Giving In

In July, I accidentally came off my antidepressants that I had been taking for over a year following a diagnosis of Post Traumatic Stress with secondary depression and anxiety. I had been feeling a lot better, was managing day to day life and my own feelings and so when Wriggles was rushed into hospital, asking someone to go back and collect them for me was not even in my top ten of priorities. In fact, it wasn't until pretty much the end of the stay did it occur to me I didn't have them. When we did get home, complete with NG tube, I was really a bit of a mess to actually register whether I should re-start taking them and was quite distracted by the fact that we had appointments and community nurse visits coming out our ears and that my mum came up for a fortnight to keep an eye on us (ie. to make sure I wasn't tipping the loony scales). I was so fatigued throughout the summer months from admissions, then surgery, then getting to grips with a gastronomy tube and then coming to terms with the CP diagnosis that the world was slightly spinning. Who wouldn't struggle? I got dressed (if mis-matched), left the house (because I couldn't bear to always stay in) and Did Things to try and amuse the toddler. We had some fun, survived the second birthday and then landed in hospital again and since then I have been struggling to bounce back. After a few horrid days, it all subsided and I wondered what I was making the fuss about. But since then, it has been creeping back up on me like a little dark cloud hovering over my head following me around and is not going away. I feel like I am teetering on a tightrope wire over an abyss, about to fall any minute into an untold pit. I can't switch off the worry, both irrational and rational, however hard I try. I can't relax or concentrate.

On Saturday, we went for a Halloween soiree (read: small gathering of 4 toddlers and cheese on cocktail sticks at tea-time) and I had a G&T. Because my previous medication didn't mix with alcohol, it had been virtually two years since I had had a drink with the exception of the day when I got the letter confirming CP where I drank enough rum to feel completely numb and send me to sleep. So, understandably, this one drink sent me a little squiffy. As I walked back at around 8pm with the Wriggly one in her pushchair dressed as a cat grinning madly, with firework displays going off around me, it felt like walking on air. I wasn't in ecstasy, just pleasantly cushioned with a warm and fuzzy feeling enveloping me. I didn't worry, I didn't obsess. And then the next day, it hit me. I used to feel like that at least the majority of the time. I used to feel like that pre-child. I used to feel that way when my PTSD and it's entourage was being effectively dealt with. I used to feel Alright, I used to feel Relaxed, I used to Smile without force. Maybe I didn't float everyday, but I didn't drag.

So I am giving in. I am going to plead with my GP to let me try medication again. I feel like I am struggling and I need a cushion to get me through this next bit. I have been patiently waiting for this 'low mood' to lift and it is doing nothing apart from drawing in closer. Memories, feeding tubes and hurt doesn't go away just like that. But if I could a little less like a zombie, that would be marvellous thank you very much. Please.

Sticking like Glue

The other day I wrote about my sleeping arrangements and my fear of being far from my daughter at night. 

I like to think I'm going to be a cool mum, but I'm having to face up to facts.

I am terrified of being apart from her.

It's not a desperation to apart exactly, more like a terror that something awful will happen and a completely irrational feeling of betrayal. She would be fine, after all, I worked 3 days a week between when she was 8 months and about 21 months. She is now more reluctant to part but is such a sociable thing. It's me.

I thought I had put Neonatal and everything that followed behind me. I received excellent counselling until very recently, took a course of Sertaline (a SSRI anti-depressant also used for anxiety and in my case PTSD) and then unfortunately this summer happened and we got a feeding tube, starting diagnosis and reunited with some of the PICU consultants although thankfully avoided their unit by the skin of our teeth. Right now, two years ago, Wriggles was in NICU and this anniversary period is a funny old time. Full of flashbacks and bittersweet pride. Sometimes I think I over exaggerate the past, and then find a scrap of something from the time and it hits me again like a ton of bricks. She was that small. She was that sick.This lunchtime I was looking at her first nappy size given to me by special care when we left. I was shocked how small it was, fitting in the palm of my hand. I remember her looking dwarfed in it. Curled up in a special nest in an incubator, small, so small, with a huge chunk of machinery attached breathing for her. Then a little white hat keeping the CPAP apparatus on so she could breathe with some help. The feeding tube in for weeks and weeks because she was gestationally too young to have developed the suck/swallow reflex. The weeks and weeks of one cuddle a day, at 3pm sometimes for less than fifteen minutes. Oh god.

