Early Breastfeeding Struggles

At some point during my pregnancy, I had decided that I wanted to breastfeed. Knowing that it was possible I might face some challenges with this given my “advanced maternal age” and PCOS, I did early research, sought help before the baby was born and requested a lactation consultant visit me when I checked in at the hospital. When I decided to breastfeed, knowing in advance that I might not be able to, I told myself I would try but I wouldn’t be upset if it didn’t work out.

Well, somewhere between that conversation with myself and the birth of my daughter I became passionate about breastfeeding. I think it was because so many things about my pregnancy and birth experience didn’t go as I’d expected that this one thing became so important to me. I didn’t get my skin to skin right after my c-section, they gave our daughter to my husband and I barely got a glimpse of her. Despite that, as soon as she was with me she latched and started nursing immediately. And in my mind that seemed to seal the deal. I had to do this.

During our two day stay in the hospital, Kerrigan wanted to nurse very frequently. Because of her size her blood sugar was monitored during the first day (it was fine). She cried a lot, slept a lot and nursed a lot. That was the extent of her existence during those early days. When they checked her weight the day following her birth, the doctor commented that she’d lost more than expected but didn’t seem to worried about it. The doctor the following day also commented on how much she’d lost, but didn’t seem overly concerned and signed off on discharging her. We had a follow up appointment with the mother and baby center at the hospital four days after her birth, and they would recheck her weight then. We didn’t think very much of it as they discharged us and sent us on our way.

In the days following our discharge, Kerrigan nursed constantly and continued to cry a lot. Being new parents, we just assumed that this was normal for babies. I mean, they are hungry and they cry, right?

Fast forward a couple of days to our follow up appointment at the hospital. That morning my milk had FINALLY come in! We could tell because I looked like I’d exploded overnight and when I hand expressed there was finally milk instead of colostrum. Hooray! Unfortunately, that excitement was short lived. At our appointment we learned that Kerrigan had lost too much of her birth weight and there were concerns about how much she was getting to eat. We were immediately scheduled appointments with our pediatrician and a lactation consultant for the following day. We were also told we needed to supplement.

I was devastated.  

Robert and I stayed firm that we didn’t want Kerrigan to have formula. My milk had just come in, we told the nurse. We were confident that she didn’t need formula. We didn’t even have bottles other than those for the pump. Since Kerrigan received enough during her weighted feeding the nurse agreed we could try without formula, but that the pediatrician may advise us differently the following day. If we were sure we didn’t want to supplement with formula (we were sure) we needed to supplement with breast milk. She put us on a feeding schedule that had us feeding Kerrigan every two hours for the next 24 hours. I was to give her ten minutes on each breast and then pump for 15 minutes. We were to save the milk that was pumped and my  husband was to give it to her in a bottle after she nursed the next session, while I was pumping. She gave us a nipple she recommended instead of the ones that came with the pump bottles and wistfully sent us on our way.

The 24 hours following that appointment were probably some of the worst of my life. The entire feeding cycle, that we followed to a tee, took about an hour from start to finish. After nursing, I was able to pump an ounce of milk each time. If we were lucky we were able to rest for an hour before starting it all over again. I was physically and emotionally exhausted. And trying to recover from major surgery. 

I sobbed the first time my husband gave Kerrigan a bottle, as I sat there connected to the pump hoping to increase my supply. We’d always planned to have him give her one bottle a day, starting around 4 weeks, but it wasn’t supposed to happen this way. Getting to nurse her was supposed to be my thing, dammit. I didn’t get my immediate skin to skin – that was given to him. I didn’t get the birth I was hoping for – that was dictated by her. But nursing was supposed to be in my control and now these moments were also being ripped away from me. I felt horrible for being upset. I felt horrible for resenting my husband for feeding our child. But I couldn’t stop the emotions or the tears. I was her mother. I was breastfeeding. This was supposed to be my experience.
Despite never having any problems latching, after her third bottle that night I strugled to get her to latch. I cried even harder. Despair set in and I was convinced that was it, I was done. I was a failure at breastfeeding, let’s just go buy the kid some formula and be done with it (the exact reason we specifically got rid of that freebie formula that was sent in the mail!). But knowing this was important to me, knowing it was best for Kerrigan, my husband pushed me to keep going. “We aren’t quitters in this house” he told me. And he was right. We didn’t quit trying to conceive when it got hard – why should I give up on this? And I am so grateful for that moment. I don’t think I’ve ever told him that – but I’m so glad that he held fast when I didn’t and pushed me to be strong.

