Friday, August 22, 2014

Out of the Darkness

I'm sitting in the dark to write this. It seems to be the only appropriate way to get it out of my head since the last year was so bleak. Bright flecks bracketed the gloom, but what happened between the parentheses has left me scarred. I'm working on turning the lights back on and it's almost bright enough to return to writing my way through my imagination.

The short version: I have a fifteen week old now, my third and final baby. My pregnancy and postpartum were full of complications so I'm still recovering.

The longer version:

I had my first midwife appointment the day after I got a positive test. I had a history of hyperemesis gravidarum so we needed to be proactive with my treatment in case it happened again. It did. By 5.5 weeks I couldn't keep anything down anymore and started taking an anti-nausea medication, Diclegis. It helped at first, but it made me so sleepy that I couldn't drive more than the mile to get Turbokid to and from school. Messy Mouse trashed the house while I dozed on the couch.

By eight weeks I was on the maximum dosage of my medication and was running out of safe foods. I was vomiting between 15 and 30 times a day. I was triggered by the shower, by the color chartreuse, by certain sounds, and by every smell. I could no longer drink water, and wouldn't be able to again for another sixteen weeks. My husband was out of the country for work so I was alone for ten days with a preschooler, a toddler, and an inability to stand up for more than five minutes without vomiting. My kids' whole foods diet became a steady stream of veggie burgers, veggie dogs, bread, fries, carrots, and applesauce.

I forced myself to sew my son's Halloween costume but I was too sick to take him trick-or-treating. My entire body ached from the frequent vomiting and lack of nutrition. We went to a friend's Halloween party and I spent almost the entire hour we stayed in the bathroom. The rosy glow in my cheeks was due to broken capillaries.

At fifteen weeks I hit my critical dehydration point. The midwife couldn't find the baby's heartbeat with the doppler. After a terrifying five minutes of searching, she took me in a different room for an ultrasound. My heart rate was fast and the baby's was slow, so they matched and she couldn't tell them apart with just the doppler. The midwives tried giving me a shot of phenergan. I vomited foamy acid into the sink, became agitated, and the walls started to move. They sent me home after two liters of IV fluids and making sure the baby's heart rate was back up in a less scary range.

Less than 48 hours later, it was Thanksgiving and I was in the ER pleading with my body to just get it over with and let me die. The vomiting was continuous, my pulse and breathing were rapid, my balance was poor, and I was so confused I couldn't figure out how to fill out the forms. I had lost seventeen pounds and it would have been more if I hadn't spent the previous seven weeks on partial bedrest to conserve calories. The IV Zofran the ER gave me made me hallucinate and projectile vomit. It took 2.5L of fluids before I could bring my thoughts into some sort of focus. I was diagnosed with a UTI, given IV antibiotics and a printout of ridiculous "tips" to combat HG, and sent home with a 10 day course of oral antibiotics. It was a fight to keep them down. I lived off a soy pediatric drink for two weeks because my stomach was so irritated from a week of vomiting every 15 minutes that it couldn't handle anything solid.

At the beginning of December I started having headaches like electric shocks to my left temple. They were brief, but frequent and excruciating. My doctor determined they weren't dangerous and were the result of nerve irritation from excessive vomiting. I had electric shock bursts 5-10 times a day for several months before the extreme pain faded to tingling. I still have strange sensations in my temple so I think the nerve is damaged.

Just after Christmas I had my anatomy scan. I chose not to find out the sex of the baby. I wanted to separate the baby from the awful pregnancy and keeping her anonymous until birth was the only way I could think to do that. The baby was healthy.

In early January I started to slowly gain back the weight I lost. My first attempt at weaning of the Diclegis was a disaster that nearly required another IV. I ended up not being able to wean off it until about 28 weeks.

February was my best month, even with the broken toe I sustained from knocking a can off the counter. I can't remember if that happened in January or February because it ended up being an insignificant injury, though it was painful at the time. I was able to go back to the gym, though all I did was walk on the treadmill while the kids went nuts in the child care center.

March was cataclysmic. At the end of February, I caught a respiratory infection. It progressed quickly from congestion to a bronchial cough. I went to urgent care on Monday when I spiked a fever and coughed up pink. I was diagnosed with bacterial bronchitis and started on antibiotics. I started getting better, but then on Friday I coughed up blood and coughed hard enough to feel a pop in my lower left ribs. The doctor thought I'd fractured a rib and the bronchitis was turning into pneumonia so he gave me an antibiotic shot in my hip and a prescription for Tylenol 3. I stopped coughing blood. Sunday night around 10pm I was getting ready for bed and had a coughing fit. My left ribs audibly popped as I tried to catch my breath. I couldn't calm my breathing and was in a lot of pain so my husband called a friend to stay with the sleeping kids and took me to the ER. I was given morphine and a chest x-ray. I went home with stronger painkillers and a printout on rib fractures. My husband was flying out for a work trip at 5am Monday so he called his mother to come help me with the kids.

