Showing posts with label Pregnancy. Show all posts
Showing posts with label Pregnancy. Show all posts

Wednesday, August 15, 2007

Giving until it hurts

As most of you know, my beautiful baby girl, may her memory be only for a blessing, died halfway through my pregnancy in May of this year. As many of you know, I have a small group of local women friends who are all moms of young children, though I am the only Jew.

These two facts are important to bear in mind during this post.

For lots of reasons, I am opposed to baby showers. In my case, for instance, had I had a shower just before finding out my baby had died? Or had to come home to a decorated nursery with empty arms? That pain can be avoided in most, but admittedly not all, situations. In a way I was fortunate; except for the memory book of the all too short time with our daughter and the pile of now unused maternity clothes, everything looks pretty much the same. (There are a few exceptions--a painted porch and a garden--but they are not important to this post.)

However, the mom friends I have wanted to have a party to celebrate the fact that there are so many babies being born among our friends. Five moms, me among them, were due between July and October. Now there are four.

Despite wanting to have a party--more a celebration of new life than a baby shower, I was assured--few were willing to volunteer to plan it. Isn't that the way it always is?

I didn't want to seem the resentful mom, especially because I never felt resentment toward the other pregnant moms. In fact, I struggled with my own fears for their babies' safety and safe deliveries. And I worried the moms would not want to be around me because it would remind them that pregnancy is risky and what happened to me could happen to them, too.

So I volunteered to help plan it. Now I am one of only three who are doing nearly all the work for a party early next week and I am conflicted.

I feel sad. The wounds of last May are being tugged at, scratched, irritated, and some I fear are beginning to weep. I was supposed to be pregnant at this party. I was supposed to be expecting my own baby in just over a month. G-d had other plans.

Yet it is hard for me to help plan a party celebrating new life when I so recently lost the new life I'd nurtured. We still hope, b'ezrat HaShem, to get pregnant again. But it is still too soon for that.

I sense my emotions being stuffed away, tucked into a dark corner somewhere until they eventually emerge and cry out in the light of day. My sadness is under the surface but each day I feel ambivalence growing stronger. I am distracted, distant.

I want this party to be over so I don't have to think about it anymore. I want to simply not go, but that seems so selfish. My loss shouldn't diminish the joy at those lives that have already been born or, G-d willing, will soon be within our group. My absence would be felt more palpably than my presence.

And still it hurts.

Monday, July 9, 2007

I had thought there were no words

I have not been on the blogs lately. I guess you can tell. I was inconsolable for many days after losing my baby, almost a week. I feel I did eventually make peace with it. I think maybe she left me with gifts, changes in both my attitude and my body. Changes for the better.

The universe was kind to me, overall. I had an appointment with my new psychiatrist and my counselor two days after I was discharged from the hospital. The psychiatrist immediately increased my meds. We talked longer than our alotted time and she was, I think, very supportive.

It turned out I had two side effects from the increase--a higher dose than I've ever been on, though it is considered a starting point for most people. My side effects were a loss of appetite and dry mouth. So I was eating less and drinking more water. So sad.

Seriously, if I could have picked any side effects those would be the ones I wanted.

I made a memory book of photographs we took at the delivery. I included our ultrasound photos and photos of the burial. Since her death, I am seeing (living) dragonflies everywhere. They fly to me and around my head. I wonder if they are a message from her. I picked an album with dragonflies and butterflies on the cover.

I thought I had done a quick recovery and was playing "it would have been worse if..." games with myself. it would have been worse if she'd been full term. It would have been worse if she'd been born and lived only a few days or weeks or months. It would have been worse if she'd been my first child. I'm quite good at those games, but they serve no purpose other than to keep me from feeling my grief.

So I turned to another better method. I am painting a (large) room in my house. It had been unusable before but I have fixed and repaired and sealed and am now painting. It will be a cheery yellow with white trim.

