Tag Archives: medical

13?!

My endocrinologist, who I now see for my newly acquired thyroid problem (thank you, pregnancy) is VERY old and the NICEST man, but also quite possibly the weirdest, and he never lets the appointment end without giving me parenting advice that I did not ask for.

Doctor: “The books are going to tell you all kinds of things, and everyone is going to have their opinion, but let me tell you right now, the best thing you can do is have your baby sleep in the bed with you.”

Me: “Oh, yeah I mean I have no judgement about that. I’m not sure it’s the route we’re going to take, but–”

Doctor: “I’m telling you, do it. It’s just the most wonderful thing to have your kid in your bed with you. And don’t let anyone tell you it’s dangerous, or it’s not healthy. That’s nonsense. Don’t listen to the critics– you can have them sleeping in your bed with you ’til they’re 13!”

Me: (laughing) “13!? Alright well THAT’S a little extreme.”

Doctor: “That’s what my wife and I did with our son.”

Me: img_6189-3

Doctor: “Yeah and I’ll tell you what, he grew up to be a very nice Jewish man. Very successful, very smart, very well-known. Went into politics. ”

Oh. Is this him?

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Mental Illness and Pregnancy: To Medicate or Not to Medicate? That is the Question. (…that I do not have the answer to. I’m not a doctor. But here’s my experience.)

**Disclaimer (in case the title wasn’t disclaim-y enough for you): Like literally everything else on this CLEARLY non-medical blog, the following is based on MY personal experience. It is not intended to serve as definitive medical advice for my fellow mental health sufferers. I am not telling you to go off your meds, and I’m not telling you to stay on them. I am suggesting that you thoroughly consider your options, under the close care of a doctor who knows you well, and that you advocate for yourself before making a rash, fear-based decision. Mostly I am just letting you know that no matter what you decide or what you are going through, try to go easy on yourself. You’re doing the best you can. You are not alone. And you got this.**

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A lot of people have asked me if I’m still on my depression/anxiety meds while pregnant. This is a totally fair and welcomed question, mainly because most of you have asked in a matter-of-fact, non-judgmental, just-curious way, like, “Oh, hey, what’d you end up deciding about that?” But some of you have asked in more of an accusatory “You’re not still on your meds, are you!?” way that implies some sort of moral wrongness should I be on them– and even though I know (most of) you people come from a well-meaning place, it still makes me want to light your face on fire.

So allow me to try to explain a few things. Knowdlege is power and faces are generally better not aflame.

The answer is no, I am not on my meds. But let me be VERY clear about this– I am not off them because I have some kind of holier-than-thou judgement about staying on meds while pregnant. I have absolutely NO judgement about that, and in fact encourage women to stay on them if that’s what works best for their health and situation. Obviously. I am the queen of mental health triage– you do what you gotta fucking do to keep your marbles, sista! #sanityfirst

The drug I was on, Prozac (an SSRI), is actually known to be safe for pregnancy, and I know plenty of women who have been on this drug or others like it and have given birth to perfectly healthy children. And in fact, countless medical studies show that having a depressive episode or being acutely anxious while pregnant is far more harmful to a fetus than taking medication that will effectively treat these conditions (these MEDICAL conditions, in case you needed a reminder that this shit isn’t made up hocus pocus, they are legitimate illnesses). But yes, it is true that some mental health meds are unsafe for pregnancy. As long as you are discussing family planning with your therapist ahead of time, though, he/she should be steering you clear of those particular meds while pregnant.

Soooo after reading the above regurgitation of all the fun medical facts I’ve learned during my family planning journey,  you’re probably wondering, “Ok, so if all of that is true, why DID you stop taking your meds?”

Well, in a shocking turn of events, it was for no good reason at all, really. Basically, my therapist presented it to me like this: “The optimal, ideal situation is that you are off all medications and feeling fine, aka not depressed or anxious. Should you go off them and feel anxious or depressed, then the next best situation is for you to go back on them and stay on them for pregnancy. The least optimal scenario is that you have an acute depressive episode or debilitating anxiety while pregnant.”

