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.

Baby-Making in the Making

Devon and I had our appointment with our second reproductive psychiatrist yesterday. She was lovely, and although she was late to see us, decided after the hour that she wanted more time with us, so asked us if we would be willing to come again. I like a shrink that is thorough, despite a busy schedule.

The last time we saw a repro psych, she was great, but basically said that my illness is too complex, and that she hadn't ever had a patient like me before, and she didn't know how to treat me. But nothing stopped this new doc. She spent an hour just asking me questions about my past and my present, going over the different degrees of my mental illness. She told me that she didn't have my full patient file and that she would order it, book off some time to go through it, and then see me again to figure out the best way to have me have a healthy pregnancy, a healthy baby, and a healthy me. Basically, she gave me hope.

It was actually wonderful to have Devon in the room with me and answer all of these intense questions. Although I don't keep secrets from her, I don't talk much about my past - mostly because I don't remember much (I lost over a decade of memory... a story for another post, another day) - but also because I am so not "that girl" anymore. But I felt really comfortable with the whole experience, and I appreciated the support so much. And I like that we're doing this kind of thing together. That makes me happy.

Once the shrink gets my full file (she's going to need a wheelbarrow) and analyzes it, she is going to have us back in the first week of June. The thing I like most about this, besides the attention to detail, is the fact that she wants to hear from me after she reads my file. She made it clear that she trusts "my side" more than anything.

Although our next appointment is to go over the specifics of my medication and the risks/benefits during pregnancy, she did mention that generally, the three medications in question are mostly safe in pregnancy. She said she had a lot of respect for me getting off my benzos over the last few months, and said that working with the existing meds is "doable". Obviously, there is a lot of layers to this and a lot to talk about still, but it seems doable.

It's doable!

We all agreed that getting down to the minimum amount of medication is the best method, so we will put a plan-of-attack in place soon, and get this show on the road. It has felt like there has been a lot of waiting and stagnancy, but I know that Devon and I are doing exactly what we can do. We had a good talk today about priorities, and put a bit of a life plan together, which involves potentially putting off the selling of our house this year to save our sanity. And probably our relationship. But, unlike our past plan to wait until we move before TTC, we were both clear that if we put off the selling of our house, that didn't mean we had to put off the baby-making plans.

I like this plan. 

So, it looks like things are falling into place. I don't see any reason why we wouldn't jump into the specifics after we have a medication plan. Dev and I had some weirdness around the baby (I felt she wasn't as involved as she could be / she didn't feel as though I was involving her, by rushing the process after she asked me to wait until she was ready), but we had a great talk today, and again, I feel very hopeful.

And I love that she is still on board. Another thing to feel blessed about. 

She's pretty awesome, and I'm pretty lucky.

Cocktails & Dreams

I went to my witch doctor today. My chronic pain is bad again, but she thinks it has everything to do with withdrawal from anxiety meds. That, along with the dizziness, shaking, night sweats, headaches, bladder and digestive issues... just a few of the lovely things I am dealing with coming off this damn medication. I hope to God that if I do have to come off any more of my meds, it won't be this hard.

That said, I have had no anxiety symptoms is over two weeks. AND, I have slept. I actually feel somewhat normal again (despite the dizziness, shaking, night sweats, etc.) Devon and I are still sleeping apart, which sucks and I miss her. She's going away for work soon and when she comes home, I just really really want us to share the same space throughout the night. Part of me feels like we're living as roommates right now, because we're so busy working all day and then we just part ways and head to our separate bedrooms at night. Not really a great intimacy builder. 

I think the worst of the withdrawal is over, and I still can't believe it's taken this long. Over six weeks since my last .25 mg and this shit still isn't out of my system. Powerful stuff. I really do hope that if my reproductive psychiatrist tells me to come off more of my meds, it won't be this hard. I just can't imagine actively TTCing through this - and I could take a few years to come down off some of my meds if I did them one at a time. 

I'm on a wait list to see the new repro shrink. She's apparently a good personality match for me, which will be nice. I'm anxious to hear what she thinks about the cocktail I'm on and I hope she dives right in and gives me a plan that will make the most sense for the health of a baby and my health combined.

