Sunday, November 25, 2007

Panic Attack Update, or Better living through Chemisty

This may seem like a hypocritical post after the last one (Is knowledge always a good thing?) regarding my cardio visit. Bear with me. I'm a modern American with many options for joy and irritation.

I went to a psychiatrist, Dr Rex Gentry, who specializes in pregnancy and post partum mood disorders. We spent an hour going over my history and talking about natural physiological phenomenon of pregnancy. For instance, pregnant women commonly develop a heightened sense of awareness in order to protect their unborn, then newborn baby. However, in some people, this sense gets turned to "11," which can present in intense crying, gripping panic and deep depression. Because of my history, he felt that I was at a fairly high risk (40%) of continued episodes of depression into post partum.

I feel he is right about this. It's been a concern of mine since before I even got pregnant and particularly because of my situation, it makes sense to me to be on medication. It's safe for me and the baby - in studies, the drug has not been found in a breastfed infant's blood. There seem to be some very long term negative effects but this isn't a med that I would take for more than about 6 months.

I feel relieved that I'll be able to be with my baby and enjoy him as much as possible. I don't feel like I'm supposed to be some automaton who is happy all the time and blissfully ignorant, dancing through the streets as if they are fields of tulips. But a little balance is good.

I cried last night when I got up from the couch because my hips hurt so much and I'm tired of it. It felt good to cry a little. That was fine. But the gripping panic attacks were too much. Not livable. And if things like that happened when my baby was in my arms, ... I don't even want to think about it. That starts going down the Yellow Brick Road of Catastrophe and Psychosis and I ain't into that trip. I really don't feel I need to get attacked by flying monkeys only to have some big green head tell me to click my heels and say, "there's no place like home." I'm good here, no reason to go anywhere else. Thanks, man. I like it where I am.

Cardio Update/Moral Dilemna - Is knowledge always a good thing?

Went to the cardiologist on Friday. He said he thought, like me, that this could be normal for pregnancy. However, because the progression of symptoms matches the progression for real heart problems, we will do a stress echo to make sure.

On one hand, this is really cool. They will ultra-sound my heart while I walk on a treadmill at increasing speeds and inclines and check for normal patterns. I hope I get to see the ultrasound! And I like the idea of being thorough. I'm so grateful for full medical care and utilizing this great diagnostic technology to verify my safety.

On the other hand, I'm scared that I'll be forced into an episode. It's scary to feel my heart pounding so hard and not be able to bring it down just with my breath, like I'm used to doing. Then the dizziness and leg numbness. Inevitably, the dizziness makes me feel panicky. And the worst part - what if something is wrong? If they find something wrong, will that mean I can't birth in the birth center? Does it mean that for sure something bad will happen during the birth? If I do this, and something is wrong but not bad, will I be putting myself in danger? Would I be bringing a legal liability into the hands of my midwives?

Sometimes knowledge can be a dangerous thing. Birthing babies is such a common yet still mysterious physiological event and western medicine tends to err on the side of the known. It's easier to have a c-section than try a variety of other methods that might not work because the baby could die and we know (very well) how to perform a c-section without killing anyone. WE should - it's the most performed surgery in America. It's easier to birth in a hospital and have the mother on her back, feet in stirrups, constant fetal monitor because we can see best (despite she's pushing against gravity) and we can know if the baby's in distress. Of course, the baby's distressed! They are being pushed through a somewhat stretchy tube with a bunch of bones at the end and if they aren't in exactly the right position, it's much harder for everyone. Birth is a traumatic event, but so is climbing Everest or walking down the hallway of your new high school. You may have an idea of what will happen, but until you've done it, you haven't done it. And I'll bet your heart pounds a lot and maybe a little irregularly from excitement and exertion.

So, I guess my question is: Am I inviting a hospital birth by doing this stress echo and is that a good thing or not? Is it just a personal bias, a bad ju-ju that freaks me out? If it's best, can I safely put my feelings aside (guilt, trauma, anger) to make sure I'm safe? And what determines best? If I have a 10% chance of going into cardiac arrest during or post partum, is that enough to say I should be in a hospital? What is safe risk and what is just plain stupid?

Sunday, November 11, 2007

Belly shot - 35 weeks

I'm 35 weeks pregnant...