Ok, so obviously all I heard there was, “The optimal, most ideal situation is that you are off meds….” and then I sort of stopped listening and everything else just became giphy. After all, it was my first time getting pregnant, I had no fucking clue what to expect or what the process TRULY entailed, so yeah, I wanted to do the thing I was told is “optimal.” No-brainer here. Do the “optimal, ideal” thing, because those are strong words that sound good. And I’m gonna be a good mom, damnit!

I’m not saying that line of thinking made sense, I’m just saying it’s the line of thinking I had when I quickly declared, “Ok, off the meds we go!” with far more confidence than any medication-dependent person with a lifelong mood disorder should have. lets-do-this

This decision was made back in July, and we weren’t planning to try to get pregnant until December, so I still had some time to wean off and be completely med-free for a bit before inviting a fetus into this  shitshow of an experiment delicate situation.

A few things to note.

  1. For the previous year before going off it, I had been on a very low dose of Prozac. That was part of why I felt I could probably be ok stopping it. Had I been on a high dose, it would have been a much more difficult and lengthy weaning process and likely wouldn’t have been worth it in my mind. Going off a low dose seemed easy and low risk.
  2. That being said, the last time I was med-free (age 26), I lost my goddamn mind. Like, completely incapacitated, lost 25 pounds, moved back in with my parents, played lots of senior-living type board games and took copious lukewarm baths just to pass the interminable minutes. I was extremely sick, and it was terrifying.
  3. THAT being said, I was younger then, far more naive, and had no idea what was happening to me. I had no reliable therapist, coping skills, or treatment plan for dealing with my illness. I didn’t even remotely UNDERSTAND it as an illness, so I certainly had no way of managing it (and no faith that it would ever end). Since then, I’ve done a ton of work on myself and have learned how to manage things (to the extent that I’m able) when life gets dark.
  4. THAAAAAAT being said, I’ve always had the medication to help me.

The conclusion I made based on these four somewhat unhelpful and conflicting points? If I go off the meds and things get bad, they probably won’t get as bad as that really bad time, because things are different now, and I’m more prepared.

But let’s be real, given I’ve had the consistent help of meds for 9 years, there’s just no possible fucking way to know that.

So I took the gamble, because gambling is fun when you’re drunk in Vegas so it’ll probably also be fun when you’re sober and housing a fetus, thought no one logical ever.

And at first it was fine. The weaning went smoothly. By the time I was completely off the meds, it was late October, aka my non-optimal time of year thanks to colder, darker weather setting in, and a general life-long refusal to understand why summer ends. So I didn’t feel GREAT* (*not really my M.O. regardless) but I certainly wasn’t depressed. Plus we had the 2-week, warm-weather honeymoon to look forward to, so that kept me going.

But the second I got pregnant in early December, shit hit the fan. I alluded to a lot of this in my post In a Shocking Turn of Events, I Am No Glowing Goddess, but shied away from some of the grimmer details because a) it was my first post about the pregnancy so I didn’t want to come out Depression guns a blazin’ and b) I was genuinely excited to finally share the news. But I do now feel the responsiblity, as a mental health advocate and general blogger of honesty, to let it be known that I was NOT ok that first trimester. I was hesitant to use the word “depressed” while I was in it, because I really didn’t want to admit to needing meds, and I felt like I should “stick it out” until the second trimester. Plus, recognizing you’re depressed WHILE you’re depressed isn’t always easy– it’s part of the mind-fuck of the illness. The very symptoms of depression (self loathing, worthlessness, hopelessness) prevent you from assessing the situation as “This is medical. I am ill,” and instead twist it to “I am the worst, I am being a little bitch, and I need to grow a pair.” (but alas, you cannot grow a pair– and the harder you try, the more you hate yourself for failing. Tricky little devils, these mood disorders).

I convinced myself it was all normal first trimester stuff. And some of it definitely was. Constant nausea and exhaustion will make anyone feel like shit. But some of it was really fucking dark, and I’m not so certain that’s normal.

