Spinning Tires

Monday, 20 March 2017

There's a lot to be said for the cloud which still lingers over mental health, not just here in the UK or back at home in Australia. Sometimes I don't even see it as lingering, but more smothering to the point that a lot of people shun the idea, run away from it, or even bury and hide it. And that's just the people who are suffering...

Media campaigns fight to unshackle the stigma, and get people talking. Posters adorn GP clinic walls. Badges are on bags and lapels. Pamphlets are stuffed into holders.

And yet, here we are. Even with all the info, and a pamphlet in the back of my baby's Red Book, I still remained oblivious to the fact that what I could be driving a hard bargain with every day is another branch of the Black Dog. (Trip Advisor: 2* - mattress is pretty good, but disappointing interiors and a questionable breakfast buffet. Left me mind weary.)

I'm still a bit unconvinced that Postnatal Depression (PND) is definitively my issue, and wonder whether it's not just rough around the edges everyday depression with some generalised anxiety piped on for good measure.

Although in actual fact, I think the reason for thinking that is perhaps one of the reasons why ladies who very much are in the throes of PND don't realise that they are. Every celebrity sufferer video says they struggled to bond with their baby.

I found it a little less natural to start, as he was taken away to the NICU for antibiotics, oxygen therapy and phototherapy for three days, at 8 hours old. So by the time he came back down to me, I'd had only a few short holds because of all the wires and monitors, and only had the initial efforts of breastfeeding colostrum after birth, plus over the first hours where I was lucky if he'd taken 1-2ml total through his exhaustion, and then once on the evening of Day 1 (birth day is Day 0 here - maybe it's everywhere but took me by surprise. God knows why). He had to show he could take a bottle of expressed milk twice before they would discharge him (despite my want to breastfeed) to my ward, and when I'd fallen asleep that night with exhaustion after nearly 4 days of minimal sleep and hadn't had time to express I panicked. I didn't know what to do. He had to feed or they'd take him away from me again. Luckily a lovely breastfeeding specialist was doing his vitals in the humidicrib in my room, and she supported me throughout. But I still felt this poorly little bundle, with all his heel pricks and phototherapy masks, wasn't really mine.

NICU phototherapy - 15 hours old

That didn't mean I didn't love him. I did, passionately and with a protective lioness verve I wasn't expecting. I just wasn't sure that I knew what to do.

So when the predominant vein of identifying PND seems to be lack of baby bond/seeing them and feeling nothing/repulsion, I talked myself out of it. I mean, you get baby blues. I had them, at Day 4. They were hideous. Milk had come in PM Day 2/Day 3 (thank you waters breaking, though medical not supposed to, for kickstarting hormones despite my Caesarean). But on Day 4 I cried at everything. Breathing seemed to induce sniffles. Choosing food off the menu (in fairness, I was so fed up with this menu after over 2 weeks of eating from it before birth anyway) had me welling up with the weight of making a choice. You can imagine how I felt then when they took my little boy away for his bilirubin heel prick, and came back to tell me he needed yet more phototherapy.

I disolved, akin to one of those pathetic Home and Away scenes when the ditzy character collapses to their knees on the beach and wails to the ears of the overtly blue sky. I was convinced I had hurt him through my breastfeeding, as his levels had plummeted to a safe zone at 6am but were sky high again by 4pm. I'm still embarrassed at how much I cried, having thought he was doing so much better. But a ginger walk (looking at you, abdominal surgery) across my (mercifully) private room to look at his wee frame in his regular hospital crib delivered me a bubba with a skin tone more akin to an extras role on TOWIE than a newborn. Serious orange spray tan issues. The guilt was palpable.

My incredible midwife Ann, on the day shift, was initially very worried until she asked how many days post I was. But at the same time, was absolutely the only midwife I had between Tuesday morning of his birth and my discharge on the Sunday night (she stayed late to make sure my paperwork was complete and to see me go, the absolute champion) who took any notice of my mental health history, and my perinatal psych review.

Blaming baby blues and adjustment to motherhood was an easy out. The perinatal review indicated that I was again a high risk of PND because of my mental health history (WOO depression!) and my genetic predication to it (karma for causing it to my mother?). But the lovely psychiatrist also said that my feelings at that time were perfectly reasonable, given the isolation I was feeling without family, my being unable to work and the financial ramifications of such a situation, and the complications and unknown situation of the pregnancy itself, plus emotional baggage from the missed miscarriage. For the most part, I had to battle to get an appointment to even get a Caesarean surgery scheduled - and despite every request, was never ever seen by my assigned obstetrician. Nobody seemed willing to make any decisions, and so I spent a lot of time sitting at home on couch rest, waiting for bleeds, never knowing what the hell would happen next.

