Turbulence Part 8: Replay and Rebuild

Post crash  - finding the black box flight recording and replaying it - What went wrong and how had this been allowed to happen? The path to recovery had to be met on every level and it had many potholes.

The replaying

“I think I need to talk to someone.”

Bill looked up from his coffee. He’d heard from my tone that I was saying something big.  

“I think I need some counselling, to talk to someone about everything that’s happened, so that we can make the complaint, I just can’t go there again and write it all.”

My health visitor had suggested that we attend an official birth debrief with a consulting midwife at the hospital. Both Bill and I welcomed this, we had so many unresolved questions. During the debrief, the consulting midwife handling my case became more and more concerned about aspects of my experiences as we relayed them. At the end of our session she strongly urged us to make a formal complaint so that there could be an official investigation into my care. I agreed that this could be a good thing to do, both for myself and future patients and told her that I’d be in touch, but as the months went on I found that I couldn’t easily talk or write about my trauma and I needed to put it all down in detail in order to lodge the complaint.

I stalled for six months.

How could I walk back into that time and relive each and every moment that had been so torturous and brought me to the point at which I’d broken both mentally and physically?  

Then, on Easter Sunday 2013, (full of chocolate) I suddenly found myself online searching for trauma counselling. As I’d put our daughter down for her nap, the niggling inner voice had come at me again saying, “You have to write about what happened, or you’ll never make that complaint.” I realised at that moment the only way I would be able to revisit what had happened, would be if I got professional help. I booked myself 6 sessions with a counsellor who specialised in trauma in order to help create a game plan to deal with all that had happened. Talking to a professional listener is always a good thing to do. I wrote my story for the first time as a part of those sessions.

The complaint went through in detail (along with recognition of great work from some key medical staff) and although many of the issues were never fully dealt with, the ward midwife who had so mishandled my situation was put on a monitoring system as a result of the investigation, it was not the first complaint lodged against her.

The Rebuilding

My physio sessions continued over the next year. 

I started my own baby steps of walking again without crutches. 

First milestone was to make it down to the end of our street.

The next was around the block and then around the bigger block, until finally the day came when I was strong enough to physically walk to the park on my own!

My daughter and I were learning to move and grow in physical strength together at the same pace. She brought (and still brings me) so much joy. I was awed at her being and revelled in her tenacity for life. She gave me new eyes, new insight and a new focus. I watched her determination to master each of her new milestones. She was definitely a major player in my recovery process. As she loved and needed me, she also filled me with new purpose, kept me busy and meant that I had no choice but to throw myself back into engaging with life.

I must admit however, that at the same time as I was awed with my new sense of purpose and the wonder that is my daughter, the trouble and turbulence of loss began to rattle and shake me while I struggled to rebuild myself. This time the loss centred on my identity as I tried to figure out who and where I was in the new version of me as a mum.

I think that on some level, every new mother has to face these questions of how to come to terms with their post baby body and their new baby filled life?

One of the big questions that played over and over was how could I become Rachel, "The Singer Songwriter" again? That person on a stage in a kooky hat and steam-punk dress playing those songs, seemed so alien and far away now. The lady who would walk into an unknown room, in an unknown city, in an unknown country and sing a capella bringing a rowdy crowd into stillness, she was not this unfamiliar person, called mum. This new version of myself couldn’t even fit into any of those gig clothes, let alone stay awake long enough play a set!

I was huge. I tried not to beat myself up about it, (I mean what else is there to do when you’re house bound, recovering from injuries and growing a baby, but to eat cake?!) but after pregnancy and the birth trauma I found that I didn’t recognise myself either physically or internally. My scar was a daily reminder of all I’d been through. It was a physical jagged line reflecting back the lines that my mind and body had crossed. Having such limited mobility for all those months as well as the invasive surgery had meant that my muscles had atrophied. My core muscles weren’t even strong enough for me to hold my notes in tune when I sang, let alone strum my guitar. I was stripped of music and my ability to make it from within.

This was hard.

Music was and is so much a part of me.

