Unable to Function/Take Care of Baby

Posted elsewhere on 9/16/2013

My son (my first child) was born on August 30th so I am a little over two weeks postpartum. Vaginal delivery, water broke while in triage at hospital being observed to see if I was really in labor. Had pitocin after epidural, pushed for two hours, needed episiotomy and tore a little.

All that went typically. After that, things got worse. The epidural setting was too high and I was unable to walk for over 24 hours after I got it. They had to cath me several times, eventually putting in a Foley catheter. My uterus filled up with clots and I started hemorrhaging in the recovery room. They had to remove them manually, and it was only then that I was grateful the epidural hadn’t worn off.Then more Pitocin and an injection of something else to make my uterus contract.

To try and not make this part too long, I lost a fair amount of blood and felt the effects. And every time I held my son I’d feel worse so I didn’t want to hold him. I ended up getting a transfusion that night (one bag). He spend the night in the nursery because we were so worn out and he was spitting up and we didn’t think we could stay up to make sure he was okay.

The next day he ended up being taken to the NICU due to spitting up. He wasn’t digesting the breastmilk or the formula they tested him with. He was there 5 days. (Saturday and came home on Wednesday).

I was discharged Sunday night but they allowed my husband and I to stay in the room for free for a night since he was in the NICU, so my husband and I went home Monday afternoon (two days before baby).

I had felt panicky ever since the evening after I gave birth (he was born at 9:47 am). The panic wasn’t too bad after that first night while in the hospital, although it was there. They just said it was normal hormones.

I was pumping while he was in the NICU and tried breastfeeding a few times. He didn’t have too much problems with it, but after he came home I had a huge problem with it. And then with pumping. All mental. I stopped pumping/breastfeeding a little over a week ago. Breastfeeding/pumping increased my anxiety 1000x. It was around then I began to get obsessed with sleep also.

I have had insomnia for years. Towards the end of pregnancy, Tylenol PM with Ambien and the occasional Melatonin instead of Ambien got me mostly enough rest. They gave me Ambien in the hospital after delivery and I got some rest in the hospital but not enough. I have Fibromyalgia and really require about 9-10 hours to function well and be free of pain. So I came home sleep deprived. And have remained that way, only getting about 5-6 hours (not consecutive).

With the baby in the NICU still you would think I could get some sleep but I can’t sleep during the day and at night I would fall asleep okay (with Ambien) but even after I stopped pumping during the night, I couldn’t fall back asleep in the middle of the night. And sometimes taking Ambien again in the middle of the night (I think I have built up a tolerance to Ambien also since I am using it much more in the past few weeks than before). Ambien CR also does not keep me asleep.

So then it’s time for the baby to come home. OMG. Cue huge panic attacks. My husband was home for the first week and then had to take off a second week as well, partly without pay.

I do not want to take care of my son and even thinking about doing so starts off panic attacks. I especially do not want to take care of him during the night. I made my husband sleep out on the couch this past weekend with the baby out there too so I wouldn’t have to hear him crying and I *still* slept poorly, waking at 5 am and unable to fall back asleep.

I also keep getting hot flashes and chills and sometimes run a low not-quite-fever (never over 100 and usually about 99.3-6). I’m cold a lot and that just adds to my panic/misery. I’m sure I have anemia and have been taking iron pills. I had a UTI last week and felt awful from that and just finished the last pill of the antibiotic (Cipro).

I have seen my family doctor. I first talked to her on 9/6 when she prescribed Prozac 20mg. I had been on that before, but only for mild depression. She said it would take 2-3 weeks to kick in, so it’s only been a little over a week. This was just part of my son’s checkup so I set up an appointment for myself for the following Monday where the doctor I saw gave me Cipro for the UTI and 0.25 Xanax up to 3 times a day, for 7 days, to use until the Prozac kicked in.

