All Supernatural, all the time

Hello world.  It's been 21 months since I last posted here but now I have Thoughts I want to gabble on about.

If anyone has looked at this blog over the last 5 and a half years they will have noticed a distinct lack of posts, and of those posts, the tone changed somewhat from mid 2014.  As much as I feel strange bringing up my dead child into what seems every topic conceivable, the death of my child changed everything.  It took me out of everything I was enamoured with and my connection to random internet dudes with seemingly normal, happy, un-traumatised lives.

Yes I know that you can never tell what is going on in someone else's life, especially when you just read internet personas, but that's how it felt.

I kept buying comics, irregularly, and I tried really hard to regain the enthusiasm I once had, and it was in there, but buried, and I still can't quite connect with it.  I've been a comics fan my whole life, and a serious comics reader from age 23 ish.  Comics, superheroes, DC comics, are part of my DNA.  I really wanted to take part in them again.  For fuck's sake, I named my child after Superman.  I fucking love comics.  But because of all that, 5.5 and a bit years on, I am still finding it difficult to get swallowed up by them.

I've watched tons of superhero telly and films.  I've got my fix that way.  Some shows are better than others.  Some gave what I want, some didn't.  Titans series 1 is fucking awesome.  I haven't managed to watch series 2 yet.

Then last year I cancelled netflix and got Amazon Prime.  I watched a few shows and got very into them.  Then I settled down to watch Supernatural.  A friend has been into it forever, and it's always been on my list to watch, and then Prime had seasons 1-13 available.

So last October 31st, I watched episode 1.

It's now mid March and I've watched all available episodes, which is mid to season 15, the final season, now airing in the States.  They went on filming hiatus, presumably to do cons, and now the poxy plague has halted filming.

But that's 318 episodes (assuming I can count right), in 4.5 months.  I think I watched 1 episode of Picard and a few Teen Titans Go eps in this period, but no other telly really.

I fucking love this show.  I haven't felt so excited about anything since pre-2014.  That includes all the Star Trek episodes barring TOS that I marathon'd a couple of years ago.  And I bloody love Trek.

I care about the characters haircuts and food choices, and relationships, and personality depths, and in jokes, and the depiction of the monsters, and I have got my own headcanon for various episodes, and I love to hate some characters and plot developments, and I have shouted about my passion for this on facebook, and on twitter, and I CARE.  I care about who they fuck and who they fight, I imagine what would happen if they crossed over with the Discworld, I do comparative analyses of Supernatural vs Buffy in my head, I care about the philosophy of the show, the theology, the morals, the music, the actor's acting styles, the clothes.  I care about what the show has to say about women and about men and about justice.  I care that it has queer characters where being queer isn't a plot point, it's just normal.

I have fallen hard and fast for it and I am a fan again.  I fucking love fandom.  The passion and the nitpicking and the camaraderie and the jokes and the seriousness and the passion.  Fandom of nay sort can be pretty toxic, Supernatural has it's own toxic fandom, but on the whole I'm happy to be a part of it again.

Over the last few months I have had Thoughts about The Show buzzing around my head, but I was too busy watching it to write anything down.  Now I'm all caught up I have time to write, and to get my thoughts down.  Some will be Serious Thoughts, some will be Fluffy Thoughts.  This is the first post and now I need to work out what I'm going to do next.  And how to tag these posts because I swear, I have totally forgotten what my lists of labels are.

Capture your grief 2015

About.

Day 1: Sunrise

Day 2: Intention

Day 3: In honour

Day 4: Dark and Light

Day 6: Books

Day 7: Memory

Day 9: Family

Day 10: Words

Day 11: Glow in the woods

Day 12: Normalising grief

Day 13: Regrets and Triggers

Day 15: Wave of Light

Day 16: Creative Grief

Day 18: Seasons and Symbols

Day 19: Music

Day 26:Gratitude

Day 31: Sunset

Pregnancy after stillbirth: completed

The baby lives! It's a boy, he's healthy and fine and feeding like a demon.
Labour was straightforward - I was put on a drip and it took 4.5 hours. For pain relief I had an epidural and gas and air. Got a first degree tear/graze and recovered really quickly - only had a slight bit of swelling and no muscle pain to speak of.

We are now at home and comfortable and relaxed and content.  Don't expect much blogging from me for the foreseeable future :) 

Pregnancy after still birth: 36 weeks 6 days

I weigh 12stone 3lbs and a quarter. I've put on 2 stone and a quarter pounds. With C, I put on 2 and a half stone.
My bump measures between 36 and 37 cm. With C I don't think I got above 34 or 35, and this baby is likely to be a similar weight, if not a bit smaller.
From 36weeks 0 days i've been expressing colustrum. It takes an hour to get 0.8ml and I've done that 5 times now. I am informed this is good.
I noticed the baby practicing breathing a couple of days ago. It's a rhytmic movement, not as jerky and quick and hiccups,and would look a little like gadpung if the baby was out. At the last scan we saw the baby's abdomen moving, doing the same thing. This is a good sign.
All ctgs are normal and healthy.
At 36 weeks 5 days I had a sweep and this morning my mucus plug came away.  (Edit - the next morning more cane away, on two different occasions, and was bloody).
 With this and the colustrum harvesting I'm hoping induction will be quick, although it could still take 5 days.
My hospital bag is packed and in the car.  I just need to add pilloows, towels and some more snacks.
I've felt a lot heavier this last week and groin is painful, although it's from pressure from the baby's head, not pelvic girdle pain, which I can be grateful for. My indigestion is horrible. My hips hurt more at night. My nose is more sensitive (or there's more smelly people on the bus).  I've been getting Braxton Hicks contractions since 36 plus one. I put all this down to the expressing and the sweep, producing hormones that are getting things going.
My freezer is full of food for us, and a tray of colustrum filled syringes for the baby.  Tonight we clear up the house.
Now to survive the next few days until the baby arrives.