When I went back to work, I made myself because as a single parent I felt I had a duty to provide as best as I could and also not to conform to stereotypes. I did enjoy aspects of my job, but after giving birth so much felt like clock watching. There were days I loved and days I hated. The worst bit every morning was saying goodbye at the childminder's. I never dawdled leaving the office, but pelted back as soon as I could. Since being made redundant, Wriggles' needs are arguably a little more complex. Aside from the feeding tube there is a greater understanding of why she gets so poorly, which in itself comes with more caution to be exercised. 

Since she was rushed to hospital late July, we have not been separated for longer than half an hour on a sparse handful of occasions. 

This weekend, I was supposed to be travelling for a weekend away probably involving some babysitting.

This evening I broke down and admitted how scared I am of loosing some control and not being within running distance of my daughter. I have not had a panic attack for a long time, but I sat here, dizzy, tears streaming, my heart racing and my throat tight and painful. It's too soon. 

My worry is, when won't be too soon? She is now 2 and it's not like we're going to be able to forget prematurity or hospital visits for a long time, such are her medical conditions and health. I don't want to become a paranoid overbearing parent, embarrassingly clinging to her trouser leg in the playground. I want her to keep her independent streak that makes her so her and that I cherish for her beautiful personality of her own shining through. I'm going to have to let go in small amounts at some time in the not too distant future, for nursery, then school and my eventual return to work. I'm going to have to trust other people to do their best by her, to learn her cues, to know her danger signs, her quirks, her needs. But not yet, not now. She is still my baby and I am still cocooned in the after-effects of scare after scare. I need to build myself up gradually and look back out into the light. 

I just hope these needs of mine don't step on her needs of finding out about the world without me.

To be or not to be?

Cheerful, that is.

I am currently signed off work to come to terms with and acquire adequate/successful management of my depression and anxiety so that I can juggle both single motherhood and working at the same time. After a slow-building but sick-inducing wobble very recently, I simply could not do both and with no family or back up, it was with both regret and relief that I agreed to forgo a small period of working to make sure I could mummy as best as I could, rather than fall apart and let my one year old take the consequences. I am already feeling calmer, more rational and more positive with regards to the future. This weekend was a stressful weekend, as Wriggles was poorly again, but I am proud to say I held my cool and even made us leave the house yesterday to go to a parent and toddler group we haven't been to before, and speak to strangers. You know what; I think we both even enjoyed it. A breakthrough. Before I could barely manage the duration of such a group without a panic attack or breaking down into tears either and running off (with Wriggles in tow of course!).

Today was a good day.
I had a productive appointment with the psychologist I see.
Wriggles and I went to an art gallery with an interactive pre-schooler section and listened to a story and then played with some blocks, a plastic tea pot and a colour mixing bubble lamp (honestly, that alone signifies a brilliant day surely?). 
We met up with my good friend and had lunch (ie. cake) in the cafe and Wriggles ate half a packet of Quavers (dietician approved. Salt content is soooo yesterday...when your child doesn't normally eat) and consented to having some spoonfuls of fruit and custard too. 
Afterwards we went for a wander in the sun and put the world to rights while Wriggles dozed in the pushchair, wrapped up in her pink coat and spotty socks.

Then I saw some people from work.

It was a bit awkward.

When you are sick and it is not a physical illness with obvious signs, how can you prove it? Answer, I haven't a clue. Answers on a postcard please. I felt a fraud. I know I am not, but I still felt one. Do they think I'm making it up or exaggerating? Do they think I just don't care? I worried and wondered if they would say anything to my seniors back at work. Silly, even if I was at working, Tuesdays are my day off anyway, why shouldn't I be out?

