Monday, August 27, 2012

Motherhood's darkest secret


"I can't do this," I wailed to The Brit as he held our sleepy son in his arms. "Not tomorrow, not tonight, not next week. Seriously. We made a mistake. We need to put him up for adoption."

J. was a month old. I couldn't fathom making it to the next day without a nervous breakdown; the thought of 18 years filled me with the deepest despair and dread. That night, the only thing that got me to talk to The Brit instead of quietly putting J. into his car seat and surrendering him and a bag full of onesies at his birth hospital was this thought: "I lost my mom. I'm sure as hell not putting anyone else through that pain and loss."

Hi. My name is Stacey, and I have postpartum depression and anxiety.

After the first eight weeks, J.'s pregnancy was a relative piece of cake. The delivery? That's another story, but suffice to say: four hours top to toe, no epidural, pushed out in 20 minutes. Violent but quick. Despite wonderful care and a speedy labor, I sat in the delivery bed, watching the sunrise, holding J. and thinking, "Is that it? He's interesting, but what do I do now?"

The insta-love? The "I was put on this earth to take care of this person?" Not for me. I was robbed of that moment. And so much more.

In fact, that's exactly it. Postpartum depression robs you of everything the childbearing experience is supposed to entail. And yet, you're expected to smile. To seem in rapture with a mewling cabbage. To feel something for this lump of flesh that appeared in your house and won't go away. Underneath it, you feel sorry for the kid -- that he's being robbed too. Because he is. And so is your partner. And so is everyone around you, whom you've shut out because you're isolating and telling everyone "I'm fine, I'm fine, I'M FINE -- I JUST NEED SLEEP."

Which you do. Desperately, because (as your therapist will later explain to you) your neurotransmitters can't replenish themselves due to sleep deprivation. You think you can't do this because, physically, you can't. Your brain is on strike. Add to that too much thyroid medication (hello anxiety) and the uncovering of a weird genetic mutation that doesn't allow your body to process B vitamins (hence, no serotonin -- gee whiz) and you have the perfect recipe for bottoming out. Right when you can't afford to do so.

The Brit let me sleep through that night -- my first six-hour stretch since two nights before J. was born. I felt fine the next morning. "I've pushed through worse," I lied to myself. "I thrive in crisis situations. I run a company. This kid isn't even eight pounds. What can he do to me?" Not much, it's true -- but my wonky brain doesn't understand that. And that same brain -- the one I have adored and relied on faithfully for 39 years -- can kill me if I don't watch it.

Which, in a fit of rebellion, it almost did. No, I (thankfully) never got to the point where I was truly suicidal, but I'd be lying again if I didn't admit to getting really creative that weekend about how I might go about it. And the saving thought there was, "But I'm not taking J. with me. And I'M NOT DESERTING HIM."

After weeks of swapping night shifts in the TV room, that Sunday night we tried to let J. finally sleep in our room in his bassinet. And he kept us up all night because he HATED his bassinet. By 2pm the next afternoon, I found a new bottom in the pit of despair. By 3pm, I was about to load up the car again. Only The Brit forcing me to call my stepmom stopped me, a call in which she made me pinky-promise to call my midwife the moment we hung up.

So I did. And the nurses checked in with me every three minutes while we waited for the midwife to finish a patient exam. She talked me off the ledge and asked if I had someone with me and J. constantly until 10am the next morning, when she could see me. She said to head straight to the ER if I felt like I was going to hurt myself, J. or anyone else. And all I could think was, "Whoa. Am I on house arrest 5150? When did I become this person?"

Since that 10am appointment on July 3rd, I've slowly started to recover. After a ridiculous amount of blood work, I'm on the right meds for all of my concurrent conditions, including methylated B vitamins that I will need for the rest of my life. I'm seeing an amazing therapist who specializes in PPD. I exercise regularly and make sure I get at least 15 minutes of morning sunlight each day. I go to a support group every other Friday, full of incredibly strong, persevering women. I have good days and "dip days" where the lights seem to dim, but at least they don't go out completely like they did almost two months ago. And each dip is a little less, well, dippy.

