Monday, 31 October 2011

What would you do if your anaesthetic didn't work?

Rhetorical question surely?  Of course anaesthetics work.  That's the point.

Well no. They, specifically epidurals and spinal blocks, don't always.  And they didn't for my friend S when she was having her second baby by caesarian section.  She is not alone and she believes that this may be due, at least in part, to the protocol and questions used as standard in the NHS.  S's story, in her own words, is below, but suffice to say, she is taking an experience so horrendous it never occurred to me it could be possible, and campaigning to ensure it doesn't happen to any other woman again.

She's starting with an anonymous survey, to gauge women's experiences of epidurals and spinal blocks and please, please, if you had either, whether for a c-section or vaginal delivery and even if you read no more of this post, click here to complete the survey.  It'll only take two minutes.

And if you can spare another minute after that, please email the survey or this post on to more women.  Your responses really could help.

Thank you.


"I had to have a c-section for placenta praevia. I had a consultant anaesthetist who put the epidural in and was VERY confident it was in the right place. However, the anaesthetic worked on my motor nerves so I couldn't move, but did not work on my sensory nerves so I could feel. The test the anaesthetist was using to check what I could feel involved spraying alcohol onto my skin and saying 'Can you feel that as cold? You may be able to feel the sensation of fluid on your skin but can you feel it being cold?' I definitely could feel but found it really hard to distinguish between the sensation of the fluid on my skin and cold. I stalled and stalled but eventually the weight of expectation that it would be working and the number of people waiting got to me and so I said I supposed I must be only feeling fluid not cold... Which was a bad thing to do because the first incision felt like I was a bean bag being opened and it got worse from there. They stopped the operation 3 times, topped me up with seriously potent painkillers intravenously and gave me gas and air - the last was surprisingly effective but maybe that's because I was out of my mind with pain and just needed to be totally out of my mind. I stuck it out to see my baby boy born but then had to have a general because the pain was indescribable. 

In all it was a really traumatic experience and then it was compounded by nobody being told on the ward, and my GP and community midwife not even knowing I'd had a general anaesthetic - so I left an operating theatre after a horrific operation to zero support. Thankfully when, after 10 months, I told my GP that I was still having flashbacks and wondered whether I could have PTSD, she was brilliant - which was just as well because initially the hospital maintained that I had been 'conscious and comfortable' when my baby was born. But while I could push for more than an apology (which I did eventually get) it's only ever going to be a hollow victory because it doesn't change a thing. 

I started thinking about why I let it happen - and kept coming back to that one odd question. Talking to others I've realised that it wasn't me not knowing my own body and mind but that lots of people have found that same question very hard to answer - which made me wonder whether a better question could be used. I was put in touch with a very senior obstetric anaesthetist in the States who told me that he would never use cold and would only test using pin pricks - and that's what he teaches his students to do. 

So I've set up a survey (which respondents do anonymously) to gauge as much as I can in 10 questions about women's experiences of epidurals: whether they've felt under pressure, whether they could distinguish between sensations on their skin, whether they needed further pain relief after the epidural was administered , whether their GP was well informed and whether their experience put them off having more children. And now I need as many mothers as possible to complete the survey."

Sunday, 30 October 2011

Daylight saving

Is today officially the best day in the year? 

Pre-children that wonderful, lazy, extra hour in bed.  Always in bed, obviously.  Why spend an extra hour anywhere else?  Post-children, the hour is less relaxing but so much more appreciated.  I spend 364 days of the year wishing for another hour and today I get it.

And they want to take it away from me...

Am I the only person in the country who thinks this is an awful idea?  It's not just, honest, because I'm now in Scotland. I've felt like this ever since I heard of these proposals.  We're told that lives would be saved because evenings would be lighter when children are coming back from school, but surely that would be counter-balanced by the darker mornings when the same children are going to the same schools.  Calling time by a different number isn't going to change the fact that we don't, whether in Land's End or John o'Groats, get enough light at this time of year.  I should know.  My birthday, in mid-December, gets less than seven hours of daylight, and to change that I'd have to go a lot further South than the South of the UK.