I cried every single day. I stared blankly a lot. I couldn’t write, and could barely read. I felt absolutely no attachment to the pregnancy, and had no ability to see how anything was going to get better, or how I was supposed to love or care for a child. I was stuck in a thought loop of “You’re going to be a terrible mom, what were you thinking? This was a huge mistake.” I could barely get out of bed and I felt horribly, utterly lonely– the kind of lonely that can’t be cured by another person comforting you, because that ironically just makes you feel all the more alone (on that note, God bless Eric. No, literally, God, PLEASE bless him with a bevy of Corgi puppies upon his eventual arrival in heaven). That self-hating loneliness was the only feeling I had– about anything else, I felt absolutely nothing at all. It was 3 long months of toggling between complete isolated self-loathing and absolute, utter detachment. I’m not sure which I prefered. Both were pretty fucking non-optimal.

But it got better, eventually. Very recently. Do I feel great now? No. But I’m not depressed, and I’m able to feel excited at times. I have some energy back. I feel more motivation to get up and go. I open the blinds. I listen to music. I’m doing my job, not just suffering through it. I walk on the treadmill. Food tastes like food again.

But please note, the second after this baby is born: tenor-1 (<— definitely what post-labor looks like, no?) I will be right back on that Prozac. That was always the plan– my risk for postpartum depression is high, and we’re not taking any chances. And when it comes to the next pregnancy, should I be lucky enough to have that happen, I will likely stay on the meds. Those 3 months were horrible, and I see no reason to make an experience that is so hard on even the average, emotionally stable woman even harder. 

So, this is just to say, if you are one of those pregnancy newbies out there, and you are presented with your options in the same way I was, please know that it’s ok to not choose the “optimal, ideal” scenario if it’s not going to work for you. It’s not optimal or ideal if you feel like a self-loathing garbage truck for three months. It doesn’t make you selfish– it makes you reasonable and responsible. There is no wrong moral choice here, and you shouldn’t feel bullied* into making a decision that might not make sense for you (*to be fair, I really wasn’t bullied by my doctor. I still completely trust her. While I wish she had worded it slightly differently, what she said was perfectly reasonable– but I heard what I chose to hear and then I proceeded to bully myself, because that’s what we depressives do best).

But how should I respond when told it’s best to try to go off the meds, even if I don’t feel that’s the best option for me, you ask?

Well, next time, I’m probably going to say this, so feel free to borrow it: “Nope nope nope! No thanks, Doctor Person Who Isn’t Me, but I am me and because of that, I know myself farily well by now, and I sure do enjoy being sane! Seems the risks of the meds are pretty low, and the risks of me losing my shit are pretty high, so I’m going to keep doing that thing where I’m lucid and functional and seeing the point in showering, because, even though I don’t know much about babies yet, I DO know it’s easier to care for them when your mind is firmly planted in reality and you don’t wake up wondering why you have to exist. Right? Babies like moms who care about living and eating and clothing themselves? I feel like I read that somewhere and it sounded accurate.”

Or something similar. There’s probably a less condescending way, I don’t know.

Bottom line, do what works for YOU. I am not advocating for either option– every mental health situation, and every person, is different. I am simply advocating for you to advocate for yourself (under the care of a doctor you trust, of course. I really hope that goes without saying), and to really think through what will work best– again, for YOU.

Did going off meds work for ME? Meh. Hard to say at this point, because now that I’m out of the darkest darkness (I hope), it’s like “Ok, I survived that and no one died or anything, so that’s good.” But should that be the standard? No one died? Probably not. I feel like it was a lot of unnecessary suffering and potential risk, and I can’t imagine ever willingly going through that again. Plus, I can only hope and pray that my struggle didn’t harm the baby. So far everything looks good in there, the heartbeat is rapid and strong (doc says “Sounds great!,” I say “Sounds like anxiety!”), and I have no tangible reason to think she’s not thriving. But who really knows. And whether on or off meds, I’d have that “who really knows” feeling regardless. So next pregnancy, pretty sure it’s gonna be tenor.

And if you’re not ok with that? That’s cool. Just express your judgement to someone else, not me. I can’t go lighting faces on fire once I’m a mom, but I can definitely teach my kid to spit in your eye and claim it’s an accident.

