HTT - Guest Blogger Edition

Today's Hot Topic comes from Tara, my new friend, fellow blogger and mother of three lovely ladies. Some synonyms for Mrs. Em would include witty, smart, funny, gorgeous, insightful, friendly ... to name a few. And we can now all add "brave" to the list because the following topic is a candid look at Mrs Em's experience with something the world still speaks about in hushed tones. Thanks to Mrs. Em for sharing the message loud and clear.

Now, tell us what you think!

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All I've ever wanted, in my whole life, was to be a mom. I couldn't wait. When ever I was asked what I wanted to be "when I grew up" ~ The response was always "I want to be a mom". I loved babies and I babysat a lot as a teenager. If given the opportunity to babysit on a weekend night, I usually opted to do that rather than go out with friends or to a church dance. Sure, I did plenty of that, but I liked kids, especially babies, and making money was never a bad incentive either.

So when we found out in December 2001 that I was pregnant, we were pretty excited. I looked forward to the day when our sweet little girl would arrive and anxiously prepared for her debut. I found a crib at a garage sale for $25, and a dresser at a resale shop on the way to take my sisters to girls camp with my mom that summer. That was fitting for our student budget and when my family went on vacation we took over their house and David refinished both pieces of furniture to match. Things were progressing beautifully through the hot, humid summer and all looked well for her end of August arrival.

I had a nice little secretarial job at the medical school where David attended, and we got to have lunch together every day. It was nice, for a while, being newly weds and all b/c he didn't have a lot of time in the evenings, since he was busy studying. But nice didn't last. I didn't know better than not to lie when I was a- asked if I was pregnant and b- tell them I wasn't going to come back to work after I had the baby. I didn't make enough money to make it worth putting her in day care, besides which, even if I did, I 99.9% assuredly would have not come back anyhow. I thought I was being nice by agreeing to train someone to do my job and putting up with more MD/PhD ego until I had her… "I didn't go to school for X # of years just to have some secretary forget to put my MD/PhD on the Tuesday lecture series flier". Whatever. After trying to make some negotiations with respect to correlation with faculty members in the department, with no success, I packed up all my personal belongings one Friday and figured I'd give myself the weekend to think about whether or not I wanted to come back to such a degrading situation.

I didn't go back.

That decision was good and bad, I felt bad about it, but to this day I stand behind it. My mom had a bout of health issues during that time. Two major surgeries within a 5 or so month period and I was terribly worried about her. My dad had been notified that he was being laid off at his job and the prospects for other employment in the area (locally) weren't looking good, I knew my family would be moving, eventually. Now I had more time on my hands than ever before. Not only was I worried about my mom, and my family, but some issues came up that had long since been suppressed and I felt emotionally overwhelmed. So I sought professional counseling.

I had been to about 2 sessions with my counselor when two weeks before my due date, my water broke (a whole other long story- we never will know if in fact it was 100% for sure my water). I had an appointment with my OB/Gyn the next day so I figured I'd wait to see if any contractions started because there were no other indications for her coming so soon. By the time I went to that appointment there were still no contractions, and to make a long story short, I was admitted to the hospital. Friday morning I called my counselor from my hospital bed to let him know I wouldn't be there for my appointment that day because this baby was coming! By noon, my labor had been induced but wasn't progressing. My doctor was not delivering babies that day (in town at a conference all day, something like that). I ended up having a c-section at the recommendation of the obstetrician's whose care I was under.

Having never before given birth, I did not know to ask the right questions as to the indications for, what seemed to me like rushing, to surgery. As far as I know the baby was not compromised in any way, like a drop in her heart rate, and I was not having any complications. Their admitted reasoning for going to the OR was that it had been almost 48 hours since my water broke and at that point you are at a higher risk for infection. So with tears streaming down my face I agreed to go, and off we went. The two things that I did not want to happen to me, were happening. My doctor was no where in sight (In fact his practice partner was one of the physicians who would now be doing my surgery, and I'd had bad experiences with her in the office during my pregnancy, I'm not a fan of female OB's) and I was now being wheeled in for a C-section. I had strong feelings about the rise of C-sections in this country and had a discussion with my OB early in my pregnancy about it. Had I know that he was "physician of the year" (aka: brings in the most revenue [cesarean] for the hospital) I would have gone running. But I was inexperienced and didn't know a lot. It wasn't that I felt like I would be "less of a woman" for not delivering a baby vaginally, I just feel that so many c-sections are done unnecessarily and that "I've got big enough hips to push a baby out, me having a c-section would be absurd!"

All seemed to be well within the next 24-36 hours after Hannah was born. Besides the fact that I was in a lot of pain from the surgery, I was happy to be a mom and loved holding my sweet little girl more than anything in the world. But with the pending loss (ie-2,000 miles away distance) of my family among other things, I was feeling a little blue and asked for something before I left the hospital. I was prescribed Zoloft by my doctor and sent home to recover and begin my life as a new mother, the day that David started his second year of medical school. Lots of change lay before us. There was some minor drama surrounding the coordination of which mother was going to come help out when, something I did not need at that time. About 5 days after I got home, one side of my incision had come open a bit and was infected. I was emotional, as most new moms are, and because of the complications with my incision, had to go in to see the OB/Gyn. I was especially weepy when I saw him and he was concerned, thinking maybe I wasn't getting enough of the Zoloft, so he doubled it, just 5 days or so after I had started taking it.

I don't remember much with any clarity after this point (or before, to be honest), I was pretty sleep deprived- needless to say- so it's all kind of foggy. My mother in law was staying with us to help out with things and the new baby. She had taken David to school on a Friday morning and gotten lost getting back. I was at our apartment by myself with Hannah and she was screaming as new babies sometimes do. To a first time mother who is trying to take care of her engorged breasts, worried about the fact that obviously her MIL is lost getting back home, listening to her baby scream, it's pretty overwhelming! I called a friend that lived in our building, forgetting that she'd just gotten her wisdom teeth out, to see if she could come hold the baby while I tried to take care of myself, and see if I couldn't reach my mother in law (although at that time I don't think she had a cell phone yet so getting a hold of her to tell her how to get back to the apartment was kind of a mute point). My friend's husband came over a short time later, but by that point another girlfriend had showed up to hold the crying baby. At this time he was a resident physician and after some dialogue with me, felt that I wasn't "myself" and needed further medical attention. A short time later my mother in law returned, she had gotten lost, and we were supposed to be getting ready to go to a doctors appointment for the baby. But at the recommendation of this friend, he retrieved David from school and he took me to the ER.

By the time David returned home, I remember being pretty frazzled and overwhelmed by all that was going on. I knew he (our friend) was suggesting I wasn't "okay" and that was stressing me out. In a later conversation I learned that he had asked me if I was having feelings of hurting myself or the baby, and he says that I responded "yes". I remember him asking me that, where I was sitting in the room and the Mormon tabernacle choir singing "come, come ye saints" playing in the CD player… and responding "no". I honestly was not having those feelings. I never have before or since. But, I don't think he'd lie, so they did what they thought was in my best interest.

I don't know what would have happened if David hadn't taken me to the ER, but by the time I got there I was not myself. I remember my thoughts were totally weird and I even tried to run from him. I was confused as to why he took me to the hospital that we were at (not the hospital I delivered at and had never been to before). I won't go into detail about all that ensued in the Emergency room, because it's pretty embarrassing, but it was scary and sad, for us all, for a while. And that is where this became a Psychotic episode: aka: Post-Partum Psychosis.

The next thing I remember was being transferred by ambulance to the Psychiatric facility. I must have been pretty sedated because while I have very coherent recollection of being transferred in the ambulance to the facility and admitted, I don't think I would have gone willingly if I knew what/where I was admitting myself to. It was so late by the time they transferred me that they had to take me in through a side entrance where I sat and waited with my husband and mother and father for a while. Then they walked us up to the unit where I would stay for the next 3+ weeks and I had to say good bye to them at the first set of 2 double doors that were always locked, lest people tried to leave the facility.

Unfortunately, my condition got worse before it got better. While this area of western medicine has come so far in that past decade or two, there is so much that is still unknown about psychiatric medicine and conditions, especially pertaining to post partum women. I received a lot of medicine via IV while in the ER and after that was given a lot of pills on the unit in an attempt to 'stabilize' my condition, and return me to normal. I was pretty confused and was telling my family that I thought they were trying to drug me because I would get a handful of pills 2 & 3 times a day and I don't remember a lot because of it. Honestly, I have my own speculations about whether my 'delusions' were being caused by my "condition" or made worse by the medications they were giving me. For a girl who has never experimented with street drugs or alcohol, all those medications were a pretty toxic shock to my system.

I have written in my journal somewhere, some of the experiences I had and things I saw there. Things I never care to see again, nor do I really want to remember. There were people in the unit whose conditions were complicated before hand by excessive drug use. That type of life style makes it even harder to treat those people. I remember I was talking to my dad on the phone in the lobby area of the unit when we were all suddenly ordered to go to our rooms. There was a patient on the unit who had gone berserk and my dad could hear him. Some of the pshyc-techs on the unit who were basically there as body guards in case pandemonium struck had to tackle this rather muscular male and get him into the seclusion room. I remember being in my room, scared to death. I felt like a little kid who was listening to some family violence in the next room. I don't know what he was doing in the padded seclusion room, but it was loud and scary, I felt so alone. After we were allowed back into the main area of the unit, My dad called back and was talking to one of the nurses on the phone- rather loudly- concerned for my well being- and rightfully so. I did not like some of the nurses and techs there, they were pretty rude, and she was pretty flippant and rude to my dad. Honestly, they are probably just numbed by the situation because "this is what they do every day".

I only got to see my family a couple times a day for hour long visitations, and I would go with the group on "smoke breaks" because that was the only chance I had to get outside and get some, sort-of-fresh-air. I'd try to find myself a little place where I could breathe non-smoke air. Actually, I would sit and talk to some of the pshyc techs who were immigrants from somewhere in Africa (I have since forgotten the state) they had really cool accents. They were pretty nice to me. I remember when I was finally discharged, the day before the 1 year anniversary of 9/11. I remember watching the news and thinking "I hope I get to go home before the one year anniversary". I wanted out of there so badly. Every day every patient on the unit met with their Psychiatrist. I remember on several occasions being asked to do things like repeat a sequence of 10 numbers in reverse order. I felt like it was so unfair because I could hardly do that when I wasn't doped up on a ton of medication, let alone zoned out on a bunch of medication! I was so frustrated trying to figure out what these people wanted from me and what did I need to do so I could go home. Close to the end of the nearly 3 weeks they wanted me washing my laundry there in the facility. That is a realistic expectation for any grown adult, except for that I had just had a major surgery and was trying to recover in this totally foreign place, on an uncomfortable, sweaty hospital mattress. Under "normal conditions" after having a c-section you are told NOT to be doing laundry or lifting anything heavier than the baby for at least 6 weeks, but they didn't seem to abide by that rule. I told David just to go to Wal-Mart and buy me some "Hanes her way" because I felt uncomfortable being "supervised" while I took a bath and got dressed. He assured me that I would be blessed for just sticking to my normal routine and that I would heal and be able to come home soon. He was an amazing support through this trial that we endured together, yet alone. Every day when he came to see me he'd bring me fresh fruit and little chocolates. I longed for that hour I got to spend with him every day. I think I would have gotten better a lot faster if I'd been able to have more time with my family.

