Dr. Annie Answers: A Parent’s Intuition

Many of the things that people have said they appreciate about me as a doctor are the direct result of advice from one of my best mentors. One thing – trusting a parent’s intuition – has literally saved the lives of multiple patients of mine, and now hopefully, also that of my nephew. He’s in the womb below, while I was also preggers with baby #2.

As a resident, I remember feeling so lost in the beginning about offering advice on things like breastfeeding or colicky babies or a kid with a weird rash. I had been around lots of kids, sure, but I had never been pregnant, had never tried to breastfed a baby, or to get a fussy toddler to take medicine.

I, for sure, gave some asinine advice in those early days and more than once had patients laugh in my face (sorry pregnant patient who I tried to tell to work on her core strength for third trimester back pain!!). What Dr. Pippitt told me was, “Of course you don’t know their kid better than they do, but you do know medicine better than most of them.” Her advice now seems so obvious – let parents be the experts on their own kids. This applies to people being the expert on their own bodies also, but I’ve found we misinterpret ourselves more than parents do their kids…. so paying attention to what parents think is even more important IMHO.

Since then, I, of course, have become a mom twice over. I know tons more practical advice and can be quite a bit more helpful in treatment strategies. But! I still know that every parent is the expert on their own kid. My bottom line advice for when to have something checked out, followed up on, checked out again is always “if you, as the parent, are still worried or feel something’s not right”.

The validity of this was recently driven home in a tragic way. My sister, back in March, called me on FaceTime to show me a lump on her 3 year old kid’s neck. I took one look at it and thought, “that’s not normal”. My sister and her wife agreed and took him in to their pediatrician right away. The doc told them it was nothing to worry about. But… they were still worried when it didn’t go away. They saw ENT who also said it was nothing. But… they were still worried. Finally at 2 month follow up, it was bigger, not smaller. A few weeks later an MRI and biopsy had confirmed it was Hodgkin Lymphoma, an extremely rare, but very treatable diagnosis in someone his age.

Their intuition was right on, and had they not followed up despite being told it was nothing, it could have been caught at a later and more dangerous stage.

So, the next time you find yourself with that, “something’s not right” feeling, go ahead and get checked. This goes for your own body too, of course. Make sure the provider you see is able to make you feel confident that your fear can be ruled out before you go. This doesn’t mean they will do every test imaginable every time – sometimes we can take a look at something and tell you with high level of certainty, “you don’t need to worry”. We did go to school for a long time to learn that medical side of things, after all. But, if your care provider doesn’t listen to or respect your knowledge about your own kid or your own body, find a new one.

Dr. Annie is a married mother of 2, aunt of dozens of other amazing kids and family doctor in the Sacramento Area.

Ps. If you want to support my sister & her family, you can find them on Caringbridge.com under starlinglynnalesker

Dr. Annie Answers: Open Letter to my Patients

Dear patients,

There are things you say to me on a daily basis that I wish I could make nationwide public service announcements about in the midst of prime-time TV. We are early in our blog-adventure, but I’m just gonna put these out there in the hopes that someday they’ll be shared widely (as a close second option to a televised career).

Things you don’t need to apologize for

In my opinion, women apologize out of habit for WAY too much sh&* anyway (I’m guilty too), and I get a fair amount of apologies from men too, but these? Let them leave your mind.

  1. Women of the world, I could not care less if your legs are shaved. Not a bit. Not at all. Nor do other doctors. Unless you’re seeing a gynecologist, the rest of us also see men – know what? Men NEVER say, “sorry, I didn’t shave my [insert any body part, ever]”, when they come in to get checked out. You have enough to worry about and apologize for – let this one go.
  2. Same goes for your choice of pubic hair management. There’s a whole large part of the population that wouldn’t ever consider waxing/shaving/electrolysis and you know what? We feel fine about caring for them too.
  3. While we’re here – no apologizing for menstruating!! We have seen blood before. Menstrual blood. Body blood. Birthing blood. All the bloods. It doesn’t phase us a bit – or else we would have chosen another profession.
  4. If you cry in the office, it’s because you need help and you do NOT need to apologize for those tears, ever. If you cry, it’s because you felt comfortable enough with me as a provider that you could open up about what is REALLY bothering you – whether physical, mental or emotional. That is one of the greatest gifts to a primary care provider. That is our goal. No apologies for that.
  5. Having ear wax. We all do. We can clean it out. Don’t use q-tips to clean it, they only make it worse. (But if you do have to use a q-tip, always lubricate it with olive oil or vaseline!)

