Annoyed

I keep meeting people - medical people! - who think that everyone on antidepressants (about 1 in 10 people!) or any kind of psychoactive drug, automatically has The Scary Dangerous Crazy.

Back at Snooty U, and this STILL annoys me, the wretched psych service* insisted everyone come in every three weeks for a 'check-in.' Or else no more medication. It was such a condescending, infantilizing, idiotic policy.

My appointments pretty much went: Does it matter how I feel? because you won't actually see me until next JUNE; actually I'm fine but I want to get back to lab so I can graduate this decade; yes, the medication I have been taking for three years is still FINE; no, I've never in my life been suicidal, do you people even listen? Can I have my drugs now? Thank you.

Every three weeks.

What really got me was that they refused to trust the patient's judgment at all. We couldn't possibly be adults, who could call if we needed help, oh no. We couldn't judge if we were stable. (I suppose they didn't really trust the clinicians either; they weren't allowed to distinguish between people they needed to see every week, and people they needed to see twice a year.) We all had dangerous, dangerous cases of The Crazy.

So when my PCP gave me a month of the drug I have been taking for four years... you can understand how I found it annoying and condescending. Hey! How about you give me a 6-month prescription and I'll CALL YOU if I need something!

* The department name also made me think "...and with lemon-fresh scent!" every time I walked in the door. Which is funnier if you know what it was.

Thank You, We're Here All Week; Also, Whining

Dear readers, I am heartened by your votes. It was an honest question, mostly along the lines of 'is anyone still out there?'. The answer, apparently, is yes.

Now let me commence to whine.

Let me preface this with: I love my baby, and I realize exactly how fortunate I am, don't get me wrong.

But you know, that doesn't make some things any easier.

I moved to Sausage City from Dante's Eighth Circle*, about 1100 miles away. I know practically no-one here, and you know what? I suck at making new friends. Also we'll be leaving in 1-3 years, and it's hard leaving people behind.

I have a couple of work-friends I have lunch with. They're lovely people. I might ever go out with them except... I can't be away longer than my 9-hours-at-work-and-10-if-I-bike, because Pumpkin wails his head off when presented with a bottle.** And the kid, unless he's really hungry he'll only nurse laying down, plus he wants to be played with all the time so why bother leaving the house, and nobody holds playgroups on Sundays here because they're all at church. If I were staying home I'd go to storytime and moms' group and actually hang out with other humans, but as it is, forget it.

I didn't even make it to my LLL meeting last week because- irony!- I had to come home and feed the Pumpkin.

I feel isolated. I'm starting to feel depressed. Working is hard, and the only time I get to myself, unless I stay up too late, is on the max-speed bike ride home. I may lose my mind.

What did you do to avoid going OFF YOUR ROCKERS? (With small children or any other kind of isolation. Gaaah.)

End whine.

*A distressingly accurate summary of all that was wrong with the place. Except maybe for sorcerers.

** Yes, we tried several different bottles. And three kinds of cups. And a spoon. And a dropper. He hates plastic and he wants BOOOOOB. He'll take a bottle after several hours of crabbiness, but there's a lot of gnashing of toothless gums.

Not That You Asked: Breastfeeding (2)

Er... I had some things to say. I think. The brain, it is mush.

But first, a poll! Dear readers, tell me if I should kill the blog. It seems to be ailing.

*gone now*

More on breastfeeding: time for more unsolicited advice!!

**OH, I remembered what I wanted to say:
-Breastfeeding is boring. Netflix and a laptop and some headphones are your friend.
-Little babies usually can't nurse laying down. This is very frustrating if nobody told you.***

After a couple months, your baby will (probably) stop waking up every hour or whatever, demanding boob. Really. It gets better.

A nice breastpump is worth it. I got a Medela Pump In Style at a garage sale for, oh, $15 or something. Warning: Medela does not recommend reusing breast pumps. Ever. (Of course, then I left it in a closet for 6 months, boiled the living daylights out of all the bottles and stuff, and got new tubing. I, personally, am not worried about organism contamination, but it's a personal choice.)

If you get thrush, you really, really need to boil all the pump parts that touch the boob. Every time. Access to a microwave makes this a lot easier: wash out, run hot water over, stick in the microwave for 5 minutes on high. Voila! Or, if you have a coffee maker at work with a hot water tap, even better.

It is also worth it to raise hell at work until they provide a suitable pumping space. Preferably one you don't have to tote the pump in and out of because OH THE HASSLE. (I am lucky enough to have a private office.)

Nipple shields do help with the pain and agony of shredded nipples. They also decrease how much milk your baby gets, and, fairly soonish, decrease your supply as a result. My LCs recommended using them as little as possible, because if you use them too much, it'll just make all your problems that much worse.

