Friday, April 28, 2017

Post-Partum Blues?

I'm starting to write this two weeks post-partum. Yes, baby Turbo is now two weeks-old and is able to squirm around to reach where he smells his sweet milk - it's a bit scary that he's moving so quickly and the assurance that I won't have to run around a little boy 24/7 for a long while seems to be evaporating.

I have huge fears of chasing a little boy around. Maybe I mentioned before that one of the biggest
problems i had with pregnancy was that it limited my mobility. I used to be able to hit 6 to 8 H&M stores in one day and while I was pregnant, and then it was difficult for me to hit two (yes I measure personal freedom by the number of h&m stores I can go to in one day.) In my last few weeks of pregnancy, I couldn't get myself to do much at all and was exhausted after venturing out into the grocery store.

But I still knew that whatever little freedom I was having during pregnancy, once the baby comes out, my freedom will more limited in other ways; i might be able to bend down and pick up that receipt from the living room that is somehow invisible to my husband's eyes, and have more energy (maybe) to go out, but having to lug a baby around everywhere I go, I realize i'd be limited to so much more.

What I didn't anticipate though, was the c-section limiting my mobility even further. Once you've been cut open horizontally from the outside, and then vertically on the inside, you're basically rendered to a bed potato for a few weeks, if not a month to two. The healing time for a c-section is about 2 weeks for your outside cut to fully heal and you can begin to walk around like a human being (in pain) and 4 weeks to be able to get a bit of your agility back (with lesser pain), and 6 weeks to be almost normal (with a little pain).

I'm now at 6 weeks in an attempt to finish this post and I am able to walk at my pre-pregnancy speed (or at least very close to it). Keep in mind I was a speed walker.

So the first two weeks after birth was an absolute nightmare for me and filled with a lot of crying. As a friend who didnt even have a c-section put it, it was difficult to see the light at the end of the tunnel. Are things going to get better?

A lot of people attribute the sadness to post-partum blues, which is something seemingly caused by hormonal changes and some type of mental illness. Throughout the two weeks that I cried so hard, I hated the idea that I was crying because of chemical imbalances.

Think about it: After 9 months of suffering through things like nausea, plugged nose, constant vaginal discharges, itchy and/or painful nipples, peeing every 3 hours throughout the night, trouble breathing, trouble moving around, not able to bend down, fatigue, etc. etc. etc., what was next was a marathon of contractions and a watermelon passing through you, or a knife cutting you open, and finally, a baby is born, and you face even more pain down below, a crying baby that needs to be held or rocked and fed on the hour, diaper changes, cracked nipples, constant bleeding below making feel smelly and dirty, and anxiety from not knowing if you are taking care of the baby properly (ami holding the right? Am I hurting him? do i have enough milk? why am i leaking milk everywhere? do i need to wake the baby up to feed? why is it crying all the time? why is there a rash on his butt? why does he hate his crib? Did I buy the wrong one? am i holding him too tight or too loose? Is the diaper too tight or too loose? What is that black and green sticky shit coming out of his ass?)

And then you have a village of people telling you what you should do, with conflicting advice from each other, and from what you think is right or what you want to do. And that pressure of not doing things right and being judged for everything you do even when you don't want to do it.

Oh, and not to mention that you realize that your tummy is still big, but now it is flabby and full of stretch marks, and there's no baby in there to justify it and making it cute, none of your clothes prepregnancy fit, and you look exhausted and feel even more exhausted, but you simply cant sleep since the tiny human needs to be tended to all the time. The fear that you will never be desirable again hits you hard.

You, as the person you knew yourself to be, is no longer - or at least it feels no longer. It feels like not only do you not look like yourself or feel like yourself, you also don't have the time to work on going back to you again AND you also need to dedicate your entire being to taking care of someone else. You can't even go out.

The overwhelming combination of helplessness, undersirability, trapped from personal freedom, the weight of the responsibility of another human life, anxiety of the present and the loss of the future...

And you attribute the above to hormonal imbalance? I think not.

For me, all this was compounded by the intense pain from the c-section (I was on morphine and two other painkillers for the first three days, then two pain killers for the rest of the two weeks which didn't do much for me) (my insides exploded every time I coughed or sneezed or laughed), and my mother telling me i could not eat 90% of the things in this world according to asian confinement rules and all i am allowed to drink is bland soup or bitter herbal meds, and literally confined to my bed due to the pain. I have even less freedom than when I was at 40 weeks.