Pregnancy after stillbirth: 36 weeks 3 days

Over the last day or so my moods are very changeable and filled with anxiety. I only feel safe at the hospital. I'm terrified of labour and the few days between now and induction. I have a sweep booked for 2 days before induction and that terrifies me too. I think I've put off grieving for C over the last 9 months and I think his loss is going to hit me like a ton of bricks once I've had this baby and I am now longer pregnant.

I have finally got a prescription for antedepressants for use as soon as I have had the baby and instructions to go see the GP in my second week home, as well as utilise the community midwife and health visitor as much as possible. Apparently paroxetine takes a couple of weeks to kick in for depression and 12 weeks to kick in for anxiety. I don't understand why, but I guess it's because different parts of the brain are affected by depression and anxiety. I just need a crutch to help me cope and keep me caring.

I feel like a burden, like I should be more capable, more calm, more excited. Instead I feel like a liability and I don't trust my own judgement.

When people talk to me about how to look after a newborn I feel a massive sense of rage and bitterness. I can do pregnancy and labour talk, because it makes me feel included, but I can't cope with people telling me how much care newborns need or how much you worry about babies when they're out. Like I'm not worrying now, like they aren't real inside you or like they are safe inside you.

People saying 'you'll learn' as if i'm thinking caring for a newborn will be a doddle, make me really angry.  No one has recently said anything about how hard it is with a newborn. If anyone was to say anything I think i'd flip, because it can't possibly be harder than not having your baby. To imagine that I won't be as worried as every other parent...to imagine I won't be more worried... I had baby resuscitation training last Friday.  Other parents prefer to stick their head in the sand and assume it won't be needed..I know better.  I'm trying as best I can and I don't think it will ever be enough to save this one.

Pregnancy after stillbirth: 35 weeks 6 days and 35 week care plan

This meeting took place at 35+6, so practically 36 weeks, and a week before my planned induction at 37 weeks.

The scan showed that growth is fine, this will be a small baby, but the growth curve is looking reasonable.  Fluid levels and blood flow through the umbilical cord (measured by the doppler) are in the normal range.

We met with the registrar afterwards, not our named consultant, and I asked for reassurance about growth, whether it was worth bringing the induction date forward (to me, a few days won;t make any difference, surely?), getting a prescription for paroxetine (antidepressant) and about having a sweep a few days before induction.  The response:

Growth and induction date:  They are more concerned with the growth curve, the fluid levels and blood flow through umbilical cord than the size.  If growth had slowed, or remained static, or the other indicators weren't good, they'd bring delivery forward.  But they feel that everything is looking healthy so they would prefer induction to stay at 37+0, as it is planned.  If I notice any change in movements I need to come in immediately.  Like I need telling...

Obviously I'm super anxious about getting to the induction date so the registrar went and got the consultant and they did another scan, where they looked at the blood flow through the baby's brain, and that appeared to be at normal levels.  The consultant said that there is some evidence to show that in the last few weeks this is a more reliable indicator than the doppler blood flow checks, hence why he did it.

He said the evidence shows that we are at higher risk of another stillbirth, but if we deliver pre-term, i.e. before 37 weeks the baby is more likely to get into distress during labour which would lead to an emergency c-section.  Now I don't care about having a cesarean, but I do care about whether they can get to the baby in time.  He also said that if I were to come in 2 days early for induction I'd have to be on delivery suite, rather than the antenatal ward, and the thought of that makes me *extremely* panicky.  I am not willing to stay on delivery suite for 2 days or more to have this baby.  Fuck that with a capital F.  Also, if I was induced pre-term I could only come in if there was room in the nursery for the baby, in case they had difficulties post birth.

The upshot is that I have a provisional induction date for 36 + 5 but in all likelihood I'll keep my date as 37+0.  Unless I have an emotional breakdown between now and then.

Getting a prescription for paroxetine: Like the last registrar I saw she seemed surprised I was asking about this (despite it being in my notes) and said they would normally prescribe one of three other antidepressants.  I explained my reasoning and kept arguing with her until she agreed.  She then said they couldn't prescribe that at the hospital (contradicting what the registrar I saw at the 28 and 30 week scan said) and I would have to see my GP.  Which could be difficult as I can't make appointments in advance with my GP and I'm at the hospital every day until I get induced. Le sigh.  I'll work something out.

Sweep: She said I could have a sweep 2 days before induction which will hopefully make the induction process shorter.  As I'm not expressing colustrum fingers crossed induction won't take days and days.

I wasn't massively impressed with the registrar.  Our consultant took us through the reasoning behind his advice - the most up to date research, the implications, the risks, but she didn't.  She seemed put out when we listened to the consultant more than her and she told us that there were no guarantees this child would be OK, no matter what we did (i'm paraphrasing, I think her words were 'we can't guarantee anything).  You know what lady, we know that better than you!  I can feel it in my bones and we're living with the daily fear of this one dying.  You don't need to tell us nothing is guaranteed.  I don't want false reassurance, though I want facts.  It pisses me off that we have to push to get extra checks and better care and better explanations.

She also wrote nothing about paroxetine in my notes and nothing about the sweep.  I have been told, by my community midwife, that they cannot do a sweep unless it is written in my notes by a doctor.  So I have to go chase that up tomorrow at my scheduled CTG trace. *rage*

I had my last community midwife appointment 4 days ago.  It's my last one as I'm having daily CTGs now so I don't need both appointments.  It was with the one I saw at 12 weeks who I loathed.  She wasn't quite so offensive today, but she was still too excited for my taste,and beause she was running late she rushed me through everything, though she did answer all my questions.  I came out of the appointment pissed off.

I had my last osteopath appointment today, she was lovely.  She and my pilates teacher are getting a card once I've had the baby, they've been a bloody wonder over the last 9 or 10 months.

I've still got a range of stuff to buy and prep.  I need to get on that this weekend.

Parenthood after loss

I wrote this with the intention of submitting it to The F Word blog, but since writing it I haven't gathered up the guts to submit it, and since I'm due so soon I also can't handle the editing and feedback process as I'm getting rather stressed about what will happen over the next couple of weeks.  So I'm going to publish it here and ask The F Word to link back to it as part of their weekly round up.