By the time we got home, Master C had lost a solid 9% of his birth weight, dropping down to 6lb 9oz from 7lb 4oz. I will, since doing some reading on the Australian Breastfeeding Association website, stoutly argue that a degree of his birthweight was due to my IV lines immediately before his birth, as their research suggests that otherwise healthy babies (granted born to term, but still) whose mothers are subjected to IV lines before birth have the fluid cross the maternal/infant barrier and artificially inflate their birthweight. I would argue this more so, given how quickly after birth he soaked my midwife in wee. 5 minutes post birth is a pretty impressive urine display, when it goes through the towel in which he is wrapped, and right through her scrubs. Mel, I am so sorry.

While his weight was borderline for discharge, and his jaundice was still visible, the first midwife who came to see me the day after we got home wasn't worried. She was super chilled. The next one was so beastly careless about me, at nearly 5pm on a Friday whilst herself pregnant, that she bullied me into submission because he was gaining weight so slowly. She threatened me with being admitted to hospital again if I didn't feed him better and his weight didn't come up.

Jaundice Central - 6 days old

And that was the beginning of the end.

What I otherwise think would have been a natural experience of blues, rough days, guilt, confusion, genuine WTF am I doing moments, and OMG WHAT IF I KILL HIM flashes, instead became one huge guilt trip.

He didn't regain birth weight until 3 weeks old. He was an incredibly slow weight gain baby. I was belittled by a GP at his 6 week check, who said that he was "failure to thrive" despite the NHS no longer using this term to describe a baby who only ticks the box for slow weight gain. She told me that an appropriately breastfed baby would gain an appropriate amount of weight, and he wasn't. It was as close to telling me I was starving him, without committing to it.

His weight was still painfully slow. Some fortnights he chucked on a burgeoning number, for him anyway, and other weeks he was gaining roughly 10-15g in a seven day period.

Every Health Visitor I was seeing at the Baby Clinic for weighing, for about 5 months, told me that I should be topping him up with formula. The fact that I had paid out the cost of a National Childbirth Trust breastfeeding specialist home visit not once, but twice, to check out my feeding (with absolutely no issues found) meant nothing. They dissed me and said he wasn't gaining enough and would be suffering. I was never offered any support. Just told formula, and come back in a week.

I had my home visit HV talk me through a paediatric referral, and she got me into my GP with a degree of speed to be seen. Yet again he was described in the official referral as Failure to Thrive. We were also referred to the Evelina Children's Hospital for a heart check, as a murmur was found.

Mercifully, after 8 weeks of waiting, the heart check showed the murmur to be innocent and no threat to his health and wellbeing, or his weight. The paediatrician couldn't find anything wrong with him, other than slow weight gain, although in his first presentation he gained the largest amount of weight in a short time frame ever. He then reverted to his meandering efforts. Eventually full bloods were ordered, to check all his vital organs, and we were additionally referred to the paediatric dietician.

Bloods came back clear - only ever so slight indications that he might not be getting enough calories, but absolutely no sign of it in his developmental progress. Queries were raised as to whether his own genetics (slim parents and families) and heightened activity level on stuff all daytime sleep could be do to with this. By this time, the dietician said it was possible. But to every question I asked, her answer was high calorie formula. She said I would need to do accelerated weaning. I asked how. She gave me no answer. I said how do I feed a demand fed baby formula when he feeds until he is full? She said, you do.

So really, with all the stress over his weight issues... The constant battle to prove myself worthy as a feeding agent... The intensifying pressure of being a failure because no amount of feeding (or looooong couch and boob/skin-to-skin sessions) were making any difference...

Is what I'm feeling PND?

Let's not delve into the greater darkness of how I feel about myself right now. Let's save that one. This epistle is long enough.

I took myself off to the GP and finally raised the question 20 days ago. She didn't give me the form to fill out to identify whether I was a mess. She offered drugs, I declined. She said she was happy to refer me for counselling, and that it would be 7-10 days for a call. She let me say that I suspected it was PND but never offered an opinion. She then sent me home to wait, without any literature or support suggestions, because I had no suicidal ideations.

Is this what it takes, still? For anyone to offer you any "in the meantime" support, or even a pamphlet, you need to want to off yourself? I thought it was shit enough when I was discharged from my miscarriage surgery without any advice on where to turn for support if I needed it.

Today I received a text message, 20 days after the fact, to say my referral had been received and to call and make an appointment. 7-10 days my fat backside.

I'll go. I should make that next step, if for nothing else than to get an actual diagnosis.

And hopefully, with a few sessions of someone kicking me up the arse about how much I think I'm a worthless sack of crap, and useless as a parent, a scourge on society, a dismal entity that people befriend out of sheer pity, and to blame for everything that went wrong with either of my babies (even though I am well aware that the latter is complete trollop, but you try telling the emotional centre of my brain that), and with some self-evaluation and deeper research into what and why PND is/occurs, I'll be less of an Eeyore. A monochrome Eeyore.

Just a little splash of colour would be a nice start.