The kids came home

My parents were watching the kids most of last week while I was the most laid up after surgery. They came home after daycare on Friday. It was hard for them the first few days to remember that mommy can't pick them up. But they have done really well. I can sit with them and they can sit in my lap pretty well without hurting me.

Owen has far surpassed my expectations. He had some major meltdowns the first day or so because I wouldn't pick him up when he wanted. But I would sit down and hold him until he was better. Now he seems to be the more conscious one of going easy on me. He is much more gentle around me than Elizabeth. And in the mornings, he has me stand up then he takes my hand to go down the stairs together. So cute how he leads me.

Elizabeth has done pretty well but she seems more incapable of controlling her flailing arms and ends up hitting my stomach occasionally. Nothing has hurt too bad, but she definitely needs to work on self-control.

Both have been really cute about wanting to see my owwies; they lift my shirt up and touch the glue on my incisions ever so gently. It makes me a tad sad seeing them play with my tummy knowing they will never get to do that for a baby brother or sister. Not that was ever a plan, but knowing it'll never happen now makes it seem more real.

Surgery and post-op

Surgery went well on Monday. We were one of the first people back in that area and our morning included a lot of questions and waiting. Finally, it was time to get wheeled back. It was typical surgery prep and I don't remember anything from a few seconds after leaving the prep room.

I woke up in recovery and felt like I needed to pee and my legs were shaking although I didn't really feel cold. They gave me meds for the shaking, ice chips, and told me not to think about the catheter and I'll get used to it eventually. After a little bit in recovery, they wheeled me into my room in the women's wing where Spencer was waiting. I got some morphine and took a nap.  I had a rough time getting used to the catheter. I could feel the urge to go and it was just uncomfortable. I was told to lay on my side to help my bladder and colon calm down, so I tried that. Most of the afternoon passed by with napping and pain meds. I got some dinner and ate a some of it.

Overnight, I started getting hydrocodone instead of morphine, which lasted longer. Sleep wasn't great but the meds helped knock me out. The overnight nurse was great. She moved my catheter bag to the ground to help with the flow, and after she did that, it wasn't so bad anymore. The next morning, I got the catheter out and was able to pee on my own not too much later. I also sat up in the chair for a little bit to help with the gas pain. The nurse said that I would get released by lunchtime. Spencer drove me home and got me into bed. I had some jello for lunch and took another nap. The next 36 hours or so went pretty much the same. Lots of sitting around watching tv with the occasional walk around the kitchen or to the bathroom.

Three days post-op now and most of the gas pain has disappeared. My muscles are sore and it feels like there is extra space for my skin or organs to fold oddly when I turn the wrong way (hard to describe). But I can mostly walk upright and get around on my own now. Doctor was surprised I was able to move once she got inside. I'm surprised I don't have more pain from surgery (most of it has been from the catheter or gas they pumped in me). I'm hoping to take a shower today. I keep waiting for the other shoe to drop and my recovery get more difficult. I don't necessarily notice a change in my hormones yet, but I figure it'll happen soon.

Good signs moving forward

I haven't had time to post anything sooner because I have had a lot going on a work lately. I'm in the process of hiring a new staff person, preparing for my presentation on automating authority control (which happened this morning and went well), and tying up loose ends at work. Plus I was out sick with a stomach bug that really knocked me out for a day; top that with two doctors appointments and it's been a busy week for sure. So now that everything seems to have wrapped up nicely, I can finally sit and write this post.

My first doctor appointment this week was to see an endometriosis specialist. I wasn't a big fan of his style, but he really knows his stuff. He explained everything about endometriosis- how you get it, what it is, what causes it to grow, pros and cons of different treatments, and studies on hormones. I had already learned a bunch of it, but there were a few new things I found especially relevant right now.
• Studies have shown that no hormones and estrogen only hormone replacement therapies have minimal impact on increasing one's chance for breast cancer. Estrogen and progesterone together increases the chances drastically. But estrogen gets the bad reputation for some reason.
• While a hysterectomy is not a cure for endometriosis, when combined by excision of what endo is visible, 90+% of patients have less pain. There are complications that can happen, but hearing that eased my fears that this surgery was a bad idea. I should expect to feel better afterwards, but there is a chance later in the future that I might need another excision surgery. I can live with that.
Overall, I feel like I'm on the right track. This appointment gave me more tools for advocating for my own health in the future.

