My Dr’s Appt

Before I get into how my dr’s appointment went I want to clarify: The whole point of the appointment was to talk about post partum depression. I did that specifically so that I wouldn’t chicken out or talk myself out of talking to Dr. E about it.So, my appt was for 2:30. This means I have to leave work by 1:30 to give myself time to drive there and then find a parking space. I was not able to pump before left work. Can you say engorged? So when I got there I asked if there was time for me to pump before my appt. There was, and they found me a nice quiet place to pump, the kitchen area. It really was nice and quiet and secluded. It was nice to be able to pump there and not have to do it in the car.Anyway, I told Dr. E everything that was going on with me and my emotions. Pretty much what I relayed in my previous post to a more detailed degree. She also asked me how I was sleeping. I told her I was sleeping well but was not feeling rested when I woke up. Seriously, I can sleep fine (even with Kirsten waking up a couple times in the night) and still be falling asleep in the car as J and I drive into work together. The first thing she said she wanted to do was to check my thyroid levels since if they are wonky, as that can effect my sleep.

Then we started to talk in earnest about post partum depression. I’m going to relay all the info she gave me because I feel it would help others who may come across my blog. She had flagged my file for possible ppd when I got pg. This is because Kirsten is an infertility baby. She said that she sees ppd in previous infertility patients for a few reasons:
-The first one is, someone dealing with infertility (usually primary) usually build up this ideal in their head about how life is going to be so much better once they achieve the dream of a baby.
As we all know, babies are hard work and the “ideal” never really happens. It is not uncommon for someone dealing with infertility to feel a little bit guilty for feeling like they made a mistake or feeling overwhelmed with the huge responsibility of it all. This can lead to ppd.
-Second, feeling guilty for putting the baby into daycare or other care during the day when the mother goes back to work. Since you worked so hard to have this baby and then leaving them for so long feels…well…wrong
I don’t think this needs an explanation. That’s me all over the place too.
-Third, dealing with primary infertility usually means the woman is in her late twenties/early thirties. This allows us time to get used to our freedom. Our freedom of working late, meeting people after work for drinks, doing things for US.
Once the baby comes we realize that this freedom is gone. We basically know what we are missing. She said that when she sees younger mothers (teens/early twenties) they tend to not realize what they are missing because they go from parental control to a different kind of control by their babies/children.
She was right on, on all counts for me. I did have this ideal in my head about what life would be like once Kirsten was born. I would always say, “Yeah,yeah, I KNOW it’s going to be hard work but I’m ready for it!”. I didn’t fully realize, like nobody can, just how hard it would be and that’s with Kirsten being a relatively easy baby. I feel tremendous guilt about having Kirsten and then leaving her in daycare most of the week. It kills me. I always feel like, “Why did we have her if we don’t spend any time with her? She’s at daycare 10 hours a day!”. This is something that I struggle with most often. The loss of freedom thing was definitely there for me as well. I don’t think it played as big role but I can tell you there were times where I was a little upset that J and I couldn’t just go to the movies or dinner when we wanted.

Some other reasons she flagged me for ppd was because my mother has been dealing with depression most of her adult life. So, there is a hereditary factor. She explained to me that there is a normal course of how moods go once a woman gives birth. Typically the depression/blues set in around 6wks or so and then wane off at around 3 months. In looking at my Edinburgh score I went from a score of 9 at 6wks post partum to an 11 at 10wks post partum to a 17 at 13wks post partum. Instead of getting better like most, I was getting worse. This is a classic signal of ppd.Dr. E commended me for recognizing that things were not right and calling her. She said that there is nothing wrong with me and that this doesn’t make me “crazy” or bound for a life on a antidepressants. She explained the difference between ppd and post partum psychosis (think Andrea Yates). Most cases of ppp are because ppd was not diagnosed and things just got worse.What happens now? She prescribed 20mg of Pax*il a day. However, she told me to start off taking half a tablet a day to see what/if any side effects I have. To also start it on the weekend for the same reason. She said it was perfectly safe to take while breastfeeding and not to drink alcohol while taking it because it effects the liver (no problems here, I haven’t had a drink in…in…hmmm…how long HAS it been?). She typically wants to meet back with her patients a month after starting the AD. Since I have an appt on June 19th anyway we will discuss how things are going then. From that date she wants to see me in 3 months to again discuss how things are going. From that date I will see her again in 5 months. This way I am in communication with her over how things are going and when I feel it’s time to come off of the AD. Since this particular one needs to be titrated down we will discuss that process at the appointment where I tell her I feel I can come off of the AD.

I left her office feeling so much better, less like a crazy freak, and finally in control. It is wonderful to feel this way. I did have some concerns that I talked to her about:
Can I breastfeed? Yes, this drug is a Level II drug and safe for pg and nursing mothers
Am I going to gain copious amounts of weight? (she laughed a little) Weight gain is a possability but she has found that a lot of women find that once they are themselves again they are more likely to start and keep up with an exercise routine.(I’ll believe this one when it happens, I want to get on the exercise band wagon and I can totally do it during lunch).
Am I going to be worse off mentally when I go off the drug than when I went on it? No, I will not abruptly stop taking the drug.

My fears are allayed, my questions answered. I’m feeling much better about things and the tunnel is now just a bridge I’m passing under. I know the AD isn’t a cure all but it will certainly help me get back on top of my life and stop letting my emotions get the best of me. As Dr. E put it, the AD will help take the edge off of the emotions. So, that’s it. We’ll see how this all works out.

**EDIT**
Per my first comment. I don’t mean to say the ppd isn’t more likely for one set of people over another. I’m simply stating that infertility is one reason why a woman might get ppd. Sorry, if I made it sound like only peopole with infertility have ppd, that is obviously not the case. Ppd can effect anybody at any age.