Talking about stress, I think I might have another post in me about the physiological and mental effects of extended stress.

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What makes a mother?  Or a father?

I used to think that you became a parent once you'd given birth.  Once the baby was outside of the mother, and breathing.  But recent events have changed my opinion on this.

My first child died at full term, for no known reason.  According to conventional wisdom, I am not a parent as I have no child at home to care for.  According to conventional wisdom, the 8-9 months I grew him and carried him aren't enough to make me a mother.  From my pre-pregnancy understanding, once my son had died, I wasn't sure if we were still parents.  We had no physical, moving, breathing, child to show and talk about and cosset.  I have the evidence in my body that I carried him to full term - the stretch marks, the linea nigra, the post labour pains, the recovery period, the dodgy knees, the sore back.  Everything about my body screamed that I was a mother yet I was missing the vital proof.

Losing a baby is likely to be the most horrific experience a parent will ever go through, and denying their experience as parents is damaging.  I am still a mother even though my son isn't here.  I ate the right things, went to the ante-natal appointments, saved the scan photos, planned and decorated the nursery, bought all the right stuff, read all the right books and took as best care of him as I could.  If that's not being a mother what is?

Louise who runs the Duck in a Dress blog wrote about infertility and mothering sunday, and came to the conclusion that you become a parent when you feel like one.  I agree with this.  It might be when you discover you are pregnant, when you accept you are pregnant, when you have the first scan, feel the first movements, or when you have their baby in their arms.  Or it might be when you decide you desperately want kids.

Leigh Kendall over at Headspace Perspective recently wrote about whether she is a mummy blogger, given that her son lived for just 35 days.  Just because Hugo isn't with her now does that make her less of a parent, does that give her less of a right to be part of the parenting blogging circles?

Still Standing magazine has an article on just this subject, the writer argues that "a mother isn’t born when a child is born. A mother and father are born when the dream of a child is conceived".

I believe that it doesn't matter whether your child died due to a cord accident, placental failure, intrauterine growth restriction, pre-eclampsia or Hellp, or if their heart just stopped.  You are still a parent, if you want to be.  Even if you choose to have a termination for medical reasons you are a parent, making a decision in the best interests of your baby, the same way as parents of living children would decide whether to turn off life support should there be problems after the child is born (at age 1 or 26).

For those of us whose babies have died, if we are no longer parents, what does that say about our experiences of pregnancy and delivery?  If your baby dies in utero, after about 14 weeks, you still have to give birth, whether that is by labour or cesarean section.  The labour process is the same as that with a living child.  I know what the difference between early and active labour and I know what ring of fire refers to, and what it feels like to pass the placenta (gross, since you asked).

I think for second trimester losses, there is even more of an inclination to dismiss the baby as not real, and the parents as not parents, and that's damaging.  Baby loss parents have pregnancy symptoms and delivery stories, the same as every other mother out there, because it's the same process, but not if others don't recognise us as parents.  Not if they treat us, on later pregnancies, as first time parents.  Dismissing our children is a crushing experience.

We are still parents and it's about time the rest of the world recognised that.

Some notes:
Baby loss, through second trimester miscarriage, stillbirth (in the UK this is classified as death of a baby after 24 weeks gestation and prior to birth), is vastly unknown and misunderstood.  People think it doesn't happen, or that it's preventable, or that you'll get warning of it.  That's not always the case.  In 2013, over 5700 babies died just before, during or soon after birth.  That’s over 100 babies every week. Sometimes reasons are found, more often they are not.  Dealing with the death of a baby, whether you are the parent, other relative or a friend, is a hugely complicated and emotional thing to do.  If you then go on to become pregnant again, it's even more messy.  However there is support available:
Sands - providing support for those affected by late miscarriage, stillbirth and neonatal death, as well as promoting research around babies dying.  June is Sands awareness month, find out more here.
Tommys - funding research into stillbirth, premature birth and miscarriage, and providing information for parents.
Miscarriage Association - UK site giving information and support for all stages of miscarriage.
Movements advice from RCOG
Still Standing magazine - online magazine dealing with child loss and infertility

Pregnancy after stillbirth: 33 week scan and a bit after

My 33 week scan went OK.  The baby is growing and blood flow etc is fine.  I agreed to being prescribed antidepressants after the birth as I think it's a good precaution.  They'll take a couple of weeks to kick in, so won't save me from the baby blues that I have been told kick in 3 or 4 days after birth, but they should stop me from giving up after that.  I have requested paroxetine as that seems safest for the baby, if I can breastfeed.  I'm planning to try to breastfeed, but if I can't I won't beat myself up about it (hopefully).  I'll get a carton of formula in just in case.  At least I know I can express colustrum so the baby will be alright for the first few days.

The day after the scan (at 34 weeks exactly) I decided I needed more checks, to keep my anxiety down.  So I booked CTG traces for that day, and more for the following week, with the end result that I have medical appointments (community midwife, growth scan, CTGs) booked for pretty much every day between that 34 week point and when I'm booked in for induction.

My mistake was in not making appointments for the weekend directly after the 34+0 point, because I spent that weekend super anxious.  Saturdays and Sundays have bad associations for me.  So now I'm going in on the remaining two weekend between now and induction, and conveniently enough CTGs on the weekend are done on the ward where I'll be induced.

I ended up having an emergency check at Delivery Suite (it's still vile visiting there) because the baby was moving far too much - increased movements are as concerning as decreased movements.  But at least when they are moving you know they are still alive.  Anyway, the check was a ctg trace and in total I was in there for 2.5 hours, which is pretty quick.

I'm now 35 + 1 and I went to the hospital today and it was pretty horrible walking into a new hospital setting, to a bay to be checked over.  I've never stayed in a hospital bay, but my partner did have a couple week stay a few years ago as he was hit by a car, and it wasn't a pleasant time.   The midwife who did the trace did tell me that for people in our situation they try to put us in a private room, which would be preferable.  However the private rooms may be being used by families in more dire need than us.  We'll see.