 

Exercise and diet

I’m gonna post in detail about this later. The bottom line here is: you can get an excellent workout in 12 minutes with high intensity interval training. And almost no one should ever be on a low-fat diet*. The low-fat diet trend was WRONG. It is BAD for you. Fat does not lead to high cholesterol or heart disease if it’s the right kind of fat. Know what does? Sugar. What’s worse for you: Bacon or Skittles?? I bet some people would guess the Bacon. Wrong.

A picture is worth 1000 words

If you have a rash that comes and goes – take a picture! If your kid is walking funny but only sometimes – video it! Take notes of what’s going on and bring them. Your recollections and descriptions may or may not be useful, but those are.

Agenda-setting

A list of all your questions is so helpful for organizing what to get to. However, you should know that depending on where your provider works, they may have NO choice in how long your appointment is. Many institutions do not allow us longer than 15 or 20 minutes total – that includes the 5 minutes it takes you to check in and have vital signs done. So, while we for sure want to fix everything (trust me, that’s why we picked this job!), we just don’t have time. We may have to choose some things for now and some for later. Insurance also regulates now what can be done at a “Physical” or “Wellness visit” and most will not let us address ‘problems’, ONLY ‘preventive care’ at those appointments. It is not our choice. We can’t “change the coding”, or we could lose our licenses. Talk to your lawmakers about this!!!

Share, learn, love.

-Dr. Annie

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Dr. Annie Answers: Birth Control Breakdown

This has been and still remains one of my all-time favorite conversations to have in my clinic. There are so many options for birth control these days, it can be a little overwhelming to know what is right for you. Even condensing it, it’s a long post, but hopefully you or someone you know and share it with will get some good background info to go get their safe-sex groove on. I’ll be sharing more detail on each category in future blog posts, don’t worry!

**This blog post, ofcourseofcourseofcourse does NOT take the place of a thoughtful conversation between you and your OWN doctor about what is the best choice for your particular health needs. I am not your doctor.**

I like to break the options down into bigger categories to keep it straight. With each I will give you the ‘failure rate’ for ‘typical use’ – aka if 100 normal women have a sex regularly for 1 year, this is how many will get knocked up (reference here). Here’s the big picture with color gradient for how frequently you have to do something to prevent pregnancy:

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Important side-bar #1: IF THIS POST IS RELEVANT TO YOU, YOU SHOULD BE TAKING A PRENATAL VITAMIN! Yes, I understand that you are looking at birth control because you don’t want to have a baby. Take one because IF you get pregnant despite these interventions, and there is a any spec of a chance in the universe you *might* keep the baby even to give it up for adoption, the vitamins need to ALREADY be on board. Like 3 months ago. Take one. Any of them. Don’t care if it’s a gummy.

Non-hormonal

The two most broad categories of contraceptive options are those with hormones versus those without hormones. I’ll start with the latter because there aren’t many (hey researches, hellllooooo??? can you get to work on this please??). There are a handful of reasons that people might need to use contraception without hormones (history of blood clots, certain cancers in the family, bad reactions in the past) or you might just want to avoid the exposure for personal reasons.

The Copper IUD aka PARAGARD®: Less than 1 in 100

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Did you notice how reliable this one is? Also, it’s good for up to 10 years with absolutely zero effort involved. AND, if plans change after 1 year and you want a baby? So easy to remove, no hormone wash-out period, so you can get pregnant right after. OK, ok, I know. Intrauterine devices have a lot of bad press. I will write a whole separate blog post with more details, suffice it to say complications and adverse reactions are RARE, only about 15% of women have theirs taken out in the first year for any reason.

Rhythm method or Natural Family Planning: 24 in 100 (about 1 in 4)

The reliability of this is INCREDIBLY variable. IF you have extremely regular cycles, AND you are meticulous about tracking AND you can avoid sex for 2 weeks at a time depending on the cycle, it can be close to other methods’ reliability. There are very few people who achieve this. In medicine we say, “what do you call people who use NFP? …. parents.”. That being said, if you wouldn’t be excited to be pregnant, not the best choice.