The Brit and I have blown through our savings to hire a night nanny a few nights a week -- expensive, but sleep is so critical...as is the support and advice she gives us every visit. Going against every self-sufficient instinct in my body, I opened myself up to accepting help from friends and family. And, for once, my aunts meddled in the right way by calling my stepmom and telling her I needed her in July, not in September when I went back to work. So she hopped a plane 36 hours later and spent almost a month with us, giving us an extra pair of hands and teaching us how to maneuver with a newborn. It takes a village, indeed.

To clarify some lies: Being a parent isn't instinctual. It's not a special skill mothers unlock because they give birth or sign adoption paperwork. The first 2-3 months are brutal, with or without PPD. Bonding and love are not always instantaneous -- and can often take weeks or months -- because the baby is truly a stranger. And I say all of this with a relatively good kid and a supportive husband who not only works from home, but truly believes he's responsible for 50 percent of J.'s care.

So here we are at J.'s three-month mark. It is a milestone of survival -- for all of us. We are figuring out what works for us as a family, including breastfeeding (yes, primarily, as it is and has been the only thing I could do consistently for J. throughout this trauma) and a wonderful preschool that J. is attending three days a week until I go back to work in a couple of weeks and we move up to five days. Being J.'s primary caregiver on Mondays and Fridays is exhausting, but a challenge I've met with great success. And I'm so glad I pushed myself to do so.

I learned to fake it and remain calm with J. until the feelings became real. And he has rewarded me with beautiful smiles, ongoing fascination at my actions, and a yearning for Mama when he is unsettled. Let me tell you -- nothing fills your empty heart like that moment where your kid snuggles in, gives a shaky sigh, and calms down in seconds. Nothing.

As for me? I'm about 75 percent there. I have days where I feel like a mom and days where I feel like a babysitter, but the former are catching up to the latter. I wake up in the morning, not because my brain is cycling through anxious thoughts and I can't stop my feet from repeatedly clasping each other, but because I have a job to do. And a son who will be smiling at me in a few minutes time.

And I'm here to remind anyone who may be reading this and facing their own struggle: PPD is 100 percent treatable. One in eight women get PPD -- you are so not alone. Cling to those two facts in your darkest moments. I know I have, and continue to do so. If you feel like you're going to hurt yourself, your child, or anyone else, call 911. NOW. And do not listen to anyone who says it's all in your head. I mean, it is -- but it's very real, caused by hormones, NOT YOUR FAULT, and you can be helped. You deserve help. And so does your child.

As my endocrinologist reminds me: "Be kind to yourself." It's amazing how little we do that. But it's the most important lesson of all -- now and throughout this adventure known as motherhood.

~*~

If you need help, here are some resources that worked for me. May they help you until you get the one-on-one support you need:

* The Symptoms of Postpartum Depression and Anxiety (in Plain Mama English): Postpartum Progress is a wonderful resource all-around. Highly, HIGHLY recommended.

* Postpartum Depression for Dummies by Dr. Shoshana Bennett: I read this after seeing my therapist for a few weeks and was comforted to know that many of the techniques and neurological explanations she told me were reiterated here.

* Postpartum Support International: Information, resources, where to get help no matter where you are.

* Arizona Postpartum Wellness Coalition -- Support Resources: If you need a free support group in Arizona, you can find one here. In Phoenix, the group at St. Joseph's is wonderful. If you need it, I will give you a ride -- just drop me a line.

Sunday, May 13, 2012

Week 36: Destination Unknown

This Mother's Day has been surreal, overly poignant, and difficult. Most of the reasons why are explained in depth here, so no need to rehash.

That aside, I've received sweet messages from loving friends wishing me a "Happy Mother-to-Be Day" or similar. And as appreciated as those sentiments are, it really drove home one fact about my pregnancy that seems completely off-kilter from most women I know.

I can't fathom having a child. It's only three or so weeks away, but its still too abstract. I'm not scared. I'm not nervous. I'm nothing. I simply can't focus on the reality that's soon to slam in. Hard.

Last weekend, a dear friend -- mom of a two-year-old and Baby G's godmother-to-be -- visited us. Partially because we've been apart for too long; partially to help us with last-minute preparations and advice.

