Hospital Holiday

by Eve, in Parenting (6 Comments)

Forgive my recent lack of blog posts, but recently all kinds of things hit the proverbial fan, culminating in my spending the last week with Timmy in hospital, with no Internet access.

My mood and ability to cope with Timmy has its highs and lows, but I’d noticed that each low was worse that the one before, so when I felt dangerously close to damaging Timmy just to shut him up (or at least giving him something to cry about), I took up the suggestion of my midwife and visited my GP to tell her how I was feeling.

The next few days were a busy cocktail of visits from Plunket, midwives, and mental health representatives, with different assessment questionnaires…apparently concluding that I had moderate-to-severe postnatal depression. My GP said that the height of my score on the questionnaires made counselling alone inadequate — I was in the Medication Required bracket, and so I came home with a pack of little white pills, and the concern of how I was going to explain this to the well-meaning friends adamantly against them. On the flip side though, I had an enthusing new hope that things would now get better. My GP had warned me there’d be a bit of a wait though — apparently the medication takes two weeks to a month to have any noticeable effect. Still, the hope for better days was there.

I continued to soldier on with a screaming baby, who could often only be calmed by feeding. When my brain felt shredded, I held on to the knowledge that at least I would have some quiet for a while following a feed.

Except then I didn’t.

After another day of living with a difficult baby, and the sky had darkened with the promise of another long night of irritatingly short and frequent feeds, I gave Timmy his first night time feed and looked forward to the peace that would follow — but instead, he continued to howl with impressive passion, his legs locking rigid between powerful kicks, as he arched backward and screamed.

Now I was alarmed. Something’s wrong with this baby, I thought.

Six hours under the white lights of the hospital’s emergency department at night would irritate anybody — so much more an already-fractious baby. That’s how long it took them to assess him, do blood and urine tests…and then to say they couldn’t find anything wrong with him. This conclusion was delivered in a tone that had the added implication, ‘…so you may as well go home now’. I was certain they were preparing us to leave.

The assessing medic then asked how I’d been feeling with the baby. I don’t know how they’re used to those conversations going, but answering questions seems a simple process to me. They ask, I answer. I neither embellished or underplayed. It never occurred to me to. Why would it? I hadn’t done anything wrong, so had no reason to dance around the facts. But when the medic heard that, yes, I have been so angry with Timmy that I’ve wanted to hurt him, she disappeared for a few moments to consult someone, then returned saying, “I think we should admit him.”

This was unexpected, as five minutes ago she’d apparently not cared about my baby, but after hearing about my mental state had done a U-turn. If they believed there was no medical concern with him, why would they admit him? The hospital isn’t a babysitting service. I’d heard horror stories that started like this. A baby is taken from a naive mother who believes that he’s just away for a weekend, or a play in the park, then she has to battle witch-hunting courts and welfare systems who are crying ‘abuse’, for months, to get her baby back.

Suddenly I didn’t mind his incessant crying. I’d much rather live with a crying Timmy, than no Timmy. But surely there was something wrong with him — if I took him home, for fear the system would never let me have him back once admitted, we might never know what it is or be able to fix it. Aiming to appease both concerns, my husband and I said we were happy to admit him into the hospital, on the condition that I’d never leave his side. These terms were accepted (although the medic didn’t look enthused about it), and in another couple of hours we were roomed in the children’s ward.

Initially he was in just ‘for observation’. I had to give his nurse reports on when he fed and for how long, and of each nappy achievement and their frequency.

The paediatrician visited our room the next morning and asked about his history. As there was only six weeks of it, it wasn’t hard to remember. I told him about Timmy’s course of erythromycin (the ghastly antibiotic of this previous post), and of how the decline in his demeanour coincided with his taking it — a connection my midwife observed. The paediatrician ordered an ultrasound for Timmy, to see if there’d been any thickening of the stomach muscle as result of the antibiotic. He expected it to be clear, but wanted to do it as a first step just to eliminate the possibility.

Among this child’s many frustrating features was his tendency to call for frequent feeds, then only snack for a few minutes. So he wasn’t happy about having to go Nil By Mouth before the ultrasound, for what turned out to be four hours! As the doctor suspected, the ultrasound reported all was well with his interior mechanics. Although I was glad of this, it still left me with the frustrating question: what’s the matter with this child?

Society has its natural defaults. If you don’t know what to give a father for Christmas, give him a tie. If you don’t know what to give a girl for her birthday, give her perfumed soap and moisturiser. And if you don’t know why a baby cries inconsolably, it’s because he has colic.

