Friday, May 18, 2012

My postpartum detour through hell

Two days after voluntarily admitting myself to the St. Louis Mercy Behavioral Health facility, I began writing this in a notebook while sitting on a bed with a plastic mattress within the cold confines of room 103. The remainder of the blog was written after I returned home as I try to continue fighting my way through the mental fog of postpartum motherhood.

recovery

After Hannah was born April 2nd, my postpartum fire actually started as a small cinder settled and smoldering beneath 22 hours of labor that preceded a C-section that frightened me to death and back. Needless to say, labor hadn't gone as planned. I was in need of some physical and mental recovery, so, after a week in the hospital, I gave myself a break and endured a few days at home trying to acclimate to my new life with a beautiful and intimidating little baby.

Our first solo week home (the week of the 9th), things didn't seem too off at first. The smoke that filled my anxious mind didn't strike me as abnormal from what I had heard about postpartum "baby blues" or new parent worries. If I slept at all, I slept with my ear an inch off the pillow. I worried about sudden infant death syndrome while Hannah slept, so I checked on her a lot. I worried about the amount my baby was consuming since she got to be a pound underweight at the hospital. I was breastfeeding - was she getting enough? But then she seemed to be spitting up excessively - was something wrong with her stomach? And her left eye seemed overly weepy - would this blind her? And her temperature...her head was warm - did she have a fever? How does this thermometer work? She won't stay swaddled in a blanket - will she get cold? Am I cleaning the breast pump materials correctly? I don't want to harm her with bacteria...and on and on.

Smoke in my brain, but I could still see.

Then, as the week progressed, the flame...

My physical recovery was harsh. I had a painful C-section incision and after first continuing to swell for several days after birth much of the water weight I had inherited in the 3rd trimester dropped fast from my body like crawling out of a 40 pound wetsuit that I had been wearing for the prior 3 months.

This physical transformation was suddenly accompanied by renewed sensitivities to emotional reminders of things I had endured throughout the pregnancy. I couldn't stop crying about things that were apparently still haunting me. I sat in the shower and cried for my brother Jesse and sister-in-law Monica and their beloved twin babies. Anthony Robert and Wesley Edmond, due on July 4th, were born 20 weeks premature on Valentines Day, each living briefly before being cruelly and unnecessarily torn from our lives. I won't pretend that God doesn't know how mad I am about that. My family had grand, beautiful plans to love the hell out of those boys on this earth...we had backyard baseball games to play (Jesse was getting a pitcher and a catcher), Hannah was going to be teased and protected by her boy cousins, and we all knew they would have Jesse's goofiness and Monica's genuine soul. It wasn't right when life's evil turn meant we would have to love them in a distant heaven instead.

I also cried for my grandparents. My Grandma Walter who passed a few hours after this past Thanksgiving to be rejoined for an eternity of laughter and dancing with my Grandpa Walter, whose warm, heavy voice still rings accurately in my subconscious to this day. I cried because I haven't spent one day without missing my Grandpa Thro since the Christmas Day he left us a few years ago. I wept for my Grandma Thro who died a week before this past Christmas. Christmas was always their holiday, and I found some solace in the notion that she couldn't stand one more Christmas without him on earth. Yet, my Grandma Thro was a typically prideful woman before Alzheimer's settled in, and the fact that she died suddenly of a heart attack in the middle of a busy Italian restaurant for my mom, aunt, and countless strangers to witness absolutely angers me. Was that necessary? Couldn't she have just died at home, peacefully warm in her bed? She deserved that dignity. I wept for her.

All these things suddenly felt unbearable again. Beyond grieving for things for which I had already grieved, I began inventing new things to cry over. I felt scared to death of my baby and incapable of providing for her. I was afraid to fail so I determined I must be failing. I decided that my husband might not love me anymore. I felt isolated and petrified and tired. Under the guise of sleepiness, I began canceling visits from friends who wanted to meet the baby.

Beneath the weight of a sliding mental state, the flame of these thoughts singed my skin and began to infect my soul.

On April 16th, I had my two week post-birth appointment with my OB. She checked my incision. We talked about parenthood. We discussed my mental state. I asked her if this much anxiety and these irrational fears about the baby were normal. She urged me to go back on an anti-anxiety medicine I had taken up until two months before I got pregnant.

