This cannot be happening

I thought I was done with this mastitis thing.  Turns out the mastitis had other ideas.

Let me just run through the course of events thus far.  After getting needles stuck in my boob, I seemed to be on the road to recovery.  The doc even confirmed this on Tuesday morning when I saw him for one last check up and ultrasound.  On Thursday evening, I took the last of my antibiotics.  On Friday morning, at around 4am, I woke with a familiar pain in my boob, and that familiar vomity, feverish feeling.  I took a couple of panadols and tried to go back to sleep, hoping against hope that when I woke up I would be fine and it would just be a bad dream.

It wasn't just a bad dream.  It was the beginning of a nightmare.  I thought I'd skip all the bullshit and go straight to A&E, so by about 9.30am (after dropping Milkbaby at creche) I was (once again) a shivering, teary wreck in the Emergency Department of Wellington Hospital.

Time for a science lesson.

This is the bacteria that usually causes mastitis:

Staphylococcus aureus

You treat that kind of mastitis with an antibiotic called Flucloxacillin.

The type of mastitis I had was caused by this:

Streptococcus pneumoniae

Unfortunately, Flucloxacillin is not really very effective against Streptococcus pneumoniae.  It's what they pumped into me during my last hospital visit and what I'd been taking for the two weeks since getting out of hospital.

As I've already said, Streptococcus pneumoniae is not your usual mastitis-causing bacteria.  You're more likely to find it causing pneumonia (in case you hadn't guessed), meningitis and ear infections.  It needs to be treated with a different antibiotic: Ceftriaxone.

Now I bet you're wondering how the crack doctors worked this out.  Well, the stuff they extracted from my boob when they stuck it with needles was sent to the lab.  And the results were right there, on file.  And I suggested to the Emergency Doctor that he dig the results out.  He came back looking like he'd made the discovery of the week.  

So the results had been there all along.  Only no one checked that the antibiotic was the right one for the bacteria.  Or the lab didn't send my results back to the specialist.  Or the specialist never looked at the results.  Or I never asked the specialist whatever happened to those tests they did.  

What happened to me over the weekend is a good demonstration of how one little systems error can have very serious consequences.

To be continued...

Overheard at creche

When I pick Milkbaby up from creche, I breastfeed him before we go.  I don't bother to find the quiet breastfeeding chair in the babies' sleep room and instead perch on the seat by the lockers, in the main thoroughfare to the bathrooms.  This means that all of the children in the over twos area can see us as we sit there.

Most of them ignore us, but I've had a few interesting conversations with the more curious among them:

Little girl:  Hahahaha [maniacal laughter and pointing], he's eating you!
Me: Yes I guess so, sort of.  He's having some milk.

Little boy: [staring from about 5 feet away] What's that baby doing? 
Me: He's having some milk.
Little boy: [coming a little closer] Why is it coming out of your tummy?
Me: Erm, well it's not my tummy, it's my breast.
Little boy: [getting even closer for a good look] How does the milk get made?
Me: [I'm starting to sweat now.  I start thinking about the pictures of milk ducts we saw in breastfeeding classes and realise I actually don't know how the milk gets made.] Um, ah well your body just is able to make milk for your baby.  I guess it's a secret recipe that only your body knows. [Little boy looks unconvinced, and after staring for a while longer, trails off.]

They're a tough crowd, these under fives.

Mastitis: how it all ends

After two nights in hospital and a week off work, I thought I was on the mend.  Until I saw the specialist on Tuesday morning, and the specialist saw the inner workings of the red-hot-poker-boob with the ultrasound machine.  And in her words:

We have a saying around here: never let the sun go down on undrained pus.

Out came the needles.  Three of them to be precise.  I'll leave the rest to your imagination.

Despite my best protests, she ordered me to take another week off work, even signing one of those certificates saying that I was "unfit for work".  

I showed it to Milkbaby but he tried to eat it.  

Attack of the red-hot-poker-boob continued

So continues the saga of the red-hot-poker-boob.

On the "would you rather" scale, mastitis pretty much tops the charts.  As in, I'd rather simultaneously give birth, go to the dentist and have a Brazilian bikini wax than have mastitis.  It's honestly that bad.  Not only do you feel like you've got the worst flu going (worse than man-flu even), but your boob is like a place where a civil war and a famine is taking place all at once.  Just touching it is painful; the pain of breastfeeding from it defies description.

By Saturday afternoon, red-hot-poker-boob was still, well, bloody sore and kind of looking more like a red-hot-rugby-ball-boob.  So I took myself to A&E, joining two sports injuries, an amputee and a guy with the terrible shakes in the waiting area.  I was seen within about half an hour of arriving, and by the time I was seen I had a fever and a resting heart rate of 115bpm.  And before I could say "Boob's my uncle", they had a drip in my arm, pumping me full of some strong antibiotics.  "We're starving you" said the nurse.  "Just until you see the surgical registrar."  Then I saw him, and for about the fourth time that day, got to show my boob to a complete stranger. [Note to self: best not to wear frumpy granny bra out of the house]

So I was admitted to the Short Stay Unit, which is kind of like being admitted to the hospital but not, since the Short Stay Unit is like the Shortbus of the Hospital - a mixed bag of all sorts of loonies and lonelies and sickies.  You're sick enough to be in hospital, but not sick enough or staying long enough to be in a "proper" ward.

