE them) came in looking very sheepish. She wanted to check me because the doctor was on the phone and thinking c-section as I was nearing 24 hours since my water broke.

Okay. No big deal. Really. At various times throughout pregnancy, Paul and I said that if there were medical reason to schedule a c-section we would. It wasn't a scary option to us. It was a controlled environment, and with the stresses of this pregnancy, control would be welcome. So they started prepping me. It wasn't an emergency; baby had been doing so very well all day. But the head was molding at my cervix, which made them wonder if the baby would even fit. So quite relaxed, we got ready.

The anesthesiologist for surgery was the one I had for my d/c. I remembered her by her funky earrings. Full circle. She was just as wonderful this time. So kind. It seemed like forever while they moved me to the OR and then to the OR table. And it was SO COLD. The kind anesthesiologist wrapped warm towels on my head. 

And then at 10.54 pm he was born - the midwife said, "we have a boy!" We were shocked. We were convinced we were having a girl (we still didn't know the sex - I consider it a bit of a feat that so many ultrasound techs managed not to slip). 

I cried. And cried and cried. All I could say was "he's here." There was a bit of meconium in the fluid, so they didn't stimulate crying until he was all suctioned. Paul wouldn't leave my side, but I kept telling him he needed to go take pictures. And he was okay. My first view:
We hadn't decided on a final boy's name, though it was down to to. I remember saying I needed to hold him before I'd name him, and Paul said he looked like an Anders. Our two boys' names were Anders and Oliver. After I held him back in my room, we named him Anders Olson Held. While the surgeons finished putting me back together, Paul went with the baby to the nursery to be weighed and checked. We met back in my room at the same time.

The nurses were wonderful. Anders was with me within 30 minutes of being born, on my chest and breastfeeding. They hadn't bathed him or done any of the newborn meds. We had a wonderful, hazy sleep-deprived, endorphin-driven night. By midnight Paul was calling our parents. It was so fun - NO ONE knew we were at the hospital until he was born. It was a wonderful day of just us. Our new family.

Those are the important details. I was up and moving less than 12 hours after surgery and kept at it. The good pain meds made me loopy at precisely the time our pastor came to visit. Oh well. Visitors came and loved on Anders, and we were thrilled.

The only bad experience - the nurses forced me to supplement with formula when Anders' bilirubin levels came back abnormally high. He was so sleepy and had a hard time nursing starting on day three, but I protested. They guilted me into it saying that high bili levels can lead to brain damage, and his was off the charts. Even the lactation consultant said we had to, but worked out a feeding/pumping plan. 

Nipple confusion is real. My little guy quickly figured out how much easier it is to eat from the bottle, and he would actually scream every time we tried to position him to nurse. Every. Time. So feeding time became fighting time. For three weeks, I'd attempt to latch him - and he was a champion latcher at first, and then when he wanted - then feed him expressed milk in a bottle, and then finish his feeding with formula, if needed. Every. Time. Exhausting. Defeating. I hated every minute of it. I still regret letting the nurses talk me into supplementing.

We saw the lactation consultant twice each week for three weeks. Even she said he was stubborn - he could latch just fine, but wouldn't. When she said that the container is our ideal and he doesn't care how his tummy is filled, I accepted that we wouldn't be nursing. By two weeks, he was only taking one formula bottle each day, if that. I was pumping the rest. Since three weeks, I've been exclusively pumping, and he's receiving exclusively breast milk. I'm very proud of that. But it was hard to let the nursing relationship go.

I promise to keep my other update posts shorter. :) This was an important one for me to capture the details of a wonderful day. I don't regret anything about my labor and delivery experience. I labored without meds in the tub, accepted pain relief when I needed, and ultimately had surgery. I'd do it all again without hesitation. Except I won't need to. We're totally scheduling the next c-section.

still with baby!

Well, friends, if any of you still have me in your reader, I'm here. Quiet online, but present. Facebook updates seem to be all I've managed, though I swear I've written several blog posts in my head. I'm working on some updates, and can't wait to introduce Anders, my son born on February 16! I promise photos.

Until then, here is a quick peek...

Anders Olson Held at 3.5 months