Barrier methods: 18 in 100 (about 1 in 5)

This includes condoms (also the only thing that prevents STDs) and diaphragms (yes, some women still use and love these). Not many people still do the sponge for a variety of reasons. There are new and better condom makers, vegan, non-toxic, etc… They still have a relatively high rate of failure due to tears, slipping, forgetting to put on at the right time… In my professional opinion, condoms should be used as STD preventers, NOT as contraception because 1 in 5 is HIGH failure rate, ya’ll! Fun guide to condoms in This Women’s Health Magazine Article.

Hormonal

There are a few advantages to hormonal methods – mostly involving period and, well, hormone regulation. Like I said above, there are some health conditions that influence the decision here, talk to your doctor. I also break this down into two larger categories: Combined estrogen/progesterone and progesterone-only.

Progesterone-only

The IUD squad: Mirena®, Liletta®, Kyleena®, Skyla®: Less than 1 in 100

No, these aren’t the top 4 up-and-coming baby names of 2019, these are the 4 varieties of Progesterone IUDs. The Mirena and Liletta are the classics – differing only in the insertion device we use. Good for 5 (under testing for up to 7) years. The Kyleena has slightly less progesterone and the Skyla has even less and is 0.1 inch smaller, but you only get 3 years here. Procedure is the same as copper IUD. The lower the progesterone, the more likely you are to have irregular bleeding.

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All of these usually decrease or eliminate your period bleeding. YAYYYYYYY!!!!! NO PERIODS!!!!!!

Important side bar #2: “But don’t I have to bleed? That seems unnatural…” N. O. No. Think about this: if your body had NO contraception and we were living the ‘natural’ life of our ancestors, you’d be pregnant or breastfeeding for most of your fertile years – aka, no periods. Your body is actually made to have fewer periods than most of us do. There is a slight decrease in the rates of endometrial and ovarian cancer with suppressing cycles, and NO negative health impacts.

Nexplanon (formerly known as Implanon): Less than 1 in 1000

No, that’s not a typo, failure rate here is 0.05%. That is 10 times more reliable than a tubal ligation. This is a tiny, flexible medical plastic device that goes under the skin of your arm and releases a steady, tiny amount of progesterone for up to 3 years. To get it in, we numb up your arm and then use the handy-dandy (nearly) foolproof inserter to put it in and release it.

Screen Shot 2018-04-17 at 8.25.53 PM Implanon isn’t used anymore because the inserter was NOT foolproof and some implants were put too deeply, and it wasn’t visible on x-ray so was really hard to get back out. They fixed both issues for Nexplanon.

Depo Provera: 6 in 100

This is an injection of progesterone you get every 3 months. It’s cheap, it is likely to wipe out your periods BUT has a high rate of side effects and you have to remember to go in every 3 months, so not my highest recommendation. However, some people like it. We usually recommend it as a short-term solution while you’re deciding on something else – ie: to buy you 3 months to convince your husband to stop being a weenie and go get a vasectomy.

Progesterone-only mini pill: 10 in 100 or more

I generally only recommend this one when you are breastfeeding (NOT pumping, but direct breast feeding) full time in the first 6 months of your baby’s life. It is otherwise very unreliable and if you miss taking your dose by even 2 hours, you can get pregnant.

Combined Estrogen Progesterone

Important side bar #3: If you’re somewhere in life that it is hard to get birth control – ie without insurance, without a primary care doctor or without any doctors in the area you live in, there’s an app for that!! Check out This NPR Article about it (yay for progress!!!).

Pills: 9 in 100 (if you remember)

Pills are the old standard of birth control. Easy to get, easy to start, easy to stop. Side benefits may include skipping your periods if you choose, better skin, hormone regulation. However… you have to remember them. every. day. I barely manage to brush my teeth every day. If you are that unicorn person with no problems with this, awesome. If you’re more like me? Think about another option.

The morning after pill – aka Plan B One Step – is something that everyone without a longer-term option (ie IUD or Implant) should know how to get or keep on hand. It does NOT cause abortions, contrary to the fake news out there, but CAN prevent an egg from being fertilized or implanting if you get to it asap (ideally within 3 days, but up to 5) of an “oops”. You can buy at any pharmacy in most states or on Amazon: Plan B One Step

Patch: 9 in 100

The patch is 7 times easier to remember than the pill and you get some decreased side effect due to the transdermal absorption which skips the gut/liver processing. Works great for a niche audience who doesn’t mind the patch being there.

