On NZd's Health Advocacy System

A bunch of stuff happened last year whilst a bunch of other stuff was happening, so there are a lot of things I would have liked to write about, that I didn't quite get to write about.  One of those things was about the problems Mum had getting medical support through the public system, and what actions we took to (successfully) negate these issues.

Mum  has a long history of gynaecological issues, and has spent the last few years dealing with various prolapses.  Prolapses (uterine and other) are very common in women that have had multiple births and hysterectomy's.  In fact, about 40% of women who've had a hysterectomy will have a vaginal vault prolapse.  That's a lot of women.  You think we'd hear more about this prolapse thing. 

So because it's a common condition which comes in a range of severities, it is often not prioritised by our health system.  Mum had a prolapse for three years before she could even get on the waiting list to be seen by a specialist.  We were very lucky that her GP really pushed to get her into hospital at any chance she got.  The impact this was having on Mum's life was quite major - she became to unwell to work, and had difficulty walking even small distances.  She was in constant pain.  It's hard watching your very active, workaholic Mum go through this, and even harder for her to live through it.

Finally she got a date for an initial surgery.  This surgery appeared to have gone well, but shortly following surgery, her prolapse recurred.  She had an outpatients appointment with her surgeon, and at that stage was told that basically they couldn't perform the surgery required as she hadn't signed the right paperwork (they hadn't given it to her).  Not only that, but more surgery wasn't planned 'at this stage' as 'sometimes these things just work themselves out'.

Mum was devastated.  She felt as though she had just been written off.  Not only that, but she was back at square one with no real answer on  how to move forward.  She talked about writing to various people, so I looked up contact details for these people (Mum doesn't have a computer or internet).  On searching for this, I found out about our Health and Disability Advocacy service and with Mum's permission, got in touch.  This service has representatives all over New Zealand, and they will travel to see people that are not well enough to come and see them.  Their role is to ensure people know about their rights regarding health and disability care, and to help you lodge complaints if needed.  With their help, we wrote a letter of complaint to the hospital concerned regarding the specialist concerned.  The advocate we dealt with was lovely (although I re-edited the letter for grammar), and helped Mum to feel as though she was important, and her concerns valid.

Following this, we received a date for mediation at which we would sit down with our Advocate and the surgeon and talk through the issues that we had raised with the complaint.  It turns out that we never even got to mediation - an appointment with Mum's surgeon magically appeared.  We could have our Advocate come with us to the appointment, but Mum thought that might exacerbate things - so I went to ensure Mum said what she needed to without getting too upset, and that there were two people there to listen and understand what the next step was.

The squeaky wheel gets the grease.  At this appointment we found out the reason for earlier issues was that they found on opening Mum up that things were worse than anticipated, and any useful surgery was far more invasive than what she'd signed on for.  We asked all the questions we wanted, and the surgeon answered them.  Mum would be having a more extreme surgery as soon as scheduling allowed. 

I wasn't at the appointment when everything went wrong, but following the new appointment both Mum and I decided there was no point in going to mediation - her concerns had been heard, and there was a plan - this was the outcome we wanted from mediation anyway.  Not only that, but we came away from the appointment really liking that surgeon.  I imagine that at the follow up where things went wrong there may have been issues of communication on both sides, and this happens - everyone has bad days.  We also decided that I will go to Mum's appointments with her, because two sets of ears and eyes are better than one (and I am more bolshy and less scared of asking questions).

Mum had that surgery, and it was very invasive, and recovery was long and painful.  Unfortunately, around Christmas she had another prolapse.  We have been back to see the specialist, and she is now waiting on a third surgery.  I arrived to this appointment late, and when I got there, surgery had been decided on, and Mum was just doing paperwork.  When her specialist saw me he was really happy, told me what was happening, and gave me some names of surgeons so I could look up the procedure Mum was having online and watch it (which Mum and I did after the appointment).  He also learnt I was pregnant, and was excited to hear I would be birthing at Waitakere - if things go wrong and I need a C Section - he will be my surgeon, and I'm kind of glad about that.

So even though we didn't go through the entire advocacy process, what we did go through was of massive help.  We now have a great relationship with Mum's surgeon/specialist, and although her health isn't magically better, there is a plan, and we have confidence that the health system is doing what it can to get Mum as well as possible.  I am grateful to live in a country where we have free public healthcare.  We can't expect this system to be perfect, or super fast - but we can learn how to use it better, so we can help negotiate better outcomes for ourselves and our loved ones.  Advocacy services helped us to do this.  I highly recommend it to anyone struggling to feel heard.

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What prompted me writing this was learning that government funding will be cut to one of our beneficiary advocacy services.  I haven't personally used this service, but I have been on the unemployment benefit, and the sickness benefit before.  Like our hospital systems, these systems are not easy to understand, or get the most out of without help or negotiation.  I found out I was eligible for certain things through friends - not staff at WINZ.  Had I known the advocacy service was around at the time, I would have used it. 

