How did you get here?

Not in the metaphysical sense.  If you can operate a computer, you probably have at least a basic understanding of the chain of events that led to your arrival on this planet.

More in the google sense.  How did you find this blog?

I get the stats.  I know the google chain of events that led you here.  And let's just say some of you weren't looking for a mummy blog.

Some of you were looking for information on co-sleeping.  Or a picture of co-sleeping.  Here's another, taken for posterity as the last co-nap of maternity leave.  As you can see, the baby's nose is dangerously close to my armpit.  Lucky for him, we live in the 21st century, where personal hygiene is not a matter to be taken lightly.  Nor is co-sleeping for that matter.  I wasn't really sleeping anyway.

In cinéma vérité fashion, the camera focuses on
the armpit of doom.

Some of you googled Miss Lily White.  My deceased cat, creme de la creme of burlesque dancers, or vintage fashionista extraordinaire.

Some of you googled Santa Claus.  Sorry about that.  Instead of mistletoe and snowflakes you got this post on Santa Claus and other lies.

Some of you googled "poker" and "boobs".  Or "hot poker pain in breast".

Not sure everyone was after the same thing there, but hey, you learnt something about mastitis right?

Some of you googled "Elisabeth Badinter".  What can I say?  I can see the appeal.  Badinter = Badfeminist.

Some of you googled "breastfeeding positions".  I hope my drawings were enlightening.

Yesterday I added a new one to the mix.  I call it "the dancing Grumet".  Picture one wriggly baby, dancing and feeding.  Oh the unmitigated joy.  And today I witnessed "the calf".  This is the one where the baby, behaving rather like a milking calf, pulls at the nipple, then nuzzles and nose-butts the udder with impatience.  Moo.

Some of you might have found a link to my blog on Kiwi Mummy Blogs.  A very large number of you found your way here via Rhonwyn Newson's article in the New Zealand Herald.

Some of you googled no mum is an island.  

And some of you googled "centraltorontoproperties.com".  This one is beyond explanation.  

However you found your way here, come, stay a while, sit by the fire.  Leave a comment or a suggestion.  Enjoy, or travel onwards through the big wide web until you reach your destination.  Watch out for hot poker boobs on your way... they're worth steering clear of.

Hello Mastitis, my old friend

This little ditty is a few weeks old now. As soon as I'd thought "well hello Mastitis my old friend" I couldn't get this damn song out of my fever dreams, complete with those ageing ex-folkies gently crooning it in my ear. At one point I was pretty sure Paul Simon had also invited Ladysmith Black Mambazo along for the ride, my head was pounding that badly.  Anyway, the song sort of works, though it gets a bit weird around the third verse.

The Sounds of Mastitis

Hello Mastitis, my old friend

You've come to make me sick again

There's a redness softly creeping

Over my breast while I was sleeping

And the fever that was planted

in my brain

Still remains 

Within the sound of mastitis

"It's all happening at the zoo."   [photo source]

To After Hours I went alone

Narrow streets of cobblestone

'Neath the halo of a medical lamp

Doc felt my breast it was hot and damp

When my eyes were stabbed by the flash of that neon light

He called it a blight

And touched the sounds of mastitis

And in the Doctor's eyes I saw

Ten thousand mothers, maybe more

Doctors talking without speaking

Doctors hearing without listening

Doctors writing scripts than voices never shared

And no one cared

For the sound of mastitis

"Fools" said I "you do not know

Mastitis like a cancer grows

Hear my words that I might teach you

Take my arms that I might reach you"

But my words, like silent raindrops fell

And echoed

In the wells of mastitis

And the doctors bowed and prayed

To the penicillin god they made

And the sign flashed out its warning

In the words that it was forming

And the sign said 

"The future use of antibiotics is written on the wall

of museum halls"

And whispered in the sounds of mastitis...

Thanks antibiotics, all better now.  And Mastitis, I'm singing a different tune now.  It goes: I am a rock, I am an island... I have no need for (your) friendship, (your) friendship causes pain...

Here's the tune, from happier times in the Simon & Garfunkel partnership.

Monstrous mastitis strikes again!