Nuvaring: 9 in 100

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The Nuvaring is a flexible ring that you put in your vagina (a la OB applicator-less tampons) and leave for 3 weeks.  So, 21 times easier than the pill. Again, lower side effects and hormone dose than the pills because you absorb directly into the bloodstream instead of through the gut/liver. You can leave it in during sex (some people find it stimulating in a good way) or remove for up to 3 hours, rinse and replace. This one is a great option for when you need something easier than the pill but aren’t ready to commit to an IUD or implant!

Things that are not birth control:

  • Pulling out. Not even ‘pull out and pray’.
  • Spermacide alone (1 in 3 failure rate)
  • Having sex during your period
  • The first time you’ve ever had sex
  • A quickie
  • Having sex in weird positions

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Wow, that was A LOT OF INFORMATION!!!! I’m sure you have questions… ask me, ask your provider. Don’t ask people who don’t do women’s health as their profession, just, please, trust me on this one. Now, go get your safe-sex on, HEY-YO!!!

Momday Faves: Part Deux

To continue a “few of my favorite things” on these Momday Faves list….

Kristy’s turn:

Mommy Hooks

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Does this look like you running errands or enjoying a day out with kids in tow…one in a baby wearing device, one holding hands, and one in a stroller? Trying to run errands, go to the farmers market, store, zoo,shopping mall, anything can be overwhelming when the “stuff” piles up.

“mommy hold this” twice from each kid….plus picking up that package from post office and the flowers that I told you to buy for yourself a few posts ago…..

Heres your solution…The Stroller Hook!

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This one, by Toogli, is one that I like but there are several comparable brands to choose from here: Hook Options

This lovely thing clips ALL YOUR BAGS into your cart, stroller, backpack, wherever you want it! Its a heavy-duty carabiner that saved my life with two kids, a diaper bag, a baby wearing device, all the coats, shopping bags, etc!

Home Meal Delivery 

I am way into things arriving on my porch, ready to be made! Taking my kids to the store ended up getting extremely expensive for a family of four who eats wants to eat a paleo diet. We found Sunbasket.com and have LOVED every box we’ve gotten. They have very healthy options, and it saves us the time and money of getting all the ingredients at the store. Most of you know Blue Apron, but Sun Basket offers organic, free range, and different options for different dietary restrictions.

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For the price point, we’ve found Sunbasket to be the most convenient and the most excellent. As cross fitters, we need to focus on the fuel we put into our bodies daily.  With our schedules as they are, we wouldn’t eat as healthy as we do without Sunbasket.  Give it a shot!

And finally, a HUGE thank you to all of you who promoted our blog and got us to 50 followers. Keep sharing the good news and we will keep posting fun/informative/inspirational/random stuff!!

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Dr. Annie Answers: Sunscreen Low Down

Anyone else feel utterly overwhelmed by THIS when you hit the stores lately? The choices are ENDLESS!!

Whether you’re still in flurries or the sun is shining, summer is coming! You all know by now that sunscreen is absolutely critical for you and your fam to prevent deadly skin cancer (if not, what rock have you been living under, seriously??). The huge array of options can be super overwhelming.

I’m going to try to simplify things here. There are 3 rules:

  1. Choose physical over chemical sunscreens.
  2. Choose creams/lotions over sprays.
  3. If your choices are limited, still choose some sunscreen over no sunscreen.

In slightly more detail….

Physical vs Chemical

There are 2 ways to block the sun’s damaging rays. One is physical blocking. This includes simple shade or clothing or reflective minerals that you put on your skin. The two primary ones are Zinc Oxide or Titanium Dioxide. The other way to decrease UV radiation is with chemical sunscreens. These are ingredients like Avobenzone, Oxybenzone, Dioxybenzone. Yes, these block UV rays. However, they have not been studied well in humans and in animal models, can be absorbed through the skin – aka, get into the bloodstream and cause problems with endocrine function (thyroid regulation, hormone regulation, blood sugar regulation). Gross.

There is an awesome guide for brand-to-brand ratings here EWG’s Guide to Sunscreens. Our family’s go-to’s are:

Screen Shot 2018-04-10 at 10.10.07 AMBare Republic Mineral Sunscreen

Easy to find at Target and Amazon, goes on nicely, badass bottle (I’m a sucker for good marketing). Sport and Baby versions available. Stick version convenient for little faces.