So I cried.

I cried when I felt pain from the C-section. I cried every time I needed or wanted to do something but couldn't. I cried when I told people or thought about my birth experience and remembered the helplessness.  I cried when the pediatrician reprimanded me for swaddling the baby except it was the nurse who swaddled him (swaddling is not allowed in france). I cried when the baby sucked on my cracked nippled. I cried when my boobs were engorged and milk was leaking everywhere and I didn't know when it was ever going to stop and if I might get masticitis.  I cried when I had to feed the baby having just come out of the shower because it took too long to shower in pain, and I was naked, fat, ugly, and exposed. I cried when my mom made me bland soup I didnt want to eat and I felt like I could die from hunger. I cried when I tried to change the baby and was told I wasn't doing it properly. I cried when I remembered all the intense travelling I used to do with Caleb that we can no longer do. I cried when I thought about the time when we would cuddle and hang out in bed all weekend.

I don't think the crying was unjustified. I don't think it was because I was hormonal. It was because I was in pain and am facing a different life in front of me where an entire human being is dependent on me and I no longer feel important. The baby is now important.

I mourned for the loss of my identity. I grieved for my life that will be no longer.

And then I stopped crying. At least stopped crying as much.

The pain from the nipples healed (though they are still sore and leak all the time). I learned how to breastfeed with better positioning (that first latch is still painful). My c-section began to hurt less (my insides still explode in pain with a cough). My belly is no longer as big (but still a pouch and just as flabby). I can shower faster (maybe not as clean). I am allowed to eat normal food (with some exceptions). I grew more confident with regards to taking care of the baby (with a lot of google consultation). The baby was no longer feeding every hour (every 2 hours on a bad day, every 4 hours on an extremely good day). I am able to go outside (though i am still limited by the baby's hunger and my fear of going out with a crying baby and having to change his diapers in public so I don't go out unless I have to and i miss it so much). I am getting more sleep than a lot of other moms because I have a wonderful mother who is in Paris with us for three months doing everything from cooking wonderful meals to being the main caretaker for the baby when I'm indisposed and my husband is at work (but sleeping 8 hours straight? yeah right).

So it got better, and my crying lessened.

It's not post-partum blues; it's the adaptation of the human psyche.

Yes, there are women who do have serious post-partum depression that need to be treated. If after two weeks, you still don't see light at the end of the tunnel, a doctor is needed.

But within those two weeks, let's not treat us like we are all sick and blame it on the hormones. Empathize with us and realize that having a baby is effing hard work and sometimes people cry when shit is hard.

It still is hard, and it will no doubt continue to be hard. But we are all adapting.

Is it worth it? I don't think we can put a value on personal freedom, just as we can't put a value on raising a human life.

Tuesday, March 28, 2017

My Birth Experience

The first rule of fight club is: You do not talk about fight club.

When I told Caleb I needed to write about my birth experience, he had asked me if I am violating some kind of fight club rules for giving birth - it's basically not something that we talk about until we are in the secret club of having given birth.  I used to joke about that, but is it a real rule? Are we really not supposed to talk about it with the understanding that we don't want to scare any potential mommies away from the experience?

I haven't been updating this blog very much about my pregnancy even though I had the initial ambition of writing everything down week by week, but my pregnancy was filled with gagging reflexes and a surge of busy-ness at work that left me mostly miserable and tired most of the day, so it never came into fruition. And even this entry has been an ongoing effort for a few days just writing these paragraphs you have read so far, so I am hoping I will eventually finish.

One of the most difficult things when telling others about birth experience is that every single mother experiences something different, so when you ask about birth experiences, you will get a whole range of "the baby dropped within 15 minutes I got to the hospital" to "I was in labour for over 40 hours and I almost died." On top of which, not every mom-to-be wants to hear about other ppl's birthing experience, so for me, I felt like the information is never properly disseminated and even though my midwife, Diana, had been a saint about trying to teach me as much as i can and providing me with reading, the entire experience was a shock all the way.

So as I document what I went through as my experience, I both feel like this is going to be a public service announcement for the mothers who do want to know all the gory details, but also realize that the liklihood of someone going through exactly what I went through might not be likely, though based on my experience it still feels like all giving birth must be traumatic? I don't know.

