The Most Helpful

My back hurts. It really. Fucking. HURTS. And so far, all of the things that are supposed to help it not really fucking hurt have come up short - or flat out failed.

Over the past three years, I have spent hours complaining and explaining to doctors and family members and friends, only to continue to feel unheard and unsupported. Everyone does their best, says they hope I get some relief soon, and nothing changes. Life goes on. I'm still in pain.

This morning I was having a particularly difficult time of it. The latest Thing That's Supposed to Help appears to be making the pain worse instead. I spent half an hour complaining and explaining (and sobbing), pacing the kitchen because it hurt to sit down. And then Rob left for work, saying, "Feel better," and I just lost it. I threw a fucking tantrum.

After Rob cleared out, I was just starting to calm myself down when I caught Westley staring at me.

"Mommy? he said, "I'm sorry you're not feeling well."

I forced myself not to burst into tears again. The kindness and sincerity in his little voice made my pain disappear for a beautiful instant. I took a deep breath, and got it (mostly) together.

"Thank you, sweetie. It's really helpful to hear you say that."

Westley has no idea how much of a help he is to me in my fucked-up state. And that's probably for the best. It seems strange and wrong that the most supportive person in my life right now hasn't even turned three yet.

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The Gift of Tired

A few weeks ago, I wrote about how friggin' tired I am. I was feeling kind of hostile toward my tired self. Like, "Snap out of it, woman! You have stuff to do!"

So I pushed against the tiredness, forcing myself to keep moving. One more load of laundry. One more set of weights. Another trip the the grocery store. More tidying, more stories, more songs, don't stop moving or else!

Or else what? Or else risk admitting that this pushing is not working? That I'm operating at about 60% on a good day and want-slash-need more time to myself? (That when I get time to myself, I don't know what to do with it because I truly cannot think of anything that would be "fun" or "relaxing"?)

Yeah, something like that.

It turns out that pushing against the tired doesn't work. You just end up hating everything and eating almost an entire batch of homemade cookies. At least, you do if you're me. (And at least those cookies were refined-sugar-free.)

So I've started taking an approach to my tiredness that seems to work pretty well with my chronic back pain. This really should have occurred to me before, as the two are almost certainly related. When my back hurts a little bit - what I called "the normal amount of pain" until Rob pointed out that it's not normal to be in pain all the time - I can move at my usual pace. And pushing a little bit can get me past the whiny, "oh poor me" stage and into building some momentum for the day.

When my back hurt-hurts - as opposed to the normal hurting - I have to rest. If I can't rest as long as I'd like, which happens if Rob is at work, I'm forced to be extremely careful. I have to take things sloooooow. Sitting, standing, dressing Westley, carrying anything...all become exercises in patience as I move half-time through my day. And I let myself off the hook a little.

It's nice not to be on that hook all the time. Which I think, ultimately, is what this pain and tiredness is trying to tell me.

The tiredness is an invitation to back off. To sit down to eat a meal. To cuddle my kid on the couch instead of obsessing over the clutter on the floor. So much of that time I spend pushing against tired is time I'm not spending with family. Because, you know, emptying the dishwasher is so friggin' urgent and my kid will stay two forever.

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Me, Myself, and IUD: The Aftershocks

Here's what happened while I was getting all thrift-store fashion on you:

I got my period. (I hope you weren't waiting around, holding your breath, wondering if my lateness meant anything.) And? It was the most amazingly awesome fantastic period experience of my menstruating life. I felt incredible!

I couldn't believe it. I still can't really believe it. I have not felt good during my period since, um...ever?

As you may remember, I had the Paragard IUD: no hormones, all uterine irritation. I don't know why I thought something that works partly by stimulating "an inflammatory response in the uterus" (to quote Babycenter's article on IUDs) wouldn't make my periods into a completely miserable experience, but it didn't really cross my mind. Never mind not knowing about the whole bicornuate uterus thing. Yikes and double yikes.