But really, a lot of it has to be a wild guess. I can't imagine there are many patients - especially going through one office - who are on the exact cocktail of meds and are going through with a pregnancy. I imagine the docs base it on expertise to a certain degree, but it's not like there is study after study of women before me. It's just not that cut and dry. If I was on your average dose of Prozac once a day, it would be one thing. But I'm not. Nothing about my illness is average.

So I dive into this a little blind and choose to trust, because that's all I can really do besides be as healthy as I can going in and controlling what I actually can control. 

First I have to get that H.S.G test. Damn. Seriously, how bad does it hurt?

We have an RE, a rapid heart beat... and a Canadian donor?

Yesterday was our first appointment at a fertility clinic. I was so flippin' nervous all day and the day before for that matter. We had to both fill out surveys to give medical history and menstrual cycle info - the usual, I assume. I could not get over the feeling that they would look down at my medical history, then look over at my medication list, then look at me and say, "Yeah, sorry. You can't have a kid. You're crazy."

I couldn't shake that feeling at all, and though it sounds ridiculous, it was in the back of my head the whole time.

We were virgins in the office and holy-oh, it is a busy place! And oddly oxymoronic... there were Anne Geddes pictures all over the place, like bunches of babies dressed as bunnies in flower pots (say that three times really fast), which was vastly opposite to the energy in the room, which was quite sad and dark, actually. There were three women without partners with them in the waiting room, an couple in their mid- to late-forties, a couple in their late-thirties, and us. Devon was desperately trying to make a deadline, so she was head down in paperwork. Everyone looked so frikkin' sad, it was awful. I was not sad, but I was incredibly nervous.

The nurse pulled me into this cramped little room to measure my height, weight, blood pressure and pulse. She got to my pulse last, and when she was measuring it, she told me not to worry, that the doctor was very nice. I smiled and tried to calm down. But my heart beat strong and loud. She actually giggled when she wrote the number down on the page. She told me again not to worry. Easier said than done in my world. My pulse was extremely fast - I shook it off as nerves...

We went into another cramped room and met the doctor, who had someone shadowing him. He was lovely - very sweet. His English wasn't fantastic, but he was very clear and took his time explaining himself. We went through my history, and when he got to my mental health, I just cringed. But he didn't. He asked me to be precise in the dates of when I was hospitalized, how long I've been on specific medications, and how my mood was now. I was honest. The conversation went deep into my history, and I found myself explaining my electro-convulsive therapy (ECT) history, as this lead to a seizure disorder. The two doctors were a little taken-aback with the extent of it all. (He was also taken aback when he read my pulse - enough so that he took it again... it was the same).

I was clear that I would be doing this under the guidance of a reproductive psychiatrist. The doc said that my illness is beyond his expertise, but that they would be certain to work extremely closely with my repro psych through this journey... yes, he did not dismiss me... I had to hear it again: they would be certain to work with... YAY!

I had already taken my fertility blood tests, so he was happy about that. But he has given me a referral to get a hysterosalpingogram (HSG). The one thing I liked a lot was that he didn't tell me I had to. He explained that it was painful and that it was not vital until they expected something was wrong, and then he said that considering the costs of IUI, I might consider thinking about getting the test done sooner, just so we're not wasting time and money at the beginning... but ultimately, it was up to me, and he'd be happy either way. It may sound small, but I appreciated it. And I am going to get the HSG sometime in the next two weeks. Can someone tell me exactly HOW painful they are?? Reading about them was not so pleasant.

Now, here's the kicker. I asked him all of the questions that you suggested the other day (thank you!) and when I was asking about sperm banks and the differences between sperm sold for ICI vs IUI, he explained what good ol' Canada has in place:

Health Canada (the Canadian equivalent to the FDA) has made it illegal to pay males and females for the donation of sperm and eggs respectively. I knew about the eggs. I wrote about that a while ago. So, in order to comply with government laws, Canada has a centralized third-party "sperm base": there is one sperm bank in Canada, where all the provincial/territory donors' sperm ends up and this is the only place in Canada you can buy sperm from.

He started to go into the legalities (which are apparently changing - I don't know to what) and I followed him for a little bit before losing him in terminology. From what I understood, it is illegal to buy sperm from the States (or anywhere else, for that matter). I did not push him on it, because I want to do some research on my own, but I'm very curious to find out.