 

 

Screen Shot 2018-04-10 at 10.12.15 AMCalifornia Baby Super Sensitive Sunscreen

No, I don’t just love this because it says “California Baby” (ok maybe a little), it’s also ultra-sensitive for the rashiest kids. Again, stick version available.

 

 

 

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Blue Lizard Australian Sunscreen because you know the Aussie’s got the sunscreen game DOWN. This goes on easily – not just for babies ;^)

 

Arbonne Baby Care Mineral Sunscreen Screen Shot 2018-04-10 at 10.49.35 AM

 

 

 

 

Arbonne is sold directly through independent providers – I get my goods from my awesome niece (she’s an adult, we have a crazy big family) Megan Fikes

 

 

 

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Elta MD UV Clear Tinted This is the only sunscreen that has EVER not made my face allergic, and with slightly tinted look, is flattering and not white. I wear this every. single. day.

 

 

 

 

 

I can hear you now:  But lotion is so hard to get on a whining, wiggling kiddddd!!! 

Strategy: Before you even get dressed to go wherever fun, sunny place you’re going, apply to your naked child. This way you have a “base layer” in case of wedgies or – if your kids are like mine – unexplained nakedness. Then, just touch up when the clothes come off. Reapply (of course) every 2 hours or when they get out of a body of water and defrost/dry off for a bit.

Spray vs Lotion

When you, as an adult, put on that super-convenient aerosol-spray clear chemical sunscreen, have you ever gotten a *little* of the spray up your nose at the end? And you know how to hold your breath well. Game over for kids – they’re for sure getting it in their nose, eyes, mouth… lungs, stomach. I’m a laid-back parent about dirt, mess, hair dye, the occasional junk-food treat. But chemicals being inhaled and swallowed?? nope.

That being said… there are times and particular children that do require faster application. So IF you must use a spray, top choice is a manual spray bottle with mineral sunscreen, because, the environment. Choice 2 is aerosol mineral sunscreen. Really, just avoid the chemical ones unless it is literally the ONLY way to not have a severely sunburned child.

Kiss My Face SPF 50 SprayAlba Botanical Refreshing Spray Mineral SunscreenBare Republic Spray

Final Rule: Some protection is better than nothing.

Questions come up in clinic all the time about “how old does my baby have to be to wear sunscreen?”. The best, safest sun protection for babies is to keep them in the shade. This goes for all ages, actually.  Avoid the strongest sun, wear hats and loose layers when you can, seek shade.

This is most applicable for babies that are non-mobile. That is the primary reason that the typical recommendation is to start sunscreen when your baby is 6 months old. That is when most babies start to crawl and shade is less reliable. That being said – if you’re gonna be at a sunny farmer’s market with your 4 month old baby in the Ergo, they might pull their perfect sun-protective hat off and yes, you should put a little swipe of safe, mineral sunscreen on their sweet face and hands and toes if they’re exposed.

And if you’re in a pinch, forgot alllll the sunscreen in the bag (maybe because someone left that bag in the entryway when the kids were being loaded into the car…), and the only sunscreen available is some aerosol Coppertone at the gas-station. Yes. Use the sunscreen. Life is all about minimizing risk and doing the best we can.

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Dr. Annie is a married mom of 2, family doctor, amateur blogger and Nerium international independent brand partner. This post is her own opinion, is not sponsored by any products listed and does not replace the personal advice of your own physician.

Dr. Annie Answers: Momxiety

For as long as I can remember, I wanted to be a mother. As a child, I have clear memories of poking my little tummy out with a stuffed animal in my shirt, pretending to be pregnant.

Fast forward 20 years, I was married, at the end of residency, my 3 best friends (the other illustrious ladies of Lockers to Littles) had all just had their first babies and I got THE FEVER!!! It took 5 months (which is not actually a long time at all but felt like forrrevvvverrrr) but it happened! I was pregnant!

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That was where the excitement ended. I got morning all day sick from week 5 that was relentless. If you’ve had morning sickness – now imagine having it while having to examine infected toenails of vagrants or while talking to a chain-smoking person into quitting or while a woman in labor is herself vomiting and pooping on the bed. I lost 15 pounds in my first trimester.

Then came headaches, insomnia and fatigue combined, sciatica, pubic symphysis pain, round ligament pain so sharp I would cry out, then premature contractions and labor scares. I was NOT basking in my joyful pregnant glow. I was confronted day to day with women with infertility, pregnancy loss or worse so I felt unbelievably guilty about any negative pregnancy thoughts. But I. was. miserable.