Identity can be a devious thing. We all fill our minds with tricks, devices and props to ease ourselves though our days. We are what we do. We kid ourselves that what we can do will build our importance. We torment ourselves over our physical appearance and our self confidence rises and falls in relation to what we tell ourselves and how we perceive ourselves. At that moment I didn’t have the ability (or time) to do much of anything that I’d being used to doing previously. My body didn’t do or look anything like that of my previous self. The rebuilding here took a lot of self compassion to accept who I was right in that moment. Sometimes I succeeded and sometimes I failed. There were days when dredging through everything was too much. The mud and muck of my circumstances clung thick and fast in a smothering blanket of dark thought. Some days I wallowed under the covers of self pity, other days it wasn’t so much wallowing, it was just too much effort to lift the weight of those heavy sheets and the best I could do was simply try to come up for air and catch my breath, but having a baby meant I didn’t have time to stay there long. In those times I think an instinctive primal ‘mum type wiring’ kicked in as I knew I needed to take the focus off myself and get busy keeping my focus on caring for my daughter.

Through it all I realised that it was going to be a long time before I was going to be able to find the singer songwriter again and that when I did, she would be a whole new entity, as the scars of these experiences had and were changing me.

Turbulence Part 7: Debris

As far as a landing goes it was more like a series of crash landings with bits of the plane falling off at every impact. It was full of confusion. Were we airbourne? Were we on the ground? Where is the plane? There I sat unable to move with the remains of the fuselage scattered around me unrecognisable as a plane, just as my life was unrecognisable from 9 months previous… 
Would we be able to find and gather all the pieces to put back together to build something that was once again recognizable, or did we need to start again from scratch?

As I’m writing my story, I am aware of so many other stories of huge suffering around me.

There are people in my life who have been through horrific chemo and radiotherapy that has savaged them to the point of a living death existence while they endure it. There are dear friends of mine who have lost their partners and/or their children. There are those living with chronic physical pain or tormenting psychological illness on a daily basis. There are a few whose bodies and minds have been violated by the criminal actions of others. I hear my own words in the context of everything else and know that all I went through, is just life. None of us makes it out unscathed. We all have to find ways of getting up and beginning again when that rug is pulled out from beneath us and we crash and burn. This is hard. 

It was heart breaking and defeating to be back in hospital.  Although my objective self knew I needed to be there, my subjective self felt like I was in prison. In retrospect I find myself thinking about torture techniques and how repeated physical and emotional pain are used to break a person.  Of course I don’t compare what happened to me as equal to what survivors of torture have experienced, but I do feel a small amount of heightened insight as to the breaking of a soul in that way.
Add to the mix: The trauma of my fall, Bill’s near death experience, months of physical pain from my injuries, months of sleep deprivation, the epic and traumatic events of birthing and haemorrhaging, necessary but excruciating physical pain inflicted by staff with no warning or worse a false statement of “this procedure will just feel a little bit uncomfortable” constant noise and bright neon lights of a hospital environment, building work outside my room and drills sounding non stop through the daytime, a continuing cocktail of drugs, claustrophobic spaces of an MRI scan, the underlying undiagnosed medical conditions that had been ignored and dismissed as nothing important and finally listening to the sound of a few gossiping staff members making negative uninformed and disparaging comments outside my door.  All this, compounded by my own sense of grief that I was unable to properly care for my newborn child, had added up to bring me to breaking point.

Nobody knew why I had lost my memory in those moments. It might have been any number of medical symptoms from anaemia to TIA, or it might have been a psychological disassociating PTSD type of response to my trauma or just sheer fatigue so great that my mind couldn’t function, but for me experiencing those episodes of confusion and memory loss was the moment that I realised I was really very broken. Something inside had snapped both physically and psychologically. There was talk of brain scans, but in the end the consultants decided against it.

My bladder was stretched and distended and retaining disturbing amounts of fluid so the catheter went back in and then a few days later a system of monitoring began. The problem was, the hospital was so understaffed that there was nobody available who was qualified to operate a bladder scanner once the scanner finally had been located. I won’t go into the gory details of how we had to measure in the end except to say it was what they described as the old fashioned way… It is likely that I’d experienced bladder trauma from the impact of my falling and that this was part of my on going back pain but that in between my hospital admission in Italy and my re admission in the UK, there was a lot that didn’t get checked out. 

