Home » FET#4 » Happiness Cycle Day 14: Downtown

Happiness Cycle Day 14: Downtown

DW took the day off work today, as we had a day of medical appointments, in town and out of town. She has also been so busy and overworked so far this semester that she really needed a “mental health” day as well.

I must mention that I finally had a good sleep last night, after almost a week of terrible anxiety-induced insomnia.

This morning DW made me a decaf coffee (such a nice treat to be served coffee in the morning), we gave the dogs got some consolation pats on the head, and we were on our way.

Our first stop was the fertility clinic’s satellite clinic, which is in our city. I needed to have my blood work and ultrasound monitoring again. Things are on track, with my uterine lining measuring 9.4 today, up from 8.7 of two days ago. I also got a “present” from one of the receptionists, who wasn’t working today, but had mentioned last time I was in that “she’d give me a troll to put down my pants”. I wasn’t sure what she meant by that, but she meant Treasure Trolls, those dolls from the 80’s, for good luck. We joked about for a bit- especially the part about putting one down my pants. Anyway, today, the phlebotomist nurse gave me this on behalf of the receptionist:

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So thoughtful and sweet!

After that, we headed downtown, to see my family doctor. I was really nervous and stressed about this appointment, not knowing how to describe and explain the overwhelming emotions and feelings that I have been experiencing since the miscarriage. When we got there, my family doctor was super attentive, gave me room to talk, listened patiently and compassionately, and gave some good advice. I shared with her how depressed and anxious I have been feeling, how it has continued to affect my sleep and made me weary of socializing with friends who aren’t aware of our situation. She had me complete some forms: a depression questionnaire, an anxiety questionnaire, and a survey on the impact of my feelings on my activities of daily living. It was the first time that I had taken inventory of various aspects of my depression and anxiety, and how it has been affecting me beyond just my feelings and sense of hope for the future. This whole time I’ve been so consumed and obsessed with our miscarriage(s) and getting back to making babies that I completely lost sight of how I have been doing as a person. I mean, I knew that I was depressed, and I knew that I had an anxiety problem, but I had always placed them under the context of the miscarriage, and not really that they themselves are focal points that need to be addressed.

I have battled depression before, and had reached a nice homeostasis with Wellbutrin for years. When I first met DW, I had already been on it for many years, but like most people with mental health issues, because I felt better, I thought “why not, let’s try life anti-depressant free!”. That was a couple of years ago, and for the entire time, I have been fine. However, with the fertility challenges and heartbreak of three miscarriages, I think my dear friend depression has snuck back into my life, and has brought his asshole friend anxiety along as back-up.

I have mentioned my emotional struggles on my blog many times, but didn’t realize how bad it has gotten until I answered those questionnaires, and saw and felt the true concern in DW’s and my family doctor’s feedback on how I seem, and have been behaving. I guess this is sort of what an intervention feels like. I’ve been so caught up in my own head, and needed to hear what other people are observing. My depression and anxiety are a big concern right now, and my family doctor is concerned enough about it to suggest that I start some medications right away. She suggested Cipralex, which is an SSRI, and is effective for both depression and anxiety. I would love feedback from anyone who has taken it before. She says that it is safe before, during, and after pregnancy, even though Dr. Google claims otherwise. But I am convinced that you can search anything and find support for it in the form of a online support forum. This I have learned from the all-consuming world of TTC.

She wants me to double check with the RE that he Cipralex won’t interfere/interact with all of the other stuff that I will be on: estrace, prometrium/endometrin, aspirin, fragmin, prednisone, intralipids. I’ve emailed the RE’s nurse, so hopefully I will hear back soon.

I have mixed feelings about taking the Cipralex. On one hand I think that it would be better for me to just tough it out, that it’s normal to have feelings of sadness and despair, or constant worry, given what I’ve been through. On the other hand, it is becoming more and more apparent to me that my depression and anxiety levels are abnormally high, and the culmination of evidence is that that can negatively impact our potential pregnancy even more than the small risk of cardiovascular defects and autism that have been reported but not confirmed. I look at DW, and some of you who seem “recovered” from your miscarriages, and wonder why I’m still stuck in this destructive loop of depression and anxiety. I realize now that it’s because I am struggling with an extra layer of mental illness.

Work has been harassing me again as well. In the past seven days, the person in charge of leaves has called me three times and emailed me once. This is after talking to her already the first time. She didn’t have anything new to discuss the subsequent times, but rather has been very negative and pushy in her tone. DW says that if she calls me again, that we should complain to the union. The last thing you want to do when you have an employee suffering from a mental health challenge is harass them.

Anyway, after my doctor’s appointment we went out for lunch at our favourite Vietnamese place.

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Then grabbed some baked treats down the street at this great little bakery we found by accident one day the last time we were here. I got a gluten-free chèvre cheesecake, and DW got “the best butter tart ever”, as well as a pear almond tort-like thing that has a fancy French name that I don’t remember.

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We then went shopping at our favourite outdoor store: Mountain Equipment Co-op, where we caught up on some much needed shopping, and bought a couple of early Christmas presents (me mostly).