But my biggest complaint?  It's the dark mornings.  Wasn't that the best thing about this morning?  Whatever time you got up, however much your children didn't appreciate the effect of that extra hour, or extra glass of wine last night, wasn't it wonderful that it was so light?  And isn't the bliss of not getting up in the dark, even if only for a few extra weeks, far, far greater than the misery of dark evenings?  I rather like dark evenings.  I like the childish excitement of shops with their lights on, especially once the decorations start to go up, I like the anticipation of a warm house, and the welcoming glow as you open the door.  And oh, I so much prefer it to the brain-assaulting blare of the alarm clock when your eyeballs tell you it's still the middle of the night.

Today was actually horrid.  B and I were out last night and were late and tired. The children were up at some horrendous hour, and my parents are staying which always stresses me, but I still think today's great. 

Please don't take it away.

Saturday, 29 October 2011

You can take the girl out of England...

L and I are listening to the Proclaimers, unofficial patron saints of Scotland (where we have now lived for 18 months).

"Why are they singing in French?" wonders L.

Not fully assimilated yet then.

Sunday, 23 October 2011

Six things every parent should know about meningitis

Go on.  Admit it. You don't really want to read this post do you?

It's like turning over that stone. You know there's going to be something gross under it. You know that you don't really want to get whatever it is out and deal with it.  Wouldn't life be much easier if you just left it there and pretended you never saw it anyway?

Well of course it would.  Life's often easier if you ignore the stuff that scares you. And meningitis scares us, especially as parents; apparently more than any other disease.

But ignoring the things that scare us doesn't make them go away, and it doesn't make them easier to face when we do have to, so it was with that in mind that I agreed (actually I was enormously flattered to have been asked*) to attend the UK Blogger forum Unfolding the complexities of meningitis last Thursday.

Faced with representatives of the three UK meningitis charities and a GP, Dr Rob Hicks, we bloggers were informed, enlightened and able to ask as many pathetic, stupid and worried questions as we liked.  I came away, not with my fears allayed (how could they be?) but determined that as many people as possible should learn what I had. 

Who knows? We might save a life.  Just read the blue bits... honest, it won't take long.  And if you've got questions, put them in the comments - the charities have promised to provide an answer to every question. 

Meningitis isn't that common

The good news first.  On average, a GP in the UK will see two cases of meningitis in his or her career.  That's it.  Two in a career of, what, forty years, seeing say fifty patients a week.  It's not common.  It's a horrible, terrifying, life-threatening disease, but the chances are you and your children will never get it, or even come into contact with it.

That said, what that means is that most GPs won't have that much experience of meningitis.  They also don't know your child as well as you do.  If you're worried, and you think your GP isn't taking you seriously, call Call NHS Direct or NHS 24.  Or even 999.
Don't wait for the rash

The charity representatives said to us that they had been victims of their own success.  Everyone knows about the meningitis rash, but this is a late stage symptom and doesn't appear in every case.  The rash is actually a symptom of the onset of septicaemia: the body is shutting down, poisoned by its own blood.  By the time it gets to that stage the disease is very, very serious.  Don't look at a sick child thinking "It can't be meningitis, there's no rash".  It could be. Get help.

Oh, and practice the tumbler test too.  It sounds awfully simple in theory, but it's much less so in a panic.  Get a glass, put it on its side over the rash. Press.  If the rash goes, it's not septicaemia.  If it doesn't, ring 999.

Three symptoms you should worry about before then

The difficulty with meningitis from a parental or indeed medical professional, point of view is that there's no one distinct symptom that you can look at and say "Phew, it's not" or "Panic, it is".   It can often appear as flu-like, and there are a number of different symptoms that can appear.  Click here for a full list from the Meningitis Trust, or here for their smart phone app or call 0800 028 18 28 to get a free credit card sized symptoms card to keep in your wallet, or on the fridge, or anywhere you'll know where it is when (if) you need it. 

That said, Rob Hicks said that he, as a GP, would be particularly worried by the following signs, any or all of which might appear before the rash:

  • Cold hands and feet even though the child (or indeed adult) is hot and feverish
  • Muscle, joint and limb pain such that the child can't stand up
  • Pale, blotchy skin and blue lips
Got those? Get help.  Now.

If your child is fully vaccinated he or she still might get meningitis
This is why I started with the good news.  Even if your child has had all their NHS prescribed vaccines, and their red book is fully up to date with a big gold star on the front, your child (or indeed you, your cousin or your friend) might still get meningitis.

