Antidepressants and Pregnancy Research

I do a little bit of medical research for my job, so spend quite a bit of time on PubMed, an international online database of all peer-reviewed medical journals, which I've learned how to navigate extremely well for work. This is both a blessing and a curse. At some level, I love being able to follow some of the research in depression and pregnancy, and at others, there really isn't a hell of a lot of anything good to say.

I work with scientists who study and treat everything from childhood diabetes to cystic fibrosis to pre-eclampsia. My background is certainly not in science, though part of my job is to translate research findings into laypersons terms so that the media gets interested. It's incredible how much "breakthrough in cancer treatment" gets picked up immediately, even if it's not a breakthrough at all but one simple finding in rodents, while top-level immunology research that is actually helping people right now gets lost, because it's not sexy enough.

We have a handful of doctors at the hospital that research antidepressants during pregnancy and I can't help but follow their work. One of the doctor is very anti medication in pregnancy, while another is working on safe levels and another differs entirely and so on and so on. Even in the medical field, when black and white answers are the ultimate goal, there is so much variation on what is safe. The bottom line is, there is such a huge unknown when it comes to prenatal safety, because really, who wants to be in that study?

Our reproductive psych gave us a website resource that is apparently really good for "real life" stats and research on medication and pregnancy. Not the medical jargon and not the wives tails, but somewhere in between. Devon and I really want to sit down and go over it together, and hopefully find some peace in the findings. We haven't been in the same place at the same time for a while, but I hope that will change over the next week or so as a few things in our lives calm down. 

I wonder how many unreported medicated pregnancies there are - there has to be quite a bit, especially with the stigma that surrounds it. Regardless of the medication, I wonder how many women keep it to themselves because of the shame. Or maybe none. Maybe I'm just trying to figure out why I feel like I'm one of the only people in the world who has this on her mind. Or in her heavy heart. I know that's a really selfish thought, but it's my thought, today.

Making a Fuss - When to Push

I'm not the kind of girl that sends the food back.

I think humans are split up into two groups: one group sends the food back, one group eats the food as-is. I'm in the latter group. It's not that I'm complacent, I'm just the kind of person that would rather eat cold food, or the wrong food, rather than bring on the awkwardness that I feel accompanies "making a fuss" at a restaurant. If I'm brought the wrong order, I honestly believe - in the moment - that it will be easier on everyone if I just suck it up and eat what I get. In theory, I know that telling someone they brought the wrong tray won't break their inner psyche, but in practice, I feel as though I'm making their world crash down if I say, "Excuse me, but I asked for a vegetarian sandwich, not a bacon wrap."

Why am I bringing this up? Because it's not just about food, although that's probably where it is quite noticeable, it's about every aspect of life - especially when it comes to health and health advocacy. I have never been a strong advocate for my health, both mental and physical. I also come from a stoic Scottish family who refuse to ask for help, so the odds are against me.

I didn't ask for a time line of how long it takes for the fertility clinic to book an appointment after a referral is made. I also asked my shrink a month ago for another referral to reproductive psychiatry, and he has not got back to me. Another doctor said he was going to ask a colleague a specific question about a specific medication I'm on, and he forgot to mention it last time I saw him, and I didn't bring it up. I don't want to be pushy about things, because that's just not what I do, but I'm realizing that for this journey that Devon and I are embarking on, we need a voice. Devon has been a really good advocate for me in the past, especially when it comes to my chronic pain that I've been dealing with, but I imagine (I know) that it becomes exausting for someone else to be the constant fighter, when you don't do any fighting for yourself. It's not really fair to ask.

With a mental illness, it's twofold. Your self-worth takes a hit, and that's why there are so many people with mental health issues that aren't getting help - unless you have a fighter close to you, you won't get the help you need, because you certainly aren't going to ask for the help yourself. All those years in hospital, I always thought that I was the most despicable patient in there, who was making nurses go out of their way to "treat" me, but in retrospect, I certainly wasn't a shit disturber, in fact, I was hardly asking for a thing. Despite being suicidal, I was actually really quite lovely. Figures...

I don't know whether TTCing is suited for people who don't fight. There will be lots of appointments, lots of doctors, lots of questions, and I'm not good with any of those. I had to get 7 vials of blood taken from me today to go through the fertility blood tests, and I couldn't even ask the lab tech whether she could take it from the other arm (knowing that it's near impossible to find a good vein in the arm she eventually took the samples from). I just don't know how to stick up for myself.

I envy those people who can just say what they mean, when it comes to service, and medicine. Those wonderful characters who can grab a waiter over and say, "Yeah, sooooo not what I ordered, so go get me the right meal, and just so you know, I'm not paying for it". Although they make me cower in shame if I'm with them, I do envy them... but I know there is a happy medium in there somewhere.

I just want to be respected through this journey. I don't want to wait for calls, but the alternative is not enticing: calling a clinic to ask how long they take to set up an appointment? No way! That's not what they're there for! They're there to make babies for worthy people! (I know, it sounds silly, but that's the dialogue that goes on in my head). I want to feel in charge of my health through this fertility journey. I'm so glad I have Devon to fight for me and us, but I need to be conscious of what I'm giving towards our advocacy.