At the end of last year, NZ had more people unemployed than at any time in the last 13 years.  It seems ridiculous to me to get rid of a service at a time it is most needed.  PLEASE think about these advocacy services and who they help.  A country where our ill are supported to get back on their feet, and where our unemployed can eat, while getting the confidence and support to get back into work seems far better than one where people in unfortunate circumstances are left to rot.  Education and support is key, and it currently appears we'll need a change in government to facilitate this.  People like my Mum are important in building our country, and there are many of them struggling out there at the moment.

On being a pregnant cripple part deux

This is me a few weeks ago at our bach - I'm WAY fatter than this now (it was too hot for pants - it's still too hot for pants)

So I thought I'd catch ya'll up with where things are at re: pregnancy and crippledom.  Am I still a pregnant cripple?  

Yes, yes I am.

So after I last wrote a few things happened.

Very shortly after writing a complaint to my doctors clinic re: the crappy Dr, I received a phone call from the head of practice.  He concurred that this particular Dr has a shite bedside manner and apologised.  He gave me another consult via the phone and said based on previous history, notes and pain levels, I should go on the sickness benefit.  I said no thank you - going on the sickness benefit would just make me more depressed (Murray probably also earns too much).  I asked if I could just try the drugs and cutting work back and doing all the exercises and see how that goes.  He said that was fine, and at this stage, it's working ok.

I have been regularly seeing my physio .  Last week was an awesome week where for the first time she could tell me my hips were sitting in the right place.  This was fantastic news as by this stage both of my hips were displaced.  The left hip was also very tight, and kept catching on tissue near the joint when I did things like tried to get up from the toilet, which resulted in me often getting 'stuck' for several minutes.  After a few good days sadly, my hip started doing this again, so it's back to the physio I go for some more painful hip/butt massage and manipulation.  Hoping a few days of good hips is a sign of more days of good hips to come.

I really like yoga now.  Every Tuesday I'm tired, and kinda don't want to go, but I make myself, and afterward I always feel great.  There are skills I am learning which are applicable to many areas of my life, and I always come out of class feeling relaxed.  Every time we have to do some sort of 'visualisation' that's too out there for me, I just visualise something awesome but somehow related, like memes about cats, or babies wearing sunglasses, or bad catch phrases from the 80's.  Murray and I went to one of my yoga teachers couple's workshops which is about massage and acupressure for pregnancy and labour.  That was awesome.  Now Murray knows some sweet massage moves, and also (I think) feels a little more confident about how to be useful when I do go into labour.

I'm also doing my best to get in the water as much as I can.  The other side effect of my hips being wonky is my lower back is in constant pain whether walking, sitting or lying down.  Even with the brace on it is painful for me to do simple things like make the bed.  And with getting heavier (I went from just fat looking to REALLY pregnant looking about two weeks ago), each week is more difficult than the last.  Being in the water takes that weight off for a while.  It means I can feel like a regular person for a bit - I'm not in pain, and I have much better mobility.  Exercise is really important to aid in getting my hips to do what they're supposed to, and this is much easier in the water.  I'm exercising regularly more now than I have at any other time in the last five years.

And despite being very sore, and having to take codeine, and needing to 'take things easy' (which I'm not very good at) - I'm feeling pretty good.  My brain is working well enough to read - and what I'm reading combined with what I'm learning in yoga makes me feel confident that I will be able to deal with labour no matter what happens (high chance of needing C section if my hips don't sort themselves out).  And I'm pretty sure all the endorphins from exercise are also helping me be less anxious.

I still think pregnancy sucks, but it's manageably suck.  Learning about what physiologically happens through pregnancy and labour has taken the fear out of the process and for me that's been the biggest thing.  I still have broken capillaries all over my chest that I'll get lasered at some point.  I still have bleeding gums and the occasional blood nose.  And I've just begun experiencing that wonderful thing they call 'reflux' (never had it before so took me a while to work out what it was - it's gross). 

And I've had a few 'happies' since I started looking really pregnant:

- someone got up so I could sit down on the bus home from work
- a lady let me go in the front of a long toilet queue at the pools 

- a boy racer dude offered me a ride home in his lowered 90's Subaru with tints and a blow off valve (I declined because I was 200 metres away from my house, and blow off valves are stupid)

- I freaked out my yoga class on Tuesday by my hip 'sticking' when I was in the Downward Facing Dog.  I would have laughed at me.

So it's not all bad...

On Cat Scratch Fever

Huckle's ear - it looks like a cut, but is actually dissected.

So even though pregnancy sucks and takes up a whole bunch of time with exhaustion, appointments and insanity, the rest of your life just keeps happening.  Including pet sagas.  I still haven't written about the neighbour-pitbull-trespass-saga (maybe another time - that will be a long rant), but we've had quite a few pet related incidents since we bought our house in the 'burbs.  The latest, and most costly one has been the Dash (ginger) vs Huckle (our ginger) saga.

When we first moved in we were cat-drama free.  Huckle settled in very quickly, Roux took a bit longer to come out from under the bed, but was soon fine.  Our cats are not the kind that have big territories, and can usually be spotted within a very short distance of our house, (or bed, or couch).  Roux now likes sleeping in the neighbours goat house.  To date, there have been no cat/goat issues.  In my head, he sleeps curled up on the goat.

Dash (and his owner) bought their house about a month or so before we bought our place, so when we moved in Dash was still settling in.  He'd lived indoors his entire life before moving here.  His owner decided that now they aren't on a busy main road, it was safe for him to venture outside.  Funnily,  the few times I'd spotted a lady walking a cat around Western Springs - that was our now neighbour, and that was Dash.  Small world.  I laughed at them numerous times. 

So maybe this is karmic retribution for the mockery - since Dash and Huckle have settled into their new homes, they have become mortal enemies.

Before the first signs of violence I was super nice to Dash.  He's quite an affectionate cat, and his owner is lovely, so I often gave him pats on our shared driveway.  I was stupid, and even patted him on our property.  As soon as he started coming in and intimidating our pets though, Murray and I did our best to shoo him away, and rewarded him from being near his house by patting him there.

A common thing to see on returning home from work/visits/adventures is Dash at our gate staring in, and Huckle at our doorstep staring out.  The epic stare-off is common, battling cats less so - but vicious when it does occur.  The first fight we broke up sent fur flying, and when I tried to shoo Dash he did something I've never seen a cat do before - he attacked ME.  My foot was bitten to bleeding point.  I was shocked at the audacity of this animal.  His owner is lovely, but she used to be a cat-breeder, so this led me to wonder if Dash is just a cat version of a very spoilt child used to getting his own way.

We thought after one epic fight maybe that'd be it.  We had a few good weeks where Dash didn't even venture near our house after Murray squirted him with the hose.  We soon realised we'd been lured into a false sense of security when we started arriving home to find stand-off's in our driveway once again.  There has been evidence of fighting on Huckle, and several of us on our shared driveway have broken up cat fights or shut down cat smack talk.

But the recent encounter was by far the worst.  I was chilling out after yoga, and staying up later than usual because Kindergarten Cop was on (best Arnie movie ever!).  Huckle came inside and hopped on the couch for a cuddle.  I was patting him, and it wasn't until I saw blood on my hands that I noticed his ear.  Initially it looked like he just had a bad cut on it, then Huckle flicked his head and I noticed that the top of his ear was almost hanging off.  Every time he flicked it, it hurt, so he flicked it again, and then the ear would start bleeding again.  It was freaky.

I wasn't sure what to do - a sliced ear isn't life threatening, but Huckle was distressed, and it was distressing me.  Growing up on farms has made me kinda like an animal MacGyver.  I have performed several basic home animal surgeries (nothing as serious as amputations, fret not).  But in this instance the only thing I could think to do was either:
a) tape his ear

b) do nothing

Both of which seemed to me that they would stress an already stressed animal further, so I did what I've never done before: I called the emergency vet to ask for advice.  Of course they told me to bring him in.

$245 later... Huckle was high as a kite and full of antibiotics.  Definitely not something I could have done myself.  The pain relief meant he wouldn't flick his ear, which would let his ear heal, and the AB's will (hopefully) prevent any infection.  REALLY wish it didn't cost so much, but glad we took him in when we did otherwise I'm pretty sure neither Huckle nor myself would have slept that night.

Our neighbour came over to talk to us the next day, as she had witnessed and broken up the fight.  She wanted to check on Huckle as when she found them Dash had been on top of him, so she thought he'd likely taken the most severe beating (Dash was also injured, cut ear and weepy eye).  When we told her about his ear, she cried (she really loves cats).  We told her it wasn't her fault, and we weren't upset, but hoped to formulate a plan to aid prevention of further incidence - cats will be cats.  The the best thing about having nice and reasonable neighbours is that you can do things like this.  So we have a plan and open communication to brainstorm further solutions should the need arise.

We're keeping Huckle inside for a few days until his ear is a bit better, and besides resenting his incarceration, he's doing just fine.  Because I felt bad, I bought some dental cat treats yesterday which he LOVES (Roux is much less impressed).  Even Murray has felt bad, so has been sneaking him extra Hucklicious treats.  He's getting lots of love and cuddles, and is being ever so slightly mollycoddled.  Now I'll have have to be careful not to turn him into a spoilt house cat...   

Huckle high on cat drugs.

On Choosing Gender Neutral Baby Things

Yeah, yeah, nah.

I have had a range of reactions from people when I've said 'yes, we're having a girl, but please don't buy us pink clothes.'  They range from  'Sweet!' to 'Just dress her up when the grandparents come over', to 'That's never going to work'.  So I thought I'd blog about why I'm making this choice.  This way I can direct any confused friends or relatives here, or print it out for any older relatives who don't use the internet.  I don't expect people to support us in this choice without understanding why we're making it.

I am definitely the driver in this decision, but Murray agrees.  And we aren't just doing this because she's a girl and cos 'feminism' - we decided before we found out the gender of our child (and we only found this out because I am impatient) that this would be part of how we choose to parent.

In having a quick look to check if my memory serves me right, I found this article on the history of pink and blue baby clothes.  Until the mid 19th century babies were dressed pretty much the same, and through the early 20th century the typical colours were actually pink  for boys and blue  for girls.  This didn't morph into the current gender/colour norms until the 1940's.  And there was a revival of non-gendered clothing for babies in the 1970's (cos feminism).  So I do find it a little odd that people would care that I don't want to dress my likely-girl in pink.  This concept ain't nothing new.