My Uterus is Wearing a Catcher’s Mitt and Now We Can’t Go to the Beach

This post is intended to serve as both a PSA to those of you who do NOT want to get pregnant and perhaps a reassuring bit of news for those of you 35-and-ups who hope to have kids (or MORE kids) at some point and have underlying anxiety about the non-stop, aggressive warnings from the medical community that it is much harder to conceive after age 34.

Now, I’m not here to argue with science. Clearly, there is medically researched backing to the idea that conception becomes more difficult as you get older. I’m just here to make you aware of the less-talked-about phenomenon that occurs in your mid-30s, but is just as real* (*have no scientific backing for this claim, based solely on personal experience and, you know, “what I’ve heard”)– it’s called Catcher’s Mitt Syndrome** (**not a real syndrome. Don’t quote this to people without a sense of humor– they won’t get it, and then they’ll research it, find out it’s fake and report me to Snopes).

Catcher’s Mitt Syndrome is when your geriatric*** uterus (***not my term– actual medical term for when you are 35+ and trying to have a child) overperforms. See, thanks to your 17+ years of popping birth control pills like tic tacs and/or using other means to impede its life work, your uterus hasn’t been given any opportunity to fulfill what it believes to be its life’s purpose (I am not saying this IS its life’s purpose, I’m just saying that’s what your UTERUS thinks. I fully support a woman’s choice to never have kids, and in fact encourage that choice. Trust me, I’m a teacher– I’ve met far too many parents who probably shouldn’t be parents.)

And so when your Guterus (celebrity couple name for geriatric + uterus) DOES get that one opportunity to shine, it gets so fucking excited that it dusts off the cobwebs, sprouts 27 limbs, and slips a catcher’s mitt on each of them. Then it does everything in its power to catch one of those incoming suckers because it knows this might be its only opportunity. This “last chance” mentality also causes your Yogi Berra uterus to text-alert your ovaries, encouraging them to release every available egg from their dark, abandoned storage room, which is why twins are more likely**** as you get older, even without the assistance of IVF (****statistic based on what my 35-year-old friend who just had twins told me. But she claims her doctor told her that, and I believe her because it sounds legit, and also this friend is a general knower of stuff and we used to share custody of a bunny when we were teenagers, so let’s just say I trust her. Yes, we ended up giving that bunny away because it was too much work and not as much fun as we thought it’d be, but that’s a story for another time and hopefully not at all reflective of our parenting abilities).

Needless to say, Eric and I did not know about Catcher’s Mitt Syndrome when we headed off to our 2-week South Africa/Seychelles honeymoon in late November. Like most people with a Guterus, I assumed that making a baby would take about 6 months if we were lucky, a few years with medical assistance if we were less lucky, or just wouldn’t happen at all. In fact, as proof of the absolute and utter uselessness of anxiety (my therapist would be so proud right now), I have spent the past 8 years worrying that when the time came for me to start a family, I would be unable to. This fear was based on absolutely nothing other than the knowledge that I would probably not get married until my mid-30s (because when you’re having a mental breakdown, living at home, and sleeping in your parents’ bed at age 27, you can safely assume marriage isn’t happening for a while).

Eight years of worrying I’d miss my chance, only to conceive on the first try. Anxiety, you deceptive bitch! Don’t get me wrong, I am EXTREMELY grateful that it turns out you’re nothing but a lying whore– I’d just like those 8 years of wasted energy back. It was exhausting.

So before we left for the honeymoon, I looked at my handy dandy ovulation app and noted that my “fertile days” would begin and last right through our 5 days in the Seychelles, at the end of our trip. Smack in the middle of paradise seemed like as good a time as any to get started!

Well, in true-to-me fashion I managed to contract a stomach bug of death during our last day in South Africa, which had me projectile vomiting through 2 countries, 3 airports, and 2 aircrafts (one of them a 20-seater so again, fellow passengers and unamused flight attendant who aggressively tried to block my path to the toilet during taxi, I’M SORRY.)

We finally arrived in the Seychelles, where I threw myself dramatically onto the sweet salvation of the bed and, with this exact level of energy and enthusiasm r7qewnm.gif , turned to Eric and said “Sooo….I’m ovulating…”

I still had dried throw up on my chin.

“Alright, well….maybe not tonight,” he replied gently, from the furthest corner of the room he could find. Because even Eric has his limits.