About 24 hours in, she turned to me and said: "So really. You're so zen. What do you want or need to know?"

I shrugged and replied: "Nothing, really. Which isn't to say I totally know exactly what to do with the kid. But I'm not there yet."

She raised her eyebrows. "How so? I mean, when I was where you were at, I was crazy reading books and preparing and such."

And I thought about it. Aside from installing the car seat, we're as physically prepared as we can be. I've read books. The Brit and I have chosen a pediatrician and agree on all major newborn issues. We even went to Costco today to stock up on Stuff and Things. There's not much else to do but wait.

So I replied: "I can't get past labor and delivery. We still have that major hurdle to survive. And only after the kid is here and we know what we're dealing with will it seem real. And THEN I'll probably call you in a panic state, but really. Until I have something to worry about, why even get there?"

I tell people I'm excited because that's the stock response, but the truth is: I'm, at most, curious. I can't get excited about something that isn't real. And perhaps that's because we were ambivalent for so long about having children. Perhaps it's because the romantic, rose-colored glasses about motherhood completely skipped my brain (having a newborn in the house when you're 17 will do that to a gal). Perhaps it's because death and illness is much more real to me than birth and renewal, and I do not count my healthy chickens before they hatch. Perhaps it's the postpartum hormonal roller coaster to come that scares the bejeezus out of me. Or maybe it's all of that combined.

The cliches do not apply here. I'm truly hoping all of this goes away within moments -- or even days -- of Baby G. making the scene. But only time will tell.

P.S. For those who are curious, The Brit posted a few pictures of the nursery and Baby G.'s big sister over here. Feel free to take a peek.

Thursday, May 3, 2012

Week 35: Baby Got Back

No news is good news, as they say. And that's blessedly been pretty much been the story of this pregnancy since the end of first trimester.

Aside from some fatigue, I've had a really easy go of it. No major aversions. No morning sickness. No serious cravings -- except vodka martinis, but what can you do. Only up nine pounds (so far). Didn't pop until Week 27 -- and it's only been in the last month that I'm blatantly showing. Blood pressure steady around 110/72, and all tests/ultrasounds right on target. B-O-R-I-N-G, but also awesome.

We did have a blip on the Practically Perfect Radar when Baby G. stubbornly decided to stay breech a little longer than wanted. But we came home, did some hoochie-coo trickery involving slant boards and The Brit talking to my nether regions ("HELLOOOOO! THIS IS YOUR FATHER! COME TOWARD THE VOICE!"), and the kid miraculously flipped head down sometime in the past week. Which is great, because undergoing an external version (where two docs manually turn the baby from the outside) didn't sound fun. And involves *shudder* an IV.

What's fascinating, looking at this from the inside out, is how being plus-size has affected this project. Luckily, I work with a midwife who could care less about size, so long as the pregnancy progresses in a healthy manner. Aside from an extra glucose test due to family diabetes history, she's never asked me to do anything different from any of her other patients. In fact, when I didn't gain more than two pounds by end of second trimester, I panicked a bit.

"This is a first for me," I said to her, "But...I'm worried that I'm not gaining weight."

We both laughed at the absurdity of it all, then she reassured me I was doing great. "The baby is gaining on schedule. You're eating healthy and getting exercise. That's all that matters. Just consider it an overdue gift from your long stalled-out metabolism."

Being a big gal has other unexpected pregnancy compensations, too. Such as no strangers rubbing my belly to date. Sure, I get the "Is she pregnant or well-fed?" glances (to which I want to say "Both!" but don't). If that's the price to pay to avoid personal assault, so be it.

The downside? MATERNITY CLOTHES. Ask any pregnant plus lady with an ounce of style and she will throw up her hands in full, unbridled lament. To which I say to her -- there is a way, but only if you're bold and enjoy the fitted look. Knits, stretchy fabrics, tunics plus leggings, and high-waist dresses my friends -- and buy a size or two up.