Physically, the baby is dropping and jeez I can feel it.  Actually I think the drop started a few weeks ago, I remember a day when I felt really heavy,  Since then I've been getting more groin pain, lower back aches and shoulder blade aches, and it's more difficult to get my legs and hips comfortable at night.  I have woken up with pins and needles in the arm I've been lying on, and it can take a couple of hours for them to stop.  My knee is playing up again.  There's a muscle on the side where it gets swollen and is painful to bend.  I think my foot arches have fallen even more as my feet ache in a new way when I walk.  When I leave the house in the morning, to go 10 minutes to the bus stop, my calves are awfully tight and I can't walk at any speed, it's pathetic.  However I'm not getting cramps at night, thankfully.  This hot weather is a shit because my feet heat up ridiculously, but at least they aren't that swollen. I guess that's all the water I drink and the sandals I'm wearing.

I've finished work now, and that's really helped with the physical stuff and my anxiety.

I can see the baby wriggling away under my belly, it's reassuring.  Even the thumps in the groin and the shifts onto my bladder are reassuring.  I got to show a friend the movements in my belly the other day, and she got to feel the baby too.  I'm glad I could show her.

A few pages from Carpe Juggulum

Pregnancy after stillbirth: 33 weeks 3 days

I've been a bit quiet.  It's been a difficult few weeks and I've not had anything to say.  Then I realised a few days ago I'm now in the gearing up for labour period and the getting ready to look after a baby period.  Writing the latter part of that sentence makes me feel sick.

I've had conversations with my consultant/registrars about labour, and also with my midwife.  At my last midwife appointment she talked to me about skin to skin contact and how long the baby would be on me, and if I couldn't hold the baby then my partner will have to do skin to skin.  We get an hour alone with the baby then they come do the blood sugar checks and other checks that I can't remember.  Then she talked me through how to express colustrum and milk, using a knitted boob (a white boob, which made me wonder if they had black or indian boobs for mothers who are not white).  She told me to try practicing now, to get the hang of it.

She gave me a labour information pack, which includes a booklet on labour and birth.  I flicked through it and there's loads of pictures of sticky and cleaned up newborns.  I really wish someone would make packs for pregnancies after loss, preferably with no pictures, because our needs are *so* different to happy parents' needs.

I found this appointment pretty traumatic.  It brought back memories.  I didn't like it.  But I know that it has to be done.  We have to act like this baby is coming home with us.  All signs so far say that the baby is healthy.  I'm having weekly CTG traces and they are fine.  So I have to prepare.

I did try expressing, and it was really easy, which made me happy. I felt excited, for possibly the first time this pregnancy.  I feel like my body is working right.  At the moment I will only try for a couple of times a week, and for only a few minutes each time, because doing this can bring on labour.  So in the week and a half before my induction date I will do it properly, and consider saving and freezing the colustrum, in case I have trouble breastfeeding.  Although I'm not sure I can bring myself to freeze the colustrum, because if the baby dies having to chuck out the frozen colustrum will be worse than having to get rid of all the nappies, like we did last year.

I packed my hospital bag 6 weeks ago.  So far I have packed just stuff for me.  I was going to check and then list what I'd put in, but since having a quick look and adding some toiletries I decided that going through everything would be horrible.  So from memory, this is what I have packed, or intend to pack, for me:
A pyjama top made by Bravissimo with boob support, like these ones. A second one would probably be good.
Maternity pads
Breast pads
Pjyama bottoms.
3 pairs of pants (knickers for you Americans)
My travel maternity pillow.
Slippers
Socks x 3 pairs
Shampoo
Conditioner
Sponge
Soap
Toothbrush
Toothpaste

I need to add tea bags (hospital tea is crap and I'm fussy), snack bars, something to read (will load books on my kindle, induction might take while), a nursing bra (I have a fitting booked for 2 days before my induction date). I might add straws as it will be easier to drink from them than from a glass when I'm in active labour.  My phone and charger needs to be packed too.

If anyone has any thoughts on what else I should bring, please leave a comment.

I also need to include stuff for the baby, which is a horrible thought.  My midwife told me that to bring them home we need only a few things - vest, baby grow, cardigan, hat and a cellular blanket.

I refuse to go through C's clothes so I will have to grit my teeth and go into mothercare and buy some clothes of roughly the right size.  Edit - Marks and Spencer do a newborn starter pack that will do, and I can buy it online.
I might be able to use one of C's blankets though. Not sure about that yet. Edit - I'm using one of his.
We can order more stuff online once the baby is out.  I also need to pack nappies, a friend has saved newborn nappies for us so we don't have to go buy any.  Lansinoh needs to go in.  Shampoo, conditioner, soap, sponge for me.  Perhaps cotton wool balls to clean up baby poo.

On the physical side of things, I can no longer sit on my exercise ball for very long because my back muscles aren't up to it.  At night my hips can be incredibly painful, more than likely caused by ligaments relaxing which allow sacro-illac joints to move, which they normally don't do as they attach your pelvis to your spine.  They need to relax in pregnancy so you can get the baby out, but they cause havoc with your comfort levels.  Exercise (walking, cycling etc) makes it worse, but pelvis stabilising exercises like pilates improve it (even though I'm bloody terrible at pilates at the moment).  So to help me I have constructed more pillow support for my back, shoulder and neck, because lying on my hips is horrible, but lying flat on my back is not good for the baby or me (the baby and your uterus would press on a major artery and your lungs and then you can't breathe).

I've bought some bra extenders to try and make some underwear fit better, as I really don't want to buy something that is only going to fit for another 4 weeks.

On the anti-depressants, I talked to a friend who has taken a lot of drugs for mental health over the years, and after discussing things with her I think I have decided to ask for paroxteine to take immediately after labour (you know who you are, thank you).  The registrar said that they would keep me on them for 6 weeks, checking in on my mood to see if the dose needed to be adjusted and then wean me off them at 6 weeks, if needed.  I will have the GP, midwife and health visitor looking out for me so people will know if they cause me to go loopy.  And my partner will be at home for the first 4 weeks too.  I figure it's a good precautionary measure and I feel better having everything set up ready to go.

