19 September 2016

Cost of Fighting A Ductal Yeast Infection

I am still fighting a ductal yeast infection in my breast -- candida during breastfeeding or however you say it. It's the pits. I've spent significant time and some good chunks of change on my efforts to kill the yeast. I am cautiously optimistic that this infection is nearly gone. Knock on wood and cross all your fingers! Here's a rough estimate of what I've done since early July to get here:
  • Six weeks of diflucan -- this is the actual prescription medication, and I'm lucky my insurance covers it. Apparently it was expensive as a brand name but is now available as generic flucanozole. I couldn't convince my doctor to prescribe it longer (I didn't try very hard), although the protocol says it should be continued until symptoms are gone for a full week. (I had not had a full week of symptom free when I stopped the diflucan, but I think I have now, or at least very nearly symptom-free.)
  • All Purpose Nipple Ointment -- another one that needed to be prescribed. I had to get it at a compounding pharmacy that doesn't take insurance. It's $75, although I put in for it to be reimbursed by insurance. They sent a check for $10 without explanation. We still need to follow up on that one, but say $65.
  • Grapefruit seed extract -- I have this orally as well as topically as a liquid. I mix the liquid into water (15 drops in a half shot glass) and use a Q-tip to saturate the nipple after nursing and follow up with the APNO. Liquid cost $11. Orally I take 250 mg three times per day. On Amazon it's about $11 for 60 pills, so a 20 day supply. I've probably been taking it for 8 weeks because I started it as soon as it seemed this was likely yeast. I've definitely purchased it five times so far (counting twice at Whole Foods in 125 mg dose, so the bottle doesn't last quite as long) and am working my way through the fifth bottle. (So $55 so far.)
  • Gentian violet -- this took me a while to find because I kept thinking I would find it locally. In the end I could have ordered and received it from Amazon several times over, so I just did that ($10) and waited 2 more days. This does help, although I'm not sure how long it's OK to use. The protocol says on for 7 days then stop. If it hasn't worked in 7 days it won't. BUT it can be repeated. So I don't know. I do it, then stop and have symptoms flare and start again. It is HELLA messy and I hate it. I like purple OK but not on my poor baby's mouth. At church this week she had a big purple mustache and I had to get into my infection/medicine with more people than I would have liked (I should have agreed to others' ideas -- purple marker or a bruise). Definitely not what I had in mind when I say I want to help normalize breast feeding. (Update since I started this post - I was able to stop the gentian violet after about 3 cycles, so 21 days total using it. I've been off it for more than a week, and I know it's there to try again if symptoms flare.)

  • Probiotics - buy locally at Whole Foods and also bought some inferior ones at CVS ($11 down the tubes) - $22 x two so far. They have to be refrigerated and need to be taken separately from the Grapefruit Seed Extract (which would just kill the probiotics I think). So I don't remember to take them too often, but at least once a day before bed and sometimes in the afternoon too. I think that's a good sign that I don't remember and am getting better!
  • Vinegar for washing clothes and towels - minimal cost but for the sake of completion - $2. I wash everything of the baby's and everything that touches my breasts (bras, towels, etc.) in hot water with vinegar rinse. Acidity kills (?) the yeast, or at least inhibits its growth.
  • Paper towels to limit yeast from towels on my hands after washing and limit chances of re-infection (not entirely convinced this is necessary) - $4, estimated because we use paper towels normally. I just kept a roll in the bathroom to use with each hand wash there and have used about 4 rolls over the time I've been doing this.
  • Jack Newman book: Dr. Jack Newman's Guide to Breastfeeding, includes the candida protocol I am trying to follow. $22.
  • Lactation consultation - should have been $95, although maybe insurance would have covered it. I got my consultation free because while I was waiting for a call back in the hospital waiting area I was hassled by a security guard about breast feeding and that I needed to go to their special rooms/couldn't just nurse in the lobby even covered up. I tweeted my indignation, which got the communications people's attention and I was given a personal apology and the consultation for free, which was nice. It was helpful because they were the ones who agreed that it was more likely yeast. They weren't used to seeing such big/older babies though. If nothing else it made me feel like someone in the medical system actually cared about me/my pain at that point (when my doctor was out of town).
  • Monistat 7 - before I got the APNO - $11
So adding all that up we're at $224 actually spent (not including the $95 the lactation consultation would have cost). I'd gladly throw money at this problem just to get better and it was the TIME more than anything that has been hard to deal with. I've been robbed of pleasure with my baby, and while we're still nursing and everything is great with her growth and health I am battered and beaten down from this experience. I hope I can bounce back and continue to get better until completely, truly healed. And I hope you never experience this. If you do/found this via Google please feel free to email me for empathy!

