Thursday, August 18, 2011

Getting back into shape: Embarassing and True tales

Sooooooo I just got back from a run.

I haven't run in like 10 years. Seriously. It's been since high school, unless you count pool runs in college. Which i suppose are pretty hard, and demanding. OK, then it's only been 8 years.

I just discovered that I walk a mile almost as quickly as I jog one. Specifically I walk a mile in about 15 minutes, and I run one in about 12. High school me would be ashamed.

High school me would also kick current me's butt at crunches, leg presses, swimming, and volleyball. Current me's only consolation is that current me would kick high school me's butt at tricep extension, bicep curls, toe presses, and walking in heels. Also bicycling, but that's kind of skewed, since high school me couldn't ride a bike.

If the title and content hadn't yet tipped you off, this entry is about working out postpartum, and what I'm trying to get back in shape. I haven't been "in shape" in a very long time. In high school I might have been slimmer, and may have had better aerobic stamina, but I was by no means "in shape." I was more interested in how I looked than how I felt, and while I wasn't starving myself, per se, I was restricting calories more than I needed to, because I didn't want to let people see me sweat in P.E. but was unwilling to give up my dress code of ridiculously short dresses and purple fishnet stockings. My average breakfast was a piece of toast, my average lunch either a piece of fruit or a bagel, occasionally half a cafeteria-portioned salad. Dinner was the only meal I would actually eat a decent amount of, but that was counteractive because you shouldn't eat large meals at night, you should eat them early to give you fuel for the day, or else you should graze constantly.

So I've pussy-footed around my current shape enough, and in the spirit of being brutally honest, I'm about to admit a few embarrassing details, so I can get them out there and start to love who I am a little better.

According to my doctors, I am obese. They have their numbers and their BMI and all sorts of things that tell them that I am obese. I am six feet two inches tall, and they say I should weigh between 140 and 190 pounds. Let me state for the record that the last time I weighed 140 pounds, I was five feet eight inches, and thirteen years old. Now I am not delusional, I know I'm not in my ideal weight category, but if you know me, you know I'm not really that bad off. What you wouldn't know to look at me is that before I got pregnant I weighed 265 pounds. I then lost 15 pounds, which I gained back before I put on another 15 pounds. As such I can actually say "I gained 15 pounds during my pregnancy" and it's not a lie. However, I am considered obese, so that's supposed to be normal.

To be clear, again, I am six feet two inches tall. I have a classic hourglass figure to go with that, and broad shoulders. I also wore a size triple D bra before I got pregnant. If you were wondering, I now wear a size H. I did not even know that existed last year. So yeah, I have some fat on me, but to be honest, it was never troubling, except when I was clothes shopping. No one makes clothes for women as tall as I am, so if you don't have thin little pixie legs you can't find a dress, since they're ALL short, and if you manage to find a good pair of pants you should buy four or five pairs, just to be sure you'll make it to the next time you find well-fitting pants. Wearing I size 20 on the hips, a size 14 top and having a size 16 waist does not make life easy. Unless you have that perfect knee-length flare-skirt dress with the halter top and the waist you can cinch in with the ties. PS, they stopped making those.

Anyway, back to working out.

I have decided that this year I need to really try to get into shape. Breastfeeding has helped me drop some weight (I'm down to 245; if you're good at math you know this is less than I've weighed in a long time) and I'd like to not only keep it off, but send it to its new home with maybe another 45-55 of its closest friends. I swear, this has nothing to do with my ten year high school reunion. Which is this November. I swear, nothing at all.

So the husband has been talking about this "Couch to 5k" running program which conveniently takes 9 weeks. I get the go-ahead to actually EXERCISE next Thursday (hopefully) so I thought I'd be pro-active and start with some simple short jogs, just get in a few before I really start this "program" they have set out. Today was the first of those, and I am sad to say I cannot jog a mile without stopping. However, it appears I can jog for about a minute, then walk a minute, then jog a minute, etc. ad nauseum (not literally, thank goodness) and then get home, sweaty and hot, drink a liter of water, and sweat some more. Then, being the masochist I am, on my "off days" I can go for 4 mile walks and do crunches with the hubby.

After two days of this I can tell you, my legs feel like jell-o, my abs burn, and I'm freaking FAMISHED. It doesn't hurt that breastfeeding, in and of itself, burns 200-500 calories a day (source)  which is supposedly comparable to running a few miles. I'm burning more calories than I'm consuming, and the weight is starting to come off. I'm already fitting into jeans a whole size smaller than I used to, which is nice, but more importantly, I have a ton of energy when I'm not totally wasted from exercise. Which I use to carry the baby, stay up late rocking the baby, feed the baby, and learn to do new things one-handed. Which is why current me's arms are SO much stronger than high school me's arms. That and carrying Costco sized bags of cat food and litter.

My goal in the next few weeks is to start the C25k program in earnest, and then to add in a bike ride once a week, amping it up to two or more a week by October. Combined with the Gillian Michaels work out that Angela has started and wants me to join in with, this regimen should get me in the best shape of my life by next year.

Assuming I don't die of exhaustion before then.

Thursday, August 11, 2011

Too tired, can't think of witty title

Last night was hard. When I say hard I mean I broke down crying more than once, and finally figured out the line of questioning they give you at the hospital.

I'm going to sound like a horrible mother saying this, but I promised to be completely honest in this blog, and I'm going to stick to that.

When you call the hospital because something is wrong, if you're a new mother, they always ask you if you've had any thoughts of harming yourself or the baby. Last night, around 5:30 am, on two hours of intermittent sleep, I broke down crying. I sat there and stared at my baby, with tears running down my cheeks, listening to him wail for what seemed like absolutely no reason, and just wanted it to stop. I would have done almost anything for just a few hours of quiet and some sleep. Anything. And that's when it hit me. This is why they ask. Because at some point you will be staring at that open, crying mouth, ready to suck the soul and brain out of you along with the milk, and in a half-delirious state you will think "I need to put the baby down or I will do something I shouldn't" but there will be no "putting the baby down."

Newborns don't cry for attention they way older babies do. There is no 'letting him cry it out' for newborns. Newborns cry because something is wrong. If you let a newborn "cry it out" you get a newborn with a sore throat, which makes them cry harder, on top of what was originally wrong.

There are 11 reasons why newborn babies cry. They are:
1. Hungry (duh). Most people see this as their go-to fix-it for newborns. Not a great idea. This can teach a baby that food fixes everything.

2. Tummy Problems. Most babies will cry to be burped at some point. They will also spit up, which can be mildly distressing (who like puking, srsly?) and then there's the dreaded colic.

3. Too cold

4. Too hot

5. Too much going on. Everyone needs so quiet time in their lives.

6. Not enough going on. The womb is a loud loud loud place. Sometimes babies need a ton of white noise to calm down. Sometimes they just get bored.

7. Need to suck (different from being hungry). Sucking releases a hormone called CCK, which calms babies.

8. Hair Tourniquet. Check your baby's hands and feet for a hair wrapped around a finger or toe. A hair tourniquet can cut off circulation, and be very painful. Babies don't have the coordination to unwrap, and even if they did they wouldn't understand where the pain is coming from.

9. Need to be changed.

10. Need to be held. Please realize this is different from wanting to be held. There was a horrible study done in Germany where they gave babies everything they "needed" excepting physical affection. The babies died. Your baby needs to know you love him/her. They need to be held and hear your heartbeat every now and then.

11. Actually sick or in pain. If you've tried everything else on the list, take your baby's temperature, assess how long (s)he has been crying, and call the doctor. At the very least, you'll get some sort of reassurance that everything is actually fine.

Now, with all that covered, let us return to 5:30 in the morning. When everything has been tried, and you know your baby isn't sick, and all you want to do is sleep, or cry, or wheel the bassinet out onto the balcony and go back inside and put in earplugs and drink a bottle of wine... ask for help.

You don't have to be strong enough to do this on your own. No one is really strong enough to do this on their own. People who try go completely insane and end up driving their cars into lakes. You have to be strong enough to ask for help. You have to be strong enough to take a deep breath, put aside your pride, and say "I can't deal with this right now. I need sleep. I need someone to hold the baby/wash the dishes/make dinner/ do the laundry/clean the cat boxes/do the shopping because I need to go take a shower and cry my eyes out and then take a nap"

And that takes more strength than some of us have. I am particularly prone to trying to tough it out. When I told my father for the first time that I was pregnant, he told me that there would be no shame in not having the baby. That terminating the pregnancy would be ok, no one would think less of me, and that it didn't mean I wouldn't be able to have kids later, when I was more prepared. Now, I may be LDS, but I am a relatively progressive liberal moderate, and I'm pro-choice, but I realized something. No one ELSE might think less of me, but *I* would think less of me. Knowing that it was going to be hard, I decided to see this through, and have the baby. So of course I feel like i have to live up to that. I said I was going to do it, and I knew i was signing on for no sleep and crying babies and gosh darn it, that's what I'll do. I'll deal with it myself.

Except I can't. I need help. And there's no shame in that.

So on the 25th when I go see my doctor for my 6 week check-up I'm going to talk about postpartum depression, about feeling overwhelmed, about tears that crop up for no reason, and feelings of inadequacy. I'm going to express concern about medication, but I'm going to listen to what she says. And hopefully I'm going to feel better.

Tuesday, August 2, 2011

The Worst Thing About Mastitis is Everything

In honor of World Breastfeeding Month (August) I'm trying to post something boobalicious every time I post. So even if I post something purely anecdotal, like "OMG MY CATS ARE TEH CUTEZORZ" there will be a follow-up post having to do with those fabulous mammalian feeding appendages.

Today we're going to talk about mastitis. Which I apparently have. Let me just start by saying ow. Like, really. OW.

Mastitis is an infection of the breast, occurring in breastfeeding mothers. It's usually linked to a lack of constant schedule for feeding, or going too long between feedings. When there is prolonged engorgement (remember, fetish video comments?) the breasts will sometimes become infected. However, it's important to point out that some women just get mastitis, even if they are feeding their baby every two hours like clockwork. Some of us are just prone to infection.

The first stages of mastitis are quickly onset, and involve temperature spikes and flu-like symptoms. In the course of one day I went from happily taking walks and going to birthday parties to vomiting, a fever of 103, violent chills, and body aches. And of course your boobs hurt. Like really, really hurt (although that didn't catch up with me until today). Other markers of mastitis are peeling skin around the nipples, and reduced milk production. Of course some of us lucky ladies get feeding chafe anyway, so the peeling skin is hard to notice. And there are also those of us to whom the reduced production does not apply for a day or two. I actually pumped 7 ounces right before I left for the Emergency Room.

Yeah. Emergency Room. I'm sure by now we're all aware of exactly how I feel about being in the hospital. And we're also aware of how long Kaiser can leave you waiting in those tiny little rooms while they run around doing more important things. Of course in an ER it's hard to argue that you're more important and require more urgent care than, say, the 6 year old who got kicked in the collar bone in a jumpy-house and now can't lift one of her arms (she came in while they were triaging me) or the 85 year old woman who fell in her kitchen and was there for several hours before anyone found her (gleaned from nurse conversations in the halls) or even the mysterious and strangely beautiful Latina lady across the hall who speaks no English.

They started by checking me for everything BUT mastitis. My mother was with me, and she said that if I had mastitis I'd probably be talking about the pain more. My mom had mastitis and she said it's very very painful. So far it hasn't really been that bad, but Angie says it's probably like giant boob back pain. You don't really notice it because you're used to it. It's just when someone makes it STOP that you realize how much it hurt. So similarly if my breast has been hurting for a while, but only increasing slowly I wouldn't notice it nearly as much. Also I have a pretty good tolerance for constant pain, it's just surging or stabbing pains that I'm a wimp about. But they (and I, as well) figured that if I wasn't complaining of breast pain it probably wasn't mastitis. I didn't have any red or hard spots on my breasts, and while I had been vomiting and had had some diarrhea, I had also had a particularly spicy burrito made by a new guy at my favorite burrito place the night before, and was not particularly surprised by either. As an aside, let me say that if you ever order anything called "devil sauce" you expect it to burn. I am no different, and when I don't order the Salsa Diabla, but it shows up on my burrito anyway, I don't just throw the burrito away; I eat the delicious 12-chile-sauce-smothered-chicken with a slightly apprehensive, but appreciative smile on my face, knowing full well I will probably pay for it in the morning.

After being checked for everything from pneumonia to endometritis (different from endometriosis) complete with chest x-rays and pelvic exam (check it out, that's extra special uncomfy when you're all sewn up down there) they checked the urine sample I had given them four hours prior. The initial results were that I had a UTI that was asymptomatic due to the amount of medication I was on, and the postpartum dilation my body was experiencing. Women who have recently delivered vaginally are usually dilated in the vaginal, cervical, and urethral areas for a while after the birth, which can lead to UTIs that fly up to the kidneys instead of creeping. Frequently postpartum women don't know they have a UTI until it start affecting their internal organs.I was excited to be out in so short time, and to have only been stabbed twice, once for an IV and once because she couldn't get the IV in the first time. I am still a hard stick. They sent the rest of the sample for the lab for the final results, and told me they'd be setting me up with some antibiotics soon.

You may notice, however, that this post isn't about nearly missing kidney infection, or uncomfortable peeing. So I'm sure a smart person like you can figure out what happened next. The results from the lab came back both corroborating and negative. Corroborating in that they did indeed find skin cells and white blood cells in my urine. Negative in that they did not by any means find a large quantity of either. So they decided I couldn't go home, and they were going to need to stab me several more times. To make it better this time the stabbing wasn't going to be anything as nice as an IV in the crook of the elbow. They needed full blood cultures, so they needed to find multiple sites that were uncompromised, so they couldn't use the saline lock that was already in my arm. They needed to find new and exciting places to stab me. They chose the backs of my hands. And they needed to rigorously clean the area before they went in with the needle.