I get to meet my health visitor in a couple of weeks.  They usually visit at 36 weeks but I'm a special (batshit) case, so she's coming round at 34 weeks.

28 week and 30 week care plan

28 weeks
This was a really hard week where I felt really, really low, and was concerned about my mental state.  Or about as concerned as I could be, given that I didn't care.  I mean, I can recognise when I'm not well and I can tell people that I'm not well.

So the scan was fine and the baby was fine.  The baby measures about the 20th percentile, which is in stark contrast to my bump, which measures the 90th or 100th centile (ish) but I am assured that  all is fine.  the sonographer wasn't going to do a doppler scan, but I said the consultant said I should have one.  So he did one, and the blood flow is right in the middle of the healthy range.

I didn't meet with my consultant, instead it was a senior registrar, but she was the right person for me to see at that time, as she was warm and friendly.  She suggested I take anti depressants either now or after I've given birth, as a preventative measure against post natal depression.  I was at risk of PND even before we lost C, so now I figure i'm doubly at risk.  She recommended fluoxetine (brand name prozac) or Citalopram as safe to take in pregnancy.  She also offered me a referral to the mental health team and psychiatrist but said all they'd do is prescribe me anti depressants and give me a number to call if I felt at crisis point.  My midwife can also refer me to the mental health team.

Once home, I found some info about these drugs:

http://www.drugs.com/pregnancy/fluoxetine.html

http://www.nhs.uk/medicine-guides/pa...ine=fluoxetine

http://www.nhs.uk/medicine-guides/pa...20hydrobromide

http://www.headmeds.org.uk/medicatio...and_everything

We changed my scans so I would have them at 30 weeks, 33, weeks and 35 weeks.  As I'm having them at week + 6 days this means I have one 1 week before induction.  I also booked weekly CTGs for those weeks when I'm not having scans.

She said that if the baby is breech or transverse at 35 or 36 weeks they'd give me steroids (2 injections 24 hours apart) and do a c-section just after 37 weeks.  When I go in they'll do a scan and if the baby has turned they'd give me the option for an induction.  If the pessaries for induction don't work (and we'll know if anything is happening within 48 hours)  they'll give me a c-section.  Both options I'm happy with.

I didn't go into work that afternoon.  I was too much of a mess.

Addendum - I ended up back at the hospital for an emergency CTG the following day, because I felt so awful I couldn't tell if the baby was moving properly or not.  It took me a couple of weeks to get back to feeling normal, but obviously my normal is not everyone else's normal, as I'm terrified of the baby dying overnight, so whenever I wake up I got to the toilet, drink a pint of water and lie awake till I feel enough movements to satisfy me.

30 weeks
The baby is fine and growing at the right rate.  This won't be a big baby, I don't think I can grow them big.

I saw the same registrar as before and we discussed post natal anti depressants again.  She got out the big book of drugs and looked up info for Citalopram and Paraoxteine (brand name seroxat).  More stuff seems to be known about paroxetine and it seems to be passed through to the breast milk more readily so I think I'm more keen on taking that.  She said that these drugs are considered so safe the neonatal doctors don't even want to know that the mother is taking them, as they see no side effects in the baby.  This is reassuring and means I can discount the info in the links above.

My notes from the meeting also say that we discussed induction, but I can't remember what we talked about.

Pregnancy after stillbirth: weeks 28 to 30 plus 2

Ah, I have not felt capable of writing these last couple of weeks.  They haven't been good.  Emotionally, I've not been well and it's taking a lot of effort and a long run up to write this post.  There's not too much detail, but there's a lot to say, a lot to record.

At 28 weeks plus one I had visits from my family, a couple of them one weekend, and then the other one the next weekend.  They are visiting because I can't bear to leave Norfolk and be that far from my  hospital.  Remember how about 6 weeks ago I talked about how I just needed to grow up and stop being such an arse?  Well it turns out that I don't deal with seeing family, not right now, and I had a meltdown, as we affectionately call it, using that word to try and downplay and poke fun at a very bad time.  I flew into a rage and sent some rather nasty emails which I am not proud of.  I apologised, but that doesn't make it OK.  No matter what people have done, and no matter what I think of their behaviour, there is no need to send nasty, spiteful, rage filled missives.

I wasn't very well.  Things were getting on top of me, I was hurting, I was lashing out and I wasn't thinking straight.  I had a midwife appointment on the Monday and cried through most of the appointment.  Then I had a counselling session later, which was OK, I guess.  Then a pilates 1:1, which was a distraction.

I came home from work one evening, Tuesday I think, and spent the evening in bed, not caring about anything.  There were a lot of self harm thoughts (I haven't had those, in such a high frequency and strength, since probably October last year).  I didn't do anything to hurt myself (because I understand that when you're pregnant that sort of thing is frowned upon) but I wasn't well.  I managed to facilitate/run an all day workshop at work the next day, but still wasn't right.  I had my 28 week scan the day after and talked to the doctor (a registrar, not my consultant) and she suggested anti-depressants, which I'll go into in another care plan post.  I declined the anti-depressants, not because I have a thing against 'popping pills' as so many people rather naively put it, but because when I'm this way I don't make quick decisions and I wanted to be able to research the drugs first.  I didn't go into work that afternoon, but I also didn't take to bed.  I functioned.

The next day I did go into work, but left a bit early to go to the hospital for my second emergency CTG trace.  I had no idea whether I needed to go or not, but because I wasn't rational enough to make a decision I thought I'd be best going in.  When I got there the midwife agreed I'd done the right thing.  However, I did have to sit in the waiting room for about 5 minutes waiting to be called through.  The same waiting room where we were kept for about an hour when we went in to check C's movements and were told he'd died.  So that was pretty horrendous.  Or would have been had I allowed myself to feel stuff.

Since then I've been improving.  I'm not right, not like I was before this 28 week mark, but I look fine and I'm doing normal life stuff and to everyone else I'll be fine now. But I feel like I've packed my emotions and fears into a little box and I've pushed it down deep inside me.  I feel brittle.  That Tuesday scares me, if I allow myself to think about it, because it was a reminder of what depression is like, and I haven't felt that way in a long time.  I'm used to managing stress and anxiety, but not used to feeling like that.  So I push it down and pack it away and I'll deal with it at  later point when I have more time and space.