07 September 2016

Tell Me I'm Fat

Last week I finally listened to the This American Life episode "Tell Me I'm Fat." It was put together around the release of Lindy West's book "Shrill: Notes from a Loud Woman," which I pre-ordered and read when it was published earlier this year. I've loved West's writing since Jezebel, and I really liked the book. I loaned it to my sister before I could go back and make notes for this post, but I checked it out from the library electronically and copied out some of what I wanted to remember/share.

I am fat, but like Roxane Gay says in the TAL episode I'm "Lane Bryant fat," meaning I can still move about in the world and there are places I can buy clothes. In Shrill West talks about that too --
"I’ve always been fat, but I was the fat person that still mostly fit. While I couldn’t fit into regular-lady clothes (more bejeweled tunics covered with skulls, cherries, and antique postage stamps, please!), and I had to be careful with butt safety (I once Godzilla’d an entire lunch setting while trying to sidle through a Parisian cafe), I was still the kind of fat person who could move through the straight-sized world without causing too many ripples. Until I couldn’t."
I'm the kind of fat person who can move through the straight-sized world without causing too many ripples. I want to be OK with my body as it is without giving that body license to break down (or something). I want to remember this, also from Shrill:
"Please don’t forget: I am my body. When my body gets smaller, it is still me. When my body gets bigger, it is still me. There is not a thin woman inside me, awaiting excavation. I am one piece."
And I want my girls to know that too. My value, their value is so much more than our bodies. Women don't have to be a certain size to be worthy of love and respect. Another of the acts in the TAL episode was about a woman who lost a significant amount of weight and got everything she ever wanted (relationship, acting jobs, etc.) once she was thin. I feel like I have everything I ever wanted, although perhaps I'm missing something???

My daughters are also an impetus for wanting to be less fat -- mainly to be able to move through the world more easily (socially as well as just literally moving more easily). And ideally to stay in this world longer. (I say that not that fat equals unhealthy, but I am a heavier weight when I'm not taking care of myself -- less exercise, more sugar, etc.)

Lots to think about and remember for discussions down the line.

No more affiliate links via Amazon, since Louisiana changed its law to require taxes be paid up front Amazon just shut down the affiliates program for anyone living in the state. So there's that...

02 September 2016

Flood Recovery

Nothing happened to me because of the Louisiana flood. But it could have. There's nothing about my character or where I chose to live that exempted me from the flood waters. It just happened that the mega rain did not fall over my house. But others in our community were not so lucky, if luck is even the right word.

Together Baton Rouge is an organization that was started several years ago to address issues of social justice and bringing the community together in rational ways to solve problems. Boy have they stepped up and been incredible in their efforts for this flood recovery. I'm proud to support them financially, and I hope you'll consider a donation too.

As a Methodist I'm proud that no matter where the disaster we are always on the ground. UMCOR is another great option for your donation dollars, and for the Louisiana flood going through the Louisiana Annual Conference is a good idea too. Our church did a lot of work in the initial week after the flood, and we continue to house "second responders," or those teams of volunteers who have expertise in gutting houses and came out to do just that.