It occurred to me today after emailing a friend that painting this room is kind of like Jewish prayer. It is something for my body to do, moving and concentrating on something known and familiar. Just as reciting prayers is almost like a mantra, painting is something like a kata, repeating movements as in a martial art. Both free my creative and spiritual mind to contemplate Something Else.

I have thought of my daughter a great deal while painting. I almost feel as if this room will be one she and I will share. It is comforting.

I am still hopeful that we will have another baby. Meanwhile I work on getting healthy again.

Having mentioned healthy, I did have another depression, as my psychiatrist expected. It was much more mild and the worst lasted only one day. She increased my meds again a little bit to try and keep my depression cycles to a tolerable level. I have usually four a year: January, April, July, and October. The worst are always October and January and the psychiatrist thinks it may be related to SAD, Seasonal Affective Disorder. I am sure that the fact that there are many, many holidays in both months might play a part, too.

I am exercising, briskly walking two miles a day. My sleep is not so great. I wake at 4am and can't get back to sleep for a couple of hours. My psychiatrist prescribed Lunesta but both times when I took it I woke with panic attacks and acute anxiety that lasted for a couple of hours, so no more Lunesta for me. I have lost 18 pounds in the past five weeks, which makes me happy. My blood sugar remains normal.

I am slowly unraveling my issues with my shul. I will save it for another post because it's so involved.

It is still so hard to reach out, so hard not to isolate, so hard to feel. Thank G-d for medication. And good doctors. And good friends. And a place to share. And the words to begin to heal.

Monday, May 21, 2007

Why, G-d?

I must announce at this time the birth--and death--of our beautiful daughter at 18 1/2 weeks gestation. I am heartbroken.

There is so much to say but the words won't come. I am exhausted and sore and empty. There is little in the way of Jewish ritual to deal with this.

I miss her. I miss feeling her kick inside me. I miss dreaming and thinking about welcoming her into our family. I miss the security of knowing we would at last have our long-prayed-for third child. I am sad I will never get to know her, never learn her hopes and dreams, never watch her find her own way, never hold her little hand in mine, never kiss her sweet face.

We do not know yet what happened, other than that when I went into the doctor's because I had the stomach flu, they could not find a heartbeat. Three ultrasounds and two hours later it was confirmed. There was no heartbeat. She had died, as much as a week or two earlier.

Labor was induced the next day and I labored for 9 1/2 hours and with one push she was out. We held her tiny body and marveled at how developed she was. Her hands were the size of my little finger's nail. Her knuckles and fingernails were exquisite. She had long slender fingers.

We will have a short private funeral/burial tomorrow. I don't want to say goodbye. I want to still be pregnant.

It is not fair. This pregnancy helped me out of my depression last winter. It was a promise of hope, that life goes on, that it's worth going on. And now? Now it's taken away. It feels like a cruel joke. I worry that this will send me right back into depression.

My meds have been adjusted to deal with this and whatever postpartum depression might follow. My care team is in place. We know we will try again.

But this doesn't change the fact that my baby is dead. And I am heartbroken.

Sunday, May 13, 2007

I don't even know where to start (good post)

I would never in a million years have guessed what has happened over the past two months.

Yes, I am still pregnant, baruch Hashem! Four and a half months and counting. Baby seems to be doing well and I should start feeling movements any time now. I have developed gestational diabetes for the third time in as many pregnancies, and while I have to inject insulin twice a day so far, and test my blood sugar four times a day, I'm doing okay with that. I don't enjoy the needle pricks, but I do like knowing that I'm taking care of myself and my baby by doing so.

That isn't the zinger though. The event that blew my mind is this:

Apparently, I am not bipolar and have been living with the wrong diagnosis for 13 years.

Here is the background. Remember when I was really depressed in January? I was referred to a psychiatrist and a psychiatric physician's assistant back then, but didn't get an appointment until April. I guess a lot of people need psychiatric help. I had an in-depth intake and several long appointments. They reviewed my psychiatric history over the past 17 years and had one question: how did I get the bipolar diagnosis?