It’s too soon for the Prozac to really kick in, I know, but the Xanax doesn’t seem to be helping all that much anymore. I’m having a lower-grade panic now and more depression. For the past week or so I’ve been nauseous and gag when I try to eat, especially anything bread. I’ve lost 20 lbs since his birth, which was all the weight I had gained. I’m still a little overweight, so it’s not dire or anything but I’m sure lack of food is doing me no good.

I scheduled an appointment with one of the doctors at my OB’s office and it’s on Wednesday afternoon. I’m just not sure how much help he’ll be. Are OB’s usually pretty good about knowing how to treat PPD? Is there anything I should ask him about with regards to making it through to the Prozac kicking in? I spend the entire weekend in bed unable to do anything but lay there in mental misery, so exhausted.

Like I mentioned, the thought of having to get up with him at night and losing sleep terrifies me. So far I think I’ve only (and this during the day) given him a bottle or two and changed one diaper. And those were very difficult for me.

My husband went back to work today and the baby spent the night and this afternoon at my mom’s house (about 15 min away). My husband works 6:30 am – 3:30 pm and it seemed like her keeping him at her house was the best solution. I feel awful about asking her to keep him overnight and during the day for several more days. Not because I miss the baby but because I’m worried about her losing sleep and because I feel like she shouldn’t have to take care of him since it was my choice to get pregnant.

I have completely not bonded with my son. I don’t want anything bad to happen to him but I feel relieved when he’s not here instead of missing him.

I am sure I probably also need therapy in addition to medication but I know that it often takes several weeks or more to get into to see someone for that. I’ve had issues with chronic depression in the past but never of this magnitude. And never with anxiety.

I feel bad about making my husband and mom do all the work of taking care of him. But I feel like I can’t even take care of myself at the moment. I’m not suicidal, just don’t want to be living my new life. I want my old one back but I know that’s not going to happen.

Posted on 9/17/2013
Thank you so much everyone. It is so nice to feel not as alone.

My husband hasn’t been at work for a year yet, so he didn’t qualify for regular FMLA but some sort of emergency family medical leave. I’m not sure of the details.

Seroquel sounds like it might be a good fit for me (I was on Trazodone several years and it didn’t do much, although I realize that since my chemisty is off at the moment maybe it would help). Can you take Trazodone and Seroquel at the same time? If you take Seroquel, do you take something else for sleep too? Does it make you groggy during the day? I read a bit about it (trying to stay away from the DO NOT TAKE THIS DRUG comments) and it seems like you have to take it several hours before bed. Is that true?

The most important question is, will my OB prescribe that? I know they’re all different but as I’ve never gone in for anything other than regular checkups and pregnancy, I’ve never needed them to prescribe anything other than birth control pills. I DO NOT want to wait several weeks to see a psych to get on anything else.

So now I just need for the moment to get through today and tomorrow morning. I’m having a very hard time occupying myself at the moment. Normally I love laying around reading or watching stuff on TV but when I do now, I can’t concentrate and get anxious or over-tired (but of course can’t sleep). Physical activity is hard because of the anemia and I’m still just over two weeks postpartum.

Xanax (0.25) helps with the panic some but makes me tired sometimes too. Is there a better drug I could take for the panic? It doesn’t feel like it fully helps me with the panic either but I don’t want to be really tired all day on a higher dosage. I suppose being tired would be different if I could sleep but I can’t so being tired just really really sucks.

I will also ask the OB about upping the Prozac dosage. I see him tomorrow, two days before the 20th, but if he gives me a new prescription I could wait till Friday to start it. But again, will the OB do that? My family doctor is the one who prescribed the Prozac. Also, since Seroquel helps make antidepressants more effective, if he prescribes that, should I hold off on the Prozac increase?

I know some of these are questions for the doctor, but I’ve had a lot of experiences with myself and others knowing more about drugs than doctors when I had other health problems in the past.