I'm lucky in that I lost 15 pounds prior to conception, so all of my too-big tops and dresses fit great now. Pants are a different story, of course, but I've managed with one started-way-too-big-now-fit pair of black stretch pants. For jeans? A belly band extended my old jeans through second trimester, followed by one pair of not-great-but-manageable maternity jeans. In all, I've only purchased about $100 worth of actual maternity clothes. Of course, I then justified a splurge on a new spring tote, but hey. Mama's got a brand new bag.

Here are other tips I've found helpful:
  • Eat a fruit and/or vegetable at every meal.
  • Watch your sugar, processed food, and white carb intake. Once it's past your taste buds, it's not doing you or the kid any good anyhow.
  • Take a walk most every day (TIP: Having a dog is GREAT HELP in doing this...trust me, my lazy ass knows).
  • Drink lots of water, even if you're peeing every 20 minutes. I know, I know -- annoying, isn't it? It gets more frequent once the baby heads down. Sorry.
  • Let other folks -- especially your partner -- wait on you hand and foot. But be sure to thank them for doing so.
  • Let go of control. This is the hardest part, but it's a fact: Your body is in charge. You're not. And you can't change that -- whether it's now, during labor/delivery, or post-partum.
  • You're going to hear/read about gestational diabetes and pre-eclampsia, but don't panic -- and don't let your medical team freak you out. In fact, if you feel your OB or midwife is dwelling primarily on your size, assuming C-section, and/or trying to find associated complications without compelling test results, switch providers. Seriously. Even in third trimester. You are not a statistic waiting to happen.

All of this is to say to voluptuous gals considering or going through pregnancy: don't let your size define what your body can do or how it looks. If anything, you are more prepared for body changes (and how to stylishly dress a tummy) than our more svelte sisters. Relax and enjoy the fact that you, of anyone, are built to handle this challenge. Hips ahoy!

Monday, February 6, 2012

Week 22: Mama, Can You Hear Me?

Despite all going well on the Uterine Front, the double whammy this past week of the Komen/Planned Parenthood nonsense and news today of Susan Niebur's passing from inflammatory breast cancer has me reeling.

Kids being raised without parents due to illness -- particularly cancer -- always hits me at ground zero. You see, I lost my mother to metastasized colon cancer when I was 10 years old. She was 36. It was violent and ugly and unlike anything anyone should have to go through -- but anyone who has firsthand knowledge of cancer doesn't need to hear that. Regardless of physical or emotional pain, the hole left behind is immense. No amount of therapy (and I went through plenty, thank goodness -- it's the only reason I can function) or amazing family (and I have that, particularly my dad who is a hero beyond measure) or finding love or deciding to have a child will fill that space. It's just there. And it's gapingly unfair.

The beginning of this pregnancy was filled with doubt. I didn't have the usual recourse of asking my mom what she went through, or family medical issues. No one in the family remembered much (after all, Mom's last pregnancy was 36 years prior -- and it was the 70s, so women weren't as open about or aware of complications). There are so many holes when I talk to my midwife, genetic counselor, and other medical folks. We just don't know.

My mom won't be able to hold my hand in the delivery room -- just like she didn't get to see me become a Bat Mitzvah or a college graduate or a vice president or a bride. She can't show me how to swaddle a baby or calm down a fussy child or tell me how to gracefully handle and support a precocious kid who is too smart for his/her age. The echo chamber is real.

My kid will never get to meet his or her grandmother. Hell, I'll only be able to tell him or her the fuzzy remembrances of a small child, and so much of that is colored by pain and chemo and learning to clamp broviac ports and loss. I dread the day when my son or daughter will want to know more about Nana Stefani -- what do I say when I don't really know? How do a handful of faded pictures, an embroidered Passover matzah cover, a teeny-tiny Doobie Brothers t-shirt, and a few pieces of jewelry stand in for someone who would have deeply loved you, if not for a tumor?

In all of this, I am lucky. Lucky that I have the most compassionate, empathetic stepmother in the universe. As she's done since I was 13 years old, she's doing her damnedest to support me. She's the one I call with detailed doctor reports. She will hold my hand in the delivery room. She will be an incredible grandmother (even if she refuses to actually be called "Grandma" -- and she does. Too old sounding.). And she, through my baby brother, has given me one hell of a role model on how to be a fantastic mom. We both cry when we talk about my mom -- me, for what I can't have; her, for what she can't replace.

