Musings on Mental Health

I started this post a week ago, so the event described as taking place “this morning”, actually took place last Thursday.

Scarlett’s two week well check occurred this morning. She is gloriously healthy so far, regaining her birth weight and then some and lengthening an inch.
The poor baby endured another heel prick for the second newborn screen. She did NOT like it and howled in a most Lucy-like fashion while the lab tech performed the test. As I nursed her to sleep after in the exam room, my mind wandered.
The kids’ regular doctor was not available today. The one we saw examined Max once before and we both liked him very much. This doctor obviously counts a little girl named Lucy among his patients, because three drawings signed “Lucy” decorated the wall. The words “Lucy love” were even scrawled across the top of one.
Between that and the discussions of cardiomyopathy and heart function that constitute a regular part of our pediatrician visits now, the possible loss of another child weighed on my mind a bit. If I’m being honest, it is never all that far from my thoughts, although it is a fairly remote possibility at this point. I found myself thinking about how I still feel so much fear of losing another child, as well as the same things I’ve always feared. I know people expect that you have more clarity concerning what is really important after losing a child. They expect it to be easier to enjoy your remaining children, if you have them, and to focus on what’s really important.
Sometimes it is. It should always be. That should be the payoff for the horrible pain of losing a child. For me anyway, it’s not that easy.
It stands to reason that we survived it once, so we would survive it again, right?
Probably. But everyone has their limit. Then I remembered that I reached my limit once before and survived. When I broke down in graduate school, I finally reached the limit of years of mental self-abuse and stress. Somehow, I survived, despite not receiving a diagnosis or any therapy for 6 years. It took a decade for me to feel like myself at all again. I thought that person was gone forever, so this was a pleasant surprise.
I finally saw the therapist who diagnosed my nervous breakdown, because I wanted to have children. Furthermore, I wanted to have my head on straight before the first one was born. I made huge progress before Max was born, but it was my children who actually began the healing process. I never intended for my children to “fix” me. I hope it did not come at a high price for them.
I never once wanted to or tried to kill myself, but that does not make me better than anyone else. I am strong, but I am also lucky. Despite the sometimes extraordinary suffering I experienced during the 12 years since my breakdown, I am still here. I know my mind flat-out lies to me and tries to hurt me sometimes. I know that my fears aren’t real, because I got help. Although only my husband and the two therapists I’ve seen know everything, I spoke up. Darkness thrives with more darkness. It disappears with light. That light comes from openness and understanding.
Living with mental illness takes more strength and courage than you can possibly understand if you have not experienced it. Anyone can experience it, even if you have no history of it. No one is immune. The mind can become ill and be healed just like the body. Sometimes the illness is chronic, just like with the body. Someone with chronic depression or anxiety is no weaker than someone with cancer or an autoimmune disease. It’s no less real and deserving of treatment, sympathy, and understanding. It is no less painful and tragic when their disease takes their life, however that occurs.
I am proud of everything I’ve survived. I feel like I am made of steel sometimes. Although I wish that life didn’t ask so much of me, I am grateful to have these hard-won coping skills.