Somehow we made it through those 24 hours, and despite our sleep deprivation, made it to the pediatrician’s office. The preceeding 24 hours were awful, and we both headed into the pediatrician’s office with the mindset that we were going to tell him we didn’t feel it necessary to keep at the pumping/bottle feeding. It was causing stress. My milk had just come in yesterday morning, we are sure she is getting enough to eat! The first thing they did was weigh Kerrigan, and then double checked her weight. The doctor came in and told us we could stop the feeding schedule the nurse the prior day put us on. He didn’t think it was necessary. In fact, he even went as far to say that he thought the scales at the hospital may have been off! Either that or Kerrigan had gained five ounces over night!

He agreed that she was getting enough to eat and told us if our appointment at the hospital had been a day later we probably wouldn’t even be sitting in his office because her weight would have been fine. We did admit that there was a positive to thse past 24 hours, and that was that we got to experience our baby with a full belly. And that she was actually a pretty content baby. And that was both great news and a hard pill for me to swallow because it meant that the reason she had been so upset before had been because she was hungry and not getting enough to eat. That realization broke my heart and still upsets me to this day.

We met with the lactation consultant later that day – and she was also amazed at how much weight Kerrigan had gained seemingly overnight and even more impressed that we supplemented with breastmilk and not formula. She admitted to having been prepared for problems with me breastfeeding, and had shared that she’d put a few red flags in my file: Age, PCOS, C-Section. But she was thrilled with how successful we’d been and was happy with how much Kerrigan was getting during her weighted feeding. She encouraged me to hold onto 2-3 of the pumpings, but indicated we didn’t need to provide extra milk after nursing sessions. She also requested that we come in and weigh her weekly over the next four weeks.

After that appointment we had two more appointments with lactation consultants. We also had an evaluation on a posterior tongue tie. But Kerrigan continued to grow and do very well. As it turns out, my supply is fine. In fact, I am blessed with an over supply such that I have a 900 ounce stash of milk in my freezer in case of an emergency. It seems that it was just the circumstances that I was presented with that caused our struggles – an almost 10 pound baby and a c-section delaying the arrival of my milk. In hindsight, I see now that Kerrigan likely never got enough colostrum to fill her belly. And was hungy for the first four days of her life. But I can’t change those things.

To this day I still have anxiety about Kerrigan gaining enough weight and getting enough to eat. I still take her regularly to the mom and baby center to use their scales and weigh her to ease my mind. I still worry about my supply, and anytime I have a lower pump at work I panic a little. I was unsettled when she dropped a feeding. I still pump after nursing twice a day on days that I don’t work. I do everything that I can to protect my supply at all costs. To say that this experience left a lasting impression on me would be an understatement; but I don’t have regrets about it. 

I am grateful that I am able to breastfeed. I am grateful that I overcame those early challenges and had a support system that helped me through those difficult times. Breastfeeding is one of the hardest things I’ve ever done in my life, but I am so grateful for the bond that only I have with my daughter when she nurses. As it turns out, I did get to keep this one thing. And it has been worth every tear shed and every struggle we endured.

What Happened to Cycle 18?

I know I’ve been a little quiet lately, but a lot has happened in the last month. Ultimately, cycle 18 ended up not happening. And I went through a gamut of emotions ranging from extremely upset, depressed to content and happy. It’s been a hard month for me to cope with, and I’ve just now felt like I could (should) write about it.

The start of the cycle began the same as any other. I had my ultrasound, everything looked fine, I started my next round of letrozole. About halfway through my cycle, I ended up having severe diarrhea. Not your normal, metformin-esque, run to the toilet fast – but the kind where within five minutes of eating I had to find a bathroom. About 12 times a day. (Hint: Tucks Pads help alleviate some of the…discomfort with this).

