Author Archives: Psych n Patient

I now write this in retrospect. During the pregnancy my motivation and concentration were too poor to be able to continue writing my story but now postpartum I can reflect back on the somewhat blurry difficult 9 months of pregnancy.

With my boy I had a difficult first trimester of nausea and vomiting that I lost a stone in weight. This time around it was present again but instead the nausea was ever present and this felt a lot harder to handle than being physically sick which would have provided some temporary relief.

Similar to my pregnancy with my boy, I considered whether I could cope and handle work but luckily this time I was working part time in a role that wasn’t particularly stressful. Despite this, it felt like a struggle to get through the working day feeling constantly sick. It started to impact my mood as feeling physically rubbish 24/7 would do. I started to deteriorate mentally.

I struggled to not consult Dr Google about what it meant to not see a yolk sac in the scan. Blighted ovum kept coming up and I stressed over these words. We considered getting another scan elsewhere before our second scan with the Consultant. We knew though that this could likely lead to more worry and stress so we waited the two weeks.

2nd scan came along and my nerves were high and on edge. Today would be the day whether I know my pregnancy is viable or not. I threw up that morning, I put it down to nerves rather than morning sickness. I didn’t want to see signs of pregnancy in case I jinxed it.

I lay there again staring at the screen and I saw a white blob and then a saw fluttering movement in the white blob. There was my baby’s heartbeat. I was seeing and hearing my baby’s heartbeat. Relief washed over me… I’m pregnant.

We arranged for an early pregnancy scan due to risk of an ectopic happening again. The wait was long and both my husband and I could not be happy with the test results because we felt we weren’t quite out of the woods yet. On the day of the scan, both of us were a bag of nerves. All we wanted to know was that the baby was in the right place, the word “viability” was not something we had ever considered until the consultant dropped it into conversation. That then opened a whole new can of worms of worry. As I lay there and looked at the ultrasound screen I hoped to see a blob or something that would say all was good. The consultant was solemn and said that I was definitely pregnant and it was in the right place but there was nothing in the sac he could see and that it could mean it was too early and my dates were off. My heart sank. All I could think of was “viability”. Consultant said to come back in 2 weeks and we would see if things had progressed. My husband and I thought we would be leaving the scan happy or sad, not left in limbo. Those 2 weeks were going to be hard….

As my husband and I came to terms with the pregnancy loss last year we started to set our sights on trying again. We had two more tablets of the fertility drug to use and so we concluded two more chances before IVF. Each month as usual was a rollercoaster and bought about desperation for a missed period. Sadly, the two months on the drug gave us disappointment. We promptly went to our Consultant Gynaecologist who told us that with one Fallopian tube and ovulation issues, IVF was our next option. We got referred.

As I had the first dose of the Covid vaccine I had to wait 2 months before trying conceive….but I forgot about this and my husband and I tried to conceive naturally again…with one Fallopian tube and no fertility drugs. Silently I hoped for a positive outcome but I knew the odds were against us. What would the chances be falling pregnant naturally one month before IVF with the fertility issues I had?

On the day I expected my period I took a urine pregnancy test and the most faintest line appeared. I dismissed it as an evaporation line which I had seen in the past. But something pushed me to buy more tests. £50 worth of pregnancy tests…because something told me to. One of the digital tests told me I was not pregnant, but the line tests were giving me two lines as a positive sign. I waited another day and tried again. This time the digital test said the words I thought I wouldn’t see “Pregnant”. What would the chances be falling pregnant naturally one month before IVF with the fertility issues I had? Pretty good. Fate seemed to play a role and in many ways I saw this as a miracle.

Just over 3 months has now passed since I had the ectopic pregnancy. Every 4th of the month I remember the loss and think about how far along I would be in the pregnancy had it been ok. Occasionally I ruminate on the memories of the day from collapsing in the hospital car park, to being on the operating theatre, to waking in recovery. Each memory brings a stab of pain…but I also feel stronger. As the doctor said to me in recovery- I must be very strong to have remained stable in surgery with massive blood loss. My strength comes from my little boy and husband. I had to stay alive for them.

Then on Boxing Day I get a call from my brother who tells me news that his girlfriend and him are going to be parents in 2021. I teared up as I congratulated them – they were tears of real happiness for them. I was going to be an aunt! Somewhere mingled in those tears of happiness were also tears of jealousy and sadness. My little boy asks me when are we going to get a baby. I said I hope next year. He asked do we have to grow it. I said yes. He replied does it need water like a plant to grow? I gave him a massive cuddle and kiss. Yes, it needs water to grow…

Husband and I bought an ornament made in America to add baby to our family photos. It is beautiful but makes me choke up every time I look at it when I go down the stairs. My little boy noticed it first thing in the morning when he woke up and asked what it was. I had not prepared myself of what to say so I mumbled something along the lines that it was for baby. He asked where I got it from and I replied the shops. He then said the most beautiful thing ever: “We can go and buy lots and lots of them and put them around the house and it will look sooo beautiful and it will make baby smile”.

People will ask me how I am feeling and on the whole I can answer the physical part quite easily as being fine. Emotionally however I am left confused on what I should be feeling….relief to be alive, fear over the fragility of life, sadness over losing my baby or worry about being able to fall pregnant again?

People have said get well soon but those words seem so finite. That there is an end process to what has happened and yet it does not feel like there is. Yes may be to the physical side but the emotional side, how do I make it well or do I just become stronger.

I had frequent flashbacks and bad dreams initially but those have slowly faded. In some ways this makes me sad as it could mean I am forgetting, particularly as I sometimes feel it happened to someone else. This could be my way of coping with the trauma. In just under a month’s time I will be seeing the consultant/surgeon for a follow up. This will be important in my journey to healing.

It was a week ago I had a positive pregnancy test. I was overjoyed. We were on our 10th round of Clomid and edging closer to IVF treatment. Although there was the excitement of being pregnant I had an underlying worry that something wasn’t quite right. I didn’t feel the same as I did when I was pregnant with my son but to reassure myself I reminded myself that every pregnancy is different. Despite this, I just could not shift the feeling something felt off. I didn’t feel pregnant and would retest again later in the week for peace of mind. I was also constantly checking my boobs to see if they were still sore to comfort myself that I was pregnant. Every time I looked at baby items online to buy a strange pull would come over me to not buy anything yet. Something was not right and deep down I had a feeling this wasn’t going to end well.

Friday 4th I am at home and having just had a toast of peanut butter I suddenly experience sharp abdominal pain. At first I think I just need to do a poo or it’s trapped wind but it slowly becomes clear this isn’t normal. I start to feel sick and faint. I call my husband and he promptly tells me to call 111. I speak with 111 and they said that a clinician will call back within 30 minutes but if they cannot get through to me they will be sending an ambulance within 2 hours. In the time I was waiting for the call, I deteriorated further and started to vomit and began to break into a cold sweat. I called 111 back again and going through the same questions, their computer gave the same outcome as before.

As I sat on the toilet vomiting on the bathroom floor, the call came in and I faintly answered in desperation for help to come. She said to get to A&E in the next hour as waiting for an ambulance may take up to 2 hours. Thankfully my husband was on his way home and was going to be back in time to get me in within an hour. As he arrived, I was very weak and struggling to stand. He helped me into the car and the cold air from the car’s air conditioning was somewhat of a relief. We arrived at the carpark of the hospital but clearly things were worsening. I struggled to get out of the car and could barely walk. I collapsed in the car park as my legs gave way. Husband called for help from a passer by and asked him to get a wheelchair. Thankfully a nurse was also walking by and came to help, taking my pulse and realising it was very weak. The wheelchair came and they pushed me towards A&E as I vomited along the way.