The Shortbus.

So I sent the Darling Husband home for some supplies for the night. [Note to self: if you take yourself to A&E you should accept the possibility that you'll be admitted to hospital so go prepared.  Otherwise you'll still be wearing that frumpy granny bra on Day 3 of your stay because your DH still hasn't picked the right black bra from your drawer.]

The Registrar came back, and after showing him my boobs, he said I could eat.  The nurse came back and said, conspiritorially, "I saved you some dinner."  Now I am very appreciative of modern medicine and all that goes on in hospitals and I know they have hundreds of people to feed, but what they were calling "dinner" was what I'd call a "light snack".

After sharing my light snack with Milkbaby, we settled in for the night.  Because he was with me, we were lucky enough to get a private room, complete with its own cage ...er I mean cot... for Milkbaby.  This cot was like something out of the 1930s - waist high, full steel construction.  The drop-side alone weighed probably 20kgs, and needed two hands and superhuman strength to get it up and down.

Suitable for small lions and babies.

We (that's Milkbaby and I) spent two nights in the Shortbus.  Every six hours (including throughout the night), someone would come and hook me up to a drip and pump me full of more antibiotics.  Milkbaby never really got used to that cot, and needless to say, I never got much sleep.

On Monday morning, the consultant walked in, followed by the surgical registrar and a team of clipboard-carrying young doctors.  Just like on TV!  Once again I got to show my boobs (and the frumpy pink granny bra) to a whole lot of strangers.  You'd think, being a breastfeeding mama, that I'd be used to showing my boobs to strangers, but there's something different about getting your boob out for the specific purpose of having it medically inspected.  

The consultant and his crack team of young doctors deemed that my breast was on the mend and that I could go home, provided that I continued on a double dose of antibiotics and came back for an appointment at the breast clinic (!) in a week's time.  I took the rest of the week off work and have been mooching around the house ever since.  I sincerely hope never NEVER to have to stay in the Shortbus again.

OMG WTF?!

Thursday was Milkbaby's 1st birthday.  It started off pretty well, with some present opening before breakfast, and then a rousing chorus of Happy Birthday upon arrival at creche.  I went to work, sat at my desk and breathed a sigh of relief (largely for having made it to work looking somewhat decent and without snot on my shoulder).  I did a bit of work and thought about what kind of cake Milkbaby might like.

At about 11am, I thought "oo, sore boob".  By 11.30, said sore-boob was impinging on my ability to type, so I took matters into my own hands (haha), and relieved sore-boob of some milk.  Easy.  (The hard part was flushing it - that stuff's like liquid gold.)

Shortly thereafter I started feeling a bit vomity.  I thought I'd better take myself on a field trip to the work sick bay.   And so by about lunchtime I was a shivering, feverish, nauseous wreck, huddled in fetal position under neon lights in the sick bay.  All I could think was OMG WTF?!  And "how am I going to bake a cake now?"

The sore-boob had become a red-hot-poker-boob.  I knew what this was.  You guessed it: MASTITIS.

Or maybe you didn't and you're thinking "huh?  I thought only cows got mastitis."

Poor, poor cows.

Fairy Godsister swept in and efficiently took me to the doctor, picked up my prescription, tucked me up in bed, picked up the DH and Milkbaby, played with Milkbaby, helped get him fed and ready for bed, and then cooked dinner.

Women are renowned multi-taskers, and motherhood hones your multi-tasking skills.  Breastfeeding is an opportune time for a little multi-tasking: your nursling is relatively still and you have at least one hand free.  My best breastfeeding multi-task is being able to change a nappy while breastfeeding - IN THE DARK.  I did not expect, however, to ever ever have to VOMIT and breastfeed at the same time.  This is what I found myself doing on Thursday evening.  It was not very dignified but I am happy to report that I managed to keep myself and Milkbaby completely clean, and Milkbaby didn't even notice the drama.

By Saturday I was still feeling and looking like a carsick beagle, the red-hot-poker-boob had an angry big red patch covering it, and to boot the milk had all but dried up.  Milkbaby was unimpressed.  I called my neighbour, a lactation consultant.

"I'm worried about my miilllk..."  I whined.
"I'm worried about you" she said.  "You should be feeling better by now and the redness should have gone.  I think you should go to A&E."
"But I'm supposed to be getting my hair cut today." [rising panic]
"Well, get your hair cut, then take yourself down to the hospital." (Luckily she's very sensible and understanding like that.)

And that, people, is exactly what I did.

To be continued...

Happy 1st Birthday

About 15 months ago, 13 couples sat nervously in a church hall, awaiting the start of their first antenatal class.  As we introduced ourselves, we were asked to reflect on what we were most apprehensive about.  One said (and I'm paraphrasing here) "I was a bit nervous about who we'd end up with in the group, but just from looking around the room I think we've done alright."