I still feel out of sorts -- I should be DOING something -- I am experiencing no negative outcomes to this flood that hits SO CLOSE to home. My life is uninterrupted, while those so nearby are still shattered. (Although I still have the "excuse" of nursing mother to keep me out of heavy work ... although if I look at myself I'm so weak I doubt I could do the physical labor required even without the need to remain with my baby almost all the time...)

The national media coverage -- rather the lack thereof -- is problematic for getting recovery dollars and private donations flowing into the community. It's also understandable if infuriating. There's no one to "blame" in the flood scenario is something I've read often, and really that means there is no villain other than mother nature. And we can pound our heads against the wall all we want there's no changing that.

But I also don't think the national media scoffs at stories of the Cajun Navy or people saving each other. It's just less compelling perhaps the farther you are from the tragedy. That's true as human nature I guess or at least the way our media system is set up now. I didn't give a lot of thought to Superstorm Sandy even though we'd recently moved from the area hit when it happened in 2012 and even though it got A LOT more national coverage.

A lot of donations have come directly to families via GoFundMe accounts that have been set up. I've donated to one for my friend. But the awful part of that is GoFundMe takes 8% off the top. I knew it was a bad idea and I should have bought a gift card or just sent her a check directly. Blurgh. 


The other instinct that has kicked in during this time "after" is the desire to clean out all my crap. For several days I looked around and thought about the things on the floor/low shelves would just be gone should water come in. And how that would probably be OK for most of the stuff. And should I take steps to eliminate excess material goods? (Yes, a thousand times, yes.)

I've also been cutting way back on spending on non-consumables. We're still doing grocery shopping and getting medicines (wait for the post on how much fighting the breast infection is costing me to see that math...), but I haven't been shopping for new clothes or shoes or anything, even as back-to-school sales are in full swing. (I did buckle today at Target during the back-to-school clearance items, so I'm sure it won't be long before I'm back to my regular type of spending habit.) We have plenty and there's no need. We should put that money toward helping others rebuild their lives. What else is there to do?

These are the main thoughts that have been on repeat in the last few weeks. In addition to the deep sense of gratitude for remaining high and dry.

16 August 2016

On an Island

We live in Baton Rouge, which has seen its share of tragedies this summer. The latest is a flood of epic proportions.

All around us there is devastation.

Our home is fine. We are fine. We have power, Internet and plenty of food and water.

There's no threat to our home now. We're in a high spot and away from where the biggest rains fell. We are also far enough away from bodies of water that we shouldn't suffer flooding from the backflow (which I still don't understand).

But I'm still unsettled, anxious and often find myself on the brink of tears.

We are so lucky. But what are we to do?

Our church is a short-term shelter for now, and I've been helping out with the communications/social media aspect of that as I can. I haven't brought myself to go to church and volunteer directly (although the way is clear and we went for worship on Sunday). Having the girls and being a nursing mom makes that much harder, and I can't tell if they're overwhelmed with volunteers already and an extra three people (since that's what I really am) would be more in the way than helpful. But that adds a level of guilt. I should be giving up some of my things and more of my time in constructive ways more than anxiety stressing.

We haven't been out of the house since Sunday. The roads around us are clear, but where is there to go? I got groceries on Sunday afternoon, and it was a madhouse and scary with a half-flooded parking lot that I later heard had an alligator in it (hopefully a false rumor, but certainly not unbelievable). We're a little stir crazy too. TBD on when Jane's school will actually start.

On Facebook I've seen a lot of complaints about how the flood isn't receiving national news coverage. I guess the cable news networks aren't covering it too much. I've read a few stories about "disaster porn" and maybe we're not important since it's an unknown city and Louisiana floods all the time so we should be ready for it. I don't know what national coverage would do to help things. Would people donate more? I don't know. But the disaster is staggering.

Oh, and my breast infection is definitely yeast and hasn't fully healed yet. I have been taking medication for several weeks that helps but hasn't been able to completely eliminate it. I am due for a refill tomorrow, but I don't know if I can reach my doctor OR if she'll agree to give me more (it's not a narcotic, but it is expensive and not usually used for so long). I was off it for two days last week and the pains came roaring back so she gave me another week. That's a personal anxiety but it hums in the background, increasing my general unease, malaise and ennui...