It is my uterus, after all.

[Photo credit]

Hi my name is Lex and I'm a benzoholic

... or maybe not anymore!

[Oh, and by-the-way, you can call me Lex - it's been nice hiding behind the Crazy Lesbian Mom persona for a bit, but it just gets awkward, especially when I'm talking about my partner, Devon, and I don't even have a name. Plus, everybody - bloggy or not - deserves a name, right? So yeah, I'm Lex. Nice to meet you.]

Today marks the first day in thirteen years that I have not taken an anti-anxiety medication. I made the decision two months ago to stop taking them, for conceiving purposes and for long-term health, and I've weaned off between 1-.25mgs every couple of weeks. 

It hasn't been all sunshine and lollipops. But it hasn't been horrific. My mind and mood have been stable, it's my body that's been taking the hits. When you've been on an anti-anxiety for this long - especially when it is your entire adult life - your body becomes physically dependent. I've stayed awake all night because I just haven't felt tired (though I know I'm exhausted). I've been nauseous and my digestive system hasn't been, um, stellar.  My joints are swollen, my chronic pain has made an appearance again, I'm shaking, I've felt very flighty and not grounded at all, I pee 5 times during the night, and my liver aches. I now know exactly where my liver is. Very well.

My naturopathic doctor, who, for the sake of ease and brevity I call my Witch Doctor (with much respect for her practice), has been working very closely with me to help flush out the toxins which she says are affecting me so much. She says my body will be ready to start trying to conceive in two months. 

Devon has been amazing through all of this. She has always supported me, but she has just made it so easy to not have to worry about anything else while I'm going through the withdrawal.  My favourite part of today was opening my lunch and reading a note: "Congrats on being free". It's true, I feel very free.

I still have (hopefully only) a good two or three weeks of potential discomfort to go through, with the lack of sleep and general ickiness, but I hope so much that at the end of this, I can look back and be proud of this milestone.

Not Just Another Anti-Depressant. Not Just Another Pregnancy.

There is a fine line between being informed and knowing too much.

I work in media/public relations, specifically in pediatric health care. Public relations and sick kids either work wonders together, or are completely conflicting. Nothing makes the headlines more than "1-year old lives over all odds: doctors call her miracle child". Actually, something always does: bad stories. Stories about tiny babies born with awful congenital disorders, toddlers dying in the ER from shaken baby syndrome, little kids with brain cancer, mothers who die on the delivery table only to have their baby die a day later. 

There is a lot of wonderful things going on with child health care and research. But for all the press releases I send out on new discoveries for cutting-edge treatments or new preventative approaches to an illness, I get 100 news stories on how our kids are the unhealthiest they ever have been, or how many kids are not getting what they need. For all the heart-warming stories about how communities pull together to raise money for a family who can't afford medical treatments, there are 100 more about how families fall apart in times of turmoil... because there is little you can do when your child is sick with something a mother's kiss won't heal.

I like my job in the sense that I need to read a lot about maternal and child health. I like being in the middle of touchy topics like vaccines and ADHD and breastfeeding and stem cell debates and women over 40 getting pregnant. I like having access (without having to search for it) to numerous sides of each equation. I like knowing the benefits and consequences to something.

Or do I?

Generally... and I really do mean generally... when it comes to depression and pregnancy, taking anti-depressants isn't the most optimal choice, but if the benefits of treatment outweigh the risks, some doctors will suggest staying on meds throughout the pregnancy. And some are vehemently against it.

I have read enough to know that the risk to the fetus of taking an anti-depressant is quite low. Note my emphasis on the singular. Here's where I lose myself. I'm not on an anti-depressant, I'm on a cocktail of head meds. I have come off two over the past year or so - with a lot of complications - but I still take a few more. I don't have the kind of depression that a low dose of Prozac is going to take care of. My depression is - or should I say was (?) - extremely abnormal. Like shock-treatment, isolation-for-10-days, been on every head med I know about kind of depression. Like the kind where people are not sure what to tell you when you say you want to die, because they can tell how much pain you're in. Like the kind of depression that I can honestly say I didn't believe for a second I'd live past age 21.

Now, I'm better. I've been stable for many years, but it took even more years than that to find a balance of meds that worked (coupled with therapy) and I'm terrified to fuck with that. My shrink does truly believe that the benefits of me keeping most meds the same WAY outweighs the risk of changing/coming off them all. But I don't want to add even a 0.00012% risk to a fetus.

In the grand scheme of medical research, there is very little data on pregnancy and head meds in the first place (really, who wants to be in THAT study). There is absolutely no data on the combination of meds that I take and pregnancy, that I can find. All I have is information on the individual Rxs... and that info isn't confidence-building on the best of days.

If a pregnant woman is being treated with anti-depressants, it can be associated with low birth-weight, developmental problems, heart defects, cleft palate, to name a few. And the flip side? If a pregnant woman with depression remain untreated, it can be associated with low birth-weight, developmental problems, premature birth (causing heart problems and many other health problems). And, as numerous people have pointed out, every child is at risk of anything... regardless of their prenatal pasts.