I do have to remember that in the third tr with C my mood crashed, completely.  I just started crying for no reason and feeling low.  I never really brought it up with my midwife because I'm not good at talking about this stuff, but it was a significant difference to my second tri mood where I was comparatively bouncing along, and the change happened overnight.  So I suspect that this week is a combination of grief, pressure, fear and hormones.

A friend at work (when talking about something completely different to the above) said something like 'you don't want to be defined by your loss at work', and my instinctive reaction was yes I do.  But now, I'm not sure if that's the 'right' response, or what I want.  I need to reconcile my status as a mother with other people's understanding of being a parent, and somehow fit all that into the rest of my life.  Which is kind of what these blog posts are about, a bit.  The purpose of them has changed, I think, since I started writing at what, 5 weeks (?) gone.

So, I guess I should also talk about the physical stuff.  At around 27 weeks I got a growth spurt, and jesus my hips and pelvis started hurting.  So I made an appointment to see the physio (at 29 weeks plus 3) and she gave me a support belt, which is bloody amazing.  Of course the departments at the hospital don't talk to each other, or read historical notes in their department, so she asked how old my child at home was and I curtly pointed to my Sands sticker on my maternity notes (the notes I bring with me that she wouldn't have seen beforehand).  She went ahh and it was fine, but for fucks sake. She saw me for about 50 minutes and gave me exercises to do to help with other pain, and on the whole was pretty good.

Speaking of pelvic girdle pain (PGP), the ways I manage it are:

• When standing or walking for long periods, wear the support belt.  I did get given one with C but it hurt more so I never used it.  This time round my bump is flatter and lower (my torso muscles have little to no tone due to the short pregnancy gap) and the belt works a treat.
• When lying down, put a pillow between your knees, a pillow against your back and a pillow underneath your bump.  You can buy maternity pillows which do all these things or you can use separate ones.  I use a mixture of 4 maternity and non maternity pillows.
• Pelvic tilts can be done sat on an exercise ball, leaning back against an exercise ball, on your side at night or standing up.  They really, really help loosen up painful lower back muscles, which while not strictly speaking are part of pgp, nonetheless don't help.
• Doing pregnancy pilates every week.
• Seeing an osteopath (experienced in treating pregnant women) every 3 weeks to realign my pelvis.
• Sitting on an exercise ball at home, not on the sofa.
• Not pushing myself.  If something hurts, stop doing it.

FYI, my pgp hurts when I walk for more than 10-15 minutes, when I roll over in bed at night, when I sit on the sofa for too long and when I stand up from the sofa I get shooting pains down my leg.  That last bit probably isn't pgp, its just general pregnancy tightness.  It all needs treating though.

Right, what other physical stuff?  I had the whooping cough vaccination at 29+3.  It made my arm hurt.  2 days later I started getting a cold and now nearly one week later the cold is still lingering. It's not that severe, but bloody hell it's knocked me out.  I feel like I've been asleep for most of the week.  Considering that and my near breakdown the week before I've done fuck all at home and the boyfriend has had to take up all my chores, as well as the redecorating job he's doing.  It's not very fair on him so now I'm better I'm determined to start pulling my weight again.

Pregnancy after stillbirth: notes on CTGs and UTIs

Recently I've been thinking about CTGs and I also mentioned UTIs.   I wanted to put a few words about them on these here posts.

A UTI is a Urinary Tract Infection, like cystitis.  They are uncomfortable/painful at the best of times, causing pain (burning) when you urinate, making you want to pee more often than normal (and crucially, not having anything to piss out when you do go), and can make you feel grotty and under the weather.  In older people (pensioners) they can make you seriously unwell.  When you're pregnant an untreated UTI can cause premature labour and the infection can travel up your vagina, to the womb and infect the baby.  This can cause illness in the baby and can be fatal (to the child).

Hence why my midwife was concerned about the leukocytes and ketones as they can indicate an infection.  However, I did as she told me and the following Monday when my urine got tested again it was all clear.  So that's fine.

CTGs, or Cardiotocography traces, are used to monitor the baby's heartrate and uterine contractions.  It's done through putting two monitors on your bump, one at the top of your uterus (your fundus) and one roughly where the baby's heart is.  The machine my hospital uses gives the uterine contraction rate in a green number, and the baby's heartrate in a red number.  If you ring up your hospital concerned about movements and they ask you to come in they'll put a ctg trace on you.  At my hospital you go into delivery suite to have this emergency check done.  I've been in twice now, it's not pleasant.

Anyway, the point of this post is for me to explain about the baby's heartrate and what the ctg trace is picking up.  I asked a couple of fellow Sands ladies about this and they, along with my midwives, gave me the following information.

My midwives have all said that a normal baby's heartrate is between 110 and 160 beats per minute. When the baby moves, it is expected that the heartrate will go up to to 180 beats per minute (just as yours and mine heartrate would go up if we exerted ourselves by going up stairs, for example).  On a ctg trace, which records the heartrate on paper, a la the top line on this image:

You will expect to see at least two spikes occurring at the same time as movement.  The mother is given a beeper thing to press when she feels movement and this is also recorded on the trace.  These increases are called accelerations.

I believe that the lower line on the above image measures baseline uterine activity, i.e. contractions, and is normal.

The ctg tracking the heartrate will pick up when decelerations, i.e. when the heartrate dips below 110.  If more than two of these happen in a 20/30 minute period for more than 15 seconds at a time your midwife/consultant should be concerned and further monitoring is needed.

You have to meet set criteria for the midwife and doctor to be happy with the traces.  A normal CTG needs 4 features - baseline rate to be between 110 and 160bpm, variability has to be 5bpm or more, at least 2 accelerations in a 20 minute period and no decelerations.