There is a real misconception that depression means a constant state of melancholy and wringing your hands. Depression can actually manifest in many other forms and is very changeable. You can have several good days followed by many more terribly bleak days. You can have several good weeks, followed by despair and isolation. Depression is not just unhappiness, it is more complex. Depression is always there in the background, but on good days it is not the defining factor in your day. It is possible to laugh and smile and do "normal" things. It is possible to make decisions and feel motivated. In fact, it is really quite important that on the good days, you really make the most of them. Sitting inside and feeling guilty is only going to enforce a negative cycle of behaviour. It can be a self fulfilling prophecy-I am depressed therefore I must act depressed therefore I will feel more depressed... in a nutshell, not helpful to you, people around you or people helping to treat you.
I know that this time off is imperative that I will be able to get on with life in all spheres soon. But I desperately needed this little break to slot my mind back into thinking mode and start feeling like I am "living" again and not just "existing". This time off is helping my focus, concentration, ability to make decisions, ability to prioritise and face up to things and think rationally. It is letting me manage things not let them manage me. It is reducing my anxiety and rekindling interest in anything other than hiding under the duvet. I have never questioned my feelings for Wriggles in the dark moments, if anything my love for her burns bright with a fierce intensity, but I could see my capabilities and my day-to-day devotion through simple tasks and attention slipping away as I would struggle with daily tasks, routine and getting things done that needed doing. I am clawing those things back now, and breathing in each moment as it happens. I am trying hard to be here in the present, not floating in the ether looking down.

But can you show people that in a brief meeting? How can you say that when people say "How are you?" and you reply on autopilot "OK, good thanks." Because anything more is a long and/or delicate conversation that is not really for fleeting moments.


I am revelling in feeling cheerful again. I am getting better, just not "cured" yet. I know my close friends and family understand.

I just hope other people do too.

Cardigan

Today I went to see the psychologist I have known since neonatal who has given me counselling and been somewhat of an extra helping hand for me. At low points in the past she has taken charge and sorted things out with my GP to kick-start more help and has offered in the past to help with things in a non-professional environment like watching Wriggles or doing some ironing. We get on well and I think she takes joy from seeing Wriggles growing up into the menace/delight that she now is. I told her how I had been feeling recently again, and we talked about ways to try and un-knot the knots that are stopping me in my tracks. She referred to them as "grounding" and a cross between meditative exercises and a comforting device. 

Letting Go

As silly as it may sound, I am afraid of letting go of the past. Despite the pain and disruption that neonatal and PICU have caused, I am scared of forgetting them and moving on. They are such an important part of our lives and whilst caused unimaginiable hurt, they also made me intensely grateful and changed the way I look at things now. They are so integral to Wriggles' journey and health, how can I just write the experiences off? How can I move on when they can loom so large?

Because things are different now.

Because this:

Is not this:

Urgh

"Mummys aren't allowed to be ill." My Dad

They certainly aren't allowed to be ill when there is just one parent, an absence for 300 miles of family and your fall-back best friends are on holiday in London or Canada. Yesterday, I was caught utterly short by this predicament.

I have been exceptionally lucky and only be truly knocked out twice so far in my daughter's lifetime, but they are times I would really rather not repeat. When there is literally no one to step in, it is really tough. Not wanting to sound like a whinger, but surely if there was a benevolent force, single parents would be made immune to all bugs, viruses, lurgies and exhaustion at the pinnacle point of singledom?

Fiona

In the last few days I have had a letter from my old paediatric social worker Fiona, telling me that our file is due to be officially closed. She has said she will always be happy to reopen the file and will always be happy to give advice off the record but as we have been without complex medical needs for over six months, for now that is us done and let loose into the big wide world. Although we have not been reliant on her for a long time, it still feels a bit like taking the stabilisers off.

I was first assigned Fiona when Wriggles was less than 24 hours old. In my NICU unit, all parents with children under a certain gestation or those that for one reason or another were clearly going to have an extended hospital stay, automatically were given a health-based social worker. This aggravated many already fragile parents at first, assuming that the referral was a comment on their parent skills or social status, but as it was stressed by the kindly team it was actually to support us and make the neonatal ride easier. I don't know if this is uniform across neonatal units or if it is a service that everyone would welcome, but personally I found it a lifeline. Fiona became a confidant, friend, financial adviser, fundraiser, housing officer, counsellor, advocater, personal organiser and voice of reason at very low times.