The main problem I have with gendered clothing and toys is that it encourages us to use gendered language around little people: 'Isn't she so pretty?' 'Isn't he so big and strong?  Are you going to be a truck driver like daddy?'.  And using language like this around little people tells them what we expect from them.  Language like this alongside saying 'girls (and boys) can do anything' is just confusing.  It's like saying 'You can do anything, but we'd prefer it if you do X'.  I don't want to confuse my kids.  I want them to be able to choose to do whatever without ever feeling worried or guilty about their choice.

Secondly, I don't understand dressing little girls in restrictive clothing when they are just learning to move around.  Dresses simply make moving harder to do - I know, I'm a dress wearer.  Babies and small children are just learning how to get about - which is why they toddle like drunks.  If I were planning on getting drunk and going out, I would not wear impractical clothing (heels, tight dresses).  Because I know from experience the likelihood of falling over and humiliating myself is high.  So why would I dress my small, tottering child this way?  And lace and decoration only aid in making movement awkward or uncomfortable.

Which brings me to a another point: lace and bows aren't necessary.  They are just there to make something 'pretty'.  Do we dress our little boys in lace and bows?  And if not, why not?  I'd say the reason is because we care more about making our little girls 'pretty' than our little boys.  Because we want other qualities than 'pretty' from our little boys.  I expect my little girl than to be more than just 'pretty' also.  Therefore I will try not to dress her in ways that will elicit this response from myself or others (I know this will be hard - I shop, I buy, I look at cute things, I'm human).  I will do my best not to objectify my child.*

Little people are like sponges - they absorb what is going on around them.  I found it fascinating when I learnt that at 21 weeks pregnant your baby can actually taste what Mum is eating through the amniotic fluid.  In utero, we are already influencing our babies future taste in food (need to cut out this lolly habit).  Our choices have a huge impact on the understanding and future choices of our kids.  And because of how I was raised/society etc, it will be difficult for me  not to use language that gender types.  So I am going to give myself as many tools as possible to aid in this.

I am well aware that I live in a world full of other little people and external influences and marketing that will influence my child.  I have no plans to wrap her in cotton wool, prevent her from watching TV or engaging with others so that she turns out like scary Victoria from this cycle of ANTM (yes, I watch junk TV, I'm not some feminist Nazi).  But until she is big enough to make choices for herself, I will try to keep her home environment as neutral as possible (ANTM in secret).  There are plenty of awesome, non gendered toys that most of us played with growing up: blocks, teddy bears, puzzles, books, wagons and trikes, educational games (square shape goes in the square hole) et al.  Toys are about modelling behaviors and learning new skills through play.  If we give her a doll, it'll come with a truck - 'dressing' things is no more important than 'driving' things.

This is particularly important to me as Murray and I fill fairly stereotypically 'gendered' roles at home.  I am the person who usually cooks (not at the moment due to malaise ie: pregnancy), and keeps the house respectable.  Murray is the person who works hard and earns money to support our family.  This is a choice we made independent of gender typing.  Murray earns, and has potential to earn more money than me, so it is logical he does this.  I care more about home maintenance, and a fair chunk of my life revolves around food - so it is logical I look after these things.  There are many other things we do that are less gender 'typical', but this is the face of it.  We will need to discuss and be open about the fact that this is a choice we've made, not what is necessarily 'normal' or 'proper'.  And we can reinforce this notion of 'choice' through gender typing as little as possible.

Although I'm sure most people I know aren't going to be thinking this, I need to mention it anyway: gender and sexuality are completely separate things.  There is no evidence to suggest that raising your children in a non-gendered environment makes them 'gay'.  I am not trying to make our child 'gay'.

And because we recognise 'choice' we also recognise that fairly early on in the piece, this kid is likely going to want gender typical things.  She will probably want to wear pink like 'Dora'.  And that will be fine (Dora is annoying, but not a bad role model for a two year old).  But if she wants to wear overalls and play in the sandpit, that will be fine too.  Like all parents-to-be, we want to do our best for our child-to-be.  And for me, modelling equality is as much a part of that as trying to cut down on the sugar so this kid isn't a sugar junkie like me.

For more info on gender neutral parenting, have a look here (I found this interesting)

* I know that most parents aren't intentionally objectifying their children, and I'm not trying to be judgy, just being blunt.

On Being A Pregnant Cripple

Check out my smiley belt.  Sexy as.

Back pain is common in pregnancy as we not only put on disproportionate weight, but also produce a hormone called relaxin, which 'relaxes' ligaments, bone structures and arteries in preparation for birth.  This can make some women feel super awesome, but can also cause issues as bits of the body may 'relax' into awkward places.  I have had back pain, and treatment before, but none of it compares to what I am experiencing now due to pregnancy.

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As a relevant, early sidebar, I started doing maternity yoga about three weeks ago.  I decided to do this because I wanted to do some prep for child birth.  I have learnt a lot from this yoga class.  I learnt that I was basically doing everything wrong.  I was sleeping, sitting and standing wrong.  I learnt about relaxin, and about some positions I shouldn't get into, not just because they aren't lady like, but because they might damage me now cos of the stupid relaxin.