... and my husband won't share his beer with me! I don't want a lot, just enough to fill my wee glass.

I made him give me some after threatening to post to all my pregnancy forums that he was neglecting my needs. After grudgingly pouring 2 oz into my tiny glass (note that it is not full), he happily offered the dog some beer. And gave her more than I got!

To be fair, watching her drink is a lot funnier than watching me drink. She snorts and snuffles and then lays down and sleeps with a smile on her face.

Blood tests normal...

Everything came back like they like it. I decided to go see a cardiologist anyway, because I'm kinda conservative that way. I still have these weird dreams occasionally of expiring after the birth, ostensibly from a heart defect.

My honeyman says I should write tear jerker novels with all the catastrophies I can summon. I'd probably get on the Oprah Book Club!

Wednesday, November 07, 2007

Thanks to the internet...

I think I'm just pregnant. That's it. It's being pregnant that causes these things.

I thought through the conversation yesterday and realized, she never said she thought I had CHF. She said she's missed things like that before, ie sent a patient to a cardio for one thing that proved to not be a big deal, but was concerned about said patient's early stage CHF.

All she was saying was she wanted to make sure I was okay. And I turned it into I might never be able to have another baby.

The way I came to this realization was, strangely enough, the Internet. I looked up symptoms of CHF and anemia and I don't have very many of them. Well, I might be anaemic but that's not really a big deal. My mom and sister were and they came through just fine.

Isn't it amazing how the brain works? I know I've always had a bit of the catastophist in me. It may be a Gothic Romantic that imagines my own death. Baby born, I gaze at him once, then quietly expire of exhaustion, like in one of those old westerns. Sweaty brow, eyes closed like I'm finally getting the best sleep in the world, the doctor's quiet head shake, like there is nothing to be done.

I laugh at it now, but you know when you see that scene in the movie, you are torn up. What will daddy do without the mama to raise his little baby? And they had such a fabulous love with much hardship before coming together and bringing this sweet child into the world... So many permutations of tragedy.

Do we have a human need to create tragedy in our lives? Is this a human condition or just my own mental illness? If it is just my own, am I too bored? Should I be more absorbed in creative activities or helping others so that I don't get bogged down in unnecessary drama? Somehow, this makes me think of soap operas. I don't watch soaps (we don't have regular tv) but I am reading a pile of trashy novels. Maybe that's bringing about this case of mental catastrophy. I guess that means it's time to pick up "Getting a Grip" by Francis Moore Lappe and see what she's got to say about Democracy in America. That ought to shake out the drama!

Oh, considering the news today, maybe not. Impeach Cheney? What good will it do?

Tuesday, November 06, 2007

Feel Scared today...

I expected to be somewhat tired during the pregnancy and everyone says that's normal. But lately, my legs are numb when I wake up and anything faster than a slow shuffle makes my heart race, the leg numbness return and brings on dizzyness and shortness of breath. It gets scary really quick. Now when I go to the dog park every morning (since beastie needs to run) I go with a friend and I always have my cell phone with me.

Today talking with my nurse-midwife who did my early pre-natal care, she thinks it could be low iron. My vitals look good and she couldn't hear the heart murmur she heard before (which no one else has ever heard). This is good. However, if the blood work comes back negative, I get to go see a cardiologist.

I'm really trying to not freak out about this.

A cardiologist would be looking for late-term Congestive Heart Failure.

See why I'm trying?

I'm not winning. CHF is not curable though it is treatable. CHF means I can forget about my current plan to birth in the birth center and a home birth is not in my future. They would push for a C-section (which I really don't want.) In fact, I probably wouldn't be able to get pregnant again unless I was watched like a hawk by cardio and OB and everything. How very not fun. Multiples (which we want and run in our families) would be even more dangerous.

I couldn't help it - I started crying on the way home.

Of course, if this were true for me, I would buck up and deal and not do anything to endanger myself or my baby. But GAWD! It's just too frightening to imagine how I can go from healthy to High risk pregnancy in the time it takes to make a diagnosis.

So, we'll find out in a few days what the deal is, or at least what the next step is. Whatever it is, it is manageable. But I certainly have a hard time not getting worked up over it! Time for a warm glass of milk and some cuddle time with the beasties.