Anyway! My period showed up, and I had no cramping. None. Not in my back, not in my abdomen, nowhere. I was a little tired for a couple of days - nothing a few cups of green tea couldn't help along. And instead of 10-14 days of bleeding (yes, as in two weeks), I had six. Six if you count the three days of barely-there spotting.

On top of having a fantastically easy-to-deal-with period, I suddenly have crazy amounts of energy. Okay, maybe not crazy amounts, but certainly noteworthy compared to how I was feeling just a month or two ago. It's totally awesome, but remained completely mysterious...until I sat down to write this post and saw the phrase "inflammatory response." One of the reasons to manage inflammation in the body is that inflammation causes fatigue. And fatigue and chronic pain go together like cat pictures and Impact font!

So it seems that there's s a distinct possibility that having my IUD removed will actually result in my not having lower back pain any more. Which - after two-plus years of having my back hurt Every. Single. Day. - makes me want to cry tears of happy-happy-joy-joy.

My next period is due in about two-and-a-half weeks, and I'm completely shocked to realize I'm looking forward to it. I can't wait to find out if this ridiculously easy, remarkably pain-free cycle is the new "normal" 'round these ladyparts.

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Writing Through Depression

On Monday I posted pictures of a cake, because I didn't know how to write about what Monday felt like.

My postpartum depression is mostly under control. And by "under control" I mean that if I eat what I'm supposed to, don't eat what I'm not supposed to, exercise, take my vitamins, drink enough water, get enough sleep, manage my stress, have open and honest conversations with my husband, and attempt to remember what my hobbies and interests are, all on a daily basis, I'm basically okay. More or less.

But if just a few of those things fall away - because, you know, life gets in the way - it's way too easy for the rest to fall away, too. And then I go from feeling basically okay to thinking dark thoughts about sharp kitchen knives and hot teakettles.

My dark thoughts exist solely as thoughts, with the occasional morbid fantasy. Still, they're pretty fucking dark. Which frequently leads me to the conclusion that I'm a bad person - instead of just a person in a bad mood. False logic from the Dirty Tricks Department of the mind.

Whenever the Dirty Tricks Department of my mind is acting up, I desperately want to talk about what I'm feeling - and I do, at length. (I'm certain Rob knows more about my emotional life than he ever expected to.) For some reason, however, I find it very difficult to write about. Perhaps because the thinking is so irrational and disorganized, it doesn't lend itself well to grammar and sentence structure. Or perhaps I don't want to be depressed in public.

When I told my mother how awful I felt and how I'd been having terrible nightmares that I didn't know what to do with, she said, "Put it in your writing."

My first thought was, "Hell no. I'm not telling my blog readers that I keep dreaming about bleeding to death at wedding receptions." But one of the reasons I started this blog was to write my shit out. And I say "out" because I think coming out about whatever the thing is - whether it's sexuality, mental illness, or how you really feel about your postpartum body - is important. I value the "over-share."

So, very simply: I had a terrible mental-health day on Monday. I hated myself and I hated my child. I think I even yelled at the cat.

Mature, I know.

After apologizing (to both Westley and the kitty), working out, and eating a couple of extra-super-mega-healthy meals, I feel basically okay again. Which, when compared to the dark of Monday, looks completely brilliant.

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Me, Myself, and IUD

*Updated, with "results" below*

This is the time of the month when I start to wonder if I'm pregnant. No, scratch that. It's the time of the month when I'm sure I'm pregnant. Despite having an IUD (that I've been assured is effective despite my uterine weirdness), despite not having actually missed my period.

The problem with having birth control you can forget about, is that you kind of stop believing in it. If it's the week before my period, and I'm a little bloated? That's it. I must be pregnant. It's suddenly the only explanation. Period five hours late? Totally pregnant.