14 July 2016

Breastfeeding Madness

I've written about breastfeeding before, including a recent post on The Mommy-Go-Round. And when I talk or write about breastfeeding I AM INSUFFERABLE!

It's so easy, she said. Anyone can do it, she said.

NOPE NOPE NOPE.

Consider me humbled, crow eaten and in awe of moms who make it through breastfeeding challenges. If I experienced this the first time around and didn't know how easy it is to "open bra, push baby to breast, go back to eating/reading/scrolling" I'm not sure we would have made it to seven months of exclusive breastfeeding, let alone 26 months total! 

Everything went great with Jane (although reading back in the posts I did have a bout of mastitis that I cleared up without much trouble). But for the past couple weeks I've been in the land of eat-your-words, because breastfeeding has been anything but easy.

To start I had a sore nipple, maybe seemed like a milk bleb. I did hot compresses and lots of nursing to get it open, but it kept hurting and last Wednesday night I got the shock of my life when knife-like pains started internally in my breast, basically all throughout the milk ducts, after my last nursing of the evening.

I've done so much internet sleuthing, but it didn't seem like mastitis (no fever/chills) and didn't seem like yeast/thrush because Livia didn't have any symptoms and mine weren't typical and it was only on one side.

I started calling the doctor's office right away on Thursday afternoon after a terrible bout with pain, but because I felt some better when I called on Friday they didn't seem to be in any rush to have me be seen. Then I had to wait over the weekend to come in, and it got worse and worse (a couple hours of level 9/10 pain after each nursing on the right side).

So far I've been to a nurse practitioner (who diagnosed mastitis even without any mastitis symptoms) and prescribed an antibiotic. Then I had a lactation consultation, and they think it sounds more like yeast, and they recommended treating with diflucan. My doctor's office prescribed that, but only one dose, which is what is recommended for a vaginal yeast infection, with a second dose 7 days later.

The lactation consultants all referred me to "Tips from the Trenches," and the handout on yeast (and everywhere else on the internet) recommends a much longer-term dosing (instead of one dose you take a double dose and then one dose daily for 14 days). So far the doctor's office has said "no way" to that and told me to continue the antibiotic (even though an antibiotic can wipe out the good bacteria that can help fight off the yeast organisms).

I also got some advice on a better latch with Livia. She was pretty wild during the consultation -- slipping on and off the breast and chomping more than usual. It's most comfortable when she's calm/sleepy and can just get down to business. But having to TRY with the latch after months of pain-free automatic nursing has been difficult.

But the PAIN has been the worst. My nipple is still sore (got some prescription cream for that now, although I had to ask if that was OK/it was never offered as an option) so nursing/initial latch is painful. But it's nothing compared to the feeling after nursing is done and the yeast starts attacking.

My pain is worse in the mornings after the first feed, although I do have pain throughout the day after nursings. PERHAPS it's because I go so long in the night between feeds (Livia and I like to sleep) and I have been hesitant to nurse on the right overnight because I know the pain will wake me up totally. But tonight I'm going to try and nurse on the right and hope the morning pain is more manageable. I'm also going to take some ibuprofen in the night, which might help.

In my own opinion, not being an MD or nurse, I have a very stubborn and strong yeast infection that will need the bigger course of diflucan. In the meantime I'm trying grapefruit seed extract, taking high doses of probiotics to counteract the antibiotic and still looking for gentian violet locally (as usual if I'd just ordered it on Amazon once I suspected yeast I could have been using it already). For the pain I'm taking double doses of ibuprofen spaced 6-8 hours apart. It doesn't really touch the pain at all, unfortunately.