My haemoglobin levels had dropped significantly below 7 and I was finally given a blood transfusion. As I felt the cold new blood travelling through my body I wondered who this blood had previously been travelling in. I contemplated the fact that my story had intersected with complete strangers who would never know how much I valued their choice to offer something so vital in donating their blood. During the second unit I suddenly found that I began to feel more human, but then sadly almost as soon as I’d received the blood transfusion, my blood pressure soared and I developed postpartum preeclampsia. The Drs wondered if the blood loss from my haemorrhage had been masking that condition all along. Again I experienced the NHS stretched beyond what it could handle, as during the night, the staff were busy with an emergency situation and were unable to administer my medication.

We decided that one of the best things for me to do would be to try and get some sleep. This meant that Bill took our daughter back home with him for the nights I was re-admitted and she spent the days with me. The majority of staff were supportive of this decision but there were a few who felt differently and made it known to me, voicing their opinion both to my face and discussing me outside my room. New mums need support, not disapproving judgement. I knew they were afraid that I wouldn’t bond with our daughter. I already felt a terrible amount of personal emotional guilt about this, not being well enough to properly care for my own daughter, but knew that it really was the most helpful scenario to choose.  I also knew in myself that I already was as bonded as I possibly could be and that if I was going to have a fighting chance of getting well enough to function, then I needed to sleep. I believed that our daughter would feel more secure being cared for in the evening by her dad who she already knew and trusted as well as my mum who had who was on hand at that time, than by a member of staff who was a stranger.

I finally retuned home with beta-blockers and a truckload of extra iron tablets and visits from breastfeeding consultants. 

In the days that followed there was suddenly a lot of concern from visiting support team about our daughter not gaining enough weight as it transpired my milk wasn’t producing the fats/ nutrients needed. It had taken two full weeks for my milk to come in at all. At the time I could still barely walk (or do anything much physically, even changing a nappy was sending my muscles into spasm) but I found breastfeeding was something I could at least try to do. It was toe curlingly painful for many weeks, but I think I’d got so used to everything being so painful that I didn’t really question it. I don’t think I really knew how ill I’d been, or was, while I was going through everything. I had to top up every feed with formula for a few weeks but eventually we settled on continuing with a mixed feeding pattern 75 % me 25 % formula. It worked well and thankfully our baby was healthy and thriving.

I wasn’t depressed, but I was utterly and totally broken. I was starting from ground zero in every sense. I felt my life was a post apocalyptic wasteland of the person that I’d known. Anxiety and panic attacks visited me daily for many months and were often triggered by lack of natural light or lack of windows, anything that reminded me of the hospital lighting. Neon supermarkets were particularly awful.

I wandered through the debris of my broken self and very slowly began to rebuild.

Turbulence Part 6: Crash Landing

Turbulence can be disturbing not only because of the physical experience of dropping through the sky but because you cannot anticipate it, you cannot brace yourself for it. The seat belt lights ping and a calm voice announces “We are experiencing some turbulence, please remain seated with your seat belt fastened at all times as the flight may be a little bumpy for while.” But turbulence is nothing compared to the landing, which is apparently the riskiest part of flying. According to Boeing statistical studies, 16% of fatal accidents occur during takeoff and initial climb, while 29% occur during approach and landing. So, after many hours of anticipation on the long haul flight you prepare yourself for the big descent but again the voice sounds over the tannoy saying “Ladies and gentlemen, this is your captain speaking. Due to heavy weather conditions we have been placed in a holding pattern circling the runway before descent...”
 

Just when I thought we might be coming into land with my whole birthing experience we were put into an decreasing flight pattern with continuing turbulence and an emergency crash landing...

After 4 days of pre birth trauma followed by the major postpartum haemorhage at delivery, I was not given a blood transfusion as my haemoglobin level was on the borderline of 7 and the Dr’s wanted to see if I would cope without one.