The Summary
Here are the things I didn't know about how invasive birth is based on my experience in Paris (not sure if its the same everywhere in the world):

  • To induce labor, they stuck a balloon inside me with catheter tubes hanging out and taped to your leg - yes it hurt. It also hurt when they took it out 12 hours later.
  • They stick a lot of IVs in you- yes it hurts
  • They stick their hands really far up into your cervix every hour to measure your dilation using the number of fingers that fits up the hole - it's extremely painful
  • To feel whether the baby is in position, they stick their hand up even further to touch the baby who is still in your belly....
  • My water didn't break naturally so to further induce labor, when they break your water, they stick a hook inside you to pop your amniotic sac
  • The epidural is injected through your spine, in addition to the IVs already in your arms
  • When you are on epidural, you can only pee if they open up your urethra every couple of hours. If you are on epidural for too long, they will use a catheter instead. This damages your ability to pee even after you give birth and they will open up your urethra again if you cant pee the next day
  • You cannot eat or drink if you are on epidural, for fear that you might aspirate food into your lungs - so if you are like me and had 36 hours of labour, you will starve
  • During a c-section, they stick more IVs in you for morphine and antibiotics - those are super painful for some reason even though they had already upped my epidural and i was already puking
  • You cannot eat or drink immediately after a c-section, for fear of hemorrhaging

Inducing the Birth with a Folley Balloon
My son's due date was Tuesday, March 14 - day one of week 41. I went to the hospital at 10am that day and the midwife who examined me did an ultrasound and told me the baby is healthy and that if he doesn't come out by Thursday, then I need to go back to the hospital where they will do another ultrasound to see if the baby is still in good condition (whether my placenta is calcifying and whether I have enough amniotic fluid, and if the baby's heartbeat is still stable). She stuck her hand up my cervix and I squirmed and squealed in pain and declared that I am not dilated. She said if the baby doesnt come on Thursday, we will have to induce on Friday, because 41 weeks + 4 days is the maximum we can wait before we need to push the baby out.

Being monitored for contractions and baby heartbeat

Knowing that any time i go to the hospital, i might get induced, on Thursday morning, I took a shower and ate a good breakfast before heading to the hospital with my mom. After going through the ultrasound, I was told that there is very little amniotic fluid left. The midwife stuck her hand up my cervix again and I squirmed and squealed in pain and was told I am still not dilated. She called the OB on call who explained to me that we will need to induce the birth right away. He suggested we use the Folley balloon method, which he explained was the least aggressive and natural way to induce a baby.

What happens is they stick a catheter into your cervix and inflates it with saline to put pressure into the cervix so it would start contractions and therefore dilation. At around noon, we went upstairs to the maternity ward and they went through my paperwork and then inserted a bunch of IV tubes into my arms for future purposes. The bruise that came from that is still on my arms 10 days after having given birth.

We waited around and they eventually took us up to the delivery room and told us there is no bedroom right now for us, and the doctors came in and opened my legs and shone one of those giant surgery lights into my opened legs so they can pry me open and insert the catheter all the way up, with two rubber tails hanging out and taped against my legs. It hurt like hell while they were doing it, and was extremely uncomfortable while the balloon was inside me. After the procedure, they told me they still dont have a bedroom for me to rest in, but i can do whatever I want now - including eating and showering. My mom and I went downstairs to the cafeteria at around 2pm and had a sandwich, a pastabox, and i had a small slice of cheesecake. Peeing was a bitch when you have a bunch of tubes hanging between your legs.

We went back to the delivery room afterwards and just hung out there in discomfort until Caleb came in at around 4:30pm and relieved my mom of her duty. At around 8pm, my mom brought us food and caleb went and bought some burritos from chipotle and some haagen dazs coffe ice cream because i am loved; I wolfed everything down with a vengeance.

They found us a double room finally at 11pm and ushered us down. Our neighbour was a lady who was also preggers but her husband did not stay overnight with her.

At around 1pm I started to have regular contractions at 7 minute intervals that hurt like a bitch, but the machine that monitored our contraction was broken so Caleb had to manually note down my contractions. At around 6 or 7 am, the midwife came to check on me when I was moaning about how i can't do this anymore and ushered me back up to the delivery room, reprimanding that i didn't call on her earlier.