I remember that part well. It was 1994. I was hospitalized for the second time in six months and my doctors convinced me to begin medication. To determine what meds I should be on, I had to answer a ton of questions about my moods.

Did my depression last for more than two weeks? Yes.
Did it interfere with my ability to live life? Yes.
Did I ever feel like I had a lot of energy? Yes.
What did I do with that energy? Clean, organize, shop.
Did I find it hard to sleep when I had this extra energy? Yes.
Did this extra energy alternate with the depression? Sort of. I never had the extra energy during my deepest depressions.
And so on.

There was no question about episodic depression, and one doctor suspected bipolar. So I was put on an anti-psychotic, a mood stabilizer. I was told that if this stabilized my moods, I was bipolar. If I didn't react to it, then I wasn't.

It stabilized my moods. Sort of. I wasn't sad but I wasn't happy either. I was just mildly depressed all the time. I lived life like a zombie. I did this for two years and finally couldn't stand feeling like I was just taking up space. I weaned off the meds and found that exercise, avoiding sugar, and a strong spiritual/religious life kept me pretty grounded most of the time. My depressive episodes slowed to two bad times per year--October and January--and two more mild episodes in April and July. My psychiatrist at the time told me to keep doing what I was doing, and eventually ended treatment.

Fast forward to April 2007. I was asked more detailed questions about these energy surges.

Did I ever feel invincible? No.
Did I ever take risks that put me or others in harm's way? No.
Was this excess energy goal-directed or generalized to everything? It was always goal-directed. That's why I couldn't sleep. I was so excited about my grand plans for whatever I was about to do (as in finding that perfect clock radio), that I couldn't wait until morning.

Then they asked other things:

Do I ever feel anxious in social situations? Yes. Always.
Do I ever worry about something that may or may not happen in the future? Constantly.
Do I ever have physical symptoms from my worrying? Yes--lack of sleep, headaches, stomachaches, sore muscles.
What do I do when I feel anxious? Clean, organize, shop.

Aha.

There is nothing here, the psychiatrist said while patting my very fat psychiatric file, to indicate mania. Episodic depression, yes. Anxiety, yes. And a high likelihood of Seasonal Affective Disorder. Even indications of Obsessive Compulsive Disorder--a type of anxiety disorder. But not mania. Every episode I had where I had to clean my kitchen until it sparkled, or shop for the perfect clock radio, or reorganize all the bookshelves? Anxiety attacks.

After a month of appointments, they are about to toss the bipolar diagnosis. My new diagnosis is Major Depression, General Anxiety Disorder with Obsessive Compulsive Features, and Seasonal Affective Disorder. And the reason for the recurring depressive episodes--roughly every three months? Most likely a hormonal imbalance.

As it turns out, the Prozac I'm on is what they'd first recommend for the depression and anxiety. And I don't have to worry about triggering a manic episode. Come September, we will develop a plan for when the baby is born, since I have a documented track record for severe postpartum depression. After that, probably after the baby weans, we'll look at other options, and both have said that I will be a full participant in deciding which option to try in what order. But medication may be some combination of an antidepressant and hormones.

This has completely changed my identity. Here I have worried, sometimes excessively, about triggering a manic episode, and the worry itself is part of what's wrong.

And yet it's a relief. It feels more right than the "atypical bipolar II" ever felt. I don't have to explain how my manic episodes aren't like everyone else's manic episodes. Now when I get the urge to clean (and it's not just prior to Pesach), I ask myself if I'm anxious about anything. So far, I always am. I try to deal with what I'm anxious about instead and that helps a lot.

The best part is, I feel like I can finally get the help I need for what's really going on with me, and that, I believe, will better my life not only for me but also my entire family.