I left my first yoga class completely re-educated, traumatised, and worried about how I would possibly be able to sleep in a different-to-usual position.  I cannot stress enough that this education was very useful.  If you are going to give birth for the first time, I recommend going to maternity yoga.  In spite of the fact that it makes me nauseated (due to low blood pressure) and tearful, I am learning things I may never have learnt without it.  And they are practical and logical things - not just hippy la la things.

I'm learning a bunch of exercises, some that will hopefully help my back (I told my yoga instructor I was having issues).  And I bought a Swiss Ball the day after my first yoga class in an attempt to sit on the couch less (the couch is apparently evil).  I haven't been 100% good with my posture, but I'm aware of it and trying, and exercising and I am attempting to sleep differently.

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Concurrently...  About a month ago I found out you can get a physio appointment via your Midwife, so asked my Midwife to organise me one because I was having some lower back pain.  And then waited and waited.  I am a person who doesn't like to 'bug' people, so didn't want to 'bug' my Midwife for a few weeks.  Then she went on holiday, and I would have to 'bug' her birthing partner who I haven't met before.  So I didn't 'bug' her until I had to leave work because I had trouble turning on the computer...

As soon as I 'bugged' her, I got a phone call from the hospital to organise me an appointment for the next day (go Midwife!).  I wish I had been brave enough to bug her earlier.  This is one of the annoying things about being anxious.  I think had I been brave enough to 'bug' her earlier, my back may not have gotten to this point.  It still might have, but case in point, being braver is smarter. 

So on Wednesday I had an appointment with the hospital physio, and she was brilliant.  I like physio - I've done a fair whack of it, so it was also nice to be the 'good' patient wearing appropriate clothing and footwear and knowing stuff and things (once a teacher's pet, always a teacher's pet).   And it was so nice to be told I have the 'typical' symptoms of a hip problem.  It's really nice to be 'typical', because it means people know what to do with you.  My right hip is tilted too far forward, and is not very mobile.  Hence pain with movement, and sometimes extreme pain as other muscles and bits catch in the hip joint.  So the joint needs to learn where it's supposed to go, and needs to be mobilised.  So she did some very mild joint manipulation and fitted me with a Smiley belt and some more exercises to mobilise the hip.  I felt instant relief as soon as she put the belt on.

So I went to work yesterday feeling super confident with my new belt and understanding as to why my back was not my friend.  I wish confidence was a better placebo than I'd assumed.  At about 1.20pm I suddenly got sharp pain in my lower back.  This was a different to normal kind of pain as it was constant (usual pain is with movement).  Then my blood pressure dropped, and I almost collapsed.   I shakily sat down, took some Panadol, drank a bunch of water, and emailed my husband.

I thought it quite likely that my blood pressure dropped because my body was shocked by the pain.  So let him know what was going on, but that we didn't need to do anything unless I couldn't get my blood pressure to come right in the next half hour.  I figured in that time the Panadol would start kicking in, and with less pain, my body would start to calm down (I'm awesomely logical, even when in agony).  Then I started getting cramping across my pelvis.  This is scary when you're pregnant.  Because I have IBS I went to the bathroom to double check if it was gastro cramps (again with the logic), and to check for bleeding, of which there was none.  Phew!

After half an hour things were not right with more cramping and shakiness, so Murray picked me up and took me to the doctors.  Although the Doctor did check my stomach for rigidity to ensure everything was ok with the baby, he did little else - he didn't even check where I was at on a pain scale and I was crying in pain just trying to step up to the bed to get checked (Murray had to help me get down).  He recommended Panadol (despite knowing crying me was me on Panadol), rest and to call my Midwife.  Then they charged me for the appointment because it wasn't deemed to be related to pregnancy.  We were unimpressed.  I have complained.

My back-up Midwife was reassuring.  Although there was nothing she could practically do, she let me know there were options.  You can take more hard core drugs when pregnant than Panadol (yay).  She recommended to go to A&E if the pain levels didn't come down because they could give me these drugs.  And I can go back to the hospital physio which I plan to do next week. 

Over early evening my pain settled to a tolerable level with doing nothing.  Today, I can walk around with my belt on and only look slightly crippled.  But I can't stand for long, I can't bend down to do things like get a cup out of the cupboard, and I certainly can't go to work.  I am hoping that this has something to do with too much or 'new' exercise, and this will dissipate with rest, but who knows.

I am glad there is a plan.  But it is frustrating being in limbo.  How do you handle having a job when you are in a physical limbo?  I feel sorry for my boss.  She has a staff member who 'might' be ok for work but who knows?  I was really hoping to not feel like an invalid until I was much more pregnant than this.   And I shouldn't feel this way because I'm being  good.  I'm doing  the exercises.  I'm going  to yoga.  And I'm resting  (I have little choice).  Surely this means I should get a reprieve?  And yes, I know, patience is a virtue, good things come to those that wait etc.  But those waiting in pain and limbo may go into psychotic rage and kill things...