Embracing the Joy and Grief of Change

The grief never lingers far behind the joy with parenting, even with normal parenting. As most of you know, my situation resides far from normal.
My family is weathering two exciting, but stressful transitions right now. Our days and nights are full of (mostly) joyful upheaval, thanks to newborn Scarlett and Max starts kindergarten in less than two weeks.
My joy at Scarlett’s presence in our lives is tempered by an unexpected resurgence in grief for Lucy. I feel silly that I thought the joy would completely override my grief, but I guess I’m an optimist sometimes.
I feel anger and sadness that I have navigated pregnancy and birth three times and am guiding a third child through infancy, yet only two children are visible. I am part of a club that I don’t feel part of. Despite birthing three children and even mothering one through a chronic illness turned terminal, I don’t feel like I have three. I feel cheated. I feel like a poser when I say I have three. I want to wear a shirt that says I have three, so that no one ever assumes I have only two.
I put in the work. I paid my dues, more than my share of them actually. I did the hardest work most parents never have to do. I held my daughter while she cried during endless IV sticks. I was the last to hold her alive and the first to know she was most likely gone. I planned her funeral, wrote her eulogy, obituary, and epitaph, and chose what she would be buried in and with.
All of that is invisible now. It shouldn’t matter what others think, but it does. I have three children. I am part of the club. I wish I could at least feel that way, even if it is not visible to others.
The other parts of my grief stem from much more typical sources. I miss the life I enjoyed with Max before Scarlett was born. I knew this would happen, but I still feel a bit guilty about it. During the past year, Chris, Max, and I built a beautiful life from the aftermath of a terrible loss. We grew as people and grew together as a family. I grew as a mother, yet felt like I moved forward with some of my personal goals.
This is where Lucy comes back in. She would be two and a half now, a playmate for Max. It would, of course, be more stressful mothering both of them in addition to Scarlett. But they could occupy each other, as well as drive me crazy bickering. (What I would give to hear the two of them bickering.) Max wouldn’t once again be stuck alone watching TV while his mother tends to a baby. We made the choice to have our first two children two and a half years apart. We put in all the work to have the family we wanted and the sibling relationship we wanted for our son, just to have to start over again. Plus, it’s just plain friggin’ hard to have a newborn sometimes. If Lucy was still here, I believe I would feel complete with Scarlett’s birth. I would feel done. I wanted three and I would have them. I don’t know if I will want to do this again. Even if I do, will I ever feel complete or done without Lucy?
The last five beautiful years with Max will come to a close with the start of kindergarten. It will be the end of an era, the end of his time at home with me. I vacillate between excitement and sadness at the prospect. I worry that it will be hard for him. He loves to be at home with me. We will be beholden to a school schedule. No more running around in his pajamas asking for snacks and videos. No more weekday trips together to the grocery store, the Aquarium, and the Thinkery. At least, not without a school vacation that will cause everyone else to be out and about, too.
All of this grief is there, because there is so much love. There are so many wonderful memories. Our children take our hearts when they are born and break them when they leave. I knew I was opening myself to more heartbreak with Scarlett’s birth, as well as more joy. I’ve already told her many times that she’s not going anywhere. She’s not allowed to die on us. One of the first things I said to her was, “Please don’t leave us, ok?” As if she or I can really control that.
So, now that I’ve examined the grief, let’s examine the joy. It deserves equal time.
Max is beginning the path that will lead to finding who he is. He will find his life and his passion. All knowledge, the whole world is there for him to take. There will be friends, teachers, and fun. Field trips, school pageants, recess, and vacations.
Having less time with him at home will hopefully lead to us appreciating our time together more. I will also have more one-on-one time with the baby, as I did with him.
We will get to watch Scarlett grow. This one will have a 2nd birthday. She will get the chance to crawl and walk and talk. I will get to put her hair in pigtails. We will introduce her to our families, have more than one of each holiday with her, and take her and Max back to Legoland as promised. I feel like this one will make it, although I am trying to appreciate her as if she might not.
I can’t wait for these first five years with Scarlett and the next five years with Max. Grief over endings will yield to joy in beginnings. Actually, what is more likely is that they will intertwine. One will ebb, so the other can surge. They will sharpen, refine, and intensify each other. They are part of each other.

Seeing Lucy

I see her posing in photos with her new baby sister. I’m not sure whether she would smile fondly or exhibit a pout, a scowl.
Would she experience difficulty sharing her parents and big brother? Would she resent her dethroning as the youngest, the only girl?
Would she lavish attention on her sister, as her brother does?
I will never know. Instead of celebrating her sister’s birth almost two weeks ago and turning two and a half yesterday, Lucy has been dead for 15 months. She has now officially been gone as long as she lived.
Scarlett’s presence points up Lucy’s absence, yet renders her more visible to me. Despite my best efforts, my imagination failed to produce an accurate picture of Lucy during these months since her death. Remembering Max at the ages of 1 and 2 failed to revive Lucy in my mind. My inability to imagine her growth frustrated and saddened me.
But now I see her. I even hear what her voice would sound like saying Scarlett’s name. I see her spinning in the living room, asking for snacks, taking naps. I see her in the space next to Max and Scarlett in photographs. I see her starting school with Max in a few weeks, potty-training, sleeping in a big girl bed.
She is taller with longer hair. Maybe she has a scar on her chest from a successful heart transplant. (I can never decide whether she is still sick in this alternate reality.)
Prior to Scarlett’s birth, the idea of part of Lucy coming back with her occurred to me. I thought it would be through physical resemblance between the two. They do share some facial similarities, but not obvious ones. Instead, Scarlett set Lucy free in my mind. Acquiring the ability to picture how my eldest daughter might look today is an unexpected and curious gift.
Grief continues to take unexpected turns. It really is a continuous journey. The grief grows, changes, and matures as Lucy would have given the chance.