While I did stop puking that night, I never fully recovered from my illness in the time we were there, but we still put in some minimal baby-making effort because it just felt irresponsible not to.

It was only on our last day in the Seychelles that we decided to actually consult a calendar and calculate when this baby would actually be born, should we conceive. To our horror, we realized that it would be during our annual 2-week trip to the Outer Banks, the family vacation to end all family vacations– and, more importantly, the one that is fully financed by Big Steve. My siblings and I literally spend the year counting the days until this trip, and it’s pretty much what gets us through life. Eric has grown to love the Outer Banks as much as I do, so the idea of not going was unacceptable to us both.

Me: “Alright, well, we only tried once. Luckily the chances of getting pregnant on the first try when you’re 35 are zero*****.” (*****Again, all quoted statistics are based on NOTHING.)

Well, you know how this story ends– I never felt fully recovered from that stomach bug and by our second week back in the US, I decided that I definitely contracted an African parasite. Shortly thereafter, we confirmed (via 4 separate home pregnancy tests, because reading lines is hard), I DID have a parasite, but technically it was of Seychellian (Seychellese? Seychellite?) origin, and that parasite was going to turn into a human.

So, of course, we’d like to thank Catcher’s Mitt Syndrome for this blessing that is our daughter-to-be, but we also wish we had known about this phenomenon ahead of time, as we would have scheduled accordingly.

“Yeah, but your parents will just switch the vacation dates, right?” many of you have queried.

Oh, you sweet, naive people from normal families.

Here’s how the conversation with my mother went:

Me (right after taking pregnancy test): “So…we’re pregnant! The only issue here is that the due date is August 26, literally smack in the middle of the Outer Banks vacation…”
Mom: “Well, we don’t know that’s the due date.”
Me: “Ok. We do, though.”
Mom: “Let’s see what the doctor says.”
Me: “The doctor is going to say that’s the due date, because I used the exact same calculation method a doctor uses.”
Mom: “Em, let’s just see what he says, ok?”
(after going to doctor)
Me: “The doctor says the due date is August 26.”
Mom: “Ok, well let’s just see what happens.”

So no. No one is switching anything.

The takeaway from all this? It’s six-fold:

  1. Ignore research-based science and listen to my unfounded generalization that is based on one thing that happened to me once– conception at age 35+ can actually occur very fast, because your uterus has now become Hamilton and it is not throwing away its shot.
  2. Be grateful for this phenomenon, but schedule life plans accordingly. All-expense-paid vacations are precious. Yes, so are babies, but I’m just saying– shifting things a month never hurt anyone.
  3. Everything I’ve presented in this post is based on stuff I heard/experienced. I don’t know if it has any general merit so do not quote me, unless you’re doing it in a light-hearted, jokey way. Like, don’t tweet this at NIH.
  4. If you think these theories DO have some merit, google them and see if you find anything to back them up. I’d love to know what you find! “But why didn’t YOU google them to see if they have merit, Emily?” Because that’s not my job here. I write a blog, not a medical journal.
  5. No, this post is not an ungrateful, whining complaint about missing a vacation to have a baby. We are of course thrilled that this happened so easily for us, know that we are extremely lucky, and this post is all in jest. It annoys me that I even have to include these disclaimers, but there is always that person who takes offense, and while I don’t understand then why you continue to read this blog, I still feel the need to address your complete misunderstanding of how humor works.
  6. For this entire post, I am sorry, Eric.

I Failed the Intake Process

When you meet with a hematologist re: a blood disorder, the first thing they do is take your medical history to determine if you’ve ever had bleeding problems in the past.

Hematologist: “Ok, this is probably the most important question that will help me determine your blood clotting status– have you ever had any surgeries?”

Me: “No.”

Hematologist: “Lucky you! Have you ever broken a bone?”

Me: “I broke my foot about 9 years ago. Fractured my wrist when I was a kid. And, well, my nose was broken when I had a nose job, obviously, if that counts.”

Hematologist: “You had a nose job? But you just said you never had surgery!”

Me: “Oh, well, that’s like, not really a surgery.”