For a non-reassuring trace, you need to meet just one of  the following criteria: baseline heartrate below 109bpm or above 160 bpm, variability less than 5bpm per 40 minutes or more than 5bpm for 90 minutes, unprovoked decelerations, decelerations related to uterine tightenings when not in labour.

A baby's heartrate is expected to vary from second to second, like humans out of the womb but there will be a baseline, which is not the same as a deceleration.  I have been told that decelerations are very obvious on ctgs, and that experienced midwives can hear a deceleration without having to have it checked by technology.  This applies when you have your heartbeat checks at regular antenatal midwife appointments and even the parents attending the appointment can hear it.  Having now heard this baby's heartrate weekly since 16 weeks, I would agree that it is obvious what a normal heartrate of around 140 to 150 beats per minute sounds like.

Note: fellow Sands women who are also midwives have told me that a normal heartrate is between 110-160 beats per minute and they expect accelerations with movements to go up to 180 beats per minute.  They have said a deceleration is classified as being at least 15 beats below the baseline for at least 15 seconds.  Which to me says it comes back to being what it normal for your baby.  One off decelerations can be fine, but the baby should always be monitored with a ctg and/or scan if one is suspected.

Another Sands mother says that when she had hours of CTG in the last 5 weeks of her pregnancy, her son only had decelerations in the day before being delivered, and that they were really really obvious on the CTG feed.  She says that movements led to a raise in heartrate, which then came back down, sometimes with a little valley below the average heart rate.  The deceleration was "massively and very distinctly different, with a marked downwards tench with no movement before it".  I'll add that although the mother might not feel every movement, on a ctg trace and a regular heartbeat check, you can hear movement as the baby pushes or shifts against the uterus.

I also asked Sands women about what they can pick up at scans regarding heartrate.  Most scans don't take 20 minutes.  They might take just ten or less.  I have been told that during a scan the sonologist looks for normal movement patterns and they can see if the heartrate is slow - they check it by eye.  if you have a doppler scan they can record the blood flow through the umbilical cord - the print out looks a bit like the ctg trace.

That's a rather long post, but I feel better for getting it out there.  I'm a huge believer in the more information available to parents the better.

Pregnancy after stilbirth: 27 weeks 6 days

Had a midwife appointment yesterday and she's had my glucose tolerance test (GTT, to test for gestational diabetes) and general blood results back.  I don't have diabetes, I'm not anemic, I don't have antibodies and my blood group hasn't changed.

The urine test showed that I have leukocytes and ketones in my piss, so she thinks I may have a UTI, so I've been ordered to drink tons of water and cranberry juice, and if I get any symptoms (burning when I wee, pain in bladder/pelvic area) to bring in a wee sample for testing.  I have another midwife appointment in a few days (part of my regular weekly ones) so they'll check my pee again then.

She measured my bump and the baby is now at the 95th percentile, when it was at the 10th on the previous 2 scans.  So either it's grown massively over the last week or I have lots of other stuff in there.  Dunno.  The bump measurement is only a guideline, the scans are far more accurate.  Of course I'm now worrying the baby is going be huge and I'm going to get a 4th degree tear.  My midwife said there are lots of reasons why women tear, it's not all about baby size, it's do with their position, speed they come out, my pelvis position, the position I'm in, loads of stuff. She said it's important to listen to the midwife's instructions when in labour - when she says pant, I need to pant, when she says push, I need to push.  No one told me to pant with C but my midwife said that was a different case so I wouldn't have been told to pant.  I have no idea why.  To me his labour was straightforward and easy.  I need to find out why I wasn't told to pant.

I'm getting more scared of labour.  If it's as straightforward and quick as last time, I'll be fine. if it's longer, I'm terrified.  I'm not sure I know how to do this anymore.

Pregnancy after stillbirth: 27 weeks 4 days

Today has been difficult.

I had my glucose tolerance test at the hospital which was OK actually.  Lucozade isn't as bad as I thought.  What you do is not eat from midnight the night before, arrive at 9am ish, have a blood sample taken, drink 410 mls of lucozade, an hour later have another blood sample taken, and an hour later have a third blood sample taken.  Then they test your bloods to see how well you are processing sugar and determine whether you have gestational diabetes or not.  Diabetes when pregnant is bad as if it's not controlled and kept an eye on it can at worst kill the baby.  Less horrific scenarios are the baby being much bigger than expected, which could make labour difficult so doctors might recommend a c -section.  If they do, it's helpful to remember that the c-section isn't the problem,  it's a solution that will help preserve the mother's and the baby's health.

While waiting at the hospital I saw a lot of young babies...and pregnant women.... looking happy.. and it pains me.  Saw some other kids on the weekend and that pained me too.  I'm glad there are healthy kids in the world, I wouldn't wish my situation on anyone, but all I wanted today was to cuddle a baby and cry into them, but I can't do that to a stranger's kid, because I'll look like a nutter.  I just want my son.  He'd be about 11 months old now.  I could look up child development month by month by I won't, because that will just hurt.  So that means I don't know what he'd be like about now.

I'm trying to make an appointment with the physio to look at my pelvic girdle pain.

I saw the Avengers Age of Ultron film on the weekend and enjoyed it..then on twitter today people are being pissy about it because of Black Widow's infertility storyline, which you can read about here, including my response.  It seems to me that people complaining about it aren't those who are actually infertile, or those whose bodies have failed their babies, or potential babies.  It strikes me that most people complaining about it want to see Natasha representing all women, whereas it's clear to me that she's not and what we are actually seeing is her perception of herself, where I can completely understand that her sterilisation means that she sees herself as monster.

If you are not infertile, or if you are childless through choice, you don't get to claim that her portrayal hurts women, because it is NOT your fucking story to tell.  Not all stories have to be about you.

I think I'm getting more scared of labour.  Last year, when everything was so fresh, I couldn't give a toss about labour.  It was hard work, it hurt one hell of a lot, but it didn't scare me.  Now I'm getting scared.  It has to be done, and it will hurt, but induction will be different because this one will be live and I don't know how to manage this or what to expect.  I need to talk to my doctors and midwives about it.