In my readings, I found out that due to this new law of taking away paying donors, there was a sperm shortage in Canada (really?), and I don't know if that's improved. I imagine people still buy sperm from outside of Canada, but I don't know if it's illegal. It just seems so odd. If you know where to ship it to, and you have the ability and technology to safely deal with shipping frozen sperm, than what's to stop people from buying it off the internet, shipping it through the border in hopes that they don't confiscate it/arrest or charge you, and basically bringing it into their homes? Not to say that's what we're planning on doing, but it makes you think.

So, I guess we'll be using a Canadian donor. Nothing wrong with Canadians... there is just not as many of us as there are in our Southern neighbour (sorry, neighbor to you). At least Canada is a huge multi-cultural melting pot, so hopefully we will get some variety - even within the caucasian population. The RE did say that East Indian and African American people looking for donors of the same ethnicity are pretty much shit out of luck here, which is really sad.

Have to do more research, but definitely something that I didn't expect!

Wake Me When This Part Is Over

I went to my shrink this evening to get a referral to a reproductive psychiatrist and I left with a prescription for Trazadone.

I don't know whether I'll fill it. I don't think I will, but I took it from him so I could have some time to think about it. It would not be to take as an everyday medication. It would be to take once or twice to finally get some sleep.

Since coming off the anti-anxieties completely, I have battled middle insomnia (waking up in the middle of the night and not being able to fall back to sleep). I usually don't sleep that long on weekdays on the best of days - about 5-6 hours - but I have always "caught up" by sleeping 8, 9, 10 hours on one day on the weekends. That's what keeps me (relatively) sane for many, many years. Without those blessed weekend days, I am feeling completely wired and exhausted at the same time.

Coming off meds sucks.

And it may not make sense to take another medication to deal with the side-effects, but when it is a physical dependence, I don't know when there will be an end in sight.

I just don't want to feel like I'm taking steps backwards. So, I have the prescription in my bag, I will not fill it for now, but I will know it is there.

As for the reproductive psych referral, I didn't ask him whether he did it last week, because I felt uncomfortable (see my post the other day on my trouble asking for thing - especially when it comes to doctors). But I thought about the comments you left, and I used them to work through all the icky feelings and just ask the simple question.

His answer? "I forgot".

Awesome. And now, you are reminded and I will be following up. (I even called the clinic today too... but - no answer there and I didn't want to leave a message. I felt like I couldn't call back. I will tomorrow).

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.

Withdrawal

I didn't think it would be this hard.

Dropping my anti-anxieties by 75% over the last three weeks has gone really well except for the last week. Although we are staying in a lush hotel with a wonderfully comfy bed, I have had major issues sleeping and I am so sad about it. I know it's not a weakness - my body is obviously dependent on these benzos, but I suppose I'm just disappointed with the fact that it hasn't been really really easy.

Not that coming off head meds is ever easy, but I just thought: this is the right time. My mood has been okay, which is the most important thing, but I know that if I continue not sleeping, my mood is next to go. Today, I'm off work because of my stomach, which gets really bad if I don't get enough sleep. I can't afford to take time off work right now... especially going into a 2-week vacation next week.

We had such a fun time last night at our friends' house - got fed really well, and when we got back to the hotel, I was exhausted. But alas, the light went off and my head turned on... work, money, home, work, car, money, friends, work, money, work, work, work - something like that. I always joke about somehow getting through quality control without an "off" switch, and it's true. I can't turn off my head.

                        [photo credit]

I've tried meditation, breathing, focusing on something else. I've tried writing, talking, writing music. I last about 30 seconds in an attempt at meditating, before I think "Oh, I'll never be able to do this."

Focus on your breath. Calm your mind.

I am going to up my meds just slightly tonight so that I can sleep tonight, and then the weekend will be okay. When I NEED to sleep, I think about it all the time. When I just need to get through a weekend, there usually doesn't seem to be a problem. But this drop is different...

I do feel that this really is my body telling me that it needs the anti-anxieties for a physical reason. I suppose I need to respect that. As much as I hate it, some times other forces are too big for one person to try to change.

So, it's okay. I just take more time to do this. It will happen when I'm ready for it. I originally said I'd be off the anti-anxieties by Valentine's Day, and then sped up the process. I think I'll just go back to my original goal. Lord knows I have to do this with some other meds soon enough.

Does this improve on silence?