I began this medicine in the summer of 2007 after discovering the dangers of leaving my over-analytical mind completely untreated. Serotonin imbalances impact millions and I have no shame admitting that for me such an imbalance can negatively impact my quality of life. I get wound up, and the medicine takes the edge off. But as someone who wanted to become a parent, I knew there were health risks to the baby if I were to stay on the medicine during pregnancy, so I slowly weaned off the medicine to see if I could handle it. It appeared I could, and at the time I wasn't seeing a devoted psychiatrist who would advise that I do otherwise.

I did perfectly fine without the medicine all 9 months of my pregnancy, so the idea of going back on it now made me ache. I was breastfeeding and didn't want the medicine to impact Hannah, and after two days of consulting with our pediatrician, two nurses, a lactation consultant, and every corner of Google, I decided to go back on a low dose of the medicine and continue breastfeeding.

The problem was, the fire in my brain and body had already started. On Wednesday April 18th at over two weeks out from giving birth, my hormones were beginning their crash. My anxiety was fueled and my body began to literally feel like it was burning (90% of serotonin exists in the gut, so this makes serotonin issues both a mental and physical problem). Down my back and through my skin I felt icy hot sparks sliding and catching and sizzling, and in my center feathers danced like Chinese water torture in what I envisioned to be a crimson-colored tunnel. Imagine burning hot flashes combined with the feeling you get in your body when you narrowly avoid a frightening car accident. My body felt like it was detoxing. From the moment these sensations began, this was the way it felt all day long. I felt like I wanted to throw myself up out of myself. I couldn't sleep although I was exhausted. I had no appetite...the thought of eating made me sick. And because I couldn't eat, my milk supply began to diminish, so then my baby couldn't eat. It shredded my heart to know that I was incapable of giving Hannah what she needed. This was my motherly job; these were my plans being demolished.

My mind started to cycle. I would lay in bed burning, repeating words and phrases in my head uncontrollably. I was terribly anxious about my friend's wedding that was coming up in a couple of weeks for which I was supposed to hand out programs, do a reading, and sing a song, so I fixated on it and obsessed over it. My mind spun verses and choruses from that song over and over again and I could do nothing to stop it.

Many friends and family members began to reach out to help me as I withdrew further. I am grateful for their attempts. Meals, great encouragement, suggestions. I was incapable of appropriately responding at the time but I know they understood. I had no desire to leave the house or interact with anyone unless they were a medical professional with a good answer. I didn't have a case of the baby blues. I had an emblazoned case of postpartum anxiety and hormonal detox and I needed to be healed immediately or I felt my life was on the line. The answer that it just takes time for the medicine to work (often 14 days for it to even start working at all) and the hormones to straighten out was not an acceptable answer to me. My body was on fire and my brain was being baked into an impossible hard rock. I needed relief and I needed it immediately.

My heroes stepped in, and for that I am so blessed. My husband and my mom spent hours calling resources, making appointments for me, and took everything off my plate to relieve me. We had heard progesterone might help so a friend/doctor called it in for us. We called my OB to see if she had any other recommendations and she suggested we meet with an intake counselor at Mercy Behavioral Health. We did and I hated their answers...meet with an outpatient group and psychiatrist each day for 7 hours through one of their programs (impossible to sit in a group like that when I was on fire and could hardly speak), be admitted to the inpatient psychiatric facility (frightening beyond words), or leave and ride it out although nobody could say how long it would take. All I wanted was to see a psychiatrist immediately, and that wasn't an option at the time, so we left and continued to take matters into our own hands.

Jason and my mom got on the phone to make a psychiatrist appointment for me as quickly as they could. We found someone who could get me in that Friday. In the meantime, I could hardly look at my baby. I had let her down. I would hear her cry and do nothing about it. My stomach turned constantly, I felt hot sensations pour down my spine, my skin crawled constantly, and the only relief I could fathom was if someone were to take a baseball bat to my back. I felt doomed to live like this forever.

We visited the psychiatrist on April 20th. He gave me advice, more medicine, a follow up appointment two weeks out, and the answer that it takes time and I just needed to mentally push through.

I had some hope after the visit, but as a couple of days passed and I remained virtually paralyzed, I realized I hated the doctor's answer. Pushing through an inferno is beyond painful, and time was not mine. I was in a desperate, dark corner of hell within my own mind and body. I shut everyone out. I could hardly speak. At this point, I was living at my parents' house during the week and at home on the weekends because it was impossible for me to care for Hannah and I was on 24 hour watch by my family because all I could say was I didn't want to live like that and I was running out of time. My mom stayed up with Hannah through the night and day while I took sleeping pills to battle insomnia and other pills to try to put out the fire. Nothing was working - not the medicine, nothing. A melancholy cloud had settled in over me, my family and friends.