I want to go into the pregnancy informed, and I want to feel confident in the choices I end up making. I obviously want to do what's best for everyone involved (baby, me, partner). I want to stay healthy, and I want my baby to be healthy. 

I know myself well enough to know that coming off my meds is life-threatening. I also know myself enough to know that I will read every single one of those awful articles that tell mothers that if they don't do everything naturally - from not eating sugar to refusing an epidural - that they are bad mothers. I will read every study I can get my hands on and will freak out about the 0.00012% chance that my baby will end up with a cleft palate and think I'm awful for taking that risk.

I will do everything I can to be informed... I just fucking wish sometimes that I was a straight girl who could get knocked up and could figure this shit out as I go. But no, I have to plan every step.

Tomorrow, I will try to find a positive headline to start my media report. Those ones really do make you realize that regardless of what happens, there are people who support and love you. Something everyone deserves - whether you're 1 month old, or a hundred.

Night vs. Light: The Eternal Battle

Today is the last day of my staycation. I never thought I'd say this, but I'm looking forward to going back to work - at the very least, for distraction.

It is dark. Depression is seeping in - not in the doses that have come crashing down on me from the past - but my mood has definitely dropped, I have been feeling really bad about myself (disgusted, even), and I'm in a little bit of denial, because I can't get depressed. I'm too tired to be depressed. I'm hoping getting thrown into a busy work schedule again will work against these stretched out, lonely hours. But it can go either way: It can be a great distraction, or it can just be an added thing that I can't handle. I'm hoping for the former. It has to be the former.

D and I have had a bit of a crappy week and have fallen back into a place where we don't like how we treat each other. Part of it has to do with just not keeping up with the great stuff we've learned from our months in therapy, and we both admit part of it has come from last week's baby talk, which was hard on both of us. We had a sort of come-to-Jesus meeting last night, and sorted some stuff out, and we're both feeling a lot better about things. We're back on track.

Although this week is really busy for D, and she's taking off to the States for work on Thursday for a couple of days, she told me last night that she hasn't forgotten that she owes me a conversation, which is coming... still coming...

When the time comes for said conversation, she has asked me to be completely objective. She has asked me to listen only, and to try not to react. She has asked me to listen as I would if I was her best friend, with no investment in the outcome of the conversation. Which I will do... I need to do... I just don't know how in the world I'll be able to yet. If I need to go stone cold and disassociate for a while, I will. If that's what it takes to get an answer, I will.

When we were away this weekend, just chatting about life in general, she said that if (with a huge emphasis on "if") we were to have children, she would want to hyphenate our last names - something we didn't do when we got married, for whatever reason.

So, there is hope. And, considering there is a lot of darkness right now too, I will take in that hope - I need to. While I was on a chairlift this weekend, I came up over a cliff on the mountain and the sun pounded on my face, and I welcomed the much needed light. I even took a picture of it to remind me that there is a light ahead - even if it looks like there is darkness all around it - there is always light.

Cabin Fever and Comedy

 

This is one of the best presents I've ever received. And yes, it's a real hoodie. With hearts and rainbows and loud colours, alongside a wonderfully bold statement. I suppose you need to understand my humour - and stance on how there needs to be more of it when it comes to mental illness - to appreciate it as much as I do. If you can't laugh about being bonkers, then it's a sad, sad day. Even on the saddest of days - especially on the saddest of days!

Although I've lost the majority of my memory due to a brain injury after too much shock therapy, I have boxes and boxes of journals from a period of about seven years, quite a few of those years were spent locked up in psych wards. I am a mental health advocate, and I do take offense to some inappropriate uses of diagnoses (one of my biggest pet peeves is when people use the word "schizo" as an adjective for something a) out of the ordinary or b) that has two distinctive sides - seriously, when are people going to learn that schizophrenia is not a split personality disorder?), but I really do think there is room for humour in a world where there is generally little. In my journals, I wrote about every single person I met in the psych ward: from catatonic schizophrenics to manic patients with grandiose ideas of breaking out of the locked wards to the "regular" suicidal depressives. Like me.

In spite of the fact that I didn't believe I was born in 300 B.C. or that I had a child that was a turtle stuck in Russia or was being followed by the entire crew of "Men In Black," I was more or less the same as everyone in there. Sad, confused, scared, misunderstood.

You have to have a sense of humour when you're locked up. There is really no other way to survive it. So, receiving a hoodie from D like the one above makes me smile.  She got it for me on one of my anniversaries of being out of the psych ward - excellent landmarks in my life. I don't think I could ever wear it out of the house, but it is one of my pieces of clothing.

There is this great group that travels around Canada called Stand Up for Mental Health. I've had the pleasure of seeing them perform live. It is a stand-up comedy group which was created by a therapist (who has a mental illness himself) as a type of therapy for people who have a mental illness. I think it's remarkable and the people are incredibly brave.

Here's a taste - it's worth a look:

I'm on my third day of a two-week staycation - my first time off work in a year. Last year, we went to Maui. This year, the money is going into the house, D has already taken time off work over Christmas, and I am taking my "vacation" alone, which, in all honesty, can be risky.