I've been uninspired to write, feeling as though I have nothing to add to the blogosphere's conversation, especially when it comes to TTC or gay parenting or anything remotely associated with this blog title. It was funny too, with the timing: H2 commented on one of my posts, and because I was not familiar with the name, I clicked on her blogger profile and read her "About Me" and it is just a simple quote, which just took me in... one of those times where it felt like it was meant just for me. A quote from Sai Baba:

"Before you speak, ask yourself, is it kind, is it necessary, is it true, does it improve on the silence?"

I was going to write just to write until I read that, and thought, "no, this really doesn't improve on the silence". And though I know it's writing and not speaking, I still feel like this is a place where I have a voice, regardless of how many people are here to "see" me speak. But I do feel that what I put on these pages count. Or should. Or, I don't know.

Christmas was great. D and I had a fabulous morning together spoiling each other, and then headed to my brother's for Christmas dinner with his wife and four kids, who we adore. [side note: I'm going to rename "D" and perhaps give myself and other "players" in my life a pseudonym, as it's more personal. Plus, I *love* Insert Metaphor's cast of characters...]

We had lots of laughs and lots of great feedback from the gifts we got the kids this year ~ I have to say, we are pretty amazing aunties when it comes to this kind of stuff... especially when our 5 year old niece says that the only thing she wants this year is a Jasmine Barbie, but guess what? There is no Jasmine Barbie in Canada. D even went to Washington State to see whether we could pick up a Jasmine Barbie, but she only comes in the Disney Princess Collection. Long story short: we got a Jasmine Barbie from the storage room at the Disney store from Disney World itself! (We didn't go all the way there, but fate had it that a Santa-like person just happened to be there at the right moment). Anyway, we spoiled the kids without breaking the bank.

Besides Christmas Eve, Christmas Day, and Boxing Day, we don't really have many plans this season, which is good... I'm catching up on many months of under-sleeping, and especially as I'm weaning off the anti-anxieties (still no problems, knock on wood), this time is really important to me to just be good to myself, and my partner, and although we have an apartment to renovate, our selves need to revamp.

It seems like this year went extra fast, which is good. It's actually been a flippin' horrible year, and though we are doing well now, and have been for some months, I would not want to go through anything remotely close to what we've/I've been through this year.

I have high hopes for 2011. I really do. I'm hopeful for the conversation that D and I will be having soon about family. I hope that she still wants to do this. I've been really respectful and have followed through on my promise to let the subject go for three months. But January is coming up, and though I'm not going to jump on D at 12:01 a.m. on January 1st, I'm looking forward to starting up a conversation that I hope sets up the rest of the year.

In my head, she says yes and we run out the door to the fertility clinic. In reality, we have some things to think through: I am currently in a job that ends this summer, and I need to find a permanent job in order to put in my hours before I take maternity leave or even start fertility treatments. I need medical coverage, which I have now, but D doesn't, so when this job ends, that's a top priority (though anything to do with reproductive "help" is unfortunately not easily covered). We are moving in the summer, hopefully, back to the city and out of Suburbia, which, although has done us some good, has mostly made us realize that our lives and our hearts are in the city. That damn, ridiculously expensive and beautiful city...

My health too. I will be off my anti-anxieties faster than I'd originally thought, if things continue to go smoothly. But there is more tweaking to do. My chronic pain issues are SO close to being gone (yay!) but I still have a little bit more to go there too.

And I'm not forgetting my wonderful partner. I have no idea what, if anything, she envisions when she thinks of our journey towards making a family. I respect that she is most likely not as eager as I am, and that's okay. I've been spilling out fears and hopes here, and she - for all I know - really did take a full 3 month hiatus from even thinking about babies. And that's okay. That was the point, right?

I'm getting antsy, yes. I just want to know. I'm a planner. I'm a dreamer. I'm a worst-case-scenario kind of person, so any answer can help me move on. I look forward to the conversation, and I trust that it will happen organically. I don't want to push. I don't want to harp. I want D to want to talk about this. I just have to remind myself that she is not me, and she will not, understandably, be on the same page as me... but this time, I'm hoping for at least the same book.

I trust that next year will be "our" year. We are going into it in a healthy place, and I do have faith that, whatever is in the cards, is the right thing for both of us. In the meantime, I will breathe.

Gotta remember to breathe.

                 [photo credit]

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).

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]

"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.