La Leche League can be your friend. The leaders around here, at least, have a hotline you can call day or night. They don't know everything, but they're nice, and helpful, and free. (With the exception of the group that JP was unfortunate enough to encounter.) A group that meets at an after-work time is more likely to be working-mom-friendly.

Dr. Jack Newman's website is also extremely helpful. With diagrams! And everything! Likewise, his book (called something with "Breastfeeding Answers" in the title) has a reasoned perspective on breastfeeding, especially where medications are concerned. (My favorite quote goes something like, 'If you must use cocaine while breastfeeding, wait at least four hours.' Not that he's advocating cocaine use, mind you, quite the contrary.)

Motherrisk also has excellent, well-researched information on what is and is not safe while breastfeeding (or pregnant!) which, if necessary, you can use to enlighten your medical providers.

Much like any other kind of provider, lactation consultants vary in ability, experience, and knowledge. Seriously, I saw four. (I think the first one was a little miffed but... oh, too bad. My pain vs. her hurt feelings, pain wins.) If you really want to breastfeed, you may have to be your own best advocate; as I and some of our fine commenters have mentioned, most GPs are not very knowledgeable about breastfeeding.

The Pumpkin also ended up seeing someone who's basically an occupational therapist for babies, and it made a huge difference. Also a $200-sized dent in my pocketbook, but whatever. LCs and LLL people may know of someone in your area who could help.

A lot of people find it easier to co-sleep while breastfeeding and will tell you how wonderful it is. And it can be. My baby thrashes in his sleep and now? He has his own room. Co-sleeping is not for everyone.

And finally, however your baby latches on and eats, as long as 1) it doesn't hurt 2) doesn't drive you nuts and 3) gets the baby enough to eat... is FINE. Don't let anyone tell you differently.

Additions from my fine readers?

Not That You Asked: Breastfeeding (1)

Or: You Can (Probably) Do It If You Really Want
First in a series of 15-minutes-at-a-time-after-baby-bedtime posts on nursing!

Breastfeeding! That favorite contentious topic.

First, let me say, less than 20% of women are still breastfeeding at all at 6 months. Most people give over after a few months; only 14% of mothers still breastfeed exclusively at 6 months. And I can totally understand why.

I go to a LLL meeting. I have lots of friends who breastfeed. My sisters and I nursed until we could read. And yet. I have had three months of nothing but pain and agony, followed by about a month of moderate misery. Fortunately, Pumpkin seems to be managing fine.

Figure 1: My Pumpkin is a chub-ball.

I think everyone can probably breastfeed- and I'm including, pump a little if that's all you have, and use a bottle. I also think it's frequently painful, difficult, and unpleasant. (I have now seen four lactation consultants and two specialists.)

Here's what I wish I'd known beforehand:

• Yes, it will hurt at first, for at least a week probably. But if after a week, you're still thinking of having a stiff drink before every nursing session, gritting your teeth and barely bearing it, and wincing and pulling away, that ain't right.

• Someone told me, if it hurts, see someone. They didn't really specify, though. Well, here you go: fissures and divots larger than 1 mm are not normal, and your nipples should most definitely not be an angry red color. Nor should they hurt after the baby nurses, especially not like a rubber band is being snapped inside your breast.
  

• Not every good latch looks alike. That diagram of an 'ideal latch' may not apply to you and your baby. Particularly if you have shallow or flat or inverted nipples. Or especially if your baby has a tongue-tie, a high palate, or an especially receded chin.
  

• If your baby's lower lip is not flared out, no matter how good the latch looks otherwise or how well he or she sucks or anything else, chances are that something is wrong. And that it will, eventually, HURT.

• If your baby is making a clicking noise, or falling off the boob several times every time he or she nurses, or sliding down the nipple and losing the latch, something is wrong, even if it doesn't hurt. Fix it earlier rather than later, and save yourself a lot of pain. Because they get stronger, and suck harder, and then it really hurts.
  

• If you really want to breastfeed and you're having problems, it's worth it to keep seeing people until it gets better. Only think of the savings in formula.
  

• Persistent pain can be related to a staph infection. Antibiotics will cause thrush, though. But it may take you several rounds of fun drugs! Hurrah! (Fluconazole and penicillins- dicloxacillin is usually given- are both, generally, safe for nursing.)

• Unpleasant itchy burny feeling? Feels like you've been sandpapered? THRUSH.

• Chances are that your GP knows almost nothing about breastfeeding. More's the pity.
  

Please feel free to add your advice in the comments! The more the merrier.

Next time: Gee, Thanks For The Depressing Advice; What Now???