Just when I thought I could relax, on Sunday evening I felt just a suggestion of that old familiar pain, this time on the left side.  For a while I tried to pretend I was imagining it.  Then I tried to explain it away ("must have bumped it during my woman-conquers-weedwhacker gardening frenzy").  Then, as the pain grew worse, I did some bargaining with it ("just let me get a good night's sleep and I'll be fine in the morning").  Then there was a bit of self-medicating.  None of it worked.

The pain was worse in the morning.  There was an angry pink stain spreading across my breast.  Milkbaby didn't care, or notice.  He still wanted his milk.  In case I haven't mentioned it before, feeding with mastitis is ridiculously painful.  It pretty much tops my "Would You Rather?" list.  But unfortunately, it's also necessary.  But strangely (and luckily), this time these were my only symptoms.  No fever, chills, vomiting, nausea and general crappiness that accompanied my last two battles with mastitis.

The DH dropped me at the doctor on the way to work.  There I faced the usual barrage of questions, poking and prodding.  What stood out for me this time was the noticeable change in attitude towards breastfeeding.  While the response 7 months ago to me still breastfeeding my 1 year old was fairly harmless (along the lines of "well you've made it to a year now, when do you plan to stop?"), the response this time from both the doctor and nurse I dealt with was more like with-raised-eyebrows "you're still breastfeeding?".  "It's not like I've had a lot of choice in the matter", I grumped at the nurse.  "You'd rather not continue?" she said.  "Well, no, it's not like that, it's just...well, he's not even two yet anyway", I stammered, somewhat defensively.

And then the doctor said, "so are you just comfort feeding now?"  [Just comfort feeding?!  I'm pretty sure there's some nutritional value there - and you haven't seen how my kid eats!]

Perhaps, given my in-laws' hints and pointed questions over the Christmas holidays, I should have expected it.  Whattoexpect.com says, in their mini-guide to nursing a toddler, that extended nursing (that's beyond 1 year!) "is bound to raise some eyebrows".

I manage a half-assed explanation that Milkbaby is MOSTLY down to two feeds a day, whilst trying to ignore the fact that the doctor's holding my breast in a pincer-grip and feeling for an abscess.

"Hm, well the good news is that there's no abscess there.  You should book an appointment with your doctor in a day or two to get checked for an abscess."

"Uh, yeah, I know what one of those feels like." [Dude, in case you hadn't worked it out from the long story I just told you, I'm pretty much an expert now.  And if possible I'd like to avoid having my boobs poked and prodded by yet another person.]

I left with a prescription for two types of antibiotics.

I finally arrived at work.  At the other end of the reaction spectrum, my colleague, upon hearing the news that I had mastitis again said, "you're still breastfeeding??!!  You LEGEND!"

Now that's more like it.

It could've been worse

That's pretty much my motto for life: "it could've been worse".  My Poppa used to say it all the time, usually when we'd hurt ourselves or something hadn't gone our way.  He'd say "it could've been worse - it could have been Poppa".  It helped put things in perspective.

It's useful to keep some sort of perspective on this motherhood gig.  For example:

• poop all over baby?  Could be worse - there could be poop on you, the floor and walls.
• baby vomits on the floor of Noel Leemings?  Could be worse - at least you got a new dishwasher out of the transaction.
• sleep deprived?  Could be worse - you could have got up 5 times in the night instead of just 3.
• housework gone to the dogs?  Could be worse - at least you have a house to whinge about.

Lying in hospital, feeling not so great after three doses of morphine and a general anaesthetic, I'm thinking "yep this could be worse, at least I'm not a Somali mother right now, having to walk 30 days with no food to get to a refugee camp".  Now that's something to whinge about.  I bet those mothers never complained.  I saw one in a clip on the news who, despite already having four of her own children to look after, adopted another whose mother died on their 30-day walk to the refugee camp.

Now it's one thing for me to sanely keep my perspective, but it's another for someone else - nearly a stranger - to try and provide it.  Last weekend we had a visit from some of the DH's elderly relatives.  It happened to come up in conversation that I'd been in hospital.  And when I say "came up in conversation", it truly was mentioned in passing, rather than "hey, guess what, I was in hospital last week, poor me blah blah".  Anyway, of course they asked why and so I told a very short version of the whole sordid story ("oh I got mastitis").