Now, it's not that I don't understand the word "rigorous," but for some reason I was still envisioning little wipes or something, not a full exfoliation with a hard white sponge and skin-bleach. the upside is the back of my hands currently feel similarly soft to Elliot's. However, that kind of rigorous cleaning left my hands really and truly sensitive, and they were still recovering from the blown veins from the LAST time I was in the hospital, so this was extra special painful.  Like "lower the head of the bed because the combination of finding out that I'm not going home, haven't eaten in nine hours, haven't fed the baby in seven hours, am in the hospital again, and am sleep deprived on top of now being stabbed in a newly sensitized area has brought me to tears and they don't want me to hyperventilate and pass out" painful. It was new and exciting, and somehow still not above a 5 on the pain scale. It was like somehow my body did not recognize that this wasn't that bad, and was channeling my 3 week old baby, looking for a more appropriate response than taking cleansing breaths.

After all that they did another breast exam. We're now at the seven hour mark. I've been through chills so bad my hips have seized up, I've had radiation poured into my body via X-ray, I've been stabbed too many times, they've put all kinds of instruments in me, I've been tempted with "you can go home soon" only to have that hope dashed against the floor, and now they're re-doing the only real non-invasive test they've done. And THIS time they decide my breasts look aggravated, and that there's some localized swelling and hardening. Never mind that I haven't expressed milk in almost 8 hours because "this won't take long, we won't need to bring you a pump," and the course of action for mastitis is almost EXACTLY THE SAME as the course for a UTI.

They tell me they're going to confer with the ER attending, and try to get my discharge papers and prescriptions rushed. Guess how well that went? If you guessed "not too well, actually," you get a prize! I left the hospital after having been in the ER for 9 hours, with directions to take my pills every 6 hours for the next 10 days, to feed or pump every 2 hours, and to get lots of rest. Someone, please, explain to me how I can be awake for half an hour out of every two and get lots of rest at the same time?

So I'm currently trying to be a good patient. I'm waking up every two hours in the middle of the night to feed Elliot what tiny amount of milk I can produce in that time, then staying up with him til he falls asleep again, which usually allows me 45 minutes of sleep at a time. I'm taking my pills at 4 and 10 and 4 and 10 again. My right breast actually DOES hurt now, and there seems to be an actual blockage in there somewhere. I'm constantly waking up covered in sweat from the repetitive fever which goes up to just under 100 and then breaks, several times a day. The funny thing is that other than the fever there wasn't much going on in the way of proof of infection. But of course, after not expressing any milk for almost 10 hours I think any new mother would get mastitis.

Monday, August 1, 2011

Heeeeeeere Kitty Kitty Kitty...

So E came home (duh) a few weeks ago, and I haven't posted anything about his interactions with the cats. I have heard from several people that this will not do and I need to post some kitty pics and baby pics and kitty-and-baby-pics. And, you know, talk about introducing them.

The day we came back from the hospital was kind of crazy (as previously explained) but it was surprisingly easy to introduce E into the home. We left him in his car seat, and brought him into the living room, and put him on the floor and just sat next to him while the cats came and checked him out. Squeak had little interest, really, and Moo just kind of sniffed around. Chimi seemed interested, but was keeping his distance.

Over the next few days we had some one-on-one time with E and the cats, letting Moo and Squeak into the bedroom for limited amounts of time to sit with us while we held E. Moo is now perfectly happy with E, and likes to sit on the bed and watch while I nurse him. I think it's because babies smell like milk.

Strange aside, actually; one of the few times I've seen Moo, Squeak, and Chimi all happy to be in the same place was when they were all hanging out with E while E was in his Crack Chair (My little Lamb Infant Seat) napping. Chimi's a little hard to see, but he's there to Moo's left.
The cats have also been learning new tricks from li'l E. Chimi in particular has learned to mimic his "feed me" cry. The first time he did it was priceless. I was sitting in the rocking chair, and E was crying, a very rhythmic and now unmistakeable "I'm hungry" cry. Chimi was sitting by the couch, watching intently. As soon as E gets his mouth full, he goes silent, and Chimi lets out the perfect imitation of him, and looks at Angela with his hopeful food eyes. It took him a while to get his food, as the laughter was in full effect for several minutes.

It makes me hopeful, seeing the cats getting along better with E in the house. Who knows, maybe his perfect-baby calming effect will last his whole life, and I can say "Yeah, I'm the mother of world peace."