The most the doctor could do was suggest I go on a dairy-free diet, and see if that made a difference. Apparently a lot of babies have an intolerance to cow’s milk protein, at least for the first few months of their lives, and so they react unfavourably after being breastfed by a mother who consumes dairy. Perhaps especially if the mother consumes industrial amounts of it — relishing whipped cream on her coffee, frequent gulps of flavoured milk straight from the bottle, and delights in Whittaker’s Peanut Slabs.

And so it was my hospital experience was made worse. Not only was I sleeping on a plastic mattress two feet away from the most fractious baby in the world, but I was now being served scrambled eggs made with water, and instead of being allowed the strawberry mousse for dessert, I would be given a banana.

Later in the week I was allowed to go home at night while the nurses bottle-fed Timmy, and I could get a good amount of sleep. (By now I’d seen their Social Worker, and was satisfied I wouldn’t have Timmy snatched if I went home for the night.) I was delighted with this arrangement, but then found that the more sleep I got, the more I felt I needed. I was irritated too, that each morning on my return, the nurses reported that he’d taken good full feeds and slept well. I wondered if they believed he slept well because they were so busy with their other patients that they didn’t notice his frequent calls for attention.

This hypothesis was strengthened when I roomed in with him again, and had the worst night I’d ever had with him — after one night feed he continued to holler for over an hour, as I paced the floor with him. I eventually had to call his nurse in to take him off me and help settle him, because I was so tired I was about to fall over. His behaviour continued into the next day, so on a couple of occasions the nurses took him for a walk around the ward, as I had tried every trick to settle him, without success.

We’d now been in the hospital for a week. Clearly, nothing could or would be done to improve Timmy. And as nice as it was to sleep at home for a full night while Timmy’s colic became somebody else’s problem, it was clear to me that to continue our stay would only delay the inevitable — I would quickly become very fatigued no matter when I brought him home. At least at home I have a nicer mattress. If I’m going to be miserable, I may as well be comfortable while I’m miserable.

The only thing I think we gained is what’s probably been the best settling tool we’ve discovered: white noise. We were lent the ward’s copy of Sounds for Silence, which included a CD with tracks of various white noises. The accompanying book said that playing quiet lullabies was wasted effort with unsettled babies — they need white noise to be played initially at a volume louder than their crying, and eventually turned down. Amazingly, even Timmy succumbed to its will most of the time. If he’d still be hollering after being fed, changed, warm, and refusing a consolatory dummy, I’d put a white noise track on loud (the one that sounded similar to a vacuum cleaner was the most effective), and instantly he’d stop to listen. Often he’d be asleep within two minutes.

So now we’re home. I’m still tired, and Timmy’s still a problem — although with the aid of white noise, perhaps less so. I downloaded a white noise app to my iPod Touch, and combined the sounds of a vacuum cleaner with a dishwasher to create the sound of the closest thing to a colic cure that I know of. (The speakers of the iPod itself are insufficient to get the necessary volume — you’ll need a dock with external speakers to project it through.)

The doctors were still concerned about letting Timmy go home with a frustrated Mum (I would dare them to find any new Mum who’s not frustrated), so requested professional certification that I was safe. So yesterday I had an appointment with the Big Cheese of shrinks — a psychiatrist who’s the director of a bunch of other psychiatrists. I wonder how much I’d be out of pocket if I’d had to pay for it…

He had a most interesting assessment: I don’t have postnatal depression, just sleep-deprivation — a condition with very similar symptoms. The doctors and Plunket nurses who’d panicked at my descriptions of my moods and thoughts, had reacted purely to those symptoms. The psychiatrist however (who was very easy to talk to, and had a delightful scottish accent) first ascertained what my own personality type was (introverted and introspective), and learned I have a near inability to guess what other people are thinking or feeling. If I couldn’t guess the needs of an adult, who’s capable of speech and constructive interaction, how would I know how to read a baby? In light of my own personality and characteristics, he concluded that I’m a very sleep-deprived new mum who has no idea how to read her baby, and would benefit from an educational course concerning that — but not from psychotropic medications.

So that’s the official diagnosis, now. Instead of having moderate-to-severe PND, I don’t have it at all. The psychiatrist said I can keep taking the pills if that’s what I want to do, but he doesn’t think I need them and suggests I stop just to see if there’s a difference.

Part of me is relieved. Now I wouldn’t have to appease (or try to avoid) the well-meaning friends who disapprove of ‘drugs that mess with your brain’. But the other part — the part that had a refreshing hope for better days — is worried. I may not have PND, but the metaphorical black dog who would follow me around and attack my mind with tooth and claw, was real. (As much as metaphors can be.) The feelings were real, whether brought on by depression or by sleep-deprivation.

I’m worried now of how to handle my low times, if they can’t be fixed with a little white pill. As long as I have a colicky baby, sleep-deprivation will be around for a while. How will I battle my black dog now? Still, the new diagnosis brings me some consolation — I feel less of a slave to a greater beast.