Hematologist: “A rhinoplasty is definitely a surgery.”

Me: “Ok, well, you say surgery, I say birthday present. Or family rite of passage. Or my mother’s suggestion. Or–”

Hematologist: “Ok just tell me if you had a bleeding problem during or after surgery.”

Me: “No.”

Hematologist: “Ok, any other surgeries I should know about?

Me: “No.”

Hematologist: “Have you ever had problems with your gums, or had gum grafting?”

Me: “No. But when I had my chin done they did cut through my gums in order to–”

Hematologist: “You had a genioplasty?! That’s ALSO surgery.”

Me: “Ok, well, that’s a very fancy word for it. And again, it wasn’t so much a surgery as just an add-on or a necessary complement to the nose–”

Hematologist: giphy.gif

 

I need a Jewish doctor.

 

 

We’re Off to a Good Start

Our first OB appointment was at 8 weeks (Jan 16th), and it is an understatement to say we went in pretty clueless.

When the doctor approached me with a HUGE dildo-looking instrument to perform the transvaginal (re: up-the-hooha) ultrasound, we did not realize that was a thing (doctor-dildos OR transvaginal ultrasounds). Movies always show the ultrasound with goo on the belly, and it’s safe to say that everything we know about the medical side of pregnancy comes from movies. (But like, well-researched movies such as Knocked Up.)

When the doctor asked me to scoot down and spread my legs wide, Eric, who had been standing near my belly, quickly scurried toward the safety of my head like a frightened crab.

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Everything in that gif is on point because I swear the sonogram tool was the size of that truck (and from what I hear, my vagina, at the end of all this, will resemble that tire).

Me: “I just have one request– please please only find ONE baby in there.”

Eric: “And I’ll take a Bitcoin if you see one!”

Doctor: 733.gif

So yeah our doctor hates us.

 

A Tired, Dehydrated People

I recently had blood work done that showed low thyroid levels, so my doctor referred me to an endocrinologist.

Endocrinologist: “Your thyroid is inflamed and operating at about 60%. You’ve likely had chronic hypothyroidism your entire life, but sometimes stress can really bring it to the surface. It likely runs in your family. Is anyone in your family ‘high-energy?'”

Me: cracking-myself-up

Endocrinologist: “So no?”

Me: “To quote my brother-in-law– ‘The Lermans are a tired, dehydrated people.'”

Endocrinologist: “You said you have 3 siblings. All low energy?”

Me: “My sister has one setting and it’s this: img_2021-6. Jeremy is essentially a bear living in eternal winter. There are times on family vacation, during his 3rd or 4th nap of the day, when I have actually leaned over and checked his pulse. Zack has spurts of energetic enthusiasm when motivated, but then needs a 16 hour slumber to recover from his efforts. He also….like….talks…..like…..this…..”

Endocrinologist: “And your parents?”

Me: “My mother moves at the pace of a snail on Valium and has the voice of a soft bird. If you’re not sitting DIRECTLY next to her, or better yet, on her lap, forget about being able to hear or understand a word she whisper-mumbles. That being said, she IS active, like socially and activity-wise. It’s just, like, a slow-motion active.”

Endocrinologist: “And your Dad?”

Me: “Can’t sit still. The one exception.”

Endocrinologist: “Your husband?”

Me: “Like a corgi puppy lapping up a dish of Red Bull. Is that even important?”

Endocrinologist: “No I’m just enjoying your descriptions. None of this matters. Your thyroid’s broken, here are some pills.”

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Stigma

Went to see my general practitioner for my yearly check-up today.

Doctor: “Are you still taking Prozac for depression and anxiety?”

Me: “Yes, 30mg.”

Doctor: “Hmmmm. That’s more than you were taking last year.”

Me: “Yes…”

Doctor: “But you just got married?”

Me: “Yes.”

Doctor: “Well that’s a happy event! That didn’t help the depression?”

Me: “It was a happy event. I’m not sure what that has to do with my mental illness.”

Doctor: “I would just think the wedding would boost your spirits, no?”

Me: “It did. It also boosted my husband’s spirits– and yet, wouldn’t you know it, he still has diabetes!”

 

Yeah, so. I need a new doctor.

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