Posted 9/18/2013

I just got back from my OB appointment. He did agree we should up to my Prozac dosage to 40 mg so I will be starting that tomorrow. He also prescribed me Restoril for sleep. I asked about Trazodone and Seroquel but he didn’t feel I should be on them, that while they may knock me out it may not be restful sleep and that trying too many changes at once would be hard to pinpoint any side effects. While I do understand the too many things at once I’m not sure I’m against a drug just knocking me out. Sounds kind of wonderful. He said that he thought upping the Prozac would help and that because of post-partum hormones, that I likely will not sleep well anyway (I will be three weeks post-partum Friday). That I may not get more than 5-6 hours a night. I got about 5 and a half last night and feel awful today. That was discouraging to hear.

He also gave me the number to the mental health services at a local hospital and said they usually call back within 24 hours. So I left a message on their answering system about an appointment.

I also asked about switching to Ativan or klonopin and he said he thought that with the increased Prozac the anxiety would get better and that the hormones would pass.

I feel like he helped but I NEED more than 5 hours sleep to function! I can’t nap. I’m not even sure the Restoril will work. I asked what to do if it doesn’t and he said to call, which I will do. He also mentioned that I could call whenever and that inpatient hospitalization was also an option if I felt I needed it.

I know I’m in a slightly different place than a lot of women here, being just three weeks post-partum and that my hormones are probably out of whack in a different way than someone three months after. Did anyone experience just not being able to get more than 6 hours sleep a day at 3 weeks after birth? I’m not taking care of the baby at night (or at all yet) so that’s not an issue for me.

Ever since he was born I’ve just wanted time to fast-forward to me feeling better (first, from the pain and general recovery and now to the mental reasons). I know that it will get better with time, but it’s hard just making it through each day. At 6 weeks I will go back to work. I work as an independent contractor web developer from home, part-time (usually around 25 hours a week) but it’s a mental job so I need sleep to do it.

I go back to the OB in two weeks, then the week after that I have a follow-up with my family doctor and my 6 week checkup at the OB. I have no idea when I’ll get in with the psychiatrist yet.

One thing he also said is that with my history of depression, I should have been started on an anti-depressant the second the placenta was delivered. I strongly agree.

They also did a CBC to check on my anemia because I said I thought the iron supplements were adding my nausea. He also recommended Flintstone vitamins so I picked some of those up.

Posted 9/18/2013

I’m not handling things well at the moment and just wanted to to get it out somewhere since posting here seems to help me feel better.

I took my regular Xanax dose at 3:30 and while I’m not feeling panic exactly, I’m feeling something bad. I am so tired but if I lay down then I just end worrying about things since I can’t sleep. But if I’m up I don’t feel like doing anything since I’m so tired. I’m nauseous too due to the tiredness and I’m worried about not having enough calories. I just drank a Boost drink and earlier today I had an Ensure Plus and an English muffin with butter. I felt so nauseous a little bit ago that I felt like I had to throw up and tried but nothing came up except some saliva stuff. I just don’t know what to do with myself. I plan to watch Survivor at 8 and then at 9 take a shower, take the Restoril and then go to bed but until then…

I’m also afraid of the Restoril not working and not getting sleep again and being absolutely miserable tomorrow. I know that if it doesn’t work I can call the doctor but then I once again have to go through another day being exhausted and I have no coping abilities at the moment.

Posted 9/19/2013

Last night ended up not good.

I took the Restoril around 10. The dosage is 7.5mg. I started yawning a lot around 10:30 and felt kinda tired. So I went to sleep at 10:45. I think I fell asleep relatively fast and woke up at 12:44 and had to pee. So I got up and did that and was still yawning. I think I fell back asleep but I’m not sure. Next time I looked at the clock it was 1:30. Then at 2 I had to pee again. I was wide awake then and feeling panicky and the doctor had said not to take Xanax since they were in the same class of meds.