I have a tendency to shut myself in, not leave my house, and get fixated on silly things. And it won't be until five days down the line when my hair is so greasy I could cook with it, and I'm scaring myself away with how bad I smell, that I recognize that "hmmm... maybe this isn't the healthiest for me to be doing."

Having been severely depressed, I have had many years of feeling safer indoors. Not needing to talk to people, not needing to fake it, just being miserable in my own skin... I thought I was doing everyone - especially myself - a huge favour. Misery loves company, and though I hated my self (and wanted to die), it was easier that going out in the world.

Once, when I was living in a house with seven other people (that could only technically house three, but we were all poor), I locked myself in my bedroom and played computer games for five days straight. I left the room to go to the bathroom, and I think once or twice to get some bread from the kitchen.

That was almost 10 years ago, but when I'm alone in the house, I can feel myself slip. Not to that extent of pure isolation (which is near impossible when you live with your spouse), but there is a pull to lock myself away. So, today, I am actually going to shower, take out the garbage and maybe even go to the bottle depot. I might even stop for groceries. Hell, maybe I'll even go to the mall. Ugh. Maybe not.

I'm better now; I'm healthy. But I wonder if that pull to disappear ever does go away.

I hear stories of women who have just given birth, who don't leave the house and don't shower for weeks. I can see this being me... but where is the line between being unhealthy and just being a good mother?

So far, so good

Day 2, and I've actually had no trouble sleeping... knock on wood.

On Thursday, I went to pick up a different dose of the anti-anxieties that I'm attempting to come off. The pharmacist, who I know is just doing his job, pissed me off big-time. I hand him the prescription, he tells me to come back in two minutes, and just as I'm walking away to go pick up some Christmas stockings for our wee family (just D, me and the kittens this year), he calls me back, "Ma'am, you know this is a different dose than you usually get, right?". 

"Right. But it's in addition to the other dose... I'm weaning off the medication, so I'm going down by 0.25-0.5 mg per week at the beginning."

"Oh."

I go pick up the stockings and head back.


With his zitty little face, he calls me up to the counter by name, and then somehow lets the entire store know what I'm on by basically yelling out the name of the medication. I'm kind of used to that though. As much as it sucks, a lot of pharmacists do it. It wasn't that that got me.


"Um, so... can I ask what you are taking these anti-anxieties for?"


"Uhhhh, well, they help me sleep. But basically, at this point, it's because I'm dependent on them."

"How long have you been on them."


"Over a decade," I reply, thinking in my head 'probably for most of the time that you've been alive'.


"I don't know how much you know about this medication, but it's not usually recommended for long-term use."


"Yeah, that's why I'm coming off them."


"Your body has probably built up a tolerance to the medication, and it may not even be doing anything for you right now, except help you sleep."


"Yeah, that's what I said. And that's why I'm coming off them."


"Because your body will start to need more and more of them to work. And you don't want to take a higher dosage after this long."

"Yeah, that's why I'm coming off them."


"Okay, well if you have any questions..."


"I won't."


I'm not usually a bitch to others, but when I feel as though I'm being talked down to about something that I am extremely well-read and well-experienced in, I get a little pissy. 


I felt like saying, "You try to deal with having a major depressive disorder with psychosis, coupled with a panic disorder when you were 17, try to keep up the straight-A-student-MVP-ball-player-piano-festival-winner persona, as you literally think you're going crazy, and then talk to me about how I should use the drugs. You try being put in a psych ward at age 17-21, pretty much exclusively, wanting to die and not believing with an inch of yourself that you're going to live into adulthood. You try getting electrodes that tickle when they're stuck to your brain, a stick to bite down on shoved in your mouth, lying in a room of doctors and nurses - enough of them to hold you down while you shake and piss all over yourself - after they put you out and shock your brains three times a week "just to see" if anything "shifts" in your mood, and tell me about how to take my medication. You have a panic attacks every day where you forget how to breathe and think your chest is going to explode and have your world shatter down beside you... and then, you can talk to me about how to take my meds. 


But I didn't. I took the bag from him, walked out with my head up (not held high, but I tried), got in the car and started my mantra:


"I can do this. I will sleep. I will stay healthy. I am doing this for the health of my family. I can do this. I will sleep. I will stay healthy. I am doing this for the health of my family. I can do this. I will sleep. I will stay healthy. I am doing this for the health of my family."

I can do this.


2 days down... a few months to go.

Time to come off some meds...

                  [photo credit]

So, it's time to do some weaning. 

I've been on anti-anxieties for almost half my life, and I've decided that this month, I'm going to stop taking them. I am on a really low dose, and although they once really helped with my anxiety, I recognize that my dependence is mostly physical. The meds help me sleep, and sleep is one of the most important things for me to get to keep me from spiraling into a deep depression. They do very little - if anything - for my actual anxiety and mood.

Anti-anxiety medication is supposed to be prescribed for short-term use. Full stop. [The University of British Columbia published a media release on an interesting study about long-term use]. But when you're institutionalized as a teenager, with no real hope of getting out, I think doctors do whatever they can to treat you in the moment. And my moments were awful. I don't blame my docs; it's not like the anger and resentment I hold from receiving electro-convulsive (shock) therapy and losing 15 years of memory... this was something that was a quick-fix. I get it. I was dying. Or wanted to.