Last weekend, 11 of the original 13 couples and their babies gathered to celebrate the babies' first birthday.  It was an informal affair, with most of us taking the opportunity to have a well-deserved beer.  The mamas took the opportunity to catch up on the minutiae of motherhood and other gossip (we've been seeing each other every week for a year now), while the dads got reacquainted with each other and each other's offspring.

This event would have passed without mention, but part of it was particularly memorable.  We decided to do an obligatory "1st birthday line-em-up on the couch" photo.  Previous attempts at similar photos have been notoriously unsuccessful, invariably resulting in a chorus of babies screaming at about 300 decibels.  Now that all the babies are very mobile, getting them all to sit nicely together on the couch was never going to be possible.  But somehow we wrestled them all into the frame, with some sitting nicely, some standing on the couch and some standing on the floor in front of the couch.  The whole thing seemed on the verge of meltdown, with a few of the babies already crying, Milkbaby standing on the head of another baby who'd slipped into a very low slouch from her sitting position, and about four others squished into the corner of the couch.  I started to clap and cheer, largely to gain the attention of Milkbaby, and this stunned a few of the babies into silence, and then someone started to sing Happy Birthday.  And there we were, a group of 30-somethings singing Happy Birthday to our precious 1 year olds.  We were singing for them of course (the incredulous looks on their faces said it all), but in a way we were singing for ourselves too.

If you'd asked me at that first antenatal group if I could visualise myself with a one year old, singing happy birthday together with the people in the room, I would have smiled and thought "nah probably not".  I don't think any of us could have imagined it - or any part of this wild and wonderful journey for that matter.  At the risk of sounding a bit cheesy, I'd like to publicly thank all the other mums in our antenatal group - our catch ups were the highlight of my week and helped me more than anything else to retain some semblance of sanity and good humour.  And I know now that we'll be staying firm friends.  I can almost taste the beer and hear the Happy Birthday chorus at the pub in a year's time.

The pukester

Milkbaby's a puker.  And when I say "puke", I'm not talking about your usual baby posseting.

Posset (the Old English kind) 

"Posset" - isn't that such a lovely polite Victorian word?  You can use it next time your co-worker turns up to work with baby vomit on his shoulder ("is that posset on your shoulder?").  Or to tell your friend that your baby's spilled on her new carpet ("sorry it's just a bit of posset").  It doesn't sound as horrid as "vomit".  Actually "posset" is Old English for "a spiced drink of hot sweetened milk curdled with wine or ale" (mmm).  But I use it here to describe the small amount of curdled milk that's often regurgitated onto your shoulder after a feed.

Milkbaby was definitely not a posseter.  He didn't even start this puking thing until he was around 6 months old.  But since then he's made it his special talent, to be practised at least once a week, sometimes every day.  And when I say puke, I mean stomach-emptying, projectile barfing.  I often wonder if it's payback for all the vomiting I did throughout my childhood - on pretty much any car, plane, bus or boat trip longer than 30 minutes.

It's been a bit of a household mystery.  The start of the puking coincided with the introduction of solids (and unless you're new to this blog you'll know that Milkbaby is all "meh, solids, schmolids - just give me some milk please").  The puking also coincided with the arrival of teeth.  So our list of possible causes have been:

• food allergy (I even kept a Puke Diary for a while - but no clues)
• teething
• constipation (the Plunket nurse suggested this)
• motion-sickness
• a series of bugs (this was the doctor's suggestion - then she suggested I keep Milkbaby isolated from other children for 6 weeks...)
• wind
• overactive gag reflex
• all of the above??

Last night's puke, and the inspiration for this blog, caused Mama a few tears.  After a weekend of eating very little, Milkbaby finally had a semi-decent dinner, scrambled eggs and some avocado.  I dared to think that I might get a decent night's sleep - or at least a stretch of longer than 3 hours.  He then proceeded to jam his fingers under the bathroom door, and in the midst of the screaming, vomited said dinner.  My hopes of a decent sleep went down the gurgler, literally.  I wept with frustration as Milkbaby, now happy, threw bath toys out of the bath.

These I'm-so-upset-I-need-to-puke pukes don't really worry me.  They're unusual, but sometimes crying's a violent habit.  It's the I've-been-sleeping-for-2-hours-puke for no apparent reason that's a bit baffling.  We're no closer to working out the cause.  And I have my suspicions that the puking is linked to Milkbaby's lack of interest in solids.  But in the meantime we've got a great list of puke spots - all christened by Milkbaby:

• down my chest
• the floor of Noel Leeming
• the floor of his room and every other room in the house
• the bathroom sink (bullseye!) or the bathroom floor
• the grandparents' houses
• into a sick bag on a plane (another bullseye!)
• the back of the rental car in Australia
• the back of the complimentary car while the VW was in the shop
• the garden bar of the Southern Cross pub (we'll remind him of this when he's a teenager)
• in his crib
• in his carseat
• outside the fish & chip shop (in the gutter)
• outside Queen Sally's Diamond Deli (in the gutter)
• in our bed (I've never seen the DH move so fast)
• in a friend's car and carseat (sorry about that!)

I'm sure I've forgotten to list a few places.  Perhaps I should start carrying one of these around: