This post is the longest one I've ever posted, and it's taken me weeks to write it. So go to the bathroom, and then get a snack, THEN read it, please.
Two bad things happened day before yesterday, first, I left a comment on someone's blog and accidentally put in their husband's real name instead of his pseudonym, and they deleted the comment of course, and I understood completely. I'm still mortified I made such a mistake. I'd be upset if this happened to me on my blog. Then, second thing, I had an online chat with someone and said something incredibly rude and inappropriate. Both times my intent was good, I was trying to communicate my thoughts, but my implementation was terrible.
I wasn't going to blog about this subject at all, but I can't stand people thinking I'm trying to hurt them, so I have to explain what's going on. I'd rather be humiliated and judged, even hated than be thought of as unkind to people I care about.
The judging by the way, will not be outwardly, but quietly, there will be fewer clicks, there will be fewer subscribers, there will be a general sort of----lack of respect that will follow. Like, hey, "we don't think Aurelia really belongs in the club now", you know, The Club of Women who will Make ANY sacrifice, even their sanity, to have a Healthy Live Baby. Or maybe there will even be a few people who might think I belong in the group called, Women who did something suspect, something WE would never ever do, and that's why she has dead babies.
I get the judgment, because when it comes to infertility and loss, there MUST have been something I did wrong, and if I was just a little more perfect, my babies would've been alive, right? All throughout my life, I have blamed myself quite thoroughly for all that bad things that have happened to me, something a lot of women do to themselves, I think. I'm trying not to do that anymore, it's not helpful to me, I know. But I can't control what you think, and I don't want to beg you all to like me, something I know I could do in a flash.
Sooooo, right here, right now, I'm giving you permission to walk away, no issues. If you don't understand what I'm about to write, or you don't get it, feel free to ask questions, wonder out loud, or even link to me and call me a fucking ungrateful bitch. (Okay, I will shrink in internal agony if you do that, but you still can do it.)
And no I'm not fishing for love and compliments and comments. I swear.
A couple of weeks ago at Motherisk, I had a two hour meeting in person with a couple of experts on medications in pregnancy, and what they do and what they mean, and what all the medications I have taken will mean for this pregnancy.
Including Adderall and Dexedrine.
For my ADD.
You know, that imaginary disease du jour, one that causes me a lot of problems, like car accidents, and falling and breaking bones, and choking on food, and tripping, and getting lost, and mouthing off to people I like in completely inappropriate ways, and hey best of all? Mind-boggling, overwhelming, crippling, anxiety as I watch myself publicly fucking up every moment of my life, and know I am unable to stop myself.
Life was simpler all those years ago before diagnosis, when I thought I was stupid, or just a bad person. (Not happier, but simpler.) I just wrote myself off, blamed my obviously poor character, and kept living. Finding out I could've been helped all those years ago, and that my life didn't have to be shit, produced an overwhelming grief reaction for so long. Sadness at knowing that I wasn't really stupid, that I didn't have to a failure for so many years----oh I wanted to die for a long time. The memories of so many humiliating moments, so many missed opportunities, things I wish I could erase from my brain.
Knowing it's a disease, a neurological disorder and that there is a really effective medication can be a gift when the world accepts the treatment and embraces your "bravery". You know, like they do with some diseases of the body? The public still avoids sick people like the plague, but at least no one tells them their disease is made up and calls them drug addicts. Mental illness, much like infertility, gets the short end of the stick. Over the years, awareness is getting a tiny bit better for both conditions.
But when it comes to treatment of mental conditions during pregnancy and infertility, it's the dark ages. We're all supposed to suck it up and cope.
Motherisk has done a lot of research over the years into antidepressants and pregnancy, and many of them are well studied and completely safe. (Go to the link for specifics, or call them directly), and as long as your doctor avoids the offensively out-of date and medically irrelevant FDA pregnancy categories from the US, most women who are depressed and need medication can get antidepressants.
But it doesn't work that way for ADD. Almost all the literature on stimulants relates to street drug users and people who used many different types of drugs mixed with alcohol, leading to the assumption that properly prescribed and dispensed ADD drugs were just as dangerous as the crap bought from a drug dealer mixed with drain cleaner and baking soda. It doesn't work that way because most people think ADD is no big deal and only an issue in the classroom, and they assume it can be left untreated in pregnant women. And so in 2003 and in 2004 I was told not to take it, because it would hurt the baby, and so I stopped the millisecond conception occurred.
And both times, my children died.