I am grateful that the baby is ok.  She has been kicking away at my bladder like an evil demon child, which is good.    And my back-up Midwife said pain is commonly 'unpredictable' in pregnancy, so I might wake up tomorrow and feel pretty good.  I really hope so.  In the interim, I am resting.  Our house is a state, but I will just sit (not on the couch) and watch DVD's like a good, albeit impatient, patient.

On Living With Anxiety and Depression

After writing the diatribe that was the 2012 Summary, I realised a few issues needed expanding on.  I'd just assumed that at some point in time I'd have written a post about anxiety and depression.  Turns out I haven't.  So thought I'd attempt to do that today.

So what causes people to have these things?  For some people it'll be purely chemical, possibly hereditary or even contributed to by hormones.  And for others it's as a result of some sort of trauma.  I was diagnosed with PTSD when I was twenty, and this diagnosis made complete sense to me.

I didn't grow up in what would be called a 'stable' living environment.  My parents continually broke up and got back together.  I moved homes often, and attended four different primary schools.  I witnessed violence within my family.  I was poor.  The thing that made this hardest was that I knew  this wasn't right.  From around the age of nine I felt like the only sane person in our household.   And I couldn't do anything about it.

When I finally escaped this situation I was fourteen.  Things had reached a point, partly to do with my father's mental health, and partly to do with me being a teenager, where I just couldn't do it any more.  Mum helped me to get to a friend's place on Christmas Eve and my Aunt picked me up from there.  Mum managed to get out a month or so later (I can't remember how long it took) and we got a little flat together with custody of my brother every other week.

Although it took years after leaving for Mum to realise that the situation we were in was one of 'domestic violence', she knew that I was messed up, and sent me off to counselling.  I've been in and out of counselling now for more than sixteen years.

I'm not going to give a history lesson on all the times things got really bad, or all the crazy things I consequently did.  I will summarise by saying that there was a half-arsed suicide attempt in my teens, there was a point where I was so unwell I couldn't leave my house, and I did a multitude of harmful things to myself and others over the years.  Now, through experience, I feel that things are more manageable, but this is something I can never be complacent about.

For people who haven't experienced anxiety I'll do my best to explain what happens to me.  First of all, it's actually a physical thing.  Usually something will 'trigger' a physical response (adrenaline).  My heart starts beating super fast.  I get flushed.  My hands get clammy.  My legs get shaky.  I feel like I need to pee.  I often have difficulty breathing.  And this starts what I call 'the head/body anxiety cycle'.  Whatever has triggered the panic attack is usually something I'll be aware of.  Once my body starts going crazy, my brain starts to catastrophise all the things I was initially a little worried about.  My brain catastrophising keeps my body 'triggered' and none of this goes away until the thing I was initially worried about leaves my immediate vicinity.

This is why anxiety/depression is a cycle.  It's chemical.  Once your body has run out of adrenaline and endorphins, there's not a lot of happy stuff left.   So then you get depressed.  Again, depression is a physical thing.  I feel exhausted.  Everything feels heavy.  I feel as though I am viewing every day life from afar, like watching TV - I feel physically distanced from my life.  It is this sensation in depression which is the most dangerous.  Because I just want to feel something, and will do harmful things to do so. 

While I've been in and out of counselling for a long time, I've been on and off drugs slightly less.  I OD'ed on prescription sleeping pills as a teenager, which made me really anti drugs (why give someone who's depressed something they can use to kill themselves?).  It wasn't until I got very ill in my early 20's that a doctor convinced me to try  SSRI's.  I tried three or four different ones over the space of a year and a half, and none of them helped.  I was regularly seeing a therapist at the same time which helped me through that particular time.  It wasn't until about four years later that I tried Fluoxetine (Prozac) and found it actually worked for me.

Fluoxetine is something I think of as a stand-by for when I can't stop my body getting to that dangerous state.  I want to be well, and I know that at certain points no amount of talking it out will keep me from going there.  I have had so many people say 'do you feel like a zombie' re: being medicated.  I feel like a zombie when I'm unwell and not medicated.  When I'm medicated, I feel like a normal, well adjusted person (with a dry mouth, side effects do suck).  I am not on Fluoxetine all the time.  I just use it when I feel it is necessary.  I've been off it for over a year currently.

The other thing I've found very useful is not believing in 'regret'.  For many people trapped in the depressive cycle, regret's an easy habit because there is so much you'd rather have not had happen.  But it puts you in stasis.  You can't move forward, and it's not possible to move back.  I acknowledge the things that have happened to me, and the things I have done, but I don't regret them.  Regret makes people bitter and miserable.  Being bitter and miserable doesn't seem very fun.  I do believe in mistakes.  I think of them as 'mis-takes', as in 'we're retaking this scene because it wasn't quite right', where you do it over, again, and again, learning each time how we can improve on the last 'take', and appreciating what we've learned from it.

Understanding why this cycle happens also makes it more manageable.  I do not think I can ever 'fix' this.  Basically, my body is programmed for 'fight or flight', which is why it reacts with the adrenaline so quickly.  This is because in the past, 'fight or flight' has been a necessary survival skill, and has often arisen out of seemingly banal things.  So when I'm feeling just slightly off kilter, anything which causes 'confrontation' will result in me having a panic attack.

This is what happened in November.  I was terrified about having to tell my new employer that I was pregnant.  This fear was impacted by the very rough year prior, which already had me frazzled.  I catastrophised that I would lose my job as a result.  Even though the reality is that this wouldn't be the end of the world, much of my esteem is wrapped up not only in my job, but it how it contributes to our household earnings.  So these feelings snowballed into daily panic attacks and the panic attacks led to a cycle of depression.  I genuinely thought my husband was going to leave me ('dangerous' point in depression aided by feeling worthless), and started to try and work out how I could live as a single mum...

It is ridiculous that things got to this point, but it is often difficult to see what point you're at when you're living in it.  And I still find it hard to ask for help, even from those closest to me.  Because you have to admit you aren't coping, and are being irrational, and you aren't a proper functioning 'grown up'.  And sometimes when things are really bad, it can mean compromising things important in your life.  Like your job, or your relationships.  That's bloody hard to do.  Once I did finally ask for help, things started to become more manageable pretty promptly.

I am certainly not a magically 'sane' person now.  But my life is 'manageable' and I've banished this particular fear by being proactive with my boss (which was terrifying, then a huge relief).  Chemically, things have reached a balance because I'm not having panic attacks any more.  And I got through this patch with my husband, home, job and everything, intact.  This is successful anxiety management.

And I hope that writing about it will help other people understand what it's like to live with this.  And for those struggling with depression or anxiety, to know that you can live with it.  Things will be ok.

A Recap on 2012

An attempt to capture the essence of Hannah-May 2012...
Bald-headed, slim and a drink in hand - I look quite different already in 2013

We're almost two weeks in to 2013 already - wow that's gone fast!  So thought it might be interesting to look back on what happened in my life in 2012.  This is partly inspired by reading a blog post on Essential Mums and partly by it being a naturally cathartic thing to do.

January
Apart from waking up on January 1st 2012 with an EPIC hangover (thank you Board Gaming New Years Gone Wild), January is most noteable for being when I got knocked up.  This was planned, but happened SO immediately it was a bit of a shock (quite possibly got knocked up at Board Gaming New Years Gone Wild).  And while initially thinking we'd aced the 'Getting Pregnant' exam, learnt toward the end of January that we hadn't aced the 'Staying Pregnant' part of things.  So it was a tumultuous start to the year, and a precursor for what to expect for the rest.

February
As a result of the failure to get things quite perfect with this pregnancy, I spent the beginning of February in and out of hospital, waiting for those in the know to work out whether this pregnancy was ectopic or not.  Turned out it was, so had surgery to remove the fallopian tube and the pregnancy.  This was sad, but not unexpected.  February was spent mostly on drugs, and in recovery.  I had a lot of support from whanau and friends, and actually had a pretty awesome time in hospital (besides the Lactulase incident and the crazy ranting Labour supporter).

March
March was the month where I had my test which determined whether or not I could likely conceive again and I ACED that test!  Unfortunately, I had an allergic reaction to the dye used in the test, so was very ill for several days.  We found out that in just a couple of months we could start trying to conceive again.  I also put myself on a diet to shake some kilos I'd gained from the pregnancy/surgery debacle.  This was a good thing to focus on after a time of uncertainty.  Despite my test, I was still unsure that we'd be able to get pregnant, and had put a time frame around trying before looking into IVF (which the government would help out with because of my medical history).

April
Easter at work proved to be a pretty horrid time of year - everyone went mad about hot cross buns, and they became the bane of my existence.  The entire shop was sticky with sugar.  I hoped I'd never see another crossed bun in my entire life (not going to happen).

Mum had been really unwell after a uterine prolapse which meant she had to stop working shortly before Christmas in 2011.  This was really devastating, as mum has always been a hard working, independent person.  April was the month of her first surgery to correct this problem that had been ongoing for some years.  We were so glad to finally arrive at this point.

My diet also proved to be working out pretty awesome (I lost weight, and learned a lot) and I did Shave for a Cure with Jade and went 'kina'.  April was also the time of the first anniversary of our Civil Union, which came about so fast!  I guess that means Civilised life ain't too bad at all.

May
May was the month of The Bite Curse - which turned out to be bed bugs, contracted from a romantic night away for our anniversary...  This was sorted, eventually.

It was the ten year anniversary of my Granddad passing away.  Having lived with my grandparents at various points in my life, Granddad was at times more like a very staunch Dad to me, and like everyone else in the whanau, I still miss him a lot.  We had a big celebration with everyone up at the bach where he is buried, which was very special.

May is also Coeliac Awareness month which meant crazy times at work and the Gluten Free Food Show.  We were more organised than in previous years, which meant I could get to some seminars and learn a little more about things like FODMAPS, IBS and Coeliac diagnosis in children.  I also got to catch up with a bunch of suppliers and which was really lovely.  I don't write about work that much in my blog, but I do really love what I do!

June
Mum's first surgery failed, and her follow up appointment with the specialist made her feel as though they were just going to ignore her, so she was back to square one, and gutted.  I discovered the health advocacy service online, and got us sorted with an advocate to launch an enquiry as to what was going on.