"Normal"

Yesterday morning I was idly listening to the...gulp...Archers omnibus, whilst chasing a newly crawling Wriggles around when I heard the storyline about a heart attack. Bloody Archers, first they have the premature baby storyline (reduced me to hysterical tears over the dinner table at Christmas just weeks after Wriggles reached 'term') and now one about hearts! A lump rose to my throat and I was transported back to the Intensive Care waiting rooms of my father and beautiful daughter within seconds, scared and tired in an empty clinical world.

I also fittingly read a discussion on "normality" after trauma and if you ever return to your former state or feel like you fit back in with the world. Can you, and are you, 'normal' again?

Growing up: Wriggles in Review!

It's that time of year again, spring cleaning my frankly horrific flat. In a delayed New Year state of reminiscing I have also been getting very nostalgic, not least as I've been boxed up grown-out-of baby clothes and coming across things still packed up from the last move, in April 2011. So to start the year off (again. Yes I do realise it's now 7th January not 1st) I am looking back at Wriggles' life so far and how we came to this point where we are.

The past 16 months have been very high and low. It has been a real struggle sometimes, so completely not what I expected with your first baby. I'm pretty sure this is true for every new family, but on top of this I have emerged with a wealth of medical knowledge and can hold my own in a doctors round. My mental "fog" is now much clearer than it has been. I'm not sure whether the past muddle has been PND, Post Traumatic Stress or a mixture of both, flitting smoothly from one to the other, but it has snatched memories I will never get back which makes me very sad. I am proud of where we are now: not least because I got here in the main part on my own.

As I have been clearing and sorting, I've been reflecting on what physically is truly precious to keep. Answer: not much. However there are some special things like any Mummy that I will treasure forever. Favourite tiny outfits; cot sheets that smell of baby, or at least baby scented washing powder... My most treasured possessions of the physical variety stem back from our time in Special Care. I do have things which mean a lot pre-Wriggles and more recent things, but the one thing I would be bereft of is a pink box (above). This was collected whilst in SCBU and the box and yellow diary were gifts from Tiny Lives, the charity attached to our unit that fundraises for life-saving new equipment and provides vital family support. 

In this treasure trove are the following: diary of our stay, Wriggles' hospital band, my hospital band, the information sellotaped to her cot, some prem-baby socks never worn, her blood pressure cuff, the photograph that I slept with all the time she was in (so it was the first thing I saw in the morning and the last thing at night), the probe which conducted her oxygen sats traces, her first dummies and her first (well not literally first; replica of) nappy.

It is so easy to forget how small she was. Born at 1090g (2lbs 5 and a bit oz) at just under 28 weeks gestation, she was not a lot bigger than my hand. Maybe head to toe she was two small hands long, maybe just under. She was, and this is crass to compare, about the size of a handpuppet. I don't know why it is so desperate for me not to forget, and we all know size isn't everything, but these physical reminders bring it back like yesterday. Our journeys make us who we are, and SCBU strongly shaped the early days of our lives and later ones two. Any ongoing issues now are put down directly to prematurity, so these objects from the 'beginning' are very precious for me. They make up for the absence of what I ideally wanted for my newborn. I do have some happy memories of SCBU, first cuddles, brief attempts at kangaroo care, days spent by the incubator, watching her grow and the privilege of seeing what would otherwise be a developing foetus but it is the stark reminders of the reality rather than the New Baby! cards which mean much more to me.

 

Images: 1. first dummy next to standard 0 months + dummy 2. first nappy next to newborn sized babygro, which finally fitted Wriggles somewhere between 4-5 months! 3. Look how far I've come!