In the delivery room, when the midwife was about to stick her hand up my cervix, I started to really freak out. I squirmed around crying about how i cant take it. They asked me if i wanted epidural and i nodded yes urgently. However, i think it had to take a while for them to assemble the team to provide me with the epidural so they gave me the laughing gas instead. I was kind of suspicious that it wouldn't work or would make me puke, but after breathing it for a while, i couldn't feel it when she stuck her hands up me to feel for the dilation. I was at 2cm and after i confirmed that i still wanted the epidural.

Epidural and No More Food
The team of anaesthsiologists were called into our room after and they added some IV stuff into my arm and then I had to sit up so they can inject more IV needles into my spine to receive the epidural. It was kinda scary and I almost immediately regretted consenting to the epidural, but thinking about more hands up my cervix, I sucked it up and turned my back to allow them to inject needles into my back. In hindsight, i probably should have stuck with the laughing gas.

From there on, there was no more pain. I could not feel my contractions nor the pain from someone sticking their hands into my body from below every 2 hours to check for my dilation. Every 3 hours, the anaesthesiologist would come with a little cold bar and check to see how the epidural is working. She would touch me in various places and i would tell her if i can feel the coldness. Every 4-6 hours-ish, they would also come in and insert something to my urethra and relieve my bladder. 

By around 10am Friday, I was starving, but I was no longer allowed to walk or eat and i could only drink like a sip of water every hour. I was around 4cm dilated and they decided the best way to speed up the contraction and dilation now is to take out the balloon and break my water by inserting a little hook into me. The water didn't all come splashing out since I was running out of fluids anyway and they told me the baby's head had corked the cervix.

The cycle continued where people would come in, insert their hands up in me to feel my dilation, force open my urethera to empty my bladder, and I was unable to eat and drank very little. At around 4 pm, they were concerned that I have not moved past around 4.5cm in dilation. This was when they decided to stick a catheter inside me so they no longer have to manually relieve my bladder, and began pumping a minimum dosage of oxytocin inside me to induce my contractions, hoping i would dilate more.

Around this time, one of the anesthesiologists came to check on me realized i havent been pumping extra epidural in me. The epidural was working pretty effectively right away and i was to press a button to pump extra dosage if i was feeling discomfort or slight pain. I cannot press the button more than once within a 30 minute period, but i haven't been pressing it for the last 3 hours because i felt like i didnt need more. Because I started to be able to feel the coolness of the frozen bar around my hips, she pressed the button for me and said i needed to press it every 30 minutes, which I started to do because i dont like to be yelled at by french authorities. Within the next two hours, my entire left leg was numb and i couldn't feel anything. When the midwife came back to check on me, she was upset with the anaesthesiologist who gave me the bad advice since I am only supposed to press it as needed and not every 30 minutes - it was very awkward. 

Around this time, I was also on the verge of breaking down from the lack of food and liquid. I was crying and begging for something because I was starting to feel really dizzy and nauseous. I asked about eating or drinking something other than a small ounce of water a few times and was refused, but when I finally found the french word for dizzy (étourdi)) and told them, they immediately sent in someone from the anaesthesia team who told me I can have some apple juice. Apparently being dizzy is much worse than being nauseous. We also texted my mom who made miso soup and brought it over and I had a few sips. I can't even begin to explain the relief from having even that little substance in me, which allowed me to carry on in that state.

Less Epidural? More Oxytocin? 
At around 8:00pm, the midwife came back and stuck her hand up and said I wasn't dilating anymore and required more oxytocin, and we asked if we can have less epidural given that my legs are completely numb. Caleb noticed that I was only having contractions every time I moved and because I was not allowed to walk around or move on my own or feel the contractions, he was concernd it could be why i stopped dilating. However, it's under strict policy that I was not allowed to walk, so even though we lessened the dosage of the epidural and I started to feel pain again, I was still not allowed to move on my own.

But even with the new, albeit slight, nourishment and the additional oxytocin being pumped into me and the reduction of the epidural, things were not looking good. I had big and steady contractions according to the monitor and i was feeling intense pain at a single spot that was causing me cry, but after being felt up twice up my cervix again, I was told that I was not only not dilating, but the baby was unable to move into the right position because i no longer had any amniotic fluid to ease his movement. How were they able to tell?  They stuck their hands right up in there until they can feel the baby's head position.

At around 10pm, we were nearing 36 hours after the inducement and the midwife told me gently that it looks like we are going to have to have a c-section, but at least it won't be an emergency one as the baby's heartbeat has been really steady at around 130 bps the entire time. 

When they told me this, I bawled. In fact, as I am writing this and thinking about that moment, I am still tearing from the feel of the defeat.

Caleb said he saw a sign of relief on my face at the same time. I guess it was relief knowing that there's a finish line to cross, rather than lying exposed on the delivery chair starved and dehydrated.

The resident OB on call came in to explain to me what is going to happen next. All I could remember was that Caleb can be with me during surgery and i wont be able to do skin to skin but he can. They will show me the baby once he comes out and Caleb will take him away. They gave me a moment to speak with Caleb alone to swallow the reality of it all. I cried even harder because all this work for 9 months + the last 34 hours and I wont even get to hold my baby when he comes out. Life is so unfair.

A part of me was comforted to know that Caleb can still do skin-to-skin with the baby right away and they can bond really quickly, but I felt so disappointed that i still cry talking about it.

They led Caleb out to get dressed while they prepped me. I was quickly razored and a team of people entered my delivery room, including a doctor anaesthesiologist who upped my epidural to the full extent and told me that everything will be completed within two hours, before the epidural wears off.

Before they even wheeled me into the surgery room, I started to puke (that's why I wasn't allowed to eat...). I was puking out all the water and bile that was left in me nonstop while borderline unconscious. After i seemed to have nothing more to puke, they wheeled me in the brightly lit surgery room. As soon as they rolled me from my bed to the surgery chair, i started to puke all over again, except this time I had less substance to puke out and was mostly dry-heaving. 

As I was heaving out whatever that was left in me, I started to scream. I was puking to my right and they were stabbing my left arm when I wasnt looking. The doctor told me softly that they were inserting a new IV in me for the morphine and antibiotics needed for the surgery and I started to cry from the pain. The doctor became concerned that the medication wasn't effective if the IV is hurting me so they tried again and again and again. Three different spots on two arms - i have holes and bruises all over me. Caleb was brought into surgery while i was finishing the second puke storm and mid-scream.

Throughout the surgery, I kept hearing them talk about how the medication was not working on me but I was in a complete haze and deathly afraid of them poking me with more needles. I honestly could not tell how long it was but it felt like within 20 minutes of them wheeling me in, I heard the baby cry and was brought to me to look at for a few seconds and then Caleb went out with a nurse and the baby while I was left on the bed with the team sucking stuff out of me and closing me up, chit-chatting about mcdonalds and cakes and st patrick's day.

After Birth
They were right, within two hours of them knocking me out, I was rolled into another bed and wheeled into the recovery room, where they told me that i cannot eat or drink still. They needed to make sure i was not hemorrhaging blood before i can drink water. I cried again. Caleb finally came in with the baby but i was under so much drugs and there was pain everywhere in my arms from four different IVs and one in my back that i couldnt really hold him. 

We also were told that we needed to spend the night in the recovery room because they didnt have a room for us in the hospital, but we were also not allowed to eat in the recovery room. I cried harder at the idea that there's no foreseeable time when i can actually eat food.

Thankfully, within the next two hours, they were able to put us back into the double room from before, but before that they had to peel off all the IV. It was slightly less painful than putting them in. We got a private room a day or two later.

However,  just when i thought people were done putting things up in me, they came to release my bladder again the next day because i wasn't peeing from the catheter damage. I cried pretty hard, again.

The C-section aftermath is misery too, but i will save that for another day....

What I would do differently next time around, if there is one
Honestly, I would have held off on the epidural until I really could not handle it anymore. Although at the point when i wanted it, i felt like i couldnt handle it, i really feel like if i had waited a bit longer and endured through the pain of them going up and down me you know where, i might have been able to avoid the c-section because i could have walked around and allowed the baby to move into position. Also, it would have given me opportunity to eat and drink because not eating for so long doesn't help birth happen. For the pain of checking for dilation, i would have asked for more laughing gas to stave that off.

It's hard to say if i could have avoided the c-section had i not been on epidural so early, but it's worth a try for next time. 

And although i joked about wanting a c-section rather than have a baby come down my birth canal, it's effing painful and much much worse than being pregnant because you literally cannot do anything or go anywhere for a very long time.