Since then, I have learned that almost everything I was ever told in the past by GPs and REs about the causes of pregnancy loss and infertility was medically inaccurate, poorly researched guesswork, a patchwork joke that proves no one gives a damn on this planet about women's health.
Motherisk isn't perfect, but it has better information than most sources. They have a worldwide consultation group on reproductive mental health with names listed here, of professionals all over the world who prescribe psychotropic medication for women in pregnancy. I have to admit, my eyebrows went up at the list, since I know some of my favorite bloggers go to hospitals where these doctors work.
This is the official stand of Motherisk on ADD drugs in pregnancy. My appointment was with the second doctor on the list of authors, we'll call him Dr.Two. In the article, I found it a bit offensive and disturbing that drug abusers were even mentioned, after all no-one discusses heroin addicts when a prescription for surgical morphine is written, sigh....but whatever, I've come to expect it. And at least the article mentions that there are too many confounding factors like alcohol use and dosage issues to include those drug abuse studies with any credibility.
The key for a good study is to find large groups of women who were perfectly healthy for all intents and took stimulants during pregnancy for whatever reason. Something unlikely to ever happen in an ethical world, right? Nope, surprise! In the 1950s, 60's and 70's it was quite common to prescribe dexadrine and dextroamphetamines to average pregnant women, so they wouldn't get FAT while having babies. Can you freakin' IMAGINE?!?! (If anyone is surprised by women having body issues, they just need to look to our history....fuck, the things the medical profession does to women....) They quote studies of 10,000 women total, but Dr.Two told me there were hundreds of thousands of women who took these medications, and never had malformations or a higher rate of miscarriage then the rest of the population. Only problem is that both the group on the drug and the control group drank plenty of martinis and smoked cigarettes, and the stats were not quite as well gathered as they are now. Many women had early miscarriages and never knew since there were no home pregnancy tests back then. They just assumed their period was late and never got any medical attention.
So Dr.Two was concerned that some of these women could've had early miscarriages but no one attributed them to the drug. We then had quite a lively discussion about how he was making assumptions he couldn't prove, and of course, I wanted to know how the women would've taken the drug before even going to the doctor and getting a scrip. See, back then, no one showed up at the OB's office for their first appointment until 3 months, and so unless they kept a few in their cupboard, they would not have had any to take. Hell, even if they did take some, anyone further along than 8-9 weeks pretty much needed a D&C after a miscarriage, since misoprostol didn't exist, and of course there would've been a record of what happened then, and it would've been counted.
We talked for about two hours, and discussed every symptom, every implication, every OCD, hyperfocused obsessed issue I could bring up. There is very little evidence on ritalin, except one study on narcoleptics (no malformations, no risk of problems) and no evidence on Strattera at all. (It's not a stimulant, but something chemically very different, so I'm not taking that at all.) Wellbutrin might be safe, but I don't like the study they did, and clonidine has the same issue. Besides Wellbutrin and clonidine don't work for ADD very well. Why bother to take something ineffective? Pointless....
So I have been on and off of my meds for the past 13.5 weeks. Various Doctors have lectured me, my husband has told me just to go off it and we'll cope, and I have been terrified to tell any of my friends I've even taken one pill. Somedays I take a 4 hour pill and other days I took an all day time release, but I'm trying not to take those too often, mostly because of guilt.
Except we're not coping and my family is falling apart, and I'm afraid to talk to my friends in real life for fear I'll say something wrong and they'll hate me. And yes, I'm afraid to comment or chat online when I'm off my meds. I can get the cleaning lady to come in more often, and we're hiring someone to help put up christmas lights, but no-one can replace me as a mother, and I really do a dramatically better job at momming when I'm on my meds. I'm stressed and anxious and I have no freakin' idea how I'm going to make it through another 6 months, never mind adding breastfeeding time.
You may wonder how I made it through my pregnancies with Kaz and Mac and Matthew? Pretty simple....I assumed I was simply insane due to hormones and probably even a bad mother. I spent loads of time in therapy trying to cope, all of it useless. I went through some postpartum depression after Kaz was born, mostly due to feeling helpless in the face of the overwhelming responsibility I felt.
In the end, I don't know what to do. I can't cope without the meds, and they are medically safe if I go by Motherisk's assessment.
But my husband will soon lose his mind or divorce me, my children will have been late for school every damn day this year, and I will have enough bloody broken bones to start an anatomy museum if I don't get myself together.
If nothing else though, I'm definitely going to stop comparing myself to those Fifties housefraus. Poor things....life really did suck back then. I have officially learned why Martha Stewart is an unattainable goal.