My other precious object is not in the box because it is in the photo-album. It is the first picture ever taken of her, in NICU (Neonatal Intensive Care Unit) on the night of her birth shortly after she had arrived at the unit from a&e at a different hospital. She is battered, bruised and bright red. Her skin is see-through and still smeared with blood, only one eye had opened and there is a slight perferation to her chect. There are ECG leads on and a tube attaching her to a ventilator. It is not a pretty picture. But I love it. It gives me back what I wasn't there to see. I couldn't hold her hand but it does give me that piece of history to hold on to.

More Grey Hairs

There has been a pause in any posting due to my little troublemaker deciding it is once again time to visit, as Grandma calls it, the H Place.

At the very end of September, Wriggles had a very minor sniff but nothing out of the ordinary. Our physio came out on Friday 30th and at the end of a session listened to her chest and was perfectly happy. She was a bit of a grump at bedtime but nothing more. However, as the night progressed things went very downhill, very fast. She could not settle and quickly developed a hacking cough. Calpol and inhalers and saline drops did nothing and the poor mite could not even take water if she wanted as would just cough, choke and vomit. All through the night I held her upright, rubbing her back. As the hours wore on, she grew palers, clammier and her breathing gew decidedly more laboured. She was vomiting consistently (delightful) due to the cough. In the early hours I had had enough. After beginning to bring up bile with fleck of blood, I rang NHS Direct in a panic who sent us along to a&e. Oh dear a&e! How I have er.....missed it. Since the weekend previous. Oh well. 

Mind you, it has been a while since a middle of the night dash. Unfortunately it was quite reminiscent of when we had the dash that culminated in the infamous PICU stay; whereby I bundled us into a taxi who was a driven by a chap called Maxell Onions (you can't make these things up) who drove the wrongway down a slip road onto a major A road and would go right every time his sat nav said left.......

Once there this time, a nurse eyed the invalid warily muttering "She looks quite short of breath". She effeciently whisked us around to the room that brings a chill to my spine: the snappily named 'resus'. Bays of resusitaires, with monitors, ventilators, emergency equipment for life-threatening occasions and such like. Wriggles, who was slightly less wriggly than normal, laid on a adult bed which of course dwarfed her ridiculously. She was quickly hooked up with ECG leads and an oxygen pulse monitor. As suspected, her sats were low and her heart rate was looking a bit silly. Bucket-loads of oxgen with nebulisers were administered whilst different medical staff ran around waving themometres, trying to take blood tests and piece together medical histories (that was the easy bit. One doctor walked in "Oh hello!! It's you two again...what are you doing here? Oh dear...." and was able to bring everyone else up to date). As the shifts changed over and breakfast dawned round, Wriggles was more normal-coloured and trying to eat the oxygen mask and was showing far more acceptable numbers on the monitor. Whilst they tried to work out whether to send us home or keep us in for observations, we got ready to go round to the Day Unit rather than take up space in a&e. 

Off we went, pushing the big bed along with an emergency oxygen cylinder Just In Case. We got through the first set of doors from a&e and suddenly the newly-stabilised patient deteriorated infront of our eyes. Within seconds she was labouring breaths again, recessing so much you could see all her ribcage and muscles and her heartrate shot through the roof. Casualty-style, we quickly all jogged into the second Resus room of the day. More oxygen, more nebulisers.............. This time, it took hours and hours for her to reach anything nearer stable. A blood-gas had them debating whether to send her up to High Dependancy straight away or to give her the benefit of the doubt.

At least that made the former decision easy: we were definitely staying in.

In total, we ended up in hospital for just under 3 weeks. As no definitive infection seemed present, the likelihood is that Wriggles aspirated something. There has always been a slight infection in her right lung on X-rays, but normally this is not the root of problems. After the initial weekend, where she was on oxygen and IV fluids, she was weaned off both. A team of paediatricians decided that the likely explanation was that due to her cardiac arrest whilst being ventilated for pneumonia aged 6 and a bit months, her swallow coordination is sometimes defective resulting in infrequent aspiration. Due to the fact she already has Chronic Lung Disease (Broncho Pulmonary Dysplasia) and a history of respiratory tract infections, they decided that this combined with her notorious solids aversion and reflux were all grounds to be fed nasogasterically for the forseeable future to allow her tissues to renew and her brain to mature. We were referred to speech and language who observed a one-off oral feed and agreed that this was a good idea. Just to be sure, they booked a fluroscopy (moving X-Ray, like a barium swallow) for the following week. In between this, Wriggles did catch a gasteric virus which put us in isolation. 