Needless to say, I visited my doctor.

As it turns out, Cycle 16 was the gift that kept on giving. Due to the heavy dose, broad-spectrum antibiotic that I was given in the hospital, and subsequently sent home with, I ended up with a moderate case of C. Diff. C. Diff is an intestinal bacteria that lives within the intestinal flora of many people. However, what happens is that sometimes when you take a broad spectrum antibiotic it will kill off the good bacteria, and if the bad bacteria is resistant to the antibiotic, it starts to multiply. And without the good bacteria to help keep it in check, it can start to infest your gut.

Ultimately, if left unchecked, C. Diff. can cause severe problems and lead to a stay in the hospital.

Needless to say, this is not desired. As such, all of my doctors wanted to get on top of the infection and get it under control. Unfortunately (and somewhat ironically, the treatment for C. Diff is antibiotics. More specifically, Metronidozole. Which is not safe for pregnancy. In fact, it’s so hard on your system that the RE had me stop my Metformin for the duration of the antibiotic treatment.

I’m sure you can see where this is going…

Because of the infection and treatment, we had to cancel my IUI cycle. I was so upset by this, after cycle 16 in the hospital and cycle 17 where the timing was off, that I spent about a week just severely depressed. Just thinking about it made me tear up and cry. And for the first time ever, I broke down on the phone with the nurse at the fertility clinic discussing wether or not I should take my trigger shots (I was concerned about cysts). I apologized profusely about being upset, but the truth was that if one more thing went wrong, I was probably going to break. I simply was out of capacity to deal with it.

As it was, we already had to postpone our re-conference with the RE and try two more IUI cycles, since we hadn’t TRULY completed the first treatment plan. I just wasn’t going to be able to handle something going wrong the follow month. At this point I pretty much felt the Universe was against me and that maybe this just wasn’t meant to be. In my mind, there was simply no other reason I could think of at the time for why this was happening.

It took some time, but once I accepted that we were going to have a set back, I started to feel okay. And then okay turned into better. And eventually better turned into good. In time I realized that the break was actually good for me. A month without stress. A month where I wasn’t constantly wondering about what my body was doing. And slowly I started feeling a little more like ME. And it was kind of nice. I just felt a little lighter, things didn’t seem so bad. And I was…relaxed. Something I don’t think I’ve truly been in a fairly long time.

In addition, some other good things happened. The best of which is that my last CRP results showed that my CRP was down to 6.5 (from 12.5 the prior 6 weeks, and 17 prior to that). This is probably the most exciting thing that has happened in a very long time. Unfortunately, I’m not entirely sure what is causing the drop, since 4 things I have changed since it dropped. I’d had a tooth infection cleared. My plaquenil has been in my system long enough to start noticing effects. I had an intestinal infection cleared. And, lastly, I swapped to mostly organic eating.

Robert teased me that this is the exact reason that they only change one factor when they are testing things at work. Because we don’t know WHICH change is making progress, and we don’t want to stop anything because SOMETHING is working and we don’t want to risk backsliding.

Regardless, it’s something that made me really happy. For the first time in a long time I feel like maybe my body is going to be on board with this whole baby thing. For the first time I feel like something is progressing. And, going into Cycle 19 I feel something that I’ve been too afraid to acknowledge for a long time: hope.

So my status right now is that I’ve cleared my C. Diff infection, I’ve restarted my Metformin (although I have to work my way back to a full dose gradually) and my inflammation appears to be going down at rapid rates. We are going to talk to the nurse about doing the advance auto-immune bloodwork this month and we have a re-conference scheduled at the end of July.

All things considered, even though the start of the month was heartbreaking, it turned out to be an alright month. And I find myself invigorated and excited to get started on my next cycle over the next few days.

The Sad Story of Cycle Sixteen

As I sure you may have guessed from the title of this post, I am not pregnant.

