Tuesday, February 15, 2011

Pain and Mood

In learning lots during the past few years about mood disorders and their functions, I've read that two main things to check for/rule out when it comes to depression and anxiety are low iron; anemia can have a big effect on mood, and thyroid function; also a huge mood effector.
I heard at last year's breastfeeding education day that PAIN can also be a huge mood effector. If a post partum woman has pain from breastfeeding or healing from a traumatic or surgical birth and she is tested on the depression scale, she will OFTEN score as depressed, even if she is not. Chronic or frequent pain is HUGE when it comes to quality of life.
I experienced this myself today, a bit. I saw my OB this morning, and when I left his office I was very happy~he's amazing. How do these people actually come my way, and why don't I appreciate it more how willing they are to accept and work with my 'style?' Two major things about him made me happy today:
(1) He palpated my belly and said, "I just don't think this baby is that big! What do you think, compared to your other pregnancies?"
HELLO? Number one, you just affirmed what I think myself, and what my midwife has said to me several times. Plus you boosted my confidence. PLUS, you just asked me WHAT DO I THINK? As if my judgment and self assessment counts! Counts enough to add to your clinical judgment! Wowsers. This man is a gem.
(2) He asked me, "What should we do if you go overdue?" Number one, you just said "we," because we're in this together and I'm the one who chooses. Plus, you just asked me what should we do, instead of telling me.
I stated that if I go overdue, I think we should do some non stress tests and fetal surveillance, but that I would like to avoid induction unless it's very clearly indicated because of the increased chance of rupture for me as a VBAC.
He said, "I absolutely agree with you."
We are on the SAME PAGE.

So I was so happy. I really don't think I'll go over, I'm not actually worried about that much at all: I have an appointment for March 1st with this OB but I'm pretty certain I won't be at that appointment. Because I will have already given birth. But it's so good we talked about it and agree that induction is not the intervention of choice particularly for VBAC women.

I came home, picked up Riley from my mother in law, and then did my afternoon marathon stint: Brent was at work so I had the kids and all their responsibilities and cares and woes and needs for the rest of the day. I have to manage my diabetes, so I have to exercise. It's hard to fit that in but one of the best ways is to walk to the kids' school to pick them up at 2:30. So I walked. And then when I got home my back HURT like beFRICKINjeepers from the long walk and pushing the stroller, but I had task after task after task to do...by the time dinner came it was mile 38 of a marathon I didn't train for, and I was sitting on the kitchen floor crying while Matthew thumped on Riley and Ayden screamed at me for making him practice his violin and Riley bawled in my arms for having been thumped on, and there was meat in the oven and rice in the cooker but no vegetables prepared yet and my back, my back, my back....

The point is that I felt so drained and cranky and DOWN as a result of my pain that it totally wrecked my earlier positive mood. By the time every kid was in bed I was so DONE that I wanted to scream at every little inevitable "Mommy!" that comes out of the bedrooms each night, even though I normally don't mind. And normally I like to make dinner. And normally I'm quite good at intervening or averting thumping episodes.

I kicked the dog. Like, I ACTUALLY kicked the dog, because I was in such a horrible mood. All from pain! He's on his bed in the living room, watching me with one eye as if to say, "Poor me," and here I am over on the couch blogging as if to say, "Poor me!" I can watch this whole evening with an observational eye and note that it's interesting that pain can affect one's quality of life so profoundly, and now that I've gotten finished with the tasks and tasks and tasks, and everyone is sleeping, and there are no more "Mommy!" calls, and I've been all introverted on the computer? I feel much better. It helps that I'm sitting and no longer have to walk around or get up and down, or get anyone a frickin' knife or glass of water or napkin or more broccoli (both Ayden and Riley are crazy about broccoli, isn't that funny?)!!!!!! It only hurts when I walk around or stand, and only after a long walk or swim or whathaveyou. Gurk. Only a few more days, maybe a week or two, and it'll be over.

Actually, except for after I exercise, I'm more comfortable now than I was a month ago, generally speaking, and more peaceful for sure, and feeling much more confident about giving birth (thank you, most wonderful friends and family, for all the encouragement, and ROB: I just might post a video to make you watch me give birth and traumatize you for LIFE, hobo). Please don't think I'm feeling this way all the time, I'm not at all. I've been getting lots of help from my mom, my mother in law, Brent, and several friends, not to mention my kids themselves, and I'm feeling quite good most of the time. I just found it an interesting experience in the power of pain and wanted to share.

So if you know some post partum women with sore nipples, sore butts, and/or depressed mood, help them out! =) And spread the word: pain hurts.


Doulanic said...

I totally hear you on the pain=depression thing. Makes so much sense!!
Sounds like you're doing very well. Good on you! I read each of your posts with interest ...and I'm hoping your birthing time goes exactly how you need it to.

By the way -- who is this splendid OB? It's good to know who these OB's are ...can you send me an email to doulanic@gmail.com


Jen said...

Reading about your conversation with your OB and how encouraged and confident you are feeling about your upcoming labor/birth makes me cheer! Yay yay yay!! (sorry you're in pain)

Writers of Kosciusko County Jail said...

A corollary is the human capacity to overcome extreme pain, under certain circumstances (ex. birth!). Seems like so much of how we deal with pain has to do with our psychological state at the time, and also, pain can so severely influence our psychological state at the time! Oh, the complexities of being human.

Caryn Ouwehand said...

I love your OB.

Sorry your hurtin'. I would suggest a large margarita... but well ya know...the whole no booze thing, maybe just pretend sip a margarita?...

melissa said...

Tamie, I really think you're right, and that being alone and in pain is far more difficult to cope with than being supported. And those who support you need to understand what is normal and supportive behavior in order to actually support instead of adding to your pain perception. The fact that I was in pain and had task upon task and was with children, who are largely incapable of the type of supportive empathy I needed to cope well, made it worse.

In all manner of ways, isolation makes pain worse. Solitude is golden. Isolation is rot.