I remember one or two visits I had where I got to leave the unit escorted by a tech and visit with my family down in the main lobby so I could hold Hannah. I got tired pretty quickly holding her. Having now had 3 cesarean sections I know why, I was still recovering from major surgery, not to mention a traumatic psychotic episode and I was very weak. I was pretty emotionally detached because I don't remember being totally distraught that I was separated from her. To think now that I was not devastated by that, devastates me. I had a few pictures of her in my room as well as some other mementos that went missing. I had a plaid and canvas bag that had all my stuff in it that David brought up to me, but I went home with all my stuff in a plastic garbage bag. I loved that bag, but it went missing. Not 2 days or so that I'd been there they confiscated my hand pump that I was pumping with, in hopes that I'd "get better" quickly and still be able to nurse her. I would see it in the nurse's medication closet every time I had to take my meds, a painful reminder of what I had lost. I did finally get to go home on September 10th. My mom and dad came to pick me up and take me home because David was in class and his mom was taking care of Hannah. I remember walking out to our family van with them. It was a very sunny day. I could hardly open my eyes outside because I wasn't used to the sunlight.

Coming home felt so good, but days and months that lay ahead were hard. I just wanted to come home and get on with my life and enjoy motherhood. But I felt like the joyous experience I deserved it to be was thwarted by this ugly thing I had no control over. I also struggled to face society again. Most people at church knew that "something" had happened to me, but not all the details, and I was afraid of what people thought. To be honest, I still don't just volunteer the experience for that reason, but here I am, revealing it to the world, and the blogosphere at large!

In light of the year anniversary of the Andrea Yates tragedy that had just passed before I had Hannah, I totally understand why the issue is taken so seriously. Depression and especially psychosis are scary issues and very stigmatized by our society. There of course is no going back and changing what happened to me in that instance, or how things were handled but almost 5 years, and 2 more little girls later, I am doing really well. Post Partum Psychosis is something that happens to 1 in 700- 1,000 women. Statistically the chances of it happening again are about 20%, pretty high. It still has not been determined exactly what causes psychosis to occur, but research has shown that it is most definitely linked to the rapid change in your body's hormones after childbirth. Pre-existing history of depression or bipolar disorder increases the vulnerability of women to episodes of postpartum psychosis. It has also been found in research that unexpected cesarean and delivery complications also present a higher risk for post partum psychosis to occur. I had several of the risk factors for it happening stacked against me at that time. Unexpected Cesarean, my doctor did not deliver the baby, several stressful life events occurring simultaneously, family history of depression. I learned after this happened to me that my great grandmother was hospitalized after the birth of her 9 or 10th child because she never "came out of it". She was hospitalized until she died sometime in the 1970's. They just did not know as much about it back then and couldn't do much for these poor women. The way society views those who suffer from these conditions has changed drastically in the past 50 years, but still has so far to go.

My dream, one day, when I'm not raising children at home anymore, is to help women who experience this, somehow. I don't know what I'll do, but it will come to me when the time is right. I feel very strongly that there needs to be special in patient care for post partum women who have to be hospitalized after childbirth because the conditions of most psychiatric facilities are not set up to care for post partum women. I know this is a very real and painful experience, to any who may read this that have questions or are struggling with depression feel free to email me if you'd like to talk. The most important thing to remember is that this is a "medical condition" like having diabetes. It can be treated and does not define who you are or make you less of a human being. I've often wondered where the other women are out there who have experienced this to the degree that I did. Not to minimalize anyone's experience because I know it can be a personal hell at lesser degrees than this—but I have always felt like maybe I'm the "only one" which I know is not true, I just haven't found you yet (o: If you or someone you know has experienced post partum depression or psychosis, I would love to hear your story-- email me. For those to whom this all sounds totally foreign, I hope I haven't freaked you out (o: I would encourage anyone who reads this, that might think they are experiencing depression, post-partum related or not, to seek counseling and work closely with your doctor &/or counselor. It can and will make all the difference. And lastly to seek comfort in the Lord, He loves you and He knows you, and what you need, and how to succor you more than anyone ever could.