Things started out normally. I had my scan on day two. Took my medication. Had 2-3 eggs that would mature and release. Robert had excellent sperm. We did two IUIs – one with 68mm sperm, one with 44mm. And we started our two week wait. It didn’t take long for things to go south.

The Monday after my second IUI I felt like I was coming down with a cold. My nose started running, did that thing where all your snot runs down the back of your throat and makes it super sore. I thought it was just a cold and went on with things as usual. By Wednesday I was so congested I couldn’t breathe through my nose or taste anything. My teeth started to hurt. On Thursday, my lower left jaw hurt so bad that I couldn’t chew anything on that side of my mouth and was starting to swell a little bit. Friday morning I went to see the doctor.

The doctor started me on some antibiotics (Augmentin) and advised me to take some tylenol for the pain I was having in my teeth. By 3:00 Friday afternoon, the pain was almost unbearable. Robert had called the doctor’s office to let them know, and when the office called me back all I was told was that my doctor had left for the day, they wouldn’t prescribe painkillers over the phone and I would just need to deal with it until the antibiotic started working. I was very upset, as by this point I could hardly open my mouth and eating soup caused so much pain that I could barely manage it.

I took a vicodin I had left over from a crown being done last year. Don’t worry, vicodin is pregnancy safe.

About 8:00 Friday night, I decided I was going to try to sleep it off and hope that I felt better in the morning. Within about an hour of lying down I simply couldn’t tolerate the pain anymore and ended up holding my face and rocking back and forth crying in the bathroom. Robert decided that we were heading to the emergency room.

After waiting, in great pain, for about 90 minutes in the ER we saw the doctor. He looked at my swollen jaw, asked some questions and decided I likely had a tooth abscess. He debated doing a CAT scan, but since we weren’t sure if I was pregnant or not, he indicated he’d treat an abscess the same either way regardless and we opted not to do the scan. I was provided some Vicodin, given a prescription for more, told to keep taking the antibiotics and sent on my way with a list of free/low cost dentists in the event that I didn’t have one (despite my indicating I did, indeed, have one).

The Vicodin numbed that pain enough for me to sleep…for about three hours. At which point I woke up in pain again. I got up and used the bathroom, felt lightheaded and immediately started sweating when I got back to the bed. I laid in bed and watched the clock for the next three hours until I could take more vicodin for the pain. About 5:30 am I took two more tablets, and slept for another three hours. I woke up, again, in pain and went to use the bathroom with the same lightheaded feeling from the effort of walking from the bed to the bathroom.

This time, I looked in the mirror on my way back to bed. To my shock, the swelling in my left jaw had tripled and spread half way across my face towards my right jaw, including my neck. I looked like I had gained 100 pounds overnight – or that I had been given a fat suit like they use in the movies. I went and woke Robert up, and we immediately went back to the ER calling the dentist’s emergency line along the way.

We got to the ER about 9:30 am and this time I was given a bed right away (apparently, I’d hit a lull in activity). I saw the doctor within 30 minutes, and we explained the situation. Well, mostly Robert did as by this time I couldn’t really open my mouth, it was incredibly painful to swallow and I was having a hard time talking. The doctor asked why we were back in the ER and when we explained how much the swelling had increased in roughly 9 hours and that we’d had three doses of the Augmentin, he ordered the CAT scan.

The CAT scan showed that there wasn’t an abscess, but that there was severe infection coming from the last molar of my lower left jaw (the tooth that had been hurting since Wednesday – an oddness given that it had a root canal almost a decade ago). The doctor advised me that I was going to be admitted to the hospital, I was quickly started on IV antibiotics and given morphine for the pain.

While I was waiting to be admitted, Robert went outside and got in touch with the dentist who indicated that we had done the right thing going to the emergency room – as that would have been what he had us do – and that we should keep him informed as things progressed. Robert spoke with the dentist a few times that day, and the dentist went into the office to review my file. He also called me Saturday evening to see how I was doing and let me know to call him as soon as I was released so we could figure out was going on.