I woke up very early Tuesday morning with a crackle in my left lung. Every breath caused more pops and more pain. The pain spread down my back and up into the hollow of my collarbone. Every movement was agonizing. I knew something was very wrong and drove myself to the ER. After I had a positive D-dimer, the doctor told me he suspected a blood clot in my lung. Since I was seven months pregnant I had to sign a bunch of consent forms for the recommended CT scan. I was afraid the test could hurt the baby, but I knew a life-threatening pulmonary embolism needed to be ruled out. I had a CT with contrast and ultrasounds on my legs. I didn't have any clots, but my left lung wasn't normal, either. I had pleurisy, pleural effusion, a partially collapsed lung, and torn intercostal muscles, though that last one wasn't diagnosed until a month later. There wasn't anything I could do but take Vicodin and wait out the extreme pain. The Vicodin didn't help.

About two weeks later I was starting to feel a little better and could move around a little, but then I fell in a hole in the yard and sprained my ankle. It was the same ankle I had reconstructed when I was in college and I had nerve damage from the repair so I wasn't sure how badly it was sprained. I was given crutches and referred to an orthopedist, who said my old ankle repair was tight and well done so I escaped with a moderate sprain. Unfortunately, I could only use the crutches for a day. The strain on my ribs was too much and my pain level went back up to an 8-10. If I laid in bed on my bad side and didn't move, I was only at an 8, but moving turned it into a pain worse than my worst kidney stone. Several times when the pain or the lingering HG made me vomit, I ended up stuck on the bathroom floor unable to move.

The month of March was pure torture. As the baby grew, more and more pressure was put on my ribcage. It didn't help that she was persistently breech and liked to jam her head into my injured side. I felt like whatever I used to be died months ago and my mind was nothing but a numb shell. That wasn't the beginning of my depression since I was already having issues with it due to the HG earlier on, but it certainly aggravated it. I was in so much pain that I couldn't function. I couldn't take care of myself, let alone my family. I finally got a referral to the pain clinic after the last non-invasive treatment option, lidocaine patches, did nothing. My appointment was in early April, when I was 34 weeks. The doctor examined me and decided that the pain was most likely neuromuscular. He gave me a series of trigger point injections, which released the spasms in the damaged muscles and finally gave me some relief. I was very sore for a couple days afterward, but soon the pain levels were greatly reduced and I could resume living. I still couldn't do any torso-twisting motions and coughing and sneezing were horrible, but after a month of agony just being able to breathe was wonderful.

My muscles relaxed enough to allow the baby to flip head-down just before 35 weeks. That was definitely a relief because I had about run out of room. I measured behind the last six weeks with my first two babies, but this one was bigger and I was measuring ahead. At 35 weeks I was already bigger than I was when I went into labor with the other two even though my weight gain was much lower. I only gained 10 lbs this time compared to the 40 and 35 I gained with my other babies.

My water broke in the morning on May 8th. I didn't have contractions for a couple hours, but once they started up I knew it was going to go fast. After a 2.5 hour labor, my little warrior Elora Eowyn came into the world with a scream. She was born with her right arm next to her head and a true knot in her cord. I had hoped for another waterbirth like I had with Messy Mouse, but since I went from 7 cm to baby out in under 5 minutes with a series of involuntary pushes there was no time to get into the tub.

Our pain journey wasn't quite over yet. I aggravated my torn intercostal muscles from moving around during labor and injured my tailbone during the rapid birth. Elora's face was bruised and her eyes were red with broken capillaries. She screamed whenever she was moved. On day four she was hospitalized overnight for jaundice and we found out the screaming was because her right collarbone had snapped in half on her way into the world. It took about six weeks to heal, and during that time we had to dress her only in front-fastening clothes and swaddle her arm to her chest.

Elora is wonderful now and I love everything about her. She's chubby, smiley, and cooing. I'm still fighting my way out of the darkness, though. All of the physical trauma I went through triggered postpartum depression and anxiety. I've been on antidepressants and going to support groups for two months now, and those have been a great help. I no longer feel so overwhelmed and disconnected from myself and the world. The derealization I had for a while was terrifying, especially when I started feeling lost in my own neighborhood or having panic attacks at the grocery store. I'm coming up on month six of rib pain with no end in sight, but now it usually only bothers me when I move the wrong way or do too much physical activity. I tried a restorative yoga class last weekend but it was still too painful. The tailbone still aches sometimes, but hasn't bothered me much in a month or so.

I'm working on feeling like myself again, both mentally and physically. Progress is slow, but it's still progress. My muscles are starting to feel a little less gelatinous and my mind is leaving surrealism behind. For a while I struggled to write a single coherent sentence, but now my stories are starting to come out of hiding. I'm heading toward rereading what I have already written on Sand Into Glass so I can finish writing the last act of it, but I'm not quite there yet. It's coming back, it will come back, I will come back. It is taking some time to find myself again, but the fight is no longer as daunting as it was a couple months ago. I just need to be patient with myself through the endless days as I battle out of the abyss and back into the light.

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