Scarlett’s Birth Story

On Tuesday, July 29, the contractions came off and on all afternoon and evening. I both welcomed and feared them. They crept as close as 10 min apart, even five minutes apart a couple of times. Chris and I wondered if we would make it to our scheduled induction the next morning. I truly thought we wouldn’t at one point. But, as usual, the contractions stopped.
Sleep came surprisingly easily, but I woke at 3:30 when the carbon monoxide detector started chirping from a low battery. As soon as I was up, contractions tightened my belly. Fort started meowing. I gave up, got up, and started dressing and packing for the hospital.
Whenever a contraction hit, the fear did, too. All I wanted was to get to that hospital and get hooked up to the epidural. Even though I gave birth the first two times without any drugs, all I felt was terror at the idea of doing that again. One of the contractions was so strong, I had to stop and breathe through it.
We arrived at the hospital at 5:15 or 5:30. I kept reminding myself to just face each step as it happened. As we stood rather giddily at the check-in desk, the concierge appeared with a woman in a wheelchair. She was obviously in great distress, having been in labor all night with no sleep. A bit of guilt over strolling in there so happily joined our giddiness.
As we entered room 5, I committed the number to memory and thought, “This is it. This is the room where my daughter will be born.” Our doula Susan and photographer Heather arrived soon after. I changed my clothes, gave the nurse my birth plan, and we were off.
Or so we thought. The induction was scheduled for 6 am and we were settled in the room by 5:30 or 5:45. I didn’t get the Pitocin until 8:30. The hospital was really slammed that day and the doctor neglected to sign the paperwork saying my pelvis was adequate for vaginal childbirth. (You would think two previous vaginal births would provide enough proof of that.) They couldn’t start the Pitocin without that paperwork.
My contractions were 20 minutes apart, but fairly strong. The first order of business was the insertion of the IV. It took four tries. Then, the doctor tried to break my water, but the baby was still too high up and it caused an incredible amount of discomfort. So, they decided to try again once the epidural was in. (My water either broke on its own during the epidural administration or the doctor started a slow leak that didn’t really get going until then.) It was 7:35 and I was 3 cm, 60% effaced.
My doula gave me a foot massage while we waited for the Pitocin, which helped immensely with relaxing and passing the time.
Once the Pitocin started at 8:30, my contractions seemed to jump right to two or three minutes apart. A seemingly never-ending contraction hit 15 minutes after it was started. The nurse said it couldn’t take effect so quickly. Maybe it was psychosomatic.
Our nurse said we were third in line for the epidural. The Pitocin had been started at a 6, but they dialed back to a 3, I believe, since I was progressing so quickly.
The nurse anesthetist came in. I felt so incredibly relieved until it took four tries (It might have been more.) to get the epidural in. They said I have “really tight spaces” in my back, which is a good thing, except when you are trying to get an epidural. Despair filled me at the thought of seeing the birth through without pain relief again. Luckily, the next anesthesiologist got it in after a couple of tries. It really didn’t hurt to get it inserted, although I felt some odd twinges once they did get it inserted properly. I knew that was a possibility and they passed quickly, so it didn’t worry me. The worst part was staying in that hunched over position so long, especially during contractions.
Chris sat in front of me, holding my hands, the entire time I hunched over waiting for that epidural. I looked into his calm, steady eyes as best I could with my head hanging towards my chest. When a contraction hit, he encouraged me to think of Max and Lucy and how all of the pain was worth it. I started picturing all three kids’ faces (what I knew of Scarlett’s from ultrasounds) every time I felt my uterus tighten up. Eventually, this technique devolved into thinking, “Max, Lucy, Scarlett” really quickly over and over, but it worked. (Also, strangely enough, the blood pressure cuff helped. Whenever it went off during a contraction, the contraction didn’t seem as intense. Just a little pro tip there. 😉 )
The baby experienced some decels during transition, so the nurse administered some oxygen to me. Scarlett quickly rallied, thank goodness. The nurse said she just needed some time to catch up, since everything was going so fast.
The anesthesiologist had given me some extra medicine after the epidural was in. I think this was to make up for it taking so long. I began to feel very relaxed and numb, but I still felt a great deal of pressure and a little pain. The epidural did not have the effect I was hoping for after hearing other’s stories, but I think all of the pain relief and the oxygen calmed me. I wasn’t yelling the baby’s name or dropping F-bombs like I usually do during transition. 😉
There was just SO MUCH pressure and I felt like I wanted to push a few times. I wasn’t quite complete, but I was dilated to 8 cm. I progressed from 5 cm at 9:55 to 8 cm at 10 am. They turned the Pitocin off after that. I started shaking hard at 10:05. The nurse started making phone calls. I heard her say that she hadn’t been able to go in to her other patients since room 5 was moving so fast and she needed someone to check in on them. She also called down to my doctor’s office and warned that we were going to need him very soon.
By 10:15, I was 9 cm, 100% effaced, and the baby was at zero station. By 10:30, I was fully dilated except for an “anterior lip”. The nurse said I could do some “practice pushes”, but to not push full-on until the doctor arrived. I think she might have called again and said, “We need Dr. Seeker right now!” I asked how quickly he could get there and she said, “Don’t worry, he can run really fast.”
I started pushing in earnest at 10:45. The nurse told me to hold off, so I breathed through a few contractions. The doctor arrived at 10:55 and Scarlett emerged, yelling her beautiful little head off, at 11 am. She entered this world almost exactly 15 months after her sister left it at 15 months of age and just short of a year after the loss of Baby Bean.
It was all I could do to avoid lunging and snatching her from the doctor’s hands. The most overwhelming urge to see and hold her hit me full-force. He handed her to me after holding her up briefly, but they had to warn me not to pull her up too far, because the cord was still intact.
Our doula received the honor of cutting the cord after Chris demurred. The nurse did ask at one point during the pushing if I wanted to see the head, but I said, “No, I just want to get her out!” I felt some embarrassment about that later. Chris did look and I think it was a pretty odd sight for him.
All I wanted to do was look at Scarlett. I did notice Dr. Seeker working to get the placenta out (He wanted to deliver it quickly to help avoid excessive bleeding this time.) and stitching me up. But she consumed my attention completely most of the time. She reminded me more of Max than of Lucy. Her hair seemed to be blond and she didn’t have much. She was also so tiny compared to our other babies. Max weighed 8 lbs, 3 oz; Lucy weighed 7 lbs, 14 oz. Little Scarlett weighed in at 7 lbs, 3 oz, surprising us all. We thought she would be another eight-pounder, but she probably would have gotten closer if we had waited instead of inducing.
I did experience some bleeding issues again, but the nurse worked aggressively to stop it. After a little extra time spent in L&D, she got it under control with much less trauma and discomfort than after Lucy’s birth.
My back is fine. I actually pushed lying completely flat this time, instead of curling up and pushing. It did seem a bit harder and it still hurt, despite the epidural. But it was worth it to avoid herniating that disc again. I experienced a first degree tear, like the first two times. It’s already stopped hurting.
I wondered if I would swear to never give birth again after this one, as I did the first two times. The answer is “Not exactly”. After still suffering so much anxiety and the epidural not working quite like I wanted, I decided that there is just no way to make birth easy. Plus, the fact that I have apparently suffered bleeding issues after each birth (I didn’t think it was any worse this time than after Max’s birth, but the nurse said it sounded like I bled too much after his birth, too.) makes me wonder if it is just too risky for me. I will ask my doctor about those issues. Only time will reveal if there is another waiting to join our family. For now, I love Chris, Max, Lucy, and Scarlett with all my heart.
To see the stunning photographs taken of Scarlett’s birth and her first meeting with big brother Max, please visit:
Thank you so much to our photographer Heather Gallagher, our doula Susan Steffes, my doctor Christopher Seeker, and the nurses and staff at The Women’s Center and St. David’s NAMC.
And to my love Chris – looking into your eyes reminded me why I was doing this and helped me through it. I love you.

Saying Yes

I started this post over a week ago, on Max’s 5th birthday. Our beautiful new daughter Scarlett arrived 4 days later, hence the delay in posting. Scarlett’s birth story is forthcoming. For now, here is the story of the night Chris and I became engaged.

Even though today is Max’s 5th birthday, I am going to write about the anniversary of Chris’s and my engagement two days ago. (I wrote Max’s birthday letter a few months ago in case you want to check it out:
July is a special month for us. Chris and I met on July 30, 2005, thanks to our mutual friend Stephanie Kopp. We had our “second first date” July 15, 2006, and became engaged July 24, 2007. Our son Max was born July 26, 2009.
I knew Chris was going to propose. After all, I picked out the ring. However, I wasn’t sure when. We planned a special evening on July 24, two days before our couple anniversary on the 26th, because we already had plans on the 26th. I got a very strong feeling that the 24th would be the night.
I was so nervous and excited during the entire day at work. Chris and I took off for Hyde Park Bar and Grill right after work (We were trying to recreate the night we officially got together, but Mother’s was closed at the time due to fire damage.) I could barely eat, due to a ludicrous fear that I would say no when I meant to say yes. I kept remembering the episode of “Cheers” when Diane browbeats Sam into proposing and then says no.
After dinner, we drove over to Mt. Bonnell, another location from that fateful date. Chris made up some excuse to bring the camera with him. He told me later he was worried I would hug him and feel the ring box in his pocket.
We ascended the steps to the top and sat down to admire the view. I can’t remember if there was much conversation before Chris got down on one knee and said, “Sara O’Brien, will you marry me?” I think he also said he loved me, but all I clearly remember is the fateful question. Thankfully, I smiled and said, “Yes” with a definite air of “Of course” to it. We kissed and happily took photos, despite the searing July heat.
I started calling people on the way home. Everyone was so happy for us. It was one of the happiest nights of my life. There have been many happy nights in the 7 years since, but that was the one that started us on our way.

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