Of course, every time, I'm not pregnant. And every time, Rob and I share a "oh, thank God, there's not going to be another baby any time soon" moment. My monthly pregnancy not-quite-scares are quite the household joke at this point. Which is why, this month, I'm feeling a little the girl who cried "pregnant." Because this time, my symptoms have been especially potent, and I'm starting to think that maybe, this time, it's not a joke.

I've been absolutely exhausted for the past week or so. Like, going-to-bed-at-8:30-PM-and-sleeping-'til-7:00-AM exhausted. I'm also queasy like crazy. And my breasts, which are normally a negative two on the sensitivity scale, actually hurt.

Being pregnant right now wouldn't be ideal. But it wouldn't be a disaster, either. And it would definitely explain why my body seems so hormonally out-of-whack!

Fortunately, Rob isn't concerned enough to have stopped teasing me about thinking I might be cooking a biscuit. Last night, when I asked Rob what he thought of the dining chairs I was looking at online, he narrowed his eyes at me.

"Why are you shopping for dining room furniture?" he asked.

"I just...I dunno...we're always saying how the table is too big, and I'm--"

"Nesting!" he accused.

"No!" I was immediately defensive. "Okay, maybe..."

Because while the IUD makes it nearly impossible, it's still possible. Possible that Westley won't be the only one much longer.

Later, we lay in bed, remembering how before I was pregnant with Westley, we were both sure I'd gotten pregnant on vacation. I'd had my first IUD removed a month before our trip. We came back to work all nervous and excited and sure that we were going to be parents, but at the same time claiming we didn't really care.

And then I got my period. And we were both disappointed. Much more disappointed than we'd expected to be.

"Do you think we'll be disappointed this time, too?" I asked, cozying in.

"A little."

I think I might be more than "a little" disappointed if my period shows up. But then I wonder if I'm really ready to face a positive pregnancy test...let alone another pregnancy (and another labor, and another newborn...and oh my God).

One thing I am certain about, however: I'm done with the IUD.

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Two days later, I've definitely started my period (a little early, actually). It's both a disappointment and a relief. I'm still absolutely, positively over the IUD, though. It looks like we'll be kickin' it old school with condoms for a little while...unless we decide not to/forget to use them.

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Sick Sick

After being sick with worry about traveling with a toddler, and then heartsick over having faraway close friends, I find myself just plain old sick. For what seems like the thousandth time in two years.

I've written about this before, but it still seems noteworthy that I was never sick with this kind of frequency before Westley was born.

"That's the way it was with us," my dad told me, when I complained to him about yesterday's Stomach vs. Food smack-down. "Your mom and I were like Clydesdale horses before you and your brother came along. Then we caught everything that came down the pike!"

Apparently, I should have expected this. But it still doesn't make sense to me. I mean, I would be willing to accept the demise of my healthy-as-a-horse self if Westley were in daycare and bringing home every illness the Pacific Northwest has to offer. But Westley and I don't really go anywhere (a problem I'm hoping to remedy in the near future). Rob goes off to work and presumably brings home writer-germs on a daily basis. But you'd think that if that were the issue, my husband would get sick at least as often as I do. (Right?)

So I've concluded that one of two things must be going on here. Either I'm much more physically depleted than my doctors or I realize, or else I'm just a giant wuss.

On the microbiological level, of course.

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Gurney Humor

I am short-waisted with a long torso, something I re-discover about my body every time I try to buy a dress (or - help me, Mary - a bathing suit). When I was pregnant this meant that I didn't look all that pregnant until about the 8-month mark. It also meant that Westley had room to stretch out.

"You've got a lot of space in there," one student midwife said, examining me. "You could carry twins, no problem!"

Well, not exactly no problem.

Finding out that I have a bicornuate uterus (my official diagnosis as of yesterday evening, though who knows how accurate that is) right when Rob and I were not-so-tentatively planning to ditch our birth control later this year shakes things up. My pregnancy-planning apple cart has totally been upset. In fact, now that the thing has capsized, I'm not even sure it was an apple cart in the first place! More like a rickshaw. Full of artichokes.