48 hours, IV fluids and 8 rounds of IV antibiotics later I was finally able to eat solid foods again, provided that it was in small enough bites, and was released. I left the hospital about noon on Monday with a 7 day dose of clyndimyacin, strict instructions to finish the antibiotics and an order to see my dentist within 24 hours.

I went to the dentist 2:30 Monday afternoon. He asked me “did the doctor tell you how serious your condition was?”, “um, no”, “well, if you had swollen much more you could have cut off your trachea – if the swelling started to go the other way it would have cause swelling in your brain. You had a life threatening condition”. I am actually rather glad that I was not told this while I was in the hospital as it probably would have freaked me right the fuck out. My swelling had probably reduced by 50% at this point. The dentist did an exam and assured me that there was nothing that anyone could have done to have prevented the infection (a statement also made by the doctor in the hospital) – apparently sometimes these things just happen. Bacteria can apparently just reside dormant in a tooth that has had work done, or a root canal can fail, and some random event will trigger it. It can’t be predicted or even known that it will occur. Who knows how long my body has been trying to fight this infection without my knowing it.

Anyhow.

The dentist personally called the endodontist to see if he could get me in that day, and we went over to see him. He took and xray and pointed out the infection where the tooth and jaw meet, and where the bone was starting to fail in my jaw. He told me “I don’t say this lightly, and you know I mean it since this is how I make my money, but we’ve got to get this tooth out”. Assured that I can get an implant once the jaw heals (about a year), he sent me over to an oral surgeon.

I met with the oral surgeon on the following day. I contacted the fertility clinic to see if I was far enough along for a blood test to determine if sedation was an option. They were really great – indicating that I wasn’t, but that they were okay with the sedation. They worked with the oral surgeon for a treatment plan – letting him know what was okay and what wasn’t, going under the assumption I was pregnant since we simply didn’t know. Since I couldn’t open my mouth wide enough for the surgery, it was tentatively scheduled for Friday and I was given some things to do to try to get the swelling to go down and the range of motion on my jaw back.

I was able to open my mouth almost its full extent on Friday and the surgery went as scheduled, with the sedation. My tooth is healing well, and I’m able to eat just about anything. I required a few small doses of vicodin the day of the surgery, but was fine after that. Right now I sorely miss my tooth, and am leaning towards having the implant down (at great cost to us, I’m sure), but we will wait and see how I’m feeling about it come a year from now.

Saturday, against my better judgment, I took a pregnancy test. I pretty much expected it to be negative. There is just no way I would hold a pregnancy through the trauma I just went through. I knew that this was true. But the confirmation of the test was still upsetting after what started out as such a great IUI cycle. Even though I know it was probably for the best this cycle, and if I’d ended up pregnant I would have spent nine months questioning the effects of the past week and a half, I was still upset and had a good cry about it. Actually, I was downright down. I feel like this is never going to happen and the universe is against me. I mean I can’t catch a fucking break any which way I try and it’s frustrating as all hell. I go between wanting to keep going at this because SCIENCE is on my side here and waivering because it’s so damned hard to get that negative every month and ride the roller coaster of emotions that come with it. I’m just so fucking sick and tired of feeling disappointed and like I’m living my life around something I can’t make happen. Every decision I make has a reflection of the future we are trying to procure for ourselves.

I finished my antibiotics yesterday. The swelling in my face is gone and I look like myself again, albeit with some acne – either as a result of lying in a hospital bed for two days or the plethora of drugs that have gone through my system. I need to take some me time to go an have my eyebrows done, because they are getting out of control and I’m growing selfconscious about it. Well, that and being off the birth control has seen an increase in hair growth on my face and makes me feel a bit…I dunno. I’m sure it’s 1000 times more noticeable to me than anyone else, but it’s definitely a hit to the ol’ self esteem. Apparently it’s a side effect of the PCOS that I didn’t really notice because I’d been on birth control for the past 18 years. I’m not a vain person, but sometimes you just want to feel beautiful and that’s hard when, well, you don’t.

Anyhow, my period started today. So it’s on to cycle 17. I guess that means it’s time to get back in line for the roller coaster. Maybe this time I’ll enjoy the ride, but I doubt it.