Life is a funny thing -- not a day goes by that I don't miss my mom (or, more to the point, the concept of having a mom), but I also can't imagine my world without my stepmom or my baby brother, who are easily two of the five most important people in the world to me. Don't ask me to choose. It's a "what if" I can't even consider.

And all of this? Aside from emptiness, I'm livid. Beyond angry that politics and money and grandstanding are higher priority than saving real lives and families. Cancer is complex, but the treatment standards aren't working. Compassion and support are truly lacking. And we're worrying about pink yogurt lids and pointless walks for "hope." Give me a break. Fuck your survivor ribbon nonsense. We are all AWARE. Give money to research and let's get on with it. We don't have time -- or lives -- to waste.

So do something. Do something real so that one more mother doesn't have to desert her children. Today, you can give money to The Inflammatory Breast Cancer Research Foundation in honor of Susan Niebur. Or to the American Head and Neck Society Foundation, so that no one else will have to go through the nonsense my beloved aunt is currently handling so she can meet her great-great niece or nephew. Or to Planned Parenthood, who are truly supporting women's health and saving lives through screening. Tomorrow, it may be another research foundation for another person whose time and luck ran out. Maybe that handful of cash gets one more person on the road to early treatment. Or provides funding for the breakthrough that allows us to kill these tumors once and for all. Or allows one more mother to meet her grandchildren.

All we can do is try.

Friday, January 13, 2012

Week 19: If you try, sometimes you find you get what you need.

"Whoa."

I stopped putting my sweater back on with one arm in and one arm out. "What?"

"Don't panic, but your blood pressure is elevated by 40 points."

The only thought that flashed in my head was: pre-eclampsia. And how we almost lost my cousin to it. Twice.

In came the midwife, who handed me tissues and calmed me down with a kind laugh and said, "You're fine and the baby is fine. You can't have pre-eclampsia until at least next week. And even then, this isn't it. This is just your 'get out of jail free' card, if you'll take it. Now let's talk about how to make this right."

We discussed my work load. How lucky I am to work for myself, and therefore be in somewhat of a position of power over my daily tasks. How I'm not sleeping or eating due to work stress (which is fairly par-for-the-course for PR folks, sadly). Her advice: "It's time to cut back. Not entirely, of course, but your body is in control right now. You have to convince your mind to listen is all. And believe me, this won't be the first time you have to make an adjustment like this. It's okay to give yourself a break."

There's no crying in PR, but let me tell you -- in the immortal words of Spinal Tap, I cried, cried, cried all the way home. And then I sat down with The Brit and made some hard decisions.

Yes, I just signed contracts the week before. And as usual, I said "Absolutely!" to new, exciting projects. A new year (and fresh budgets) is good for that -- you get a little giddy at the possibilities. Of course, the extra money doesn't hurt, especially with unpaid maternity leave on the horizon.

But something has got to give -- particularly with two lives on the line.

So I had a heart-to-heart with my main client. Who immediately put pressing priorities to the side, found another consultant to take on part of my load, and fixed the time/responsibility issue within 30 minutes. And then followed up these actions by calling me and talking through, as a friend would, the mental difficulty of evolving from hard worker to working mom. "I know this is a big transition for you," she said. "You've been doing things a certain way and framing your life like so for almost two decades. But I promise that soon enough, this new life will fit much better. And you'll get just as much personal satisfaction out of it. Probably more."

This morning, I received two exceptionally kind e-mails from my main client contacts, making sure I'm all right and thanking me for being so valuable to the team. I'm in a tough industry, but it's the people that make it more than a paycheck. Especially those who realize, even if it takes a mini-crisis to do so, that we're really only human after all.

I had a proper dinner last night -- my first good meal in a week. I slept eight full, hard hours. Today, my heart doesn't hurt. In fact, it feels at least two sizes bigger than it did yesterday. And that's from gratitude. Sheer gratitude for the people who surround me, near and far.