Going potty and loopy

 Where have I been?

Apologies to my regular readers for neglecting my blog. Truth to tell, I have been unwell for most of August. I put it down to another Lupus flare. But the symptoms just went on and on. The hospital where I go for regular treatment has been closed since the fire in April. I heard from other Lupus patients that doctors from our department were available on Wednesdays at the Helen Joseph Hospital. I really did not want to go to this hospital that’s struggling to cope now with patients from two busy government hospitals. But I had no choice. I had to bite the bullet and went yesterday.

My specialist suspects that I have POTS (Postural tachycardia syndrome) and I have been booked for CT scans later this month. Lucky for google I have been able to find out more about this syndrome – more importantly how to cope with it and understand that even though I’m feeling really crap at times, I will get over this, and if the diagnosis is confirmed, I will be able to find ways to live with it.

Sometimes it does one good to get out of your comfort zone and see the world around you for what it is. The fear of Covid has kept us so isolated, I could not imagine myself standing in long queues as we do at government hospitals. I had my good man with me for support and to help me find my way despite ‘brain fog' and vague instructions. The sun was shining on our first day of spring. People standing in the queues were friendly and patient. At first, the department where we were directed was relatively quiet and well controlled. But, by the time we left a few hours later, it seemed that thousands were packed into a small space (no social distancing) and people were getting irate and impatient. I was happy to leave.

When you’re unwell, it helps to know what’s wrong with you. Then at least you can do something about relieving the symptoms, or learning to avoid them in the first place. It seems that this POTS comes from my Lupus and Sjögren’s that I, along with my amazing specialist, have managed to keep under control for the past 15 years. It seems now that many who have had Covid are left with autoimmune symptoms, one of these being POTS.

Whenever I come out of a flare, I resolve to make the most of each and every day. I know that others may find it difficult to understand what I am going through, and it’s best for me to do something positive like read, hand-crafts, play the piano or just sit in the sun and listen to the birds. That I have opened my laptop and filled in the gap of my blog speaks volumes. It means that I am on the road to recovery, and we’ll catch up with Hannah and baby Sarah just as soon as I can.  

The first week after birth with Hannah and Sarah

 Day five – Hannah’s home and feeling good

Hannah* and baby Sarah are home and adapting to their new life. In this short time, Hannah is learning not to be too hard on herself (mistakes can and will happen she says), to communicate her needs and share responsibilities with her partner and to accept help from family and friends.

Hannah is trying not to be a ‘worry machine’, but it’s easier said than done. “Like knowing when Sarah’s full and when she’s hungry. Today I’m on ‘poo patrol’ because Sarah didn’t poop yesterday. I stress when she doesn’t. But I also stress when she does – it’s so yucky.”

Baby’s first poop is called meconium. It’s a slimy, sticky, blackish, tarry-looking thick mucus. It’s what collected in baby’s bowels during pregnancy (babies don’t poop when you’re pregnant). During the first few days after the birth, this mucous is gradually cleaned out. It changes to dark bottle-green, green-mustard colour, mustard colour to yellow when bilirubin is excreted. Breastfed poops smell ‘sweeter’ than formula poop. Formula-fed babies can have firmer or even hard stools. Its important to mix the formula according to instructions, and not to pack the scoops too tightly – or add extra formula in the belief the more is better. Breastfed babies can have up to five poops a day – or one big poop every second or third day.

It's important not to give newborn’s laxatives or suppositories or to add brown sugar or cooking oil to formula. This is because the baby’s bowel needs to build up natural organisms called microbiomes that are so important to prevent allergies, set-up an immune system and help digest milk. It’s better to stimulate peristalsis by massaging baby’s tummy or pressing baby’s knees into the tummy when the baby is lying on his/her back.

Adapting to motherhood is a topic Reva Rubin, an American midwife, studied and wrote extensively about in the 1960’s. Now in her sixth day, Hannah is at the ‘letting go’ stage: letting go of her pregnancy, her independence and ‘singleness’. She’s becoming more responsible for Sarah’s safety and survival while recognising Sarah’s independence (Sarah still associates Hannah as part of herself and will do this till she is about six months old). Hannah is also adapting her lifestyle to include Sarah. It wasn’t like this on the first and second day after birth. During this time, according to Reva Rubin, a new mother focuses on self, because she needs to recover from the birth. She only wants to eat and sleep, is dependant on others for help and has a strong need to talk about her birthing experience. On the second and third day after birth, the new mother is recovered enough (especially after a c-section) to start coping with the needs of her baby. This is when she takes more care of her physical recovery, asks questions about baby-care and is preparing to look after her baby on her own. It’s helpful to have a midwife either in hospital, or at home to give advice about feeding, burping, bathing and swaddling.

Luckily, most babies are sleepy and very co-operative during the first week – especially while they’re in the hospital. In Hannah’s words: “It’s been a blissful bubble of every emotion a new mother can ever experience….and all of them, totally worth it!” 

* We have been following Hannah’s pregnancy (see previous blogs). Her baby girl was born by c-section on Monday, 16^th August, 2021.

Photograph: Aloise Ireland

An ode to a daughter

 Hannah’s baby girl is here!

Very slightly early, Hannah’s baby girl was born at 3am on Monday morning, 16^th August – her c-section was booked for Tuesday 17^th August. I don’t have the details yet, but here is a passage I would like to share with her, and all new mothers out there – especially if you have given birth to a baby girl.

Mom and baby are well and healthy.

This is an extract from “A Daughter for a fortnight” by Mrs. Robert Henry.

“There is a belief that every woman first longs for a son, but a son, by the very nature of things is lost to her after the tenderness of his early years. A woman who has no daughter of her own misses most the intellectual companionship she can only obtain from an adolescent version of herself. Our intelligence differs from that of men. It is sometimes deeper and invariably more subtle. There is great satisfaction in having continually at one’s side a daughter with whom one can share interests and problems peculiar to one’s sex. For that reason, a daughter must be the most precious of joys.

“It is true that a mother soon loses her daughter by marriage, though her daughter’s marriage will be the very thing she will strive for most.”

Photograph: Aloise Ireland

Ready for lift-off: Ready for baby now

 One week to go

This time next week, Hannah and her partner will be holding their baby girl – and a whole new life would have begun. Everything has been packed and planned, and understandably, Hannah – who has never spent a day in hospital – is anxious about the unknown and the unexpected, the drips and injections, the operating theatre, and the recovery room. The only reassurance I could give her is that the staff knows what they are doing. It's something they do every day. Hannah doesn’t have to do their job for them. She and her baby girl will be safe.

Hannah was also asking how she will know that she is doing the right thing for her baby girl. It’s something every new mother worries about, not understanding how our ‘mother instinct’ kicks in. I refer here to an extract from Niall Williams's book ‘Boy and Man’.

“How do you know you are doing the right thing? That’s a question, isn’t it?” the Master asked at last. “How do you know? And is it enough to, say, do this one good thing, and by doing that does that mean you are doing the right thing? Because it can seem so small, can’t it? One small good thing, what’s the use of that, a voice in the back of your head says. And sometimes that’s the voice that wins!” He shrugged. Then again, he had the classroom before him. “But I don’t think the other voice gives in. It comes back. All the time, we have something telling us to go ahead, do the good thing. Believe in it. That’s the thing. It keeps coming back because that’s our nature, we want to do good. And that’s a kind of proof to me.”

“A proof?”

“Oh yes, definitely, because we want to do good, because, despite everything, and I mean so much evidence to the contrary, we still believe in it, that’s the proof.”   

All packed? Here’s a checklist for my readers:

Don’t leave packing till the last minute. It’s best to be prepared from 36 weeks onwards. Do things like bulk shopping and filling up the deep-freeze with ready-made meals in good time. Decide what you will wear when you come home. Put baby’s home-coming clothes into the car seat and let your partner know where these are for the Big Day.

Take Hannah’s advice. Don’t write a ‘birth plan’. Wait and see what happens.

For your labour bag you will need:

Documents: medical aid/hospital card, ID, booking forms

Comfortable pants, top, and shoes to ‘labour’ in

Toiletries e.g. face cloth, toothbrush, and toothpaste

Disposable panties

Tissues and moisture cloths

Lip balm or Vaseline

Hand cream

Hair accessories

Energy snacks and drinks

Distraction: cell phone

Nightie

Pads (if the hospital has asked for these)

Socks

Packet for your clothes to be taken home in.

 

While you’re in hospital you will need:

sanitary pads

breast pads

disposable panties

breastfeeding bra’s

toiletries for mom

disposable nappies

toiletries for baby:

Soap

Shampoo

Powder

Vaseline / bum cream

Aqueous cream

Cord care: cotton buds, surgical spirits

babygrows

vests and socks

wrapping blankets

 

Take along some things for dad:

‘Snack pack’

something to drink

reading material

camera/cell phone

 

Photograph: Aloise Ireland

 

An important message to pregnant women

 An important announcement. 

THE SOUTH AFRICAN SOCIETY OF OBSTETRICIANS AND GYNAECOLOGISTS (SASOG) CALLS ON PREGNANT AND BREASTFEEDING WOMEN TO VACCINATE

The South African Society of Obstetricians and Gynaecologists marks National Women’s Day 2021 by encouraging all women to be vaccinated against Covid-19 to protect themselves against severe disease.  This includes women who are pregnant and those who are breastfeeding.  In the case of pregnant women, SASOG recommends taking the vaccine after 14 weeks of pregnancy.

Studies show that the risk for critical illness is higher for pregnant than non-pregnant women, particularly in the 3rd trimester.  It has been found that, while most women will have no COVID-19 symptoms in pregnancy, pregnant women who experience COVID-19 symptoms have a higher risk of being admitted to ICU, needing mechanical ventilation and dying, than non-pregnant women of the same age.  Taking the vaccine also means a potential reduction in the risk of Pulmonary TB associated with Covid-19 and a reduction in the risk of passing on the virus to vulnerable members of the household. 

While there is a lack of information on pregnancies during vaccine trials, there is mounting evidence that taking the vaccine during pregnancy is safe for both mother and fetus and that the vaccine provides protection of the newborn from Covid-19.

SASOG also recommends that women who are planning to become pregnant or undergo fertility treatment should become vaccinated and need not delay conception.

“If you are uncertain about which vaccine you should take or the risks that the vaccine poses to you or your baby, we strongly advise that you consult your doctor or clinic who will be able to provide you with the most up to date and reliable information to assist you in making your decision”, concludes Dr Haynes van der Merwe, SASOG President.