We had been very slack on the looking-to-buy-a-house thing.  If you've ever had to do it, you'll know that looking at houses is boring and time consuming, so easy to want to ignore.  We had had a couple of potential houses fall through over the last year (both of which I am now very grateful for), and were probably a little more prepped than at this time in the previous year.  So we started the hunt again.

We also started to try and get pregnant again, (despite my plan of not being super pregnant in Summer) just because we could.

July
In July we finally found the right house!  We managed to purchase within our budget, but we learned the process of buying a house is fraught with other non financial stresses.  Builders reports/LIMS/Kiwisaver/Lawyers fees/Realtor douchebags were all things we got up to speed with pretty quick smart in July.  And the settlement was quick.  Quicker than we'd hoped for.  So we were in our new house by the end of July.  And planting herb gardens, and also living together, ALONE for the first time ever.  It was bliss.

August
More time settling into our new home and remembering the 'joys' of commuting to work.  Very excited to have lots of visits from family and friends, and realising how awesome it was to live closer to some of our friends.  I turned 31, but my memory is bad and I can't even remember if I did anything to celebrate, but I probably did.  We weren't pregnant yet, but continued to half-heartedly give it a go (pre-occupied at this point my the interest on our mortgage)

I THINK it was around the end of August (possibly early September) Mum was given a second appointment to see her specialist.  I went with her so she wouldn't wig out at him.  We did get some things resolved - there would be another surgery, which was the best possible outcome.  We asked our advocate to stop mediation proceedings.  The squeaky wheel does get the grease it seems...

September
The company that pays my wages (different to the company that I work for - complicated) went into receivership.  I found out I would likely never see the $1400 in holiday pay owing to me.  I had my hours cut down at work, and this was quite possibly going to mean I needed to get a new job.   Also, it looked like the company I worked for, was going to sell.  And my boss launched her first ever cookbook.  Crazy bad timing.  A lot of crying. 

I was quite unwell for about a week, and had the symptoms of a rumbling appendix so saw my GP.  The following week I had surgery to see what was going on, and they removed my appendix (to prevent future stress) and found the actual culprit to my pain - a burst ovarian cyst.

While recovering from surgery I noticed my boobs getting swollen and sore, thought 'wow, that basal thermometer stuff sure works' (we had just started doing Basal Thermometer reading this month), took a test, and sure enough I was knocked up.  An eventful September!

October
Which was followed by an even more eventful October.  Because of my ectopic earlier in the year, the one before that, and the fact I'd had surgery very shortly after conception, I was understandably worried about this pregnancy.  My doctor was also worried, so booked us in for an early scan.  October was also when Mum's surgery was scheduled, and also when we were due to go on a holiday to Melbourne (we needed a real break from the crazy) to celebrate Murray's birthday.

So of course our 6 week scan/Mum's surgery and our holiday not only converged the same week, but within three days of each other.  Our scan was two days before we left for Melbourne.  If things were bad, we wouldn't go.  Mum's surgery (and it was a major surgery this time) was the day before we left for Melbourne.  Our scan was fine (yay), and Mum's surgery went well, but I felt massively guilty for not being there for the first week of her recovery.

Melbourne on a budget (because there was no holiday pay), was still fantastic!  I will try and blog about it at some point, as that is something that fell by the wayside with all the drama of early pregnancy, work crazy and Mum's surgery.

November
By this time I had started to realise that I really didn't like being pregnant.  I was extremely grateful to BE pregnant, but with all the horrible side effects, hormones and the stress of the last two months, I finally started to lose the plot.  Our work place did sell at the end of September, and our new owner took over at the beginning of November.

I was quite depressed.  I felt as though every aspect of my life was falling apart: work, health, finance, brain, home (neighbours pitbull cross continually breaking into our section and terrifying me and our critters).  I was having panic attacks every morning on the way to work.  Eventually things got to a breaking point and I went to the doctors. 

This didn't fix things - I am still waiting on a phone call from Maternity Mental Health, and was advised against antidepressants.  But it did give us a window to get things started.  I started taking natural adrenal supplements and rescue remedy to help with the anxiety.  Feeling like something was happening to remedy the situation helped more than you'd think.  And I allowed myself the space to be upset.  Given the year I'd had combined with my mental health history, this type of response was actually quite normal.  Being pregnant on top of that was probably just the tipping point.  I had been ok when this had happened before, and I would be ok again now. 

December
December tends to be one of the most stressful months of the year.  Despite already being pretty stressed, mine wasn't that bad.  We were organised with our Christmas shopping and  I was reasonably organised with work Christmas time craziness.  We weren't hosting anything over Christmas besides our usual New Years Gaming party.  It was manageable.

Christmas was a pretty relaxed day, and I had a week off between the Christmas and New Year stats, which was great.  New Years Gaming was massive, with over 25 people turning up, and I survived my first completely sober New Years (in a long while).

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I know that 2013 will provide new challenges for us, but am hoping that it will also mean slowing the pace down a little, and having time to enjoy these challenges.  2012 was an eventful year, with many ups (buying a house and getting successfully pregnant) and downs (surgery, work stress and more surgery). So lets clink a glass to 2013.   Happy New Year everyone!