I had made plans to meet up with friends to show off my girl baby. I had to have Jason cancel many appointments because I couldn't speak, focus, put sentences together, or function. We proactively made arrangements for our friends Matt and Cari to step in for us and sing in my friend's wedding in case I didn't pull through in time. I felt subconsciously devastated. I was so honored and had been looking forward to it for so long. But my mind's record wouldn't spin right. I desperately wanted to be well for the wedding, and instead the words to the song cycled in my brain and I couldn't budge.

I tried to be optimistic sometimes. I would cut off the mental cycle and repeat, "The SSRIs are working. God has not left me. I am healing." Then my mental voice would only repeat "SSRI selective serotonin reuptake inhibitor" over and over again. I was spinning.

My subconscious knew what I was missing but my surface thinking had turned to ash. Deep down somewhere, I knew I had an amazing life. I knew I loved my husband deeply. I knew I loved and wanted to care for my baby. I knew my family was working hard to help me. I felt like a burden. I knew my friends were reaching out to me to help and I could do nothing about it because my surface mind was too packed with ash. I had crawled into an in-body experience where I was suffocated by my own skin. I had lost all surface feeling. I couldn't cry.

Physically my eyes were dead, my body was tired but couldn't rest, and my appetite was lost, which made it nearly impossible to take the medicine that needed to be taken with food.

I was desperate for relief, so we went to a lab to get my blood drawn to see what we could find on our own, specifically around my hormone levels that were surely crashing. Our goal was to take the findings to my primary care physician in hopes she would identify the issue and come up with a relief plan that didn't involve taking time and pushing through.

On April 23rd we brought in our blood results to my primary care doctor, told our story and pleaded my case for new relief options. She said push through, it takes time for the medicine to work, and come back in a few days if I still feel desperate.

A few days passed in a fog. I continued to have a devastating existence punctuated by glimmers of hope for my family where I appeared to push through enough to show signs of positive progress. For some reason I felt better in the evening. Unfortunately, all glimmers were short-lived. By morning, the inferno would return to my body and I would withdraw.

We went back to my follow-up appointment with my primary care doctor. Nothing had improved as far as I could tell. I told her I was desperate for relief. She decided she should do something, so she switched my anti-anxiety medicine to a newer medicine made by the same company. It was also an SSRI but supposed to target the specific part of the brain that needed serotonin. She gradually increased my dose. Our hope was that it would kick in faster. I went home with new hope.

The hope faded fast. The fire burned hotter than ever, and my emotions were completely dull.

I obsessed even more about avenues like hormone replacement therapy, natural hormone remedies, creams, gels, acupuncture, everything. I made an appointment with a counselor to explore the options she could offer. Perhaps new anxiety relaxation techniques, talk therapy, anything that might help. At the appointment with her on April 30th, I sat with a sunken face, incapable of expressing feelings. My words could hardly leave my lips. She asked why I was there, and I plainly replied, "Because I'm in hell in my own body and I can't get out."

She attempted techniques that are intended to move the colors of pain throughout my body and out through my feet. My colors were orange and red, and they wouldn't budge. She asked me to envision myself in the situation I currently feared most. I placed myself in bed, the morning sun peering through the window, the burn setting in and the tremors in my body, the record in my head saying, "I am afraid this is forever. I don't want to die from this but I can't live like this." The counselor implemented a technique that was designed to convert my fear into an opposite sensation. I remained in the bed, my colors were still orange and red, and I wasn't converting. The counselor knew it. She wrote the name of a pharmacist who specializes in natural hormone remedies on a card, wished me luck, and told me she couldn't help me.

That visit was a disappointment. Every visit was a disappointment because I was fighting as hard as I could, I was letting time pass, and I was getting no relief.

I had my follow up appointment with my psychiatrist scheduled for Wednesday, May 2nd. I wasn't eager to give him the news that my meds had been changed by my primary care doctor. We had made an appointment for Thursday with a new OB's office because I saw on their website that they specialized in hormone replacement therapy. Granted, it's for women in menopause, but I thought perhaps they had new ideas. We were making appointments with any doctor we could and trying everything.

Other than researching solutions online, I stayed away from the Internet. I stayed off Facebook because I didn't want to see people's pictures of their babies. I didn't want to know what people were doing that I couldn't.

I never made it to the psychiatrist or new OB. I woke up Tuesday, May 1st, and it was different. The fire had burned for too long. I needed relief and since my current OB was supposed to navigate me through pregnancy I prayed she could navigate me out from the deadly postpartum waters and back into my old safe life. I made an emergency appointment with her for that afternoon.

That day I knew something had to change. I was tired of burning. I was exhausted physically and mentally. My body and mind had betrayed me, left me, and I feared they would never return. I was doomed. I knew I was dying. I had started to think about Hannah and how her life would be without me. Years from now she would lay her sweet head on her pillow at night, innocent face touched by moonlight, wondering what her mother was like - her laugh, the sound of her voice, how her hands felt to hold - and she would cry angry tears at my death. I thought about my love Jason. Would he remarry? Would she be like me? Would Hannah like her? Would he be able to keep my belongings? What would remind him of me as he drove around? I thought about my family. They'd been through too much the past few months and I begged God to spare them more misery. I thought about my friends and how many people had reached out to me as I shut down and how I wished they could know how truly blessed I knew they made me even though at the time I had no surface feelings.

This could not be my life. Something had to change that day.

In my visit with the OB that day, she was forthright. She was out of her element with postpartum patients so severely infected that they were dreaming, vividly, of dying. Our phone conversation a week or so earlier had led us to the intake facility where we were originally given options I hated. I still hated them, but this time I had no choice. I had liquefied beneath the heat. I was afraid and desperate for relief. We decided I needed to be admitted to the hospital.

My mom dropped Hannah off at her house to stay with my brother and took me to the hospital. Admission was unnerving. When I entered the behavioral health facility, I prayed that God would make things right. It hurt when my mom left me there that night. I took my seat among a roomful of strangers, each suffering within their own psychiatric battle. I felt this was my last chance to get my life back. I was petrified.

After begging for and receiving a sleeping pill from a nurse, I went to sleep that night on a plastic mattress in a concrete room with an unknown woman 8 feet away. I woke up at 4 am as I had been waking up nights before, walked out to the nurse's station asking for more medicine, and got rejected. I laid back in bed until the sun arrived to indicate morning, scared and on fire. A tech came in to check on me and see if I wanted to join the group for breakfast. I couldn't move. I asked when I would get to meet with the psychiatrist so I could get some relief. He said technically the doctor had 24 hours to see me. Incredibly discouraging.

As I laid on the plastic bed waiting for better news, a woman had an outburst in the hallway. For what felt like eternity, she screamed and bellowed down the hall, begging not to be put away, pleading for her mom. I shook.

Fortunately, it wasn't too long before I was told the psychiatrist to whom I had been assigned had arrived and would see me. I asked him to promise me I would get relief. We discussed my current state and the medicine I was taking. He converted me back to my original anti-anxiety medicine, prescribed another "band-aid" anti-anxiety pill for more instant relief, and a new medicine for insomnia since the other wore off too quickly. It gave me nightmares, but I figured sleep with nightmares was better than no sleep at all.

I don't know if it was the new band-aid pill or the fact that I coincidentally happened to have been on anti-anxiety medicine for 14 days, but that day I began to feel better. Not instantly perfect, obviously, but some of the burning subsided and my skin crawled less. I was advised to give myself small goals to focus on and to distract myself with anything I could to take my mind off how I was feeling. With some momentum, I needed to act like I was well first and my mind and body would follow. Beyond getting well, my goal was to get out of the hospital in time to attend my friend's wedding that coming Saturday. Distractions are hard to find in the psychiatric facility where there's nothing but a tiny old TV in the corner of the public seating area and old 90s National Geographic magazines, so I decided to attend every group session they offered. I attended sessions on spirituality, how to find resources outside of the center, thinking positively, and even an Alcoholics Anonymous meeting for kicks. Once I started feeling better, I decided it was God's plan for me to be there and I wanted to soak in as much as possible.

I also realized that God put me there to alter any stigma I had about people who seek treatment in those facilities. They were all God's children, each there seeking relief like me, but with other triggers and pasts. I prayed over everyone I met. I will never forget the people I encountered there.

Misti - one year older than I am, 2 young children. She had a stroke after giving birth years ago and has never been the same. Her body hurts her all the time. She cried to me as she told me how she was in so much pain and took so much medicine for it that she was addicted and was in dire need of a new way.

There was Chris, who struggled with bipolar disorder and lived and breathed fishing. He repeatedly invited anyone and everyone to join him on his boat at a lake some miles away. He had 2 kids around my age and worked at an outdoor sports store. He encouraged everyone to talk and share their stories.

Young Amanda was there because she had run out of hope. She had been diagnosed bipolar 6 weeks earlier and struggled with alcoholism. She and her kids lived with friends in an abusive environment. She left the kids behind to get herself straightened out, and she didn't know where she was going to go when she got out but she knew she and her kids couldn't go back to that home. In fact, there were several people in the facility who did not know where they were going to live when they left. It hurt my heart.

There was Will who was recovering from a drug addiction and had done manual labor for tornado recovery in Joplin and was hoping to be able to find some sort of work when he got out but good work was hard to find. Jesse played guitar, was a solid artist, but couldn't figure out why he couldn't feel happy. Kay was retirement age but didn't know why her self-esteem wouldn't allow her to enjoy it.

Hearing their stories and knowing what they so desperately wanted relief from softened my heart. I lost myself in their lives and forgot about my problems for awhile. I want them to heal. I begged God to save them.

After working through the process in the facility and feeling I was on the upswing, I met my goal of getting out the day before my friend's wedding. As I attended the wedding the next day I still didn't feel great, but I was finally at a point where I could push through, and I continued to act like my old self in hopes that my mind and body would follow. It hurt to see someone hand out programs knowing that my postpartum ordeal had robbed me of that chance. I fought tears during the reading, and I cried as my friends sang the song I was supposed to, but I was also incredibly grateful that they had stepped in for me and I was so proud of the beautiful job they did.

Each day now I continue to power through. I don't know why God chose this experience for me, and at first I was pissed off that He did. But I am not a victim of this; I am surviving a temporarily crippling severe battle with postpartum depression and anxiety. It saddens me that I don't get to breastfeed my baby because I was truly enjoying the bond I felt with her, but I feel fortunate that formula exists so she can thrive as she is. It angered me that I missed out on participating in my friend's wedding, but I was happy that I could cry there because at least that meant I was having feelings again. I regret any burden I put on my friends and family, but sometimes it takes a terrible trial to reveal how deeply people can love you, and I have never felt such support from some of my friends and family. My mom deserved to simply fill a role as a grandma, but she selflessly stepped in and carried out my motherly responsibilities when I couldn't. Jason showed great strength, and pushed through his own battles to be a great dad to his new baby girl and an incredible husband to me.

I am thankful for the help the behavioral health center provided me, but I resisted for so long out of fear that it wasn't the appropriate place for me and in truth I don't think it was the perfect place for someone in my situation, but I had no other options because I don't believe the right postpartum recovery facility exists. As a new mother who was struggling but never had any thought of harming my baby, it was punishment to only get 15 minutes of supervised time with Hannah while I was there. As someone suffering with frightening postpartum anxiety, I needed a softer place than the scary, restrictive walls and the strict regimen of that ward. I'm not sure how I would have dealt with the doctor taking longer to see me and the delay in medicine. I believe a specialized recovery center for postpartum women needs to exist in St. Louis.

Perhaps God allowed this to happen to me so I can have better insight into the treatment options for postpartum women. I still struggle some, but it's a vast improvement over what it was. Now that the hormonal/anxiety fire has started to subside, I feel an internal fire to help women who are suffering from this complicated, scary illness that robs so many women of joy during a time when the rest of the world would expect them to thrive. I am grateful to be out of that deep postpartum hell and on a road to recovery, and I pray God uses me to help others through my experience. One day at a time.

2 comments:

  1. Rebecca, that is such an insightful journey of your emotional turmoil. I am so glad you recognize the blessings of a loving and supportive family and the strength that can come to a family through prayer and love.

    Thank you for sharing such a personal experience.
    Writing your blog is probably a healing process for you, but it also shows those who know you and Jason what a strong woman you are and confirms the love and support of your family. It was terrific seeing you at the Oakwood office and knowing you are doing well and getting to meet Hannah Sophia Rutherford. I love her name but think you and Jason should change it to "Monkey Toes". I look forward to reading your updates! Thanks again for sharing.

    Linda Bersch

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    1. Thanks so much, Linda. I appreciate your kind words and support. I am lucky to have such encouragement, and it doesn't hurt that my little "Monkey Toes" is so sweet. I have a lot to be thankful for, despite the tough situation. :)

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