My second appointment was my pre-op admission stuff. I got the insurance break down (the hospital alone charges a crap ton of money let alone the other parties involved). Then I answered what seemed like a million questions with the nurse about my health background. I felt pretty at ease most of the time, especially after the nurse said her son shares my exact birthday down to the year. If that's not a good sign, I don't know what it. She drew blood to run some tests and gave me all of my directions for preparing for Monday morning.

So come Monday, I'll be starting a new chapter in my life, surgical menopause. I will no longer have a uterus or my ovaries or my one remaining tube. No more periods but no more hormones either unless I want to add them back in. And hopefully a life with less pain. It will be a six week recovery process, during which I can't lift more than 10 pounds. The kids weigh about 26-27 pounds each, so it's going to be a long six weeks of not being able to carry them. We have tried working in getting them to walk on their own more the last few weeks and they are doing better. My hope is that they instinctively know they need to behave a little bit better during this time.

Overall, I'm feeling positive about my surgery on Monday. All of the signs the universe has thrown out there have been positive. I haven't seen one negative one. Everything just seems to keep falling into place. Of course, I'm not looking forward to being cut open, but this will be my fifth surgery in a little over 4 years so I know in general what to expect. I'm looking forward to the end result.

How my body has betrayed me

I don't really know how to start this post. I last posted in early April about all of the doctor's visits regarding the pain/infection in my ovary. I did make an appointment with the gynecological oncologist in April and we decided instead of rushing to surgery, let's give the antibiotics a few months and see what everything looks like. I had a few conferences in May and June and the kids' birthday in July, so I didn't want to do anything before mid-July anyways. The pain had gone away and I had started doing the nuvaring back to back so no period for a while.

I went in for another scan in mid-June. The oncologist doesn't do scans in office like my gynecologist so I went to an imaging place. They got me in super quick. The technician didn't describe anything she was seeing, nor did I get to even see the screen. All I could tell about the procedure was that she took at ton of pictures. I wondered at the time if it was normal to have that many taken. I knew that I wouldn't know anything until my follow up with the oncologist.

Spencer had a fair to attend for work during my appointment, so I took my mom with me for moral support. The doctor came in and told us that what's on my ovaries is smaller, but still there and still a decent size. She suspects that the infection and inflammation is gone, but that my endometriomas are still there and rather big. I have two on my left side that are the size of a lime and a walnut and one on my right the size of a grape. She suggested just taking everything out. So at the ripe age of 32, I get to go through surgical menopause. Because of my endometriosis, hormone replacement therapy may not be the best route for me afterwards.

I'm still trying to wrap my head around it all. I'm scheduled for surgery on August 5th right now. I kept debating whether or not to postpone again for a long time, but the pain comes back every now and again. Plus my boss said August would be a good time for me to be out for awhile. I have a consult with an endometriosis expert on the 30th. That's mostly for a second opinion on how to proceed after surgery (i.e., hormone replacement or not). This surgery won't cure me of my endometriosis, but perhaps it can go along way toward easing the pain.

Medical mystery

After a very long doctor's appointment today, I finally am on the road to answers. A week ago, I started to feel super crummy. Just off. I went home from work early and found out I had a low fever. Hubby made me go to the urgent care to get checked out. By then, my left ovary was quite painful and I didn't have any appetite. I was crampy and had a back ache. The doctor annoyed me by asking how I knew the pain was from my ovary when there are several options in that location. I nicely told her I have had endometriomas on my ovary and the pain felt the same as it did when those flared up. She felt around my pelvis area and then had me leave a urine sample. She diagnosed me with an infection (probably UTI) and put me on antibiotics. Said follow up with PCP or gyno if it doesn't get better.  I spent another day and a half at home in pain and taking my antibiotics. I felt okish by Friday and over the weekend, although I had pain and a low grade fever off and on still.  Urgent care called back and said my urine culture turned out negative but to keep taking the antibiotics. Friday, I also started a period about two weeks early. So while bad timing, at least it helped explain some of my symptoms.