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At 39 weeks 3 days of pregnancy, I was still having on and off contractions as I had been for 2 weeks. During my morning clinic, they got progressively stronger and were coming every 5 minutes. I called my afternoon clinic and told them I wouldn’t make it. Rosalyn Elizabeth was born 12 hours later. I was so excited! Labor and birth had been (relatively) easy for me. My baby latched well. I was finally going to get my motherhood bliss on!

735077_663767542506_803843932_n.jpg3 days later, post-partum anxiety and depression hit. Hard. I naively thought since I was used to working 30 hours at a time with no sleep that having a baby wouldn’t be that much worse. But, in parenting, there is no “post-call day” that you sleep for 8 hours and recover. Hormone sh*% hit the fan and I remember sitting up in bed in the night, tears streaming down my face, seriously contemplating leaving the baby with my husband and running away to Mexico. I wanted this baby so badly, but I had never been more depressed. What was wrong with me??

I thought I had “baby blues”. I struggled through. I hated motherhood. Week 6 hit and I had to go back to work. I couldn’t stop crying and was in a panic about how to get through a day of clinic when I broke down doing things like making toast. The day before, I scheduled a last-minute appointment with one of my attendings (the boss-doctors). It finally dawned on me that she had given us a lecture on post-partum depression. She had admitted that she had it too.

We had both been taught – AND taught others – about this but fell into it without recognizing it ourselves. I started Zoloft and though it’s physiologically not possible for the full effects to kick in that fast, within 2 days I was well on my way to being a (mostly) normal person again.

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When you are in the depths of that kind of depression and anxiety it is nearly impossible to even recognize there is another way to be. Of course you worry about your baby. Of course you feel guilty for not getting things done the way you used to. The issue is when this prevents you from living a relatively normal day to day life.One in seven women will experience postpartum depression. There is a lot More Information In This AAFP Article. It can hit any time between 1 day post-partum through the first year, but the peak is 2-4 months of baby’s life and it can harm not only mom but baby too. It’s harder for bonding, breastfeeding and nurturing when mom is suffering from PPD.

The screening tool for depression we use is SIGECAPS:

  1. Sleep issues? check.
  2. Loss of interest? how could you possibly do anything fun when the baby takes all your everything, so check.
  3. Guilt? Oh man, there is no guilt like mom-guilt.
  4. Decreased energy? duh.
  5. Lack of concentration? what was the question?
  6. Changes in appetite? Does EAT ALL THE THINGS count as appetite?
  7. Psychomotor retardation (aka do you move slowly)? Took 2 hours to get dressed, so, yeah.
  8. Suicidal thoughts? This one is less universal. But was there for me. Never in an active way, but did I think “wouldn’t they be better off without this useless lump of human?”, yes. I did.

A few positives, some of the time, yes, is “baby blues”. I hit all of the above. every. day. of that time. But I still couldn’t imagine a happier me. So when that serotonin finally hit my struggling brain cells, it was an absolute revelation. I wanted to shout from the rooftops “YOU DON’T HAVE TO FEEL THAT WAY FOREVER!!”. Yes, I still worried about my baby, but I no longer stayed up for days on end because I was convinced she would stop breathing in her sleep. Yes, I still felt a little guilty about not getting stuff done, but I no longer felt like the world would be better off without me if I didn’t get the laundry done.

That’s the thing about depression and anxiety treatment – it’s not meant to make you a zombie or to fix all your problems. The medicines correct imbalanced brain chemistry. The therapy helps you retrain your wayward thought processes. Treatment helps you get back to normal. In the case of moderate to severe symptoms, the fastest and most effective course is usually both therapy and medication. The medicines is safe (even while breastfeeding – in fact it sometimes increases milk supply). It does no harm to your long-term mental health. It is not addictive. It may actually save your life.

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There are a lot of resources for parents with anxiety and depression, but the most direct access to care is usually your primary pregnancy care provider. Your family doctor, OB or midwife can help you get therapy, medication and other treatment or testing. If this is you, ASK for help. If this is your friend, partner, sister, colleague – share this story with them.

As you may have noticed, I got “momnesia”, forgot all of the above misery and decided to have another baby. I had been able to wean off the meds after about 6 months and was back to my usual crazy awesome self. This time, week 2 post-partum, when the all-day crying jag hit, I knew what to do. I called my doctor and got on my Zoloft right away again. Wouldn’t you know, it went so much better, now I want a third baby!  I could never have been as effective of a primary care doctor myself had I not gone through all of this. We live and we learn and life is a beautiful adventure that way.