The circling begins

Day 5:

My right leg had lost further mobility during labour and we discovered it lacked normal feeling when I had an ice test the next morning. I needed an MRI scan. This meant undoing the metal beading from my stitches around my C-section scar and then re-stitching my scar. I also had to have a drain removed from my wound in order to undergo the scan. I was told to expect a little discomfort at its removal. This was not a correct description so I was unable to brace myself and mentally prepare. Slowly dragging a skewer out of your insides without any form of pain relief is the best description of what it felt like. Bill could hear me shrieking from the other room.

I blacked out during the MRI scan so it had to be halted half way through. (MRI result: aside from discovering I also had a degenerative disc and slipped, tilted vertebrae, was that my daughter had been pushing on the nerves at the top of my leg during labour causing bruising and numbness)

I developed an infection, spiked a fever and became covered in rashes and enormous blisters in an allergic reaction to the plasters I was given around my wound.

Day 6:

My back muscles were too weak and spasming for me to really hold my baby, let alone change her or feed her and I kept having reactions to the various painkillers (we found out later this was most likely a bi-product of my anaemia) I experienced reoccurring dizziness, so was also feeling scared to hold her in case I dropped her during a dizzy spell. I felt an inconvenience to the staff constantly pressing the button for assistance for everything, (even though that is what they were there to do.)

My body was too weak for my milk to come in properly so we had to top up and supplement with formula. I tried very hard to take in the information that the midwives and breast-feeding support offered.

My catheter was taken out.  (Too early it would later transpire…)

Day 7:

I had a run in with a midwife who thought I was exaggerating and being a hypochondriac when I said I was worried because it felt like my bladder was about to burst through my scar. She told me that was perfectly normal and just my wound, so I believed her. I later heard her gossiping and discussing me negatively in the corridors. (Bill heard also) It was very distressing.

I just needed to leave.

I was desperate to go home. I asked the midwife if there was a still a medical reason that I couldn’t go home at that point and said that I would stay if there was one but if not I would like to be discharged.

I felt that if I could just go home, I’d be able to breathe out and begin to get better. After all, having raised my health concern issues, the midwife in charge of me hadn’t seemed to take them seriously, so I just figured it was all part of the process and normal to be feeling the way I was feeling.

I was discharged with antibiotics and huge amounts of iron tablets.

 

I got home... coming into land...

Our baby daughter was safe and beautiful.

Bill and friends were around to help.

I had 24 hours at home and finally after a visit from a community midwife, I went to sleep.

I’d hardly slept for months.

Since my fall I hadn’t been able to lie down without pain, so my nights were spent propped up with pillows all around me and I’d only been getting three to a maximum four hours sleep. During the week of labour and post the birth I’d had much less per night.

I was utterly and totally exhausted.

I slept.

Deeply.

 ...Crash...

I woke up several hours later in my bed and felt contractions.

I saw Bill in the doorway, holding a child.

“Who’s that?” I asked feeling confused.

Bill became arrested in the moment and waited for my next words.

I carried on, feeling the afterbirth contractions and said something like

“The baby will be coming soon now.”

Bill began to look alarmed. 

“Rach?” he said.

Then, as he began to ask me some questions,

I realised that I couldn’t remember.

I had no idea what had happened or that I’d already had our baby.

It was another of the most terrifying moments I’ve ever experienced.

My reality was not reality.

I felt a thousand things at once, questions, confusion and fear all pounding, "What happens if I can't remember?" My brain clawed its way forward, in an effort to make sense of what was happening. In my minds eye I saw electricity sparks trying to connect as I searched for the pathways that would connect my memory and find the huge chunk that was missing. This lasted about five minutes, but it felt much longer.

Somehow, I found my way back. 

Guilt.

How could I not know my own child?

I woke up disorientated and confused for a second time again later that day but the effects only lasted one minute that time. A wave of dizzy, tingling, terror flooded my whole being.

My bladder still felt like it was going to burst though my scar. I could feel the weight of it.

The anxiety kept building.

My mind and body filled with dread as Bill phoned our DR who then called for a first response team and an ambulance to take me back into hospital.... this time our steadfast and unfaltering friend Becky was literally left holding our baby... 

The Fall (or how I took an accidental 24 weeks pregnant stage dive in Italy!!)