We also got a call from our primary nurse today. I am supposed to start my long list of meds on Saturday, in preparation for our embryo transfer on Wednesday morning!

I hope that time moves fast, as I’m anxious for our last embryo to come home, but I also feel like I need some time to process everything that has happened today. The good, and the bad new.

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31 thoughts on “Happiness Cycle Day 14: Downtown

  1. I’m glad you’re starting a new medication for your depression and anxiety. I too suffer from anxiety and I feel that after my losses, depression has come along for the ride. I need to find a doctor and address my feelings – I applaud you for doing so with yours. Hoping you feel more like yourself very soon. Also, I want a pear tart now 😉

    • Yes, it is so weird though- as sadness and anxiety became sort of a normal for me after time. I look forward to having some stable emotions during (fingers crossed) pregnancy. And yes, that tart looked awesome! Too bad it had gluten in it- it would’ve been MINE! Lol.

  2. My partner takes max doses of both Wellbutrin and Cipralex and both of us would tell you that these meds are much better than the previous combinations both in terms of effect mess and side effects. I have also seen huge improvements since a family member started Cipralex about 18 months ago especially with anxiety reduction and improved mood and quality of life. I am a big fan of both drugs when patients need them and they work with a given person’s system (because not all drugs work well for all of us in this area). I talked to my dr about maybe taking Cipralex last year after a particularly bad loss and she was willing to Rx it but said it wasn’t ideal to take in pg’y or while BFing so I decided not to take it. I am now taking inmune meds totally not recommended in pregnancy unless risk of not taking them outweighs risk of taking them. It does. So I do. We each need to weigh out what’s right for us. If I were feeling as you have been I would have no hesitation taking Cipralex based on my personal observations of how it has helped two people close to me. I’m sorry I can’t offer more direct personal experience with the drug. Wishing you peace as you march with hope toward a Wednesday transfer.

    • Thank you for the feedback. I do find it very helpful. I had another sleepless anxiety-filled night last night, which is another example of how I need to deal with this soon. Funny that your GP was hesitant to prescribe it, while mine felt very strongly that it is totally safe for pregnancy. It’s technically a class C drug, but I trust her. So that little incongruency kept me up all night. But you’re right, the whole lot of immune meds too have their risks, and it’s all about risk/benefit. I do feel that depression and more so the anxiety has stripped me of so much happiness and health already as it is. It’s time to deal with it. Hopefully, the RE gives his okay and I can fill that prescription soon.

      • Not sleeping was what made me ask too. If you haven’t already I’d make sure your RE knows you dont sleep at all many nights a week. That is terrible for health, fertility, pregnsncy and well being generally.

      • Yes, I would if I ever saw him! The last time I saw him was in September at my D&C for like seconds before I went under general anaesthetic. I only seem to get to deal with him through the nurses, who have been very difficult to communicate with.

      • Ugh. The factory fertility clinic model. I hate that personally, my first clinic was like that too. Have you told the difficult nurses about the long term insomnia and asked them to tell him that this is context for the Rx?

  3. Around the time of our IVF cycle, depression and anxiety both hit me HARD. I was really struggling. I didn’t blog about it, but it reached a point where I was scared, and I finally went to the doctor. He knew I didn’t want meds, but he did connect me with a social worker for therapy. I filled out similar questionnaires, and it was really shocking to see it written down on paper. Anyway, I don’t have any advice, but you are not alone in this. Everything about this time is hard, and I hope you can find some peace despite the struggle. You are in my thoughts… I have so much hope for you this cycle.

  4. I’m so glad you have the supports and medical help that you do. So often, mental health issues go overlooked or ignored. I’m so glad you’re seeking (and getting) help. ❤ ❤ Which bakery is that?

    • Thanks Lindsay. I agree completely about mental health issues often being overlooked. The bakery is called Andrea’s Gerrard St. Bakery, and it’s near Broadview and Gerrard, old Chinatown.

  5. First, I love the trolls – I think that is about the cutest thing! Slightly weird at the same time, but the cuteness and thoughtfulness totally wins out! 🙂
    Second, the mental health side of all of this is so freaking hard!! Coincidentally a few months before our first loss I started seeing a counsellor to learn stress management techniques due to my work situation (little did I know that my counsellor would become my lifeline through the last two years, and has even experienced her own IF struggles and loss). For me, having her has been absolutely critical to my ability to survive all of our losses and working through our decision to adopt. She has seen me at my worst and I will forever be thankful for her. I’d venture the guess that I’ve stayed away from the medications because I’ve had the ability to talk through a lot of these things as they’ve been happening (as opposed to finding a counsellor after multiple losses and digging into so much grief after the fact). I don’t know for sure, but I feel like that’s been critical for me.
    Anyways, I absolutely wish you the best and support you doing whatever you need to do to be healthy and sane through all of this! It’s not an easy road and I just wish I could come give you a giant hug (and I’m not a hugger so that’s saying something).

    • Thank you. For the hug, and for the support. I wonder if things would’ve been different had I seen my therapist throughout this process, or if my genetic predisposition to and history of depression would’ve won in the end anyways. Hard to say. I am finding the therapist somewhat helpful, but not long-lasting. I feel like my issues may stem from a deeper biochemical root, triggered by work and TTC and the miscarriage. Surprisingly, and thankfully, my marriage has grown stronger through it all.