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Photo credit: Fiona Margo Photography fionamargophotography.com

Annie is a married mother of 2 and family physician in California.

Potato, potato and other messages from above

So, part of what led me to this awesome blog adventure is an ultra-inspiring book called The Universe Has Your Back: Transform Fear To Faith by Gabrielle Bernstein. The book plopped into my life at the exact moment I needed to hear her message: don’t let fears about the future stop you from following your passions.

Meditation and positive thinking have been shown to have very significant positive effects on all sorts of aspects of one’s health. And, I’m not just talking about mental health. In this study published in 2015 in the International Journal of Cardiology by CM Dubois et al on patients with coronary artery disease a meta analysis “showed  that positive constructs were associated with reduced rates of rehospitalization or mortality”. Let me break that down for you – if you had a positive outlook, you were less likely to have to go back to the hospital or DIE from your heart disease. There are similar findings for diabetes, arthritis, and of course depression, anxiety and all sorts of psychiatric disorders.

I had lived in fear about the time commitment of writing a blog, even though I knew it would be fun and fulfilling for me, for literally, years. Letting go of that fear was obvious. My Our decision about baby number 3 was more difficult. You see, even though my ovaries and soul (are those the same thing? a question for later….) were crying out for more, my level headed hubby was quick to point out all the reasons not to rock the boat. I couldn’t figure out if it was fear or logic holding me up.

I decided to sit down with one of Gabriella’s meditations where you clear your mind and ask [The Universe, God, Uncle Tony (if you’re my mom)] for a clear sign that you’re on the right path guided by love and joy. Having done yoga and meditation for about a decade, I still struggle to clear my mind every. dang. time I start a meditation. But, not this time!! When I wanted something to *pop* into my mind as my sign I’d look for, nothing. Blank, black, peaceful nothing. And then, finally, clear as day, this roars into my head:

“Potato potato, ching chong tomato!”

Um, excuse me Universe? That’s my sign?? The absurd line from an insomnia meme I looked at 3 days ago??  At the same time, I realized the Universe was probably looking at me going, “Really?? How do you expect me to pull that one off? Most people pick owls or the numbers 1234.”

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I decided to go for a second sign. Peanuts! I always think of little babies as a peanut. So, peanuts in the shell seemed like a much more doable sign.

On went my life in a bit of a blur. The usual day-to-day was extra-challenging because Noemi got the dreaded post-cold-ear-infection and was miserable and so clingy and whiny (and yes even doctor moms stress about whether their kid does or does not need antibiotics). Today, FINALLY, she was well enough to go back to preschool and I got to go to the gym and the grocery store without a child in tow – basically a mini-vacation! As I waltz through the grocery store in my post-workout chill, I am contemplating, “how in the heck am I going to find ‘potato, potato, ching chong tomato’?”. Maybe my sign was getting an ovarian cyst a month ago and that emotional breakdown and I am overdoing it asking for a specific sign… Suddenly, I’m starving and head for the deli section. And stop dead in my tracks.

The middle prepared food cart has, in this order, french fries – mashed potatoes – 2 containers of crappy “Chinese” food – and tomato-vegetable soup. I kid you not. Potato, potato, ching chong tomato. I almost keeled over in shock. Then, I immediately was mortified and mentally berated myself that I had associated the Chinese food with “ching chong”. I quickly convinced myself I was reading too much into this. In a daze, I ambled over to the produce aisle, where I ran smack-dab into the large display of…  peanuts in shells. Well, butter my butt and call me a biscuit. You could have knocked me over with a feather. (I start talking in all my mom’s southern sayings when I’m in heightened emotional states, it’s not something I can control).

So, friends, moral of the story is: If you’re unsure that you’re following your joy and a decision is right for you, ask for a sign! Make it specific, and then be open to find it. If it’s meant to happen, the Universe will find a way! And also, this blog will, probably at some point in the next year, feature my pregnancy stories if I am reading the signs right 😉

My favorite app for guided meditations is the Insight Timer (they don’t pay me). It is free, has thousands of guided meditations from 1 to 90 minutes long and also just a timer setting for quiet meditation.

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Last pregnancy, delivering babies at 36 weeks!