As most of you will know I am currently 25 weeks pregnant with my first child. Last weekend I was on tour with gig dates in Italy and unfortunately on the Sunday eve I had a nasty fall from stage. The stage was 1.5 meters and the floor surface I fell onto was tiled with no give. I'd just climbed the stairs onto it ready for my sound check and a combination of my big baby bump and not seeing my feet and the lights in my eyes not seeing anything beyond just totally misjudged my footing and stepped out over the edge. I managed to twist as I fell and landed on my hip and back but fortunately not the baby bump, pins and needles through my legs instantly I knew it was a bad fall, and the terror that something had happened to the baby was immense. As I looked up at the various faces that surrounded me as they discussed calling for the ambulance, the first words that I spoke were in Italian and simply Bambino- amazing the way the survival instincts kick in and the brain choosing Italian rather than English in the desire to communicate the most important thing at that moment- the welfare of the baby… During the wait for the ambulance sensation came back into my legs and I found that though I could barely walk I could at least move them…

Rushed to hospital the Italians looked after me brilliantly. The relief when the paramedics found the baby’s heart beat on the way was indescribable. I was seen straight away by a obstetrician, then catheterized (as I couldn’t walk anywhere) then wheeled in to see a neurologist and both were able to confirm after thorough tests that the baby was fine and that my spine was also OK, however they were still keen to X-ray and for me to be seen by orthopedics as they possible suspected fractures to the hip and or back. A motorcycle accident however prevented me from having X-rays at that time and so I was taken to a small room in the maternity ward to spend the night.

During that time I’d had the moral support of my Welsh touring companion and good friend Dylan Fowler as well as Italian musician Stefano Giacconne who was hosting and performing with us as well as the lovely Sonia Ponzo a local photographer who had been on hand to document the gig. Stefano and Sonia translating everything for me was very reassuring and Dylan had the awful job of phoning Bill back in Cardiff to let him know what was happening.

The hospital staff brought me pain killers and told me that they were keen for me to stay with them a further 3 or 4 days. Here was a dilemma. I was due to fly back to Cardiff the following day with Dylan, who himself had to be in Germany 2days after. Further complicated was that my poor husband Bill in Cardiff is about to undergo major reconstruction surgery after and injury in his right had and is unable to drive distances at present making travel arrangements a little more tricky (though of course he was willing to do everything in his power to get there ASAP!) 

As I lay in my bed wondering what the best options were, relieved that the baby was fine but in lots of pain. I decided that if in the morning the Drs could again confirm that travelling wouldn't harm the baby and that any injury to me was orthopaedic and not neurological then I would discharge myself and get back to Cardiff and go straight to hospital there for the continued treatment, as it would mean that I wouldn't be on my own in a foreign land (even though everyone was so kind and good and supportive) , but in an English speaking environment and most importantly with my husband as soon as I could be. Decision made I reached for my iPod scrolled through the A’s and put on Abigail Washburn’s City of Refuge album. It was just what I needed to hear! The music transported me to another place that was beautiful uplifting and comforting and welcome distraction indeed! As track 3 'Bring Me My Queen' began to play the tears rolled down my face- it felt so affirming and spiritual, like a prayer, calling to the deep parts of myself, to awaken and just bring me my own queen and I'll be able to do what I need to do and find the strength to travel and make it back home the next day… the morning came with the words of the final track "Day Is A Breaking In My Soul' . As music is my job I am a strong believer in the power that it has to connect and inspire and transcend and heal, and the experience of those songs at that moment of crisis has been a very real reminder to me of those qualities that the moments of a song can bring.