This is because there are multiple different sorts of meningitits and only some of them can be vaccinated against.

Briefly, meningitis is an inflamation of the lining of the brain which can lead to blood poisoning (septicaemia) but which, crucially, can be caused by a number of different bacteria (or viruses or fungi, but these are less common and generally less serious), each of which responds (or doesn't where none is available) to a different vaccine.  

Children in the UK are vaccinated against pneumoccoal disease, which can cause meningitis as well as pneumonia, HiB (another cause of meningitis) and meningococcal disease type C.  That's it, and it doesn't cover the biggie.

The biggest infectious killer of children under 5 in the UK is meningococcal disease type B.  There is, at present, no vaccination for this disease, although one is in development. 

In addition there are three other types of meningococcal disease, A, Y and W135 (no, I don't know why it has a number either), which tend to occur in other parts of the world and are very uncommon in the UK.  We're not vaccinated against those either.

Where to get help fast

If left untreated 90% of people who catch meningoccal disease type B will die.  Even if diagnosed early and treated, 5-10% will die and up to 1 in 7 of the survivors (and new research by the meningitis charities suggests that this may be an under-estimate) will be permanently disabled.

Speed is absolutely of the essence.  And this is why all the charities and the doctor were unanimous.  If you think it might be meningitis, get help. 

Call your doctor.  If you get fobbed off or ignored, insist, or call someone else.
Call NHS direct on 0845 4647  or NHS 24 (in Scotland) on 08454 24 24 24 (I've actually rung both from Scotland, and they don't turn you away if you're the wrong side of the Border.)
Call 0800 028 18 28 for the Meningitis Trust's 24 hour helpline to talk the symptoms through with someone who knows.
Or 0800 8800 3344 for the Meningitis Research Foundation's helpline.
Call 999.

Don't feel stupid or guilty, feel relieved and proud

If you're like me, you'll be thinking "Yes, but if it turns out just to be one of those non-specified viral infections it was last time, they'll be looking at me like I'm neurotic and then I'll feel stupid and guilty for wasting the doctor's, or worse, the paramedics', time".  But we were told, again and again, that that's wrong.  If you see the doctor and it's not meningitis, you should feel relieved, obviously, and proud that you have taken action that could have saved your child's life, even if it turned out not to be necessary.

You are your child's advocate.  If you don't fight for them, no one else will.

The Meningitis Forum was an amazing thing to have taken part in. I don't tweet, but apparently tweets from those taking part reached over 21,000 people on Thursday alone.  This is important information and should be disseminated.  Please pass it on.   The Meningitis Trust wants symptoms information in every house in the UK;  I really hope that it is now in yours...

The three charities who attended the forum were

The Meningitis Trust - which supports people affected by Meningitis in the UK
Meningitis UK - which does pure research into finding vaccines to prevent against all forms of meningitis
The Meningitis Research Foundation - which funds research, supports those affected and raises awareness.  They are currently, in advance of the new vaccine, running a campaign called Counting the Cost: weighing up the cost of caring for a meningitis sufferer against the costs of vaccination.  You can sign their petition here asking the Government to do all it can to support immunisation against meningitis.

All of them have agreed to answer any questions, any at all, on meningitis that you put in the comments of this post.  Now is your chance....

Thank you.

*In the interests of full disclosure, Novartis, the drug company that is, you guessed it, behind one of the two new vaccines against meningoccal disease B currently in development, set up the forum and paid for me (and M, who throroughly enjoyed his trip to Birmingham) to go.  Thank you to them.

Tuesday, 18 October 2011

Balance bike or stabilisers?

We have a policy on Christmas (and indeed birthday) presents: try and get them something that we'd be buying them anyway.  It's worked so far, although I realise it probably won't for much longer, and certainly not once they hit school and peer pressure.

Anyway, this year, with L four and a half and S and A coming up three, we think it's time we introduced another life skill.  Time to get up on two wheels.  Bikes it is.

But even the world of bikes is not as straightforward as it was when my parents bought me "Bobcat" thirty-odd years ago.  There are now choices:  do we go for the tried and tested stabilisers, or the modern and trendy balance bike?

I rather feel that for L, we have missed the boat (if that's the right metaphor in this context) with a balance bike, although that might simply be because you tend to see very small children on them, and not the slightly bigger ones, but that for S and A, we could decide to go either way.

Fortunately we have cousins, and fortunately the cousins have both sorts, so this weekend we tried them out in an attempt to see what suits.

My instinctive preference is for the balance bike.  If riding a bike breaks down into two parts: balancing and pedalling, then pedalling is, surely, the easy bit.  Better therefore to master the tricky one first and then add the easy one.

The problem is, of course, that that leaves balancing as the tricky bit, and three year olds, or at least my nearly-three-year-olds, aren't that good at perseverance in the face of initial failure.  They tried the balance bike, gave up and proceeded to fight over the one with pedals and stabilisers* for the simple reason that they could do it.  My sister-in-law also pointed out that with twins, balance bikes, which require an initial intense element of parental participation, are even harder - you can't hold on to two children on bikes at the same time, apparently, especially if they're heading in opposite directions.

So I'm veering back to the principle of four wheels good, two wheels bad, but what do others think? Does mastering a balance bike first really make learning to ride a "proper" bike easier in the long run? Or doesn't it make much difference?

PS: You'll be pleased to hear that compromise was finally reached...

Monday, 17 October 2011

Places my car keys are not

The car
The table
The kitchen worksurface
My handbag
My pocket
B's pocket
L's pocket
S's pocket
A's pocket
B's desk
The toy box
Under the bed
My handbag again
L's school bag
Under the table
In the pushchair
The bedside table
The chest of drawers
My handbag one more time (just in case)
Down the back of the sofa
On top of the cistern
M's carrycot
The other toy box
The wendy house
The fridge
The kitchen drawers
The fruit bowl
The bin (even under the nappies)
All the other bins
The recycling bin

Air of desperation...

The oven
The dishwasher
The tumble drier
The architect's pocket (he was here this morning)

My handbag.  Still.

If I don't find them soon, my sanity might vanish too.


Update - and one place they were!!!  Under the kitchen table, tucked into the frame into which the leaf of the table would fold if it were folded.  Thank you A.  Didn't look there.

Wednesday, 12 October 2011

Brainwashed by the breastapo

Let's get one thing straight.  Breast is not "best".  Breast is "better".  Unless you think there are more than two options for feeding a new born of course.  Pate de foie gras?  Chicken biryani?  Steak and kidney pudding?

I have breastfed all of my children.  I did it because I believed, as I still do, that it is better for them and for me.  L, A and S consumed nothing but breast milk for the World Health Authority's recommended six months and beyond that they had it combined with food.   It was good for them. They grew and thrived and enjoyed it. 

But M, who is now four months, is different.  He is, clearly, enjoying it, and he is, equally clearly, thriving and developing.  But he is still not, really, growing.  At 19 weeks he's now about twelve pounds (I think), which is significantly smaller than a friend of mine's (admittedly very large) four week old.

He has, thus far, had nothing but breast milk.  And if I want him to put on lots of weight, which he is not at the moment, there is an obvious plan of action.  I can see it.  I can virtually smell it (unpleasant isn't it?). Formula.  Formula fed babies tend to put on weight quicker. They tend to be bigger.  They tend, let's face it, not all to grow up to be psychopathic killers.

But I can't do it.  I have been brainwashed.

I know, logically, that formula is fine. I have many friends who have either never breast fed, for whatever reason, or who have, again for multiple reasons, moved onto formula before weaning.  Their children are all just as exasperatingly,  infuriatingly, lovingly, brilliant as mine (well, not as mine, but as most other people's anyway...).   I also live in a country where I am fortunate enough to have clean water with which to make up my bottles.  Formula is not going to damage my baby.  I know this.

But I don't feel it.  And what's weird is clearly nor do the health visitors.  I think part of this is that although M is small we are not, now, worried about him. He is growing - just not as quickly as most other babies - and  he is tracking the bottom line on the authoritarian charts. He is doing all the things a baby of his age should do and he is happy and smiley with it.  But while no one is worried, we are all agreed that it would be nice if he were a bit fatter.  Yet when I wondered out loud about formula, I was met with looks of horror.

What is that about?  How did we all get so scared of something which, let's face it, the majority of mothers in this country use from birth?   How have we, intelligent women all, become so brainwashed?