There's also the risk of re-infection and the breastfeeding literature says baby and mom should be treated simultaneously to prevent spreading it back and forth. So far Livi has no symptoms so her pediatrician won't treat for it. I hope it stays that way, and that if she does get symptoms we can do some gentian violet or similar to knock it out fast. There's lots of extra laundry in that towels and burp rags, baby clothes and bras all have to be washed in hot water with vinegar rinse. All the breast pump parts and any pacifiers/toys that go in her mouth have to be washed AND boiled (daily!). I've already melted some of her best toys doing that, so I've been limiting what I let her put in her mouth to things that are definitely washable/boilable or that I don't care if they get ruined.

I plan to write a Mommy-Go-Round post after all is said and done -- and to eat my crow in a more public way. And I have a lot more to say about the experience emotionally. But in the mean time, that's where I am now.

24 June 2016

Being in Two Places

Out and about -- photo by Aunt B
I'm 12 weeks into this "having two kids" life, and so far it's pretty great. The age difference is good, as Jane is happy to have a baby sister and helpful most of the time. We've had our moments, and someone from church said "Oh, I hate a four-year age difference ... just think about one in high school while the other is in college." (Or something like that -- I honestly can't really remember her objection logic.)

But the age difference also has struggles, but it's really just the struggle of having a newborn during the heat of the summer and wanting to maintain Jane's active schedule.

I've wanted to be in two places at once so many times already, starting with a field trip at Jane's school when Livia was just a few weeks old (I couldn't even walk properly yet, so it was impossible to consider) and the latest being taking Jane to the Finding Dory movie yesterday (my sister and nephew did that for me).

Basically Livia needs me right now, while Jane needs someone to do activities with her and that can be daddy, Aunt B or a friend. I can still do a lot with her, and we do. I've been taking her to swim lessons this week while Aunt B watches Livia -- two hours away at a time is the longest I've stretched it so far, and it was doable but not my favorite. We also go to the library, since that's something Livia can easily come along for. But I couldn't volunteer at VBS so Jane was there alone, and I can't take her to the water park or similar.

Yesterday the Mommy-Go-Round blog published one of my last (or last?) blog posts - Bringing Home Baby #2. (I could look it up whether I've submitted anymore. I honestly can't remember.)

09 June 2016

More Writing ...

My freelance (emphasis on the free) writing continues to be published on my hospital's blog, The Mommy-Go-Round, and my doula's blog at Birth Help. Here are a few recent posts:

Better Birth Through Improved Communication
I’m a communications professional by trade with degrees in journalism and years of experience in public relations. I excel with the written word and communicating within a marketing framework. Communicating is my vocation, but when it came to talking to my doctor about my wishes for childbirth I came up short. Standing up for myself and what I need does not come naturally to me.
I needed some help to become a more effective communicator in the doctor-patient relationship.

VBAC Success: I Will Push This Baby Out of My Vagina
Despite everything stacking up against my desire for a VBAC (vaginal birth after cesarean) – previous big baby, ultrasound estimating an even bigger baby, being overdue and having gestational diabetes – I was ultimately successful and delivered my second daughter vaginally.

Our Jaundice Experience
Both my daughters had jaundice, a condition in which the baby’s blood contains too much bilirubin and makes her skin and eyes appear yellow. My older daughter’s jaundice resolved itself on its own, but my younger daughter born at the end of March had a more severe case. She had a lot of risk factors – exclusively breastfed, larger baby (born 10 lbs, 8 oz.) and our blood types were incompatible, which seemed to be the thing that worried the pediatrician the most.

A Mama's Choice: Getting Started Breastfeeding
I breastfed my first daughter for 26 months, and that nursing relationship was a very healing thing for me after the disappointment of my C-section. I’m proud of myself and my body for feeding and nourishing her for so long. So I knew no matter how my second birth went I would be a nursing mom again for this second baby.

I have high hopes to actually write more HERE and have a list of posts I'd like to write (and have probably written dozens of times in my head). Nothing earth shattering but just continuing to chronicle bits and pieces of this life I'm living. Time at a keyboard is limited, and I'm also trying to work on a (paid!) freelance project and ease back into my volunteer work at church.