And now I'm not dying, nor do I want to. I'm doing this for me, but I'm also thinking long-term with medication and pregnancy. Out of the meds I'm on, this one is the one that I don't need for it's purpose, and it's one of the most harmful to a fetus. It's probably the best one to come off first. My plan is to come off the benzos completely, and cut down on the others (see my Happy Mommy, Happy Baby post for the logistics of what needs to happen / my ethical stand-point on medication and pregnancy). If I happen to be able to come off any other medication - all the better. But I also need to stay healthy.

I have some low-stress time coming up. I'm off work the week between Christmas and New Years, back at work for just over a week, and then off for a stay-cation for two weeks in January. This means that if I'm up in the middle of the night staring at the ceiling because I can't sleep, dealing with night sweats and little panic attacks, and god knows what else, it won't be as detrimental as it would be if I had to get up at 5:30 am every day to go to work. 

I'm scared. There has been two other occasions in my relatively recent past where I've attempted to come off some meds. One was pretty successful, despite the extremely low energy and the added 20 pounds. The other time was horrific. I was on disability assistance and in part-time school at the time; I locked myself in my apartment, letting only my then-roommate (who actually ended up being my partner for a year) come near me. I puked every day. I couldn't eat. I sweat through all of my clothes, but couldn't stop shivering. I didn't sleep for four weeks. I hallucinated. I punched through walls in frustration and broke my hand. And the sad part was, I totally shouldn't have come off that medication at that time of my life, but I told myself that being on it was a weakness. I fell into the stigma trap, knowing full well (theoretically) that I needed those meds as much as a diabetic needs insulin. But there's the age old debate...

When I was 20, I was on ten psychiatric medications at a time. I'm not exaggerating. I've always had treatment-resistant depression, but ironically, I was being over-treated. I don't remember life before Monday to Sunday pill boxes, taken morning and night. That's been my life. And still, even though I go out and do public speaking gigs where I talk to people about the stigma of mental illness, I still feel a sense of shame that I can't "just come off" my meds. 

It's more complicated than that.

So I'm taking it one step at a time, extremely strategically, and under the guidance of my awesome shrink. It will work, and I will be okay. It will be hard, but it's one step... and one step of many that I'm committed to take throughout this process.

With any luck, by Valentine's Day (or maybe sooner), I will be anti-anxiety free. And hopefully anxiety free.

Now that's a heart-racing, loving thought.

 

                [photo credit]

TTC is hard to see; poetry is easy.

Today, I've been reading all of the blogs I follow (on my blogroll and through Google Reader). There are some really positive ones, written by people I couldn't be happier for: couples who've just conceived, couples who are basking in the delights of new parenthood... but then there are endless entries from women who are at their wits ends with this whole TTC thing (I won't list them out of respect for their privacy and pain).

Their honesty has got me thinking about my own journey, which has hardly begun, and make me question whether I'll be able to stay sane through the process. Knowing my health isn't great on the best of days - will I be able to do this? 

I don't even know whether I'll be able to go on fertility meds with the meds I'm currently on. I don't know how screwing with my hormones is going to screw with my head. Fuck, I don't even know if my partner still wants to have a baby with me... whether we'll even go down that road. 

The process excites me, but freaks me out beyond belief. I feel like on top of the mad journey of TTC, I have so much else going on. So should we even start trying? Perhaps I'm writing this, and doubting myself, because I am still in my pajamas on a Saturday at 3:00 p.m., after sleeping for 10 hours because work is killing me right now, and I need a break. 

How the hell am I ever going to get by without sleep, stressed out about getting pregnant, or up every hour with a new baby? Does this innate parenting thing kick in that makes it possible? I'm not not looking forward to it - I know it will be worth it all... I just worry about post-partum depression, and though my shrink is confident that the odds aren't high enough for me to worry about, that's what I do: I worry.

I have a good friend who has a 7-year-old daughter (pregnant on the first date with her now husband). She's a wonderful mom, and she wants me to be a mom, but she says nobody tells you how much you worry. Granted, she's a bit of a helicopter mom whose child can do absolutely no wrong, but if I'm a worrier by nature, what will that translate into when motherhood arrives?

I work at a Children's Hospital, which is wonderful and sad. I see kids every day who are sick, and I can't help but wonder whether my health will affect my baby's. You see? My partner and I haven't even decided on whether we're going to get pregnant yet, and I'm already worrying about the health of my baby. Lord knows that if we do start this journey, our baby may not come for years. Can I keep up the worrying for that long, or will I just worry about something else in the meantime? Probably.

But then there's this other part of me that *knows* I'm going to be an incredible mom. I just know me... and I know, no matter what the circumstances, I will thrive. Maybe that's what gives me hope and is pulling me through.

D and I have less than a month and a half before we can start talking baby again (therapist helped us make a deal that we'd drop the subject for 3 months so that we could work on "us" first). 