Monday, I finally got to see my PCP. She said my hormones are probably out of whack and that she wants to run labs and do a scan. She figured my gyno would want to do all of the same things, and since I already had an appointment for tomorrow, she was just going to wait. I asked her to do the blood work now so I can get the results that much faster. I'll insist on the scan at my appointment on Tuesday.

My appointment with the gyno was way more involved than I expected when I made the appointment months ago. It started as a well woman exam. She found a huge polyp to remove, about the size of my pinky finger tip. She sent me for an ultrasound next. There the tech didn't describe much, but I noticed her measuring a cyst on my right ovary that was decently big. Then by the end of the exam, measurement stats popped up on screen. My left ovary measured 3 times bigger than my right. So I was told to wait for my doctor again to go over results.  Turns out that my pain doesn't seem to be endometriomas like I thought. I have a bunch of cysts (I also have PCOS so I'm not surprised by that news) and an infection. They can't do an exploratory laparoscopy until the infection is gone. So I'm back on antibiotics for two more weeks. Then no surgery for at least 6 weeks after that. In the meantime, I have a referral to see a gynecological oncologist. My doctor feels that given my history of endo and now this random infection, that if I'm done having kids, then maybe just take everything out. I was already prepared to fight for this option just because of how much pain I've been in every month. Now that it's a real option, it seems so much bigger.

So, I have some answers. We need a few more. And I'm going to do my best to stay in the present and not worry about the future.

Weekends

Each week, I seem to want to live for the weekend. Life during the week is just so busy. We get up, go to daycare/work, go home, eat, play for a few minutes before bedtime. Then Elizabeth takes an hour or two (or three on a bad night) to put to bed. By then, I'm exhausted and often just ignore the mess in the kitchen and fall into bed instead. The weekends are time to catch up and play, to have fun. But these two kiddos require so much attention right now (read as they cry unless mommy sits with them), so not much gets done. We try to take the kids out to a store or somewhere different in order to wear them out, but that wears out everyone and the adults don't get to nap.

I suppose this is a new normal. The routines help and eventually E will get better about going to bed and we will have more time in the evening to get a few things done. Just hope that comes sooner rather than later.

PPD, PPA, PPT?

Haha. I made that last one up. (In my mind, it'd be Postpartum Tired.)  But seriously. I want to write about my experience with postpartum depression and postpartum anxiety.  Partially as a way to cope with my feelings and thoughts, and partially as a way to share in case someone else can see similar symptoms in themselves.

I finally broke down and admitted that I don't feel right around December (I think).  I'd go to the doctor's office and end up have a small, teary melt downs. I'd blame it on lack of sleep and stress and that's how I usually function at a doctor's office (I hate it, but I've always been that way).  I think the visit that finally led me to admit defeat (not the best term, but all I've come up with right now) was for tummy problems.  Without getting graphic, I was having way more upset stomachs than I usually do.  Looking back now, I'm pretty sure it was stress related.  The doctor offered to run some blood tests and check me out.  Everything came back normal.  But while describing the pain, I broke down crying. This isn't uncommon for me because I'm so stubborn that I usually end up visiting the doctor as a last resort and when I've finally reached by breaking limit. So if I'm there, then you know it's bad.  

The doctor kept asking if I was sure I'm okay and if I've been depressed.  And here's the thing- I didn't feel like I was.  I didn't really have many negative thoughts or self-harm thoughts.  I was still rather cocky about my ability to "handle" everything. I didn't usually feel down or sad, but I would cry more easily at stupid things. Maybe I'm not sure what the official definition of depression is or I was in denial and blaming things on being tired (my twins were only 5 months old, so of course I'm tired) or hormonal (I'd recently given up breastfeeding/pumping, not to mention pregnancy and my PCOS before that).  I didn't get to do activities because of the kids, not because I didn't want to.  But after being asked by at least two doctors in less than a month if I was depressed, I decided to admit that maybe I am a little bit. (Although to this day I still think of it as more anxiety than depression; perhaps that from society placing such a negative stigma on depression, who knows?)

My doctor had me fill out a questionnaire to measure my depression level.  Imagine the surveys in Cosmo about what kind of wedding dress to buy based on what cake you pick or your dream guy based on your dream date.  I don't remember all of the questions exactly, but many of them were hard to distinguish between am I saying yes to this because I'm depressed or because my kids don't let me sleep or have time to do anything.  I think my score came out rather high, so probably moderate to severe depression.  The doctor gave me a prescription, told me about the side effects, and told me to come back in a few weeks to see how I felt.

OMG the side effects of starting a depression medication suck!! Stomach cramping was the worst, as well as an immense level of fatigue as my body tried to figure out what to do with the changing hormones again.  But as I grew more accustomed to it, I realized I was no longer crying over stupid things and I felt more calm.  Things were getting better and I felt like I could cope better. 

A month or two in, the "month of sickness" struck.  The kids had started daycare and their immune systems went down, taking ours with them.  We all took turns getting sick; I think everyone missed at least one day of work/school each week.  With my parents out of town, it was a fight for survival. The bare minimum was accomplished each day. And my stress levels began to increase.  I'd find myself having anxiety attacks occasionally- usually in the car, sitting in traffic while one or both kids cried.  My nerves would be frayed and I'd just tense up and not be able to calm down.  I might shake some and my heart rate would increase. Breathing seemed more labored and my appetite would disappear.  After the second one of these in two weeks, I called the doctor and we upped my dose.  Things got better briefly, then another major stressor a few months later hit. I think this time the kids were teething and fussy more often.  Things at work were kind of crazy too. Panic attacks all over again.  Upped my dose to the highest level and it seemed to help. 

For a while. During my period, the hormones would take over and cause my meds to be less effective.  I'd find myself clenching my jaw unconsciously. I was stress eating (or not eating sometimes). Dr. Pepper became water for me and I was lucky to convince myself to drink a glass of water a day.  I used to have a very strict one soda a day policy, but I could not help myself now.  I drank coffee, which I hate unless there's more sugar and milk in it than coffee!  I went through huge bags of candy way too quickly. I'm so glad it's not a candy holiday for a while; but I've recently started to raid my baking supplies for chocolate and icing (Don't judge too harshly please).  

Memorial Day was particularly stressful because the kids decided they no longer needed to nap that weekend. I forget what we did to throw them off their schedules so bad, but I remember wanting to leave and not come back.  I was ecstatic that my girls trip with my mom and sister to California was the next weekend. I was finally going to get a break! And it was nice to get away.  But I realized that I was eating way more than I should and when I came back, things hadn't improved much. I was still stress eating sweets and having thoughts of being a failure.

Back to the doctor's office; this time, she gave me a new prescription to try.  The stomach pain was miserable during the adjustment phase.  And I'm still stress eating and drinking Dr. Pepper like it's water.  I kept getting dizzy with this new medicine too. It's the strangest feeling of numbness in my extremities for about a heartbeat, accompanied by a faint, dizzy feeling.  I feel weak and ready to pass out at any moment, but don't.  I go back again this week and plan on telling the doctor that it's not working.  I have little patience with the kids unless they are perfect angels, which isn't going to happen while they are teething again.

I'm tired of this. I just want to feel normal again. Part of me doesn't even remember what normal feels like.  I'm back to crying a lot and just feeling like I can't handle life (not in a suicidal way, but more of a childish-run-away-from-my-problems-and-not-look-back way).  I'm struggling to find the will to turn off Candy Crush and get off my butt to clean the kitchen or cook dinner or do laundry.  I want to go out with the kids and immediately regret it when it becomes slightly difficult or they start whining. Life with twins has gotten so much easier, but also so much more complicated as they get older (that's a whole other post in itself).  I'm slowly rediscovering things that make me feel normal (like reading a book or cooking).  I think it's just going to be a long hard process.  In the meantime, I'll keep trying to get creative with the ways I cope and lean on friends and family and the fun times to get me through the rough times.