The first thing they said?  "Well, it could have been worse -- at least it wasn't cancer."  They went on to tell a story about someone they knew with cancer.  It was a sad story, I felt for the cancer victim, and I was definitely glad it wasn't cancer.  But I couldn't help but feel a bit taken aback by the conversational one-upmanship that had just taken place.

But hey, it could have been worse - they could have been my relatives!

Going under the knife

I realise that this blog is starting to stray from "motherhood and apple pie" territory into "medical misadventure" territory.  But bear with me.  I'm hoping that this interruption in service will be over soon, and I can return to ranting about baby poop, sleep deprivation, and square carrots.

So there I am, back in hospital.  I've been given the medical third degree and my boob has been prodded and drawn on, and the Doctor says the large lump inside it is "indurated".  I think he says "injurated".  'What's that?' I ask, feeling a bit stupid.  He explains that it means that the tissue is inflamed and hard.  "Why use a fancy word when you can use a simple one?", I want to ask.  But then he's still prodding my breast so I keep my thoughts to myself.

I tell him I've already had some fluid extracted from it and that it should have been sent to the lab.  He goes out.  Then he comes back and excitedly delivers the news that the bug causing my mastitis is 'atypical' and that I've been on the wrong antibiotics.  I allow him just a moment of glory, thinking that he must feel like House.  "I thought so", I said.  I was conscious at this point of sounding a bit jaded, but jebus I'd been telling everyone who listened since I walked through the doors that morning to find those bloody lab results.  As the surgeon said to me as I was lying on the operating table (after another sensible suggestion), "you should work here".

He sends me for another ultrasound.  And lo and behold, there's another collection of fluid in there.  An abscess.  Before I know it, there's a surgeon standing over my bed, explaining that they're going to have to do surgery to drain the abscess, probably that night.  I sign the consent forms.  "Nice pen", I comment blithely, as if I sign consents to have my boobs cut open every day.

I get sent to a ward this time, a private room, complete with cage for Milkbaby and Lazy Boy lounger in the corner for the DH, who is being allowed to stay over to look after Milkbaby while I'm in surgery.  Milkbaby goes straight off to sleep, the DH curls up on the lounger in a romantic embrace with his iphone, and I try not to think about food.

Toast: not to be eaten quietly.

At about 12.30am a nurse comes in and tells me I'm not going for surgery that night and I can eat now.  "Awesome", I whisper, thinking that even a hospital meal would go down a treat.  "I'm afraid all I can offer you is some toast" she says.  She brings in three bits of dry toast, along with a knife and a selection of spreads.  I make a hash of spreading the toast in the dark, and then proceed to try and eat it as quietly as possible, so as not to wake Milkbaby.

"Honey, you won't feel like lunch once
we're finished with you."

I am finally wheeled off for surgery at 1pm the next day.  I have eaten three pieces of toast in the previous 36 hours.  Three.  "Save me lunch?" I say hopefully to the nurse as she hands me over to the theatre team.  The operating theatre looks just like the ones on TV: lots of people all wearing masks and scrubs, and bright overhead lights.  Last thing I remember is the anaesthetist saying she's going to give me something that's going to make me feel drunk.  I come round in the PACU (the Post Anaesthetic Care Unit).  Two nurses are hovering over me, one of them with short hair and tattoos, the other a trainee.

"Sure, why not?"

They ask if I'd like some pain relief, and when I say yes, proceed to give me three doses of morphine.  Three hours and three types of anti-nausea medication later, I'm seriously regretting the morphine, not to mention the surgery.  Lunch has long been taken away, and dinner is rapidly cooling on my side-table.  An officious nurse comes in and opens the curtains, and makes me get out of bed to pee, saying I'll feel better if I get up.  I don't want to admit it, but she was right.  She brings me dry toast, which I eat slowly and carefully, followed by dinner.

I bring myself to look down my gown.  The boob's still there.  Only there's a massive bandage covering it.  I'm wondering how I'm going to breastfeed with that thing there.  Then I realise the giant bandage is probably the least of my worries...

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...

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...