Which is to say I'll have a lot of questions for the specialist my doctor has referred me to - if I can ever get an appointment to see her.

While I'm waiting in appointment-scheduling Limbo, I can't help but think of my ladypart insides like a duplex. "I should have twins," I think (as though I had any real control over that): "One in each uterine cavity!"

Of course, then they'd come out and want their own rooms right off the bat.

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IUD, WTF, OMG

I thought I was so brilliant for choosing an IUD. Unfortunately, most of the medical professionals I spoke to in my quest for long-term, hassle-free, non-hormonal, effective birth control were not easily convinced of my brilliance.

I repeatedly explained that I was in a long-distance relationship, but that my dude-person and I were getting married in six five four months. I explained that I did not want to use barrier methods, and that I didn't feel comfortable with the idea of artificial hormones. That my future husband and I were both healthy and infection-free and that we wanted children someday just not right away and I've done my research and know that insertion is going to hurt and I can deal with it so will you please, please put a copper-wrapped plastic T in my uterus so I can have consequence-free sex with my husband?

Because I was 22 and had never had the kind of sex that can get you pregnant a child, most of the health care providers I spoke with refused my request. One woman, after examining me and ostensibly listening to my history and list of birth control "wants" and "do not wants" suggested, "Have you thought about using condoms?" As though I'd never heard of them. (Never mind that condoms fall into the already-rejected "barrier method" category.)

It took some serious doctor-shopping and several very uncomfortable women's-clinic visits, but I was finally able to find a doctor who was willing to trick out my uterus with a shiny new ParaGard IUD. My new OB-Gyn BFF was also willing to really listen, and he somehow managed not to talk down to me despite my being a college student and his being a doctor. Amazing! (If I could have taken him to Seattle with me when I moved so he could be my doctor forever and ever, I totally would have.) Thank you, Dr. Patton. You rock.

The IUD made my periods heavier. I knew that this could happen, especially with the ParaGard, but I'd been suspicious. Why? My periods have always been very heavy, and I guess I thought there had to be some sort of limit. No one makes a "super plus plus" tampon. But it turns out that IUD-plus-me results in periods of WTF-proportions.

So I had semi-hassle-free birth control. Whatever. And, as promised, the IUD was super-effective at preventing pregnancy.

It's no secret what happened when I had the IUD removed just to "see what would happen." I had one (alarmingly late) IUD-less period before Westley was conceived.

"What are you planning to do about birth control after the baby is born?" my midwife asked during one of my final clinic visits.

When I mentioned thinking about having a new ParaGard put in at the earliest opportunity, she was very enthusiastic: "Do it!" Hippie-dippy, crunchy-granola Seattle midwives are passionate about IUDs, it would seem.

With my midwife's blessing upon me, I went in for IUD-insertion numero dos when Westley was two months old. It was a breeze. I left Planned Parenthood feeling very pleased with myself for being so responsible.

A year later, I was sitting in the doctor's office, filling out paperwork, trying to cram my symptoms onto the three lines available under "Please describe below." Persistent, debilitating low back pain. Fatigue. Pelvic pain. Periods lasting 9 or 10 days.

The fatigue was more or less resolved with diet and exercise. The low back pain didn't respond to physical therapy, and the effect of acupuncture was minimal. And my periods were getting worse: 14 days of bleeding and pain so bad that walking was a challenge.

Finally, this past Monday, I had a pelvic ultrasound. I was expecting them to find something growing on the back of my uterus, pressing into my back. Possibly a fibroid, since they seem to be an issue for the women in my family. Of course, it could be something else. A tumor. Rob and my mother both suspect endometriosis, but that's hard to check for. And then it's possible that it's "nothing."

I lay on my back, staring at the wall-mounted TV screen, wishing the ultrasound technician would tell me what was going on but feeling too nervous to say anything. Instead, I told her a little about Westley and the cute things he says. I mentally flip-flopped between hoping the technician would find something and hoping she would find nothing.

When I scheduled the appointment, I forgot to ask if the ultrasound would be transabdominal or transvaginal. It turned out to be first one, and then the other. The abdominal ultrasound was easy, though I felt lost at sea, watching the black and gray swirls on the screen. When the technician got to the transvaginal part of the exam, she was very quiet.

I'm daydreaming, trying to relax and ignore the probing of the camera-wand, when she asks, "Have you ever had this done before? What I'm doing now?"

"No." My First Vaginal Ultrasound, by Mattel.

More silence. Black and gray blobs on the screen. Something looks vaguely circular, but as soon as I decide it's there, it disappears. I stop looking for shapes.

"Has anyone ever commented on the shape of your uterus?"

What a strange thing to ask. "No. Just that it's over to the right side."

After another minute or two, she leaves to get the doctor. After a minute, the ultrasound technician comes back into the room alone to take a few more pictures. I try not to feel the magic-camera-wand. "Where is the doctor?" she wonders out loud to herself. She doesn't sound relaxed. I make the scared part of myself to calm down.

Finally, the doctor arrives. She's very pleasant. Kind of jolly and maternal. She takes over with the magic-camera-dildo-wand and tells me to rest my knee on her side. It's nice to have some human contact; everything is momentarily less scary and clinical. As I move my leg slightly, I'm suddenly aware of how tense and cold my feet are.

The doctor looks at the screen, and then at me. She's still very pleasant. Cheerful, even. "It looks like you have a duplicated uterus."

The words echo in my head.

"Okay," I say, like this makes sense to me. I can feel my mind trying to process. Duplicated uterus. That must mean--

"What that means is you have one uterus...with two separate cavities."

"Okay." Oh, God.

"Your IUD is in the right cavity."

"Uh-huh." I don't like where this is going. I really don't like where this is going.

"Your left cavity is...unprotected."

Just like that, my 99.9% effective birth control is more like 50-50. But I can't focus on my coin-flip fertility for long. My head is spinning. I'm not pregnant now, am I? Is that what they're going to tell me next?

No, no. Not pregnant. The doctor is saying something about my possibly having two cervices also. Though she says "cervixes." "I think you do." But I'd need an exam to confirm that. The doctor finishes up with, "So we'll fax this report over to your doctor, and be sure to use an alternate method of birth control. An IUD might not be the best choice for you."

"Right." I try to laugh.

Duplicated uterus. My mind is repeating it, so I don't forget. "A duplicated uterus? Is that what it's called?" That sounded like my voice, asking for clarification.

"Yes," the doctor says, and quickly offers a slightly more in-depth explanation, throwing in the words bicollis and didelphys (which I will be surprised to realize I remember a few hours later).

The doctor leaves, the technician leaves. I get dressed in the dark, feeling disoriented, and hollow.

Usually when I have two of something that I'm only supposed to have one of, it's desserts. Or glasses of wine. Or Aleve tablets for my excruciating back pain (which, come to think of it, having a duplicated uterus doesn't really explain). Rob and Westley are waiting for me in the lobby, and I can't decide what I'll say when I see them. I wish I had a picture of it. All I can think about is circus sideshows.

At least it's not bad news. But it's not exactly good news, either.

Waiting for the elevator, listening to Rob narrate the saga of Westley-and-Rob-wait-for-Mommy. I still haven't told Rob anything other than, "I have something to tell you. It's nothing bad." I'm not even sure if it's nothing bad. The doctor sure made it sound all normal-variation-y and not freaky-scary-dangerous.

I notice that the woman waiting next to us is holding a little ultrasound photo. She's smiling quietly at the shiny black and gray blobs. Her midsection looks soft and round.

I suddenly feel incredibly freakish and alone.