I was flipping through my menstrual calendar app on my iPhone - amazing little things - and my birthday is in a few months. On the calendar, there is a big, dark box around my birthday: it is the day of the month that is my best chance of conceiving. Last year on my birthday, I told D that I wanted to be pregnant by this birthday coming up... that's nowhere near happening. 

But thank you, Apple, for reminding me of the cruel irony that for my birthday, I *could* be in a clinic office, with the possibility of conceiving on that very day, but instead, I will be worrying... about something, I'm sure.

I suppose I didn't have to download the app, eh?

 (Photo credit: here. And no, that's not my real birthday, nor my real cycle).

Head, heart, and health

I’ve been to see my GP more than enough times over the past 3 and a half years. I’ve been to rheumatologists. I’ve been to neurologists. I’ve been to orthopedic surgeons. I’ve been to chronic pain clinics. I’ve seen shrinks. I’ve been to chiropractors and physiotherapists. I’ve changed my shoes. I got orthotics. I’ve had blood panels. I’ve had a full-body MRI. I’ve had a nuclear medicine bone scan. I’ve had CT scans. I’ve more than enough X-rays. I’ve had an EEG and numerous brain tests. I had “experimental” surgery this summer.

Nothing has worked.

Three and a half year ago, the dull pain in both of my feet turned into sharp pain that has taken away the possibility of activity in my life. I can’t go grocery shopping without being in constant pain. I can’t stand and wash the dishes without constant pain. I certainly can’t exercise without constant pain. I can hardly get by doing a desk job without constant pain. I am a completely different person than the woman I was when I could just “be” without pain.

But pain has become interweaved with my life now. It’s just there. And nobody knows why. There is nothing physiologically wrong with me (so far). It is not psychosomatic (according to more than two psychiatrists). It is inexplicable major chronic pain that has essentially taken my health away from me.

The sad thing? I do not have any mobility and my physical health is taking a big hit. I can’t do anything I used to be able to do. And yet, even though I am immobile and in constant pain, my physical ailment has nothing on depression. Having gone through both physical and psychological illnesses, mental illness wins in the “what’s worse” category.

I have to get back to work, as my lunch hour (where I’ve been stuck at my desk because the pain is especially bad today) is almost done. Though I will revisit this pain issue and how it has shaped the dream of having a baby… and how my mental health has teamed up with my physical health to make this an especially hard journey…

You may say I'm a dreamer....

... but I'm not the only one.

Mr. Lennon was onto something.

Imagine if John was around today. I wonder if he'd have a blog. I wonder whether he would find solace in the fact that there are other bloggers out there who were peace activists and musicians, who had  homosexual managers that were attracted to them. Bloggers who wrote about being married to famous cello players. Maybe even bloggers who were later murdered.

When I went to New York 6 years ago, I had to visit Strawberry Fields - if not for my love of the Beatles, for my dad's lust of the Beatles. I didn't imagine (no pun intended) I would become emotional at the sight of the Imagine mosaic in Central Park, but I did. Maybe it was a time in my life where I was imagining the future... actually, I know that it was. I was imagining what it would be like to get married to the woman I wanted to spend the rest of my life with.

Back to Lennon and the blogosphere. What I'm learning as a relatively new blogger is that there seems to be someone out there writing something that speaks to what you're going through. Most of the time.

I updated my blogroll today with great suggestions from three particular blogs: An Offering of Love, Insert Metaphor (awesome blog), and Schroedinger's Womb. Most are either blogs of gay women who are trying to conceive (TTC - new acronym to me!), who already have children (and seem to post endless photos of them... some even write about their poo, take pictures of their packed lunches, explain their three hour bedtime routine and update daily on how it went - some of this seems a little overboard, but in all honesty, if I ever have a kid, I'd probably do the same...) And then there are the bloggers who are trying and trying and trying to have a baby and are can't conceive. My heart goes out to all.

I have only yet found one lesbian mom who write about her mental illness: A Day in the Life of a Bipolar Turtle, though it is dedicated mostly to bipolar and not necessarily to how it affects being a mom.

I imagine that there are other depressed lesbians that want babies, but I haven't found a blog devoted to that yet, and it made me wonder whether the stigma of carrying a child while on medication has anything to do with it.

Though not my first choice, I will not come of all of my medications if I am going to get pregnant. It would not end well. I would not end well. And many out there may think that is selfish and hurtful to my non-existent fetus, but the literature is out there and it's interesting: it's not as risky as you may think.

It was mental health awareness week a couple of weeks ago, but nobody knew about it. It's a cluster of diseases which still go unnoticed and ignored, because it's crazy, right? Even I have my major concerns about pregnancy on medication, but I would never put my child at serious risk. And if it is a serious risk, I won't do it.

John Lennon: Maybe you wouldn't have found a blogger who wrote about their cello-playing, peace activist partner. And maybe I won't find a blogger who is a lesbian, clinically depressed, on medication, and ready and willing to get pregnant.

But I can imagine.

If you are out there, I'd love to hear from you...

Happy Mommy, Happy Baby...

I haven't blogged in a long time, partly because of being busy, but mostly because I've been privately mourning the loss of something that does not exist.