Once recovered, we went for the fluroscopy which confused everyone. There appeared to be no swallow problem. She did have a peculiar reaction to a puree but not one that showed any obstruction, aspiration or allergic reaction. The doctors shiftily withdrew to decide on a New Plan. No one quite knew what to do. The respiratory team had been so confident that they had discharged us from their care and handed us onto SALT, SALT now wanted to hand us onto someone else... They had just spent two weeks training me in nasogasteric feeds and setting up a community support plan with the view of ng feeding for the next twelve months minimum and not ruling out longterm PEG feeds. The respiratory team, neurological doctors, developmental paediatricians, physios, SALT had been sure of aspiration being the cause. Over the next few days we saw an array of paeds all with their own take on things. The inconclusive evidence looked shockingly to be.....drumroll.......it was all a result of prematurity complicated by pneumonia which was a most likely a complication of prematurity! Excellent. I could have guessed that myself without spending weeks in hospital undergoing a barrage of tests.

Oh, and she might have a milk intolerance. Or she might not. It could be the reflux.

So with that, we were released into the outside world again. Over the weeks, the seasosn had changed from people in shorts to people in coats, mittens and umbrellas. The air was chilled and afternoons suddenly grew dark.

So now we are back at home as normal. The ng tube, for the moment, is out. We are on high-calorie soya-milk and an continous antibiotics Just In Case. During hospital, Wriggles has perfected sitting unaided (what else can you do in a very small room you cannot leave in case you contaminate people?) and has developed a love of shredding important bits of paper and newspapers I have not yet read, and also discovered the joy of banging on cardboard boxes. I have returned to work and am trying to remember exactly how many marbles I had a few weeks ago because I seem to have less now... Almost a year ago in Special Care I believed, naively, that leaving dear old Ward 35 was the end of the premature experience. The birth and NICU/SCBU had left me in deep shock and for me, discharge symbolised a new beginning. Hope. A light. A world free of clinical procedures, antibacterial gel and feeding charts. A world where I stopped being a rabbit in the headlights and became A Real Mum. Wriggles would have soon reached term and no longer be 'a premature baby'. This began  to wobble when a week to discharge they decided she would leave on oxygen. But I still clung to this ideal of it being the fairytale end. 

Of course it isn't. I'm sure some parents do leave and leave it all behind in the hospital reception with the overpriced crisps and tacky cards. But it often feels as though we never escaped the world of prematurity. To look at, you would never guess she was a premature baby, far less a 27 weeker. But the oxygen followed by frequent admissions from respiratory "incidents" have been a haunting reminder of prematurity. Each seems to invoke the trauma of the previous. This last admission has particularly triggered the memories of PICU: the weeks in a different world, roaming hospital corridoors at night, the eerie quiet of the 24 hour Costa Coffee at midnight. If I think too much, I hear the hospital machines with perfect clarity. Of course, if the alternative was to not have my darling Wriggles, I would go through it all again with hesitation. Yes it has been traumatic. It has shook my faith in the world and a sense of right and changed my outlook of life. But equally, my darling daughter has shown me a kind of love and joy that I don't believe can be equalled. She is better than the tastiest biscuit and more fun that running down a beach in the sun. When she smiles at me, I can forget the things I've seen and hours at a bedside. At the end of the day, miraculously, she seems free of any condition and utterly perfect. I know time is a great healer; it will heal my memories and will renew the cells in her lungs and rest of body and build up her immune system to make her stronger. Time will ensure she grows up and grows strong, away from being a fragile, premature baby. A year ago, I could have put her in my pocket. Now at 14 months old, we are not quite out of the woods of the whole experience but I am dreaming of hope again.