      • It is amazing how we are all just so different, yet so similar in so many ways as we navigate through all of the IF and the accompanying mental health issues! I think it is truly amazing that you are so aware of yourself and your situation to be able to take care of yourself. And like you, I am so grateful that my marriage has also become stronger through all of this.

  6. I ran the name of the med through the embryotox.de website, which is a specialized medical institution here which gives pregnant and nursing women and their doctors recommendations about drug safety. It says that there is more clinical experience with Citalopram and Sertralin so those would be the prefered choice for anxiety and depression according to the website. But it also says that it can be used and that there is a medium level of experience from using that drug. They say that in the first trimester there is a very minor chance of heart defects, but overall few data available. In the 2nd and 3rd trimester there are lots of clinical studies. 2-3 in 10 infants show exposure symptoms after birth. Those include increased fussyness, hypoglycamia, high muscle tone, feeding and sleep issues. according to the site those are are light, self-limiting and vanish usually after 1-2 weeks, at most a month. Most importantly, no long-term problems. If a women is already ob the drug they recommend not changing that unless there’s a reason.
    I think those do sound scary at first, but aren’t that bad as side effects go. If the benefits outweight the risks, don’t feel bad about taking them.
    I remember how concerned I was when I consulted the same website about the load of drugs I got during my appendicitis surgery. But you gotta do what you gotta do.
    And although our son does have an issue (undescended testicles) that is asociated with a drug I took, lots of little boys have similar issues without a known cause and if needed there will be treatment options. It might be odd to compare surgery to depression meds, but mental health problems should be taken just as seriously as any other issue. I hope you find the best option for you so that you can feel better soon.

    • Thank you so much for researching for me, and for continuing to support me throughout this process. I think that I am at great risk for post-partum depression, so the idea is that taking the meds will definitely have more benefits than risks. And you’re right, the withdrawal symptoms for baby are temporary, and the other risks are very low. Thanks again. I hope little N and you are doing great.

  7. Doctor Google’s a quack. I don’t have any experience with that medication. My doctor told me the risks of continuing my SNRI during pregnancy, and my wife and I both decided the risks weren’t worth the benefits (I’m generally completely functional without treatment, I just tend to get in moods that take a day to work themselves out without it). I’m totally going back on it as soon as we either stop trying or the baby’s born.

  8. I take 20mg of Lexapro for my anxiety/depression and it’s great. It’s a very “pregnancy safe” one and I’ve researched it a lot and then backed it up with doctors reviews of it. I’ve decided to stay on it now both before and during pregnancy so that I can be healthy for my child. I think it’s very personal but that being depressed can be more dangerous to a pregnancy and postpartum than the Meds.

      • My side effects were minimal and only lasted two weeks to a month. They were; slight drugged feeling (like cracked out lol) about an hour after taking it, tired in the middle of the day, decreased appetite, minor headaches and hightened anxiety(mild). They were all tolerable and go away about two weeks into it. I suggest sarting at 5 or 10mg for a week and then go up from there to where you feel comfortable. It took me over a month to get to 20mg. My SIL is on 10mg.

      • Yes, I’m supposed to start at 5mg for several weeks until I get used to it, then incrementally up to a max of 20mg. My doc mentioned stomach/digestion side effects would be strong at first too.

  9. I’m glad that you are taking care of yourself in regard to anxiety and depression. I dealt with my fair share of that. It’s not always easy to take a step back and look at the other things that are affecting you aside from that one main focus in Your life at the time…good for you on taking that step. For me, it was a personal decision to get off of the meds because I wanted to actually feel things and work through them (with my therapists help and number on speed dial of course!) but it’s whatever you feel comfortable with. And that damn job girl! I’m so over them, I can just imagine how you feel. She’s lucky she wasn’t calling me because after the 4th call, her ass woulda got cursed out! (That’s the NYer in me coming out) ::sucking teeth and rolling my eyes::

    • Lol. Sucking your teeth. Yeah, I’ve been med-free since 2009, so it is tough to think about going back on them. I don’t think my therapist is a great fit for me. I can’t put my finger on it, but the last couple of times that I have gone, she seems to allude to all my problems stemming from my job, and that I should just quit my job if I want to be good to myself. Part of it is true, my workplace is toxic, but I wanted her to help me with coping skills, and I feel like I just leave feeling like my hands are tied. I still haven’t heard back from our RE about the anti-anxiety meds being okay through this process, so we’ll see what happens. With work out of the picture for a little longer (thank goodness), I won’t be as anxious (I think).

      • I always tell people, finding a good therapist that you click with is like dating. YOu have to “date” a few of them before you settle on one. If you aren’t getting what you are looking for, then it’s time to move on. You’re sharing some very intimate information, sometimes stuff that you havent told anyone before, so make sure that she is the one that want, otherwise (even though it sucks “breaking up” with them, you kinda have to). You shouldn’t leave feeling so unresolve and with hands tied…

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