Wednesday, January 30, 2013

Monday, January 7, 2013

For my birthday, I ask you...


Thank you guys for your comments on the last post. It helps. I'm feeling better. Seven days of antibiotics ahead of me, but fever is down and blockage has shifted, and I think I will make it. I've decided not to try to make any decisions about anything while I'm still a bit under the weather. But I'm going to try a number of your suggestions (the ones I'm not already doing) and will keep you posted.

In the meantime...it's my birthday this week! - and for the first time in about five years, I am not approaching it with apprehension, but rather with joy. I've got Magpie here beside me. I still can't believe it, but I feel so, so lucky. With my daughter's (my daughter's!!) arrival, birthdays (and aging in general) have been recast again as something to look forward to. Prior to infertility, I had celebrated aging each year. I am a cancer survivor, after all, and when diagnosed at age 27, I developed the deep and legitimate fear that I might not have many birthdays to come. So each birthday was a wondrous and truly celebrated occasion, a reminder of life, of my gratitude for being here. It felt strange and complicated when in my mid-thirties, the presence of infertility, and the passing of my supposedly fertile years, meant that each birthday also marked the ever-closing possibility of having a biogenetic child. I distinctly remember sobbing in my bed on my 37th birthday when after two years of infertility treatments, I was no closer to a baby. It felt so wrong to be so sad - after all, I was also so grateful to be living! And yet there it was.

And now here I am. Alive. And with a very alive child beside me. And not just any child, but this amazing girl Magpie. Wow.

So. It's my birthday this week.

And for my birthday, I have a request for you.

Would you leave me a comment and help me expand my blog reading?

Will you share with me your favorite blog?

Specifically your favorite infertility or parenting-after-infertility or loss blog. Extra points if it happens to also be from a writer's or psychologist's or MD's/RN's other health care professional's vantage point.

If you can't narrow it down to a single blog, you can cheat and send me two urls. But I really want to know your top picking(s). The blog or two that you can't wait to read when the author posts. The one you wonder where they are when they haven't posted in a bit.

I want to expand my reading horizons. So help a birthday girl out, ok?

And thanks, as always, for reading and being there. Thanks today for helping me to celebrate : )

Mo


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Saturday, January 5, 2013

My breasts, my nemeses



I am currently down for the count with my third bout of mastitis in Magpie's short two months of life. My left breast looks angry, the skin hot to the touch and reddened, extending up under my arm. I am achy and febrile. I am on antibiotics again (I will have taken more than 30 days of antibiotics for mastitis by the end of this round). Caring for Magpie at the moment is out of the question. Thank goodness for Will.

I never realized how debilitating these infections were prior to having Magpie. They last approximately two to three days, and I spike a high fever (~103-104) and have severe pain in the affected breast. It makes it very difficult to pump (but of course stopping in the midst of it is not an option because I would become engorged and only make the blockage situation worse). The intensity of symptoms means that I have had to ask for or hire help to care for Magpie each time. I don't know if I am particularly vulnerable to this type of infection for some anatomical reason, but it stinks.

The multiple episodes of mastitis (not to mention the multiple blocked ducts a week that I manage to clear prior to their developing into an infection) are just some of the many aspects of trying to give Magpie breast milk that have been a challenge. She has major problems with sucking, either from my breast or from a bottle, and so ours is, at least for now, an exclusive pumping relationship, and not an easy one.

Not how I thought it would be. And yet, so far at least, I can't give up on it. It seems so important to try to give her breast milk. Beyond the basic research on the subject (which on my more cynical days I might call almost propaganda), my personal reasons include my and my family's cancer history, my gestational diabetes history while carrying Magpie, and perhaps the fact that I and my siblings were not breastfed and have had some significant medical issues along the way (which of course we might have had anyway...who knows). I have the hope that I can offer Magpie some protections against these things by breastfeeding. Also that it will help me not develop type II diabetes (which after the GD I am at risk for) or breast cancer, which I am also at higher than usual risk for.