Sunday, March 25, 2007

I do not remember it being this hard

the last time I was pregnant. I don't remember constant morning-noon-night sickness and fatigue that won't let up. I don't remember only being able to walk from the parking lot to the store entrance and then needing to sit and rest before continuing my errands. I don't remember bouncing from elation to fear about having another child.

My husband does. According to him, this is the only way women are willing to go through this all again to have more children, if we forget the day to day difficulties. I can understand that.

My depression seems to be completely gone, but the odd concurrent problem is that I'm frequently so nauseous that it's hard to take medication, including my depression meds. I am under medicated right now but trying to get back on track. Maybe if I hid the pill in a spoonful of chocolate frozen yogurt?

Pesach has me completely freaking out. I don't have the energy to clean the way I should and my husband is doing what he can, and quite willingly, but I'm afraid it's just not going to be the same this year.

One of my favorite Pesach dishes is called Turkish Pie and is a wonderful mixture of ground beef and onions, cooked for an insanely long time, like three hours, and then placed into a shell made of softened matzo so you have something like a meat/onion pie. I look forward to it every year, and it takes pretty much all day to make. This year, I can't stand to be around the smell of cooking meat or onions of any kind. I guess I will have to wait until next year.

I'm very worried about controlling my morning sickness with kosher l'Pesach products. Saltines are my best friend right now, and I just worry that matzo won't do the trick. My previous pregnancies never took place over Pesach, so this is a first.

On a much more positive note, I have had some strange cravings at various times:
  • Pineapple
  • Caesar salad
  • Poultry
  • Potato salad
  • Chocolate frozen yogurt
  • Orange juice
I guess they're not that strange. In previous pregnancies, I craved tuna noodle casserole, pickles, Greek olives, rainbow sherbet, salsa, and Coke icees. I see there's progress here: this time there's more fruit/veggies and proteins and fewer sugars and carbs. :)

Maybe I should call myself the new improved Rivka. No longer (for now) depressed. Just hormone-enhanced. ;)

Friday, March 9, 2007

G-d has a sense of humor

I know I have not posted in quite some time. The depression got a little better, then a little worse, then a little bit more better. And then it just plateaued. I wasn't exactly happy, wasn't exactly hopeless and down. Just sort of existing.

And then I got really really tired, which made sense because of the higher dose of meds. So with my doctor's consent, I adjusted my meds down a bit.

And then I got sick.

Every morning.

So I peed on a stick and it seems now is the time G-d has decided was appropriate to bless us with the likelihood (G-d willing that all goes well) of another child.

Now I don't know what is going on. My emotions are not quite back to where they were before but now I've got hormones running the show. I can't separate what is depression and what is pregnancy.

The doctors all think this is probably why the depression was so severe this time. Normal depression + pregnancy hormones = scary.

By April I will have a whole team working with me: counselor, psychiatrist, obstetrician, OB nurse, primary physician. The plan, since I have the long history of depression and a well documented history of severe postpartum depression, is to stay on the Prozac. It is well tested and the benefits, especially at this dosage, far outweigh the risks. It will be monitored closely after birth, with no hesitations to increase it in order to head off the worst of the PPD. I feel comfortable with this plan.

I have my first OB appointment next week. I am so glad that my strength is slowly returning, even though it is tempered by the pregnancy exhaustion, and I can be alert and involved. I am glad I was not hospitalized for the depression and they didn't try changing up my meds. Who knows what that could have done to a developing embryo.

This all is a big reason why I haven't been blogging much lately. I feel nauseated pretty much all day and all night. I have a package of soda crackers nearby at all times. I have no idea what I'm going to do during Pesach if I'm still having morning/noon/night sickness. I don't know if matzo will accomplish the same thing. I don't know how I'm going to get my house cleaned for Pesach. I have decided I will not be hosting a seder this year. I may be depressed and pregnant, but I'm not a masochist.

On the other hand, G-d willing all goes well, we will be welcoming another life into our family around Sukkot. Talk about welcoming strangers! What an amazing, incredible gift. I am truly blessed.