I let my faith waiver, and after my appointment with reproductive psych - regardless of the fact that it was "information gathering" - I came to the almost 100% conclusion that I would never carry a child. And what does my profile say? Crazy lesbian mom. I'd be the crazy. I'd even be the lesbian. But a mom? No...

And I *was* opening up to adoption, so yeah, I would be the mom, just not the way I've envisioned it for years. In fact, I still think that adoption would be a viable and perhaps even easier way to go when it comes to D and I having a family.

Okay, I'm just going to jump right into it: I got the "okay" to carry a baby - healthily and (let's hope) happily. D and I had gone to repro psych, and done our own research on medications, depression and pregnancy. I think both of us didn't get our hopes up, because I promised D that I wouldn't carry if the risks outweighed the benefits (if it were up to me, I'd put myself at risk, but I really don't want D to have to care for a baby and a depressed mother... 2 babies).

So we finally went to my shrink, who has been my shrink for over a decade, and gathered some information from him. He basically looked at us and said "go make a baby" ... Yes, there are more risks, but they are not astronomical. I can stay on some medications and the baby will be okay. I will be okay. 

We both looked at him like he was just playing with us, and he said something which I sometimes forget: "You were really really sick, but that was years ago... you are a completely different woman, have an incredible support system, and are capable of so much" (I'm paraphrasing, but you catch my drift).

It was in the past, and though I struggle now with little dips, it is not these vast valleys of blackness that I used to drown in. I am healthy - not as healthy as a lot of people - but in the grand scheme of things, I am healthy.

He made a parallel to a pregnant woman taking medication for diabetes. Yeah, it's healthier not to be taking medication when you're pregnant, but people have to. His main message: "Happy Mommy, Happy Baby..." If I can stay on some medication that keeps me sane, and if my fetus isn't at some huge risk of anything life-threatening or disabling, I have faith that we can all do this - D, me and baby-to-be.

Average women who have average pregnancies can have babies with a lot of health problems. And not to say it wouldn't be awful to have a disabled baby, but we'd deal with it when we would have to deal with it. It makes me a bit nervous that yes - there are a few risks, but for instance, one of the biggest one (as a result of one anti-depressant) is a cleft palate, which is normally a .8% chance in babies, and would now be a 1% chance. 

Am I willing to take that 1% chance? Hellz yeah!

I couldn't believe it. I left the office and it still hasn't really sunk in yet. We can do this. I can have my dream. I can be pregnant - I CAN BE PREGNANT! Still in shock... good shock... And what's even better is D's reaction. I expected her to still be a little hesitant, but she's ecstatic too - and that means more than the world to me. I asked her "what next?" and she said, "look up fertility clinics!"

I know it's one doctor. But he's one of the best doctors in Canada. Seriously... I totally trust him, and he has complete faith that this will actually be in my best interest - he said that I may even feel a peace when I'm pregnant that I've never felt before - that some of the hormones may actually be extremely good for me. And as for post-partum, my chances are a hell of a lot lower than I expected. And, if I happen to fall into a depression: a) I know when I'm depressed, and after many years, know when I need to get help, and b) As I said, I have the best doctor in Canada, and he will be there, with a plan, when I need him. 

D is contacting some lesbian friends of ours who have had one child through IVF or artificial insemination (not sure) and their second through a surrogate. Other friends (another lesbian couple) will be having their little girl in mere days - and they did AI. We have many straight friends that have used clinics in our city, and I've been doing some research on those. Oddly enough, there actually aren't as many as I would've thought. But I guess it only takes one...

I am so freakin' excited. I want to do it NOW. But first, I have to deal with my chronic pain. I have a surgery assessment soon and will hopefully have some answers within the next few months. Once that is clear out of the way, we are going to barrel straight ahead.

Now... just one question: Who the hell's sperm are we going to use???

[photo credit]

Kudos to Sickies!

I've spent the last three days flat on my back... and so not in a good way.

I am so sick. Flu, sinus infection, bronchial trouble. When I do fall asleep, I wake up choking on phlegm. I have short stints where I can sit up (like now), but have to have my head down for most of the day.

No work, home alone - and I realize I don't really take care of myself. I haven't bothered to eat, because I can't be bothered to make food, or even walk to the kitchen to see what's there. Maybe because there isn't much. 

I can't imagine how moms do it - get sick like this - and still be able to look after their children. Especially those with no help, or partners. I don't remember my mom ever getting sick, but I know we never had a babysitter (until my oldest sibling was old enough (11!) to look after all of us). She must have just sucked it up around us. Figures... she's stubborn as hell, even now.

So as I'm hacking and sweating and shivering and feeling sorry for myself, I give my highest kudos to the women out there who have children to look after, who put their children first, regardless of how they feel. Who look after their children as well as themselves. It has to be a tricky balance.

My energy is so low - lower than usual. I have low energy to begin with. Even though I am not in a depressive episode, my energy has always been a problem. I am on a bunch of meds that are sedatives, and though my doctor has tried to balance me out with "uppers" in the past, I've chosen not to go through the day on a shaky buzz. I'd rather be tired. But what about when I have a child?

Do you just get this innate super energy mom thing? Do you show your kids that you're exhausted? Do you feel run down, and if so, how do you keep your children healthy and happy... even when you don't feel that yourself?

I often wonder, after weeks of work where I have trouble loving my job, whether I would even be able to look after a child. Not if I get as tired as I do. And yes, I can rely on D, but I want to be active and not that mother that are always in Victorian novels, sleeping in a bedroom away from her children while the housekeeper looks after the home and children.

I want to be on the front lines with my kids. I want to take them to 5am hockey practice or 7pm piano rehearsals. I want to be there for every minute of what they do (okay, maybe not every minute - don't want to be an overbearing mom). Basically, why would I want to be a mom if I can't be a mom that enjoys being with her kids.

I will have the energy. I need to find peace with some major stuff first (job, financial stuff), and then my mind can stop racing and I will find my mojo. 

Back to the couch I go, however not before giving a huge kudos to sick mothers who keep on keeping on! I have the highest amount of respect for you!

"Life For Sale"

I came home to my subscription to "The Walrus" - Canada's best magazine, in my books... literally. Usually I'm thrilled to read it, but I couldn't help but think that the cover story was a sign:


"Life for Sale: Canada's Underground Trade in Human Eggs" by Alison Motluk, which, brilliantly written, goes into how Canada's fertility laws fail donors, doctors, and parents.


At lunch today, I was searching Adoption Canada and websites on surrogacy, trying to be discrete, as my three male coworkers share the office space. (It's really awkward when one of them walks by and I've got a page up with a "crazylesbianmom" login or something). Everything is so confusing... I didn't open all the hundreds of PDFs of information, but with all that I read, through the odd laws, the money, the illegalities, the list of 30,000 children waiting to be adopted, I got totally overwhelmed. And then my lunch hour was up and I went into a meeting, dazed.


So what's going to be easier? Coming off a few meds and risking my health to the point where I may lose myself and my partner, and potentially get pregnant and have a baby, hoping to dear god it'll be healthy and I'll be able to enjoy the little thing without postpartum depression OR flying through loopholes and laws extracting eggs, paying tens of thousands of dollars using some stranger's uterus to grow my own baby, and suddenly have it delivered to us at our doorstep?


Money is money, and we won't worry about that until we have to - we're okay for now. And I find it really awkward to put the words "money" and "baby" in the same sentence. So, I won't.


I'm just so confused. And my partner is feeling a bit "off" and said that maybe yesterday was too stressful. And we're not even doing anything yet.


Awesome.

Dancing a Two-Step

Well, she wasn't a dragon.


Despite her horrible reviews, she was actually really informative. And surprisingly gay-friendly. I'm still digesting the day, and the visit to Reproductive Psychiatry, and the conversations pre and post visit with my partner.


Before going in, we decided that this was merely an information gathering session, and we got a lot of information. Info we needed to hear, info I didn't want to hear, and a bit of info that is keeping me from feeling completely defeated.


There are risks. Of course, I know that. We know that. My partner and I both agreed this morning (over my tears in the car ride heading in to work) that this appointment should have been secondary to an appointment with my psychiatrist. He's the one who has known me and my mental health for 10 years. He's the one that will understand what *I'll* be like if I relapse, as opposed to some other crazy lesbian.


I wanted to know whether my baby would be safe. My partner wanted to know whether I'd be safe. We agreed to disagree, I guess, on why we were going. My partner did say something that I'd never heard in these words before: "I am not scared of losing the baby; I'm scared of losing you."


Me? Honestly? I'd put my health at risk in a heartbeat if I didn't have anyone to stop me. But I have an incredible partner that will help me get through the "I'll do anything for a baby even if it means almost killing me" mindset, and keep me level. She's good at that.


I'll go into the appointment more in another blog, but what I gathered was:
a) This doc has never treated anyone on as many medications as I am on in her 30 years of practice.
b) Against popular belief, anti-depressants hold little risk in pregnancies
c) There is a 25-30% chance of depression relapsing with a pregnancy
d) Babies addicted to crack turn out fine on the most part, so... (odd)
e) I'm on the highest amount of all my medications, so that if I *do* get pregnant while I'm on the same doses (which I don't want), there will be no room to up my meds if I relapse
f) She was impressed that I wasn't fat, considering my dose of a "fattening" medication
g) She has a book, and she likes to plug it
h) It's up to us (my partner and I) on how to proceed


She said she'd be happy to take my case if my regular psychiatrist would agree to go through this with me and work on some kind of method to lower/come off some meds. She said he's the best shrink in this part of the world, and I agree.


She also threw out the idea of adoption and having a surrogate, closing with "but there are just some women that feel as though their lives will be incomplete if they never carry their own child."


I felt like saying: Yeah, that's me.


I didn't feel as defeated as I'd expected. There is still hope. But there is still so many risks - and so many more steps. As my partner said to me today: This is just one of the many steps we are going to have to get through... so let's get through them together. Did I mention how much I love her?


Next step is my regular psychiatrist. I trust him completely. I guess he'll be the one making the call. If he doesn't agree to working something out where I can get pregnant healthily and give birth to a healthy child, I suppose that's the end of this route.


I can't even believe I'm writing that.


Wow. Way too much to take in on a Wednesday afternoon.