How did I allow myself to get to the point where I feel that if I introduce a bottle, I will have failed. I will be that dread being, the bad mother?  And how is it that I know I am not alone in feeling like this?  Why am I ashamed by the thought of giving my baby a bottle in public?  Why is it that I know if I were to do so, I would be judged, and found wanting?  And, most importantly, how does that help the breast feeding campaign? Is this really what they would want?  How is that better for mothers or babies?

I know that formula is not going to hurt my baby, and I also know that if I choose to give it to him it will be for all the right reasons.  Surely that decision, whether made by me or any other mother, should be praised and not condemned.

There is, here, an added level, perhaps.  For me, dealing with three other young and demanding children, the time I spend on the sofa or in bed, M on the breast, secure in a bubble of us, is the best and most focused time I can give him.  He doesn't get much of me and this is something that I can do for and with him, and for him alone.  More than that, it is something that only I can do.  No-one else can (given the lack of wet nurses in the Yellow Pages) do this for my baby.  That feels very important.  I feel, somewhere visceral (or possibly mammarian) that I need M, in years to come, to know that I did this for him, that I loved him as much as his sisters.

But that's stupid isn't it? Because loving him as much doesn't mean treating him in exactly the same way. If formula is right for him then giving it to him is as much an act of love as breast-feeding him currently feels.

So I know all this.  I really do.  But despite that for the moment I'm going to hang on to my time with my tiny boy, and the experience that only we can share.  It just feels, perhaps against logic, right for us. Maybe I really have been brainwashed.

Monday, 10 October 2011

The strange taxonomy of children's clothes

Since having M I've become aware of a whole new area of children's clothing.  It's not the blue stuff, or the green stuff, or the brown stuff, although there's plenty of that.
No, it's the crabs, and the whales, and the bears, and the lions, and the tigers, and the snails...

Why?  Why don't these feature on my daughters' clothes? Well, obviously, I now realise, it's because they're boys' animals...

Before I had children I had no idea that animals were, or even could be, divided by gender (other than the obvious, is it a boy sheep or a girl sheep? sort of division).  But it turns out they can. Someone, somewhere, has sat down with a list of animals and, Noah-like, sorted them out.  The list probably looked something like this:

Boys' animals:
Reptiles and amphibians (all sorts), insects (all sorts except butterflies),  lions and tigers (but not, it appears, leopards), hedgehogs, alsatians but not most other dogs, crustacea (all sorts), bears, sharks and whales, aardvarks, dragons.

Girls animals:
Cats, rabbits, horses, most farmyard and domestic animals (though I remain uncertain about goats), all small rodents (except rats.  Rats don't seem to feature strongly on children's clothes of either gender); dalmatians, dachshunds and yorkshire terriers, butterflies, fish (other than sharks) but not crustacea, seahorses (do they go with horses or fish, do you think?), birds (all sorts except parrots), zebras, unicorns.

Parrots, giraffes and elephants, turtles and most Australian mammals appear to be unisex.

But honestly, who decides this stuff?  And what on earth are the rules?

ps The eagle-eyed among you may notice I've changed the title of this post.  I woke up this morning and decided it wasn't very me. Not sure if that's allowed, but I've done it anyway...

Wednesday, 5 October 2011

A venn diagram of what my children will eat*

* slightly exaggerated

Of course, if I spent half as much time encouraging them to eat new things as I have working out how to get this diagram up here, I might not have needed the diagram.

Tuesday, 4 October 2011

I've got a lovely bunch.... of flowers.

Every now and then someone offers you something through your blog that you just can't really refuse...

... so when Interflora said would I like them to send me some flowers, I think I might actually have bitten their hands off.

They arrived today, on their next-day flowers service (they offered me same-day flower delivery, but as we weren't here, and I wasn't generous enough to ask them to send them to someone else, I said no thanks).

And here they are - roses galore. I'm particularly loving the red and pink combination. With some funny berry-like things too that undoubtedly have a posh name but I don't know what it is.

Oh, and please ignore the arrangement.  When I win the lottery and have time to spare (the former being more likely than the latter) I'm going to go on a flower arranging course.  In the meantime I'm of the "just plonk them in" school.  I did ask Interflora if they could send me one already in a vase, but they didn't have any available (although I'm assured they do normally). So I just had to put up with these instead.  Poor old me.

Thank you very much to Interflora!