I wasn’t supposed to take Ambien either but I was desperate so I took 5mg of one. It took a bit but I fell back asleep until 4 I think, and woke up and fell back asleep (I think) until 5 when I felt awake and took another 5mg of Ambien and am not entirely sure if I ever fell back asleep until I finally got up at 7:45 AM.

I feel nauseus again and tired but less sleepy than yesterday morning. I just took my first increased Prozac dose. I plan to call and talk to a nurse when they open at 8:30. I’m someone who used to sleep to 10 or 11 am so this getting up early is so foreign to me.

Last evening I felt really paniced and thought maybe I should just go to inpatient treatment to see if I could get sleep that way but since it was already late in the evening I figured it would be hours until I actually got a bed and that it might be even harder for me to sleep there. And that I don’t know what it’s like there so it might make me worse mentally in other ways.

Posted 9/19/2013
I called my OB at 8:30 this morning and am waiting for a call back. The local hospital intake (where the psychiatrist is at) called be back at 9:12 but I didn’t realize my phone had Do Not Disturb still on so it didn’t ring and they just left a message. I left a message back. I’m very upset about that. It was a stupid mistake. I also called the nurse back to see if the intake people had called just returning my call from yesterday or if the doctor had had them call but the nurse didn’t know. They said I should hear from the doctor soon unless he got called into a delivery or something and that she had put it as urgent.

Posted 9/19/2013
I have a psychiatrist appointment at 3:30 today. I was amazingly lucky. First they scheduled one for Oct 1 (the first available) but then there was a cancellation and they called me back a half hour later. It’s with a nurse practitioner but she specializes in women’s issues like postpartum. If I weren’t still so anxious, I’d feel relieved.

Posted 9/19/2013

What a difference talking to a specialist makes.

She gave me a prescription for Seroquel (50mg) and Ativan. She wrote the dosage wrong for the Ativan (she wrote it for a non-existent one) but at least I was able to get the important med filled and I still have my Xanax till the prescription can be corrected tomorrow.

She told me to call her tomorrow to let her know how I slept and that there were other things we could try if the Seroquel didn’t help but that it should help.

She recognized right off that it was more than just hormones in my case. The huge life change and the stress (plus the hormone fluctuations) caused trauma from my past to be brought out because my emotional state was so vulnerable and it was all just making me a mess. The trauma was stuff I wasn’t even thinking about in a long while but it makes total sense because it was things I never really dealt with, just repressed.

She said my hormones now are probably at their lowest point and they’ll continue to climb until 8 weeks postpartum and that with their evening out and my meds I should feel a lot better by a month later about my baby.

I am so so grateful to all of you for your support. It has made me feel not so alone. And to know that there was help out there that I could get and also hope for the future.

Posted 9/21/2013

I’d thought I’d give everyone an update.

I did not like the Seroquel. It was 50mg and I did fall asleep with it but then woke a few hours later, then woke again a few hours later. And then finally woke up and just laid there a few hours because it was too early to get up. Each time I slept I had very vivid dreams and a few disturbing ones. I got a little more sleep than I had been but didn’t enjoy it. Then I felt more anxious the next day.

But the psych had told me to call her in the morning and let her know how I slept and that if she didn’t hear from me, she’d call me in afternoon. Well, I called and left a message (and another one in the afternoon about the Ativan mixup) but she never called me back. I even called the receptionist just to make sure she was in the office and not out sick and she was there. I know she’s busy and has other patients but I feel kind of abandoned since she specifically told me she’d call and that we’d try something else if the Seroquel didn’t work.

So last night I tried Ambien, Ativan (it’s a tiny dose…half of 0.5) and extended release melatonin. Then more Ambien at 4:30 AM. Then I woke up around 6:30 and didn’t really fall back asleep. I can’t seem to sleep past 6:30 am no matter how tired I am.

Maybe tonight I’ll try the Restoril again at a higher dosage. Wish I could talk with the psychiatrist. There’s a crisis intervention center number she gave me but I don’t think I’m at crisis stage at the moment.