Morning came, I managed to sit up in bed and eat the breakfast brought in and was then wheeled for more checks. Dylan and Stefano arrived and I told hem my thoughts re discharging myself. We didn’t have much time- the journey from the hospital to the airport was 3 hours and we had to be there by 12.00 if we were going to make it in time for the flight. At this stage it hadn’t occurred to me that I hadn’t actually walked since the ambulance had arrived after the accident. I just knew I could move my legs and that my spine didn’t have any neurological damage so assumed that meant I could walk. Wheeled in to see the Obstetrician The Dr and staff confirmed again that the baby was fine, said from their perspective that they would like me stay but understood my desire to get back asap- gave me pain killers and I discharged myself. The moment of truth. I tried to stand up to dress myself and found the pain shooting through my legs and managed a tiny step feeling like the pain was going to make me throw up. The kindly lady who was sharing the room with me offered help (she was attached to a drip and looked very unwell herself!) I realized if I couldn’t manage to get my jeans back on then how was I going to travel home and suddenly I wondered if I could do it at all. My room mate called Dylan and Stefano back into the room and I said something along the lines of this is really bad, I’m not sure if I can do this… The clock was ticking to get to the airport though and recalling the strength and peace I’d felt the night before made the split decision to just do it. So sent Stefano for the car while Dylan re packed my bag and then barely able to walk apart from a slow weak shuffle held up by Dylan began the journey…

It was difficult. The baby kept on kicking which was very re-assuring. We sorted wheelchairs for the airports either side made the 3 hour drive from hospital to Milan, then the 3 hour drive from Gatwick to Cardiff (Easy-jet had in the meantime left my bag behind- it was an inevitability really! But at least it wasn’t my guitar which we took on board) Then in Cardiff I was met by Bill and our good friend Becky who was being driver due to Bills hand injury and went straight to our local hospital, where we spent the next 12 hours in the hands of many other Drs and finally arrived home on Tuesday. (Verdict being severe muscle spasms in legs and a likely small fracture in hip but they decided against X-rays as they would be harmful to the baby)

In those 48 hours between the fall at 5pm on Sunday eve and getting home at 9am Tuesday morning I had amassed the grand total of 1 hours sleep!!

It was quite an experience… I am sincerely thankful for the selfless support and kindness of all the lovely Italian hospital staff and musicians, the beautiful Sonia Ponzo, the fantastic Stefano Giaccone and my rock solid and brilliant friend Dylan Fowler.

10 days later…. 

It has been such a relief to be home with Bill! The baby continues to be well however I’ve had a few more complications as am now in the care of the Maternity physiotherapy unit at the hospital who have identified further problems with my hip. So many lovely folks have been in touch asking for updates and offering support so below is the copy of my latest email update about it all…

Bill and I are both well in spirit but rather rubbish in body at the moment!! (Though the baby is fine and well)

I've just returned from the physio and have a whole new paradigm to get my head round. My general mobility has improved from being unable to walk to hobbling on crutches and the bruising and swelling are progressing as they should while most muscle spasms have eased however there are further complications that the physio has identified that need to be addressed...

The fall in Italy has resulted in my left hip being out of line and higher than the right one. Muscle tightness and inflammation are pushing it up- so I begin hydro-therapy for general muscle work to try and loosen it every wednesday from now on in the pool at the Heath Hospital- I won't start my actual physio treatment until I am a little more mobile as it will get worse before it gets better etc…

Because of pregnancy and the fact that the area most effected by the fall is my pelvic area, I will now be unable to do things like push a shopping trolley, lift, hoover or mop, drive, walk the dog etc… until 2 months after having given birth (they treat it like if you've had a caesarian) Though I may be able to drive sooner but will need ok from dr in order to be covered by any insurance…

This all further complicated by the fact that Bill is due for his hand surgery on the 30th May and will also be unable to lift/ walk dog/ drive/ etc… 

In the light of this we have decided that its best to cancel and postpone upcoming gig on 26th May/ as well as recording my EP from the 3-7 June and my new Counting The Waves show for its premier date July 6th… The physio seemed to think that the overall physicality of performing would be too much and we would hate to create setbacks that hinder recovery and health for giving birth...

There are also a lot of unknowns- as we don't know the impact that the baby will have on my now weakened pelvis/ back and hips as she grows, which may hinder my recovery- … we also don't know how Bill will respond to surgery- the healing and rehabilitation for him is very dependent on how his body responds to the metal wiring and pins and whether it rejects it or not… 

I am currently looking in to getting cleaners and dog walkers and friends on board to help us manage these next weeks… and lots of folks have been very kind in offering etc.. which is great ( I guess we have the pathetic sympathy vote- crippled husband with his pregnant wife of crutches!!)

Huge thanks for all your messages of support and concern

Rachel x

Bring Me My Queen By Abigail Washburn