We had a small wait in the A&E reception as my husband checked me in and when we were finally called in, the assessing nurse took one look at me and said I needed to be in Stat. They wheeled me straight to a bay and they put a cannula into me to get fluids in. I was extremely dehydrated and in tachycardia. My blood pressure was also very low. After a while in Stat they wheeled me to two other bays elsewhere in the hospital. One of them was called Major Bay 4. One of the bays was very cold and I was shaking violently from being cold. To help with my low blood pressure they had to tip the bed head downwards, which made the abdominal pain even worse. What I did not realise at the time was that my Fallopian tube had ruptured and I was internally bleeding into my abdominal cavity. Doctors and nurses came in and out and asked the same questions to determine what was wrong. They painfully put the catheter in and took the Covid test swab which itself was also an unpleasant experience as it went right into the back of my throat and nose. We would soon be going to theatre. Despite the Covid situation, thankfully my husband was able to stay with me up until the theatre doors. I felt physically awful and knew there was a chance I could die in theatre. I said my goodbyes to my husband with this in mind ensuring he knew how much I loved him and our son.

As I arrived in the operating theatre I desperately asked for water but they were reluctant to give me any. Just as well they didn’t because a few minutes later I vomited up all the fluid I had taken in previously. They wanted to give me a blood transfusion but they wanted a larger cannula in. I had several people surround me rubbing and tapping my hands, arms, feet and neck trying to get a vein but they kept collapsing or too small. I moaned in pain as they stabbed me in various places particularly my neck. They gave me the blood transfusion before they put me under of 2 units. At the same time the blood test results suggested I was further along in my pregnancy and they wanted to do an ultrasound. It was when she said nothing in the uterus that it hit home that this pregnancy was not going to be saved and it was ectopic as they had suggested in Emergency department. I had up until this point still hoped that it was food poisoning or something unrelated to pregnancy. That hope was extinguished when I heard her words. We had lost the baby.

I was so desperate to be put under as I couldn’t take it anymore. I knew I may not wake up again but I think my body and mind was exhausted and couldn’t hold on much longer.

I later found out from my husband that the surgeon called him to say I had lost 3 litres of blood, 60% of my blood, but I must be very strong because I remained stable throughout the surgery despite this loss. The baby had attached itself to the end of the Fallopian tube and a bit of my uterus and was in an awkward position to be removed. Thankfully the procedure was done laparoscopically and there was no need to be opened up.

When I woke I was in recovery. I was the only one in there for a long time. Three paediatric patients came in whilst I was in there but went soon after arriving. I on the other hand had to wait for more fluids and an improvement in my bloods. I had high potassium levels and my blood pressure was still very low. Despite not being alone due to having a nurse with me at all times to take obs, I felt very lonely. The time dragged as I numbly stared into space unable to think of anything specific for very long. Gynae doctors arrived to check on me and informed me that I lost a lot of blood and it was a life saving surgery. I was told earlier by the surgeon that I must be strong because I remained stable throughout surgery despite the blood loss. I was also told that I would have to wait 3 months before trying for a baby again and that delivery would have to be done c-section no matter what. She said it would be 2 weeks to recover from this, if not longer.

Eventually I was wheeled onto the maternity block ward and again I was the only one in the 4 bed ward. It was then it hit me how alone I was, how I could have died and I had lost a baby. I sobbed silently into my sheets trying to not be heard by the nurses. Compassionately the nurse let my husband visit me for 15 mins or so, due to the Covid situation, and that was a welcome relief. I needed to see him. It was important for my recovery.

Whilst on the ward my blood pressure was still unacceptably low and my haemoglobin count was 64 which is very low. I had to have another blood transfusion of 2 more units. It was after this blood transfusion did I start getting colour back into my face and began to feel a bit better.

Another lady later joined me in the ward and we made some small talk between us. Her reasons for being on the ward were not pregnancy related so I felt sadder there was no one to share with my loss.

It was our 6th wedding anniversary on the Sunday and husband came along at 7:30pm and we sat alone in an unlit part of the ward reception by the window on the 5th floor exchanging gifts. Not quite how I planned our anniversary to be but there was the overriding relief that we were both together despite where we were.

Sad isn’t a word that completely describes what a loss can feel like and yet it is often used when death occurs – “how very sad”…. Death is just that….very sad and yet the circumstances to how one dies gives a deeper level to that word. One of those circumstances is whether that person dies by their own hands.

What if that person decides that the help they need to rectify their distress is through suicide. To opt out of life. Morally, religiously, socially, suicide is generally not seen as acceptable and when someone has chosen that path it is felt that a life has been wasted. My friend chose to kill themselves this summer. Someone who touched and helped many in their life. Someone that most people were shocked by the fact it was suicide.

I have mixed feelings- given what I have written in previous posts. Seeing the affect of my friend’s loss on others…. a sense of guilt that if I had committed suicide the affect it would have had on my husband and son. I am slightly ashamed to admit this but there is a sense of jealousy she managed to do it and I didn’t. Either way her death has knocked me.

I think that somewhere on the spectrum there are those who have a higher sensitivity to emotions and distress and although it perhaps makes us more empathic, the problem is that being this attuned makes us more open to the emotional pain.

Reflecting on her suicide has made me start to cherish what there is in life and all the things she is missing out on because she is not here anymore. I will probably not find out what led her to kill herself but her death feels sadder because it was at her own hands. Life became unbearable for her and in death she hopefully has found her peace.

A struggle would put it mildly. Looking after baby boy whilst in lockdown was mentally and physically draining.

I hadn’t seen/spoken to a psychiatrist in 7 months and unfortunately due to lockdown my first encounter with the new psychiatrist would be over the phone.

I saw this as an opportunity to get the psychiatrist to reduce my medication as I was struggling with tiredness which I believed to be a side effect of the aripiprazole. The tiredness and exhaustion was making it hard to get through the day. Reluctantly he agreed to the reduction and so it was reduced from 15 to 10mg. He suggested that I may want to increase my sertraline alongside this change but yes you guessed it- I declined.

What resulted in the reduction in aripiprazole was a reemergence of thoughts about being followed and watched. I also started to feel suspicious of the new psychiatrist. He sounded American and I worried that he was sent from the US government to keep an eye on me and make sure I took the medication to keep me quiet. The US government is pertinent in this because I have dual citizenship and am also American.

Care coordinator started to worry I was relapsing and as I deteriorate quickly risking hospital admission she wanted me to increase back up to 15. Of course I also didn’t want to end up in hospital when Covid was about but I was against going back to 15mg. Why should I when what I thought and believed was true? Also I just couldn’t cope with the tiredness the 15mg made me feel.

Instead I distracted myself from the thoughts and even though the tiredness reduced, I still struggled through the lockdown.

One day my care coordinator called to let me know she had been discussing my case with the psychiatrist and out of fear of further deterioration he wanted to increase the dose back to 15 and so he wrote to my GP with these changes.

What annoyed me about this was that I had not been consulted with first and did not agree with the change although I had capacity. I requested through my care coordinator to keep at 10 and I wrote a letter to the psychiatrist. Here is some of that letter:

I appreciate that there is concern regarding the nature of the thoughts I have been having, which I am not dismissing or discounting. However, I must also consider the impact of side effects upon my functioning and on my overall mental health, and I have found that the higher dose significantly reduces my energy levels. This is particularly important with a young son during lockdown. If my condition deteriorates I would consent to an increase and my husband has agreed to continue to ensure I take my medication and would consult with <care coordinator> if my condition deteriorates.  

I also want to highlight that I feel the decision to increase my medication to 15mg was taken without my consent at a time when I have capacity. I therefore wanted to get on record that my decision to stay on 10mg is a considered one, and would not want this to be construed as an incidence of non-compliance.