Pregnancy after stillbirth: 24 weeks scan and consultant appointment

We had the 24 week scan last week.  Here are the notes from it.

Our post scan meeting with the consultant went as follows:

Can I have extra scans at 30 and 34 weeks? They will review at the 28 week scan.  The consultant would prefer me to have them 3 weekly from 28 weeks as they have pressure on resources, but if I feel I need them every 2 weeks then he will agree to that.

We agreed an induction date that is bang on 37 weeks, which I am incredibly relieved about. It's a weight off my mind to know that I won't have to argue with them.

I asked again about my muff itching, the change in discharge colour and smell. He examined me and said everything looks normal and is putting changes down to normal pregnancy changes.

I came out of this appointment feeling so much better,

Pregnancy after stillbirth: 20 week scan and consultant appointment

We had our 20 week anomaly scan.  I think writing it up here would be good, so others can see what these appointments are like.  And it will help me get my head clear.  I'm finding these meetings quite traumatic and I tend to not think about them much after we've left,

The scan itself was fine, all is normal and developing as expected.  The meeting was with a registrar, not our appointed consultant.  I shall henceforth refer to her as the underling.

I asked about what vitamins I need to take - folic acid is no longer needed as the baby is fully formed.  I am also taking zinc and vitamin D and I can keep taking those.  Bloods will be taken at 28 weeks to assess my iron levels and confirm if I need any tablets.

I asked about having CTG scanning in the last week of pregnancy, this was agreed to although it wasn't formally booked in. It will be booked in once we have decided on a delivery date.

When can I be induced? - I said I wanted to be induced bang on 37 weeks. If I can't be induced then I want to be admitted.  The underling said they would normally induce between 37-38 weeks and we would decide this at the 32 or 35 week scan. This makes me feel uneasy but I'll accept it and keep pushing for a 37 week + 0 date at future meetings.

What do I do if I decide inbetween appointments that I want more regular scans? The underling said that I could ring the consultant’s secretary but they are unlikely to see me more often than my current plan suggests, as they won’t be able to tell much so it’s not a good use of time/money.  However I can come in for emergency checks whenever I want.

Note - this is at odds with what was discussed at the 12 week appointment as we were told by the other underling there that the maximum amount of regular scans offered could be every 2 weeks, as any more often than that don’t show enough growth to come to any conclusions. So I'll bring this up again at the next appointment.

I've been having a fitting feeling in my belly, at a guess it lasts between 20 seconds to a minute. It just feels like really high intensity movement, more definite than just vibrations. There is no hardening of my uterus and it's not hiccups. The underling suggested this is down to intestinal/bowel gas. It's not gas, I know what gas feels like. My midwife suggested it was the baby moving really really fast. I'm not convinced by that either, but these two separate opinions show me that it's probably not a problem.

I've been getting pain across a small part of my abdomen. It's a tightness, and a pain, and lasts for up to twenty minutes before it eases. The underling said this is nothing to worry about and is just normal pregnancy pains. I'm guessing it could be ligaments. I think I had this with C, but back then I wasn't worried.

I next asked about delivery options if there are problems after 24 weeks. The underling said if the baby is measuring small but there is enough amniotic fluid and the placenta is doing it’s job they would induce me.  If the baby is small but fluid is low and blood flow looks bad, they would do a c-section.  I am still happy to be induced but I was assured that they would be quicker to give me a c-section (when compared to other women) if there were any problems, given my history.

I asked about my discharge as it's changed colour, it;s kinda gone creamy. She said don’t worry about the colour, only worry if it is itching, smelly or causing pain when I pee. I had a swab done pre-12 weeks and that came back clear so there is nothing to worry about. I disagree with this as infections can turn up at any time.

I also asked about taking antihistamines as I have a dust mite allergy and take piriton near daily. The underling went and checked with the pharmacist.  Piriton is prescribed up to 34/35 weeks so is perfectly safe.  After that they advise loratidine.  Both are sedating antihistamines so can cause drowsiness and tremors, but if the baby comes out pre-34 weeks it will have bigger problems for them to deal with.

Pregnancy after stillbirth: 27 weeks 2 days

My hips hurt, my lower back hurts, my calf still hurts from cramp a few nights ago and I'm nauseous again.  I can't walk far or fast.  I'm a wreck.  I wasn't this bad with C.

Also, this post from Women Write About Comics, normally a well balanced and enthusiastic fan site, has enraged me.  It contains spoilers about the Avengers Age of Ultron movie and I have left a comment.  It's about having kids, don't read it if you don't want to be spoiled.

Pregnancy after stillbirth: 27 weeks 0 days

THIRD TRI!!!!
WOOOOOOOOO!!!!!

Pregnancy after stillbirth: 26 weeks 3 days

It's been a while since I wrote one of these. Feels like it anyway. I must have other interests. Imagine!

Over the last week I have noticed back pain I didn't have with C. With C,I had bad knees so couldn't bend my ones, and therefore couldn't squat. Instead I bent at the waist to reach anything low down. Until the last few weeks when I couldn't even do that.
Now, my lower back aches and pulls considerably when I bend at the waist, but I do seem to be able to squat OK. Most of the time.
My legs and ankles are getting very swollen. It's really uncomfortable. I have to wear flight socks on the train and put my feet up in the evenings. I usually have to go to bed at 9 so my feet can be adequately propped up. They are just getting worse. My legs are really tight, I mean the muscles. I think this is because ligaments are loosening up in preparation for birth so muscles have to work harder.  I've prolly talked about this before.  it;s an ongoing gripe of mine,
I survived a dentist appointment involving a filling and cleaning last week. I was quite proud.
Last week saw two birth announcements, me meeting a 6 month old and a pregnancy announcement. Lots of babies. I'm genuinely happy for my friend who had her baby at about 41 weeks, but Jesus, so sad at the same time.
I got one drop of colustrum coming out of my nipple. Just the one.  Much earlier than last time.  i wonder if this means i will get leaky boobs this time.

Then today has been horrendous. But that's a story for a different time as I'm still feeling fragile. On the way to a Pilates 1:1 which should help centre me, I hope.