Not sure if this is supposed to be encouraging or admonishing

I tell myself that at least while I am on maternity leave, feeding and nurturing Magpie is my sole responsibility, and so it doesn't matter how hard it is. I tell myself that I went to great lengths to have her and that I want to give her "the best," no matter what. That perhaps to go an easier route would signify a lack of gratitude for her (some version of the "you made your bed, now lie in it" adage).

It boils down to another case of Mo's ridiculous persistence when all evidence points to stopping something (which of course has been reinforced in the past...most notably with the creation of Magpie herself). Or framed another way, it boils down to my intense focus on regret management. No matter the amount of acute suffering in the moment with the efforts to extract the milk from my breasts and get it into my beautiful daughter's body, I worry that if I stop "prematurely," I will look back later in her life and regret it. And what would constitute stopping prematurely for me? Prior to three months? Prior to six months? Prior to one year? I'm not sure, and honestly, I try not to think about it, because imagining going through this for any of those lengths of time feels undoable. So I don't look ahead, I just get through the next day of pumping and feeding. We're a one day at a time pumping and feeding family.

I also feel so aware of and grateful that I've been able to produce enough milk for Magpie to drink. So many of my friends and fellow bloggers have struggled mightily with this, having to supplement due to PCOS or insufficient glandular tissue or bad advice at the beginning of their attempts to breastfeed. That I am actually making what Magpie needs to eat (and some), is huge, particularly given the fact that she has never been able to latch on and that I didn't get started pumping until she was about 10 days old because of poor advice from the lactation consultants in the hospital after her birth. It feels selfish to squander this gift of milk we've been given when one of my dear friends pumped every three hours around the clock for nine long months to give her son 3 ounces of breast milk daily and the rest formula. She's a neuropsychologist (and knows her research) and felt it was that important to try to give him even a small amount of breast milk. I, on the other hand, am able to pump 3 ounces for each feeding, sometimes significantly more during the overnight hours. To just quit after working so hard  - and being so lucky - to get to this point feels foolish.

And yet...

This is tough, folks. Capital T Tough. And no one seems to talk about it. Instead, I read that breastfeeding is normal and natural and easier than formula feeding. I read Dr. Spock's advice that most women can successfully breastfeed if they give it a fair trial (i.e., if they just try hard enough). Well. Huh. I guess I'm not trying hard enough, because despite consultations with numerous professionals and 11 weeks of daily attempts, we are not breastfeeding and I am struggling mightily with exclusively pumping.

At the moment, I hate my breasts. I feel I am a prisoner to them. I am also extremely grateful for the milk they are producing. But who knew it would be so hard!

I'm sure when my fever passes, things won't seem as overwhelming.  But this is where things stand today.

Off to pump again and then rest. Hoping this fever clears soon.

Mo

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Tuesday, January 1, 2013

Christmas photos

Magpie on Christmas day

Magpie, swaddled, with antlers
Wishing you and yours a healthy and happy New Year.

2013 is going to be a year of many firsts, and a year of joy, for us. I still can't believe we are out the other side. We are so fortunate, so lucky. I want to savor every moment.

Mo

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Thursday, December 13, 2012

The first 6 weeks postpartum: some hard realities


I wanted to post about some of the harder realities of my transition to new motherhood. This time has been filled with many wonderous moments, grant you (please don't ever mistake that!), which I hope some of my previous posts have conveyed, but there have also been a number of difficult ones. Some of our lack of preparedness is because we couldn't really imagine we were having a baby until... well... we had the baby. I "knew" that we appeared to be having a living child, but emotionally, after six consecutive losses, it was a different story. Even up to the day of the induction, it felt dangerous to presume we were taking home a baby. That may sound strange, but we've had so much loss, it just felt perilous. And so my preparations - both  physically in terms of buying necessary baby things - and psychological - were a bit on the scanty side. Whatever your loss history, having a baby is a watershed experience. Somewhat of a "You don't know until you know." And everyone's experience is different. Add to that strong cultural mores that you are "supposed" to be only thrilled and happy.

If baby is healthy, then the rest doesn't matter. Right?

Right?

Well, I'd argue that if baby is not healthy, nothing else matters, but that it is ok to have feelings about the way things go down in your labor and delivery and postpartum. And I'm going to write about it, in case it is helpful to someone else:

Physical recovery after c-section: I had no idea about what to expect, because, well, I wasn't planning on having a c-section. In fact, I was naively certain I wouldn't need one (ha! ha!) because my provider has such a low c-section rate and I was so prepared to give birth (ha again!). But a c-section was needed (more on this when I share our birth story). So in addition to the emotional adjustment to the reality I found myself in, I was also very surprised to find that the initial few weeks after a c-section leave you pretty helpless physically. Initially, I was unable to roll over and had trouble getting up from a sitting position. I couldn't lift Magpie if she was in a bassinet beside the bed, which made it tough to room-in in the hospital unless Will or someone else was there at all times. All of this was magnified by the fact that Will's paternity leave was eradicated by Hurricane Sandy, as he was called into the hospital basically as soon as I was discharged home. Magpie and I were on our own. And we were physically not ready for it.

Emotional recovery after c-section: Also rough. I was sad about the way our labor and Magpie's arrival went. It felt chaotic and scary and I missed a number of things that I had looked forward to. I remember during the c-section, right before everything went to hell in a handbasket and the anesthesia failed, hearing a baby cry after they pulled her from my belly. And I thought, literally,

What is that sound? 
Oh, it's a baby. 
Why is there a baby crying in the operating room?
And then a few moments later...puzzled...Oh - that's our baby?!

It all felt so disconnected. I don't know her Apgars, I didn't get to see the placenta or umbilical cord (which I had wanted to), I never saw Magpie until she was all nicely cleaned and wrapped and hatted maybe 10 or 15 minutes later. I had moments of disbelief days later, this crazy idea that she had not actually come from inside of me. Maybe they had a room full of babies somewhere in labor and delivery and they'd just brought her into the OR to us from another room. Ludicrous, of course.

When one of a parade of lactation consultants came to the house and suggested I strip Magpie naked to weigh her before feeding, I stripped her to her diaper. When the woman commented to take off the diaper, I almost said, "But she came like this." The idea of my daughter naked felt odd for quite a while, as I hadn't seen her naked for days after her birth.

Talking to friends later, one asked, "Did you just have the most incredible high after giving birth?" The answer is no. I felt wrecked physically and emotionally. I'd been through 36 hours of labor and a rough c-section due to the anesthesia problem. When my friend asked that, it amplified some of the losses I was already processing from having had Magpie delivered in the way that she was.

I want to say that I don't think I was entitled to some wonderous type of birth experience, or that I expected my body to "know" how to give birth (which I've read people say), or anything of the sort. Obviously my body didn't "know" how to get pregnant, stay pregnant, get un-pregnant...and the list goes on. And thankfully, with medical technology, we've been able to overcome multiple hurdles along the way. But there was still a sense of loss with the way things went. I had strongly hoped to deliver vaginally, and I hadn't expected a c-section, if needed, to be so sudden and abrupt and without any of the human side of things as it was (in a non-emergency situation). I had thought there would still be some excitement: an announcement of "Here she is!" rather than no acknowledgement the doctors had her out and then hearing her faint disconnected and disembodied cry from across the room. I certainly didn't expect to have so much pain during the operation itself. I've moved on, mostly, and Magpie is certainly incredible however she got here, but there was an emotional loss.

Hormones/Mood: All I can say is Wow. This has all straightened itself out now but those first few weeks. Oh. My. I felt like some kind of combo animal-child. So emotional that I would burst into tears talking to Will. Not always unhappy, sometimes just moved, literally, to tears, but really, really intense emotions all around. I am someone who feels things very deeply but tends to keep a good lid on it. And in addition to deep emotions, I am strongly rational, and I tend to lead with the rational (or try to). For me, immediately postpartum, that went out the window.  I was a ball o' emotion. I felt needy and shaky, and...almost primitive. It didn't last that long (a little over a week?), but it was something I did not expect and haven't experienced before.