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This Is Why You're Depressed...Or Not

I am so...well...sick of thinking about my post-baby food sensitivities. But almost eight months after my doctor first prescribed a elimination diet, I still have questions. And symptoms.

When Westley asked for some muffins over the weekend (his word for muffins is "muh-tits," which might be the best toddlerism ever), Rob carefully adapted the recipe he was making to fit my dietary restrictions. The resulting almond-quinoa muffins (adapted from Veganomicon) were vegan (of course), gluten-free, soy-free, contained no refined sugar, and tasted delicious.

And they still made me sick.

My heart sank into my crampy, miserable stomach as I started to wonder whether my problem with baked goods wasn't the sugar or the gluten, but the refined-ness, the flour. Maybe not just gluten-containing flour, but any flour was unacceptable. Was I looking at a flourless--or, (help me, Mary) grainless--diet?

It seemed extreme, yes. But as I sat at Sunday brunch, staring at the second half of my "old world" cereal, which strongly resembled something I could make at home, I felt that familiar stomach sickness. I hate going out to eat, I thought.

I'm thoroughly convinced of the connection between food and depression; I desperately wish I could go back and give my 16-year-old self a gluten- and dairy-free diet instead of the medication that created more problems than it solved. But my new diet, which initially rescued me from postpartum depression, is starting to create a different kind of sadness.

Meal-planning and grocery shopping, which I used to truly enjoy, have become unpleasant chores. On the rare occasion that I find myself in a restaurant, I have to figure out what's "safe" to eat--as opposed to what I'd like to eat. And I fucking hate that when my sweet little son, who loves to share his food, offers me a bite of his toast, I have to say, "No, thank you, honey."

And then I add, "That's all for you." Because I refuse to tell him that the whole-wheat seed bread he's so enjoying will make Mommy sick.

But I'm starting to wonder if that one shared bite might be worth it.

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Back, Out

It's the closest thing I'll ever have to a sports injury.

At least, it feels how I imagine a sports injury feels. And I can picture myself old and gray, leaning on a cane, hand on my hip, grimace on my face, grumbling, "The old football injury's acting up again." Except that I never played football. (I still don't really understand football, and being married to a sports-loathing man, I suspect I never will.) The most athletic event I have ever participated in was my son's birth, and I'm certain that that's where my "sports" injury came from.

Westley was occiput posterior, and didn't turn; he was born facing up, the way monkeys are born (I'm told). My back pain in labor was unbelievably excruciating. I'd never heard of "back labor" or babies being born "sunny-side-up" at the time, but now it's the only thing I can think to point to as the source of the persistent lower back pain I've been dealing with for almost two years.

Generally speaking, the pain is manageable. But this morning, as soon as my feet hit the floor, it was clear that something was wrong. And then I discovered that it hurt to walk. It hurt to move.

Oh my God. It hurts to move. And I have a child to take care of!

Fortunately, I also have a mother and a husband who put their work on hold, stepped in to care for Westley and even track down a number for my doctor on her day off, when all I could do was sit and cry from the pain.

Several hours, a doctor's evaluation, my first acupuncture treatment, and some anti-inflammatory medicine later, I'm feeling slightly better...physically. I'm still a bit of an emotional wreck. "Random muscle spasm" was the verdict, which does not make me hopeful for the future. I have been to more doctor appointments in the past two years than I went to in eight years prior to that! And I'm following all of the recommendations from my health-care professionals, and still--still!--I wake up in the morning and can't move? How am I supposed to feel good about this?

It's all very scary, and it means having to explain to Westley that it's okay, Mommy is crying because her back hurts. And that no, he can't come "up" for a hug, because Mommy can't lift him today.

I'm not trying to be a professional athlete. I don't plan to run a marathon, or even a 5K. Picking up my child when he needs comfort is not an athletic event, but right now, I can't do that. I was worried about getting my body back after childbirth, but now I'd just settle for getting my back back.

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