Bonding: I had realistic expectations on this I think...my psychologist friends warned me - you will be thrilled Magpie is here, but you will not immediately love her. And I didn't. She was exquisite and lovely, and I felt very protective of her, but I did not instantly love her or feel that I "knew" her. This has grown. I now look at her and can't help smiling. I look at her and am incredulous at her perfectness. At her presence. I feel a growing bond each day. But it wasn't instantaneous. Not by a long shot. I'm glad I'd been warned about this so I didn't beat myself up about it. I look at her now and am just suffused with affection for her. But it wasn't instantaneous.

Breastfeeding: I envisioned Magpie suckling at my breast, milk dripping down from the sides of her mouth. Her content, me content. I imagined myself rolling over to her co-sleeper at night and the two of us doing dream feeds. Ah bliss.

Well, not so much. Magpie never could latch on properly in the hospital. She she lost 13% of her birthweight while we were there and they mandated that I introduce formula using a supplemental nursing system (SNS) to stem her weight loss. Within a few days at home, my milk came in, I started a crazy pumping schedule, and was able to forego the formula and feed her breast milk through the tube.

But breastfeeding itself wasn't happening. Magpie's tongue was severely tied. We ended up having three procedures with an ENT to help free it up. She just plain couldn't get her mouth open enough or her tongue in the right position to eat. We limped along with the SNS for a while - a cumbersome tube taped to my breast, my nipples cracked and bleeding. Each feed took over an hour. It was brutal. But even with the SNS, she still couldn't get enough milk and wasn't gaining weight. She dropped 20 percentile points on the growth chart. I grew increasingly despairing. Finally, we introduced the Haberman feeder, a bottle made for babies with feeding issues. It's been a life saver.

But now Magpie isn't so interested in the breast. And I am fighting recurrent blocked ducts and repeated bouts of mastitis. We are still working on it. I haven't given up, but for now it's an exclusive pumping relationship. And although I am incredibly grateful to be able to provide milk for her from my body, it is not at all what I imagined...

Isolation: I am a person who loves being alone. So when I thought about my maternity leave, I looked forward to it. I did not imagine feeling so cut off from others, almost as though I am under house arrest. Some of this, no doubt, is due to the fact that my family lives across the country. But the other part is that I am really stuck in a way I hadn't anticipated. It is hard to get out - especially as an exclusive pumper (for now, at least) with our relentless every two hour feeding schedule followed by pumping. Magpie takes about an hour to eat, and then my pumping takes a good 30-40 minutes (long, I know). And then with a diaper change and some burping, it is time to eat again. The heavy hospital grade pump is not transportable. And while it is wonderful and has made giving her breast milk possible, the hospital pump means that I have to be home every three hours minimum to pump during the day.

Fatigue: This one is a no-brainer, I suppose. And it was not unexpected. I am tired. Bone tired. I knew I would be. What I didn't realize is that I would be so bad at sleep deprivation. You hear people say all the time: sleep when the baby sleeps. Well, when Magpie is sleeping, yours truly is usually pumping. There's no sleeping here. And then at night, same drill, feeding followed by pumping. There is some sleep then, but very interrupted. Something like 1 or 2 hours of sleep followed by usually about 2 hours of interruption...it is not enough sleep for a geriatric mom like myself. So still trying to come up with a better plan for this, or a better way to handle this. Not sure how long it will be until it gets a bit better, because with the pumping I'm not seeing how I could sleep through the night, even if Magpie did. And right now, I wake her to feed over night a few times because her weight gain has been so problematic. But hopefully someday....somehow...sleep....it would be so nice.

So these are some of the tougher parts of new parenthood. Some expected, some not as much. Some of these things may seem trivial, and they are. I would go through anything to be able to parent Ms. Magpie. No questions even asked. But I wanted to be honest about the tough parts in addition to all the joys. In case it is helpful to someone else heading down the same paths.

Mo


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