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... 

Turbulence Part 5: No, I'm Not Gonna Lay Down And Die

It seems a huge failing in my mind that we humans haven’t evolved to make the childbearing feat of endurance easier on ourselves by now. The fragility of the birthing process is terrifying. No matter of the details, any woman who has given birth is heroic in my opinion. As I write about what happened next, I am aware that in spite of all that I went through, I am so very fortunate. I am forever grateful for the medical staff and the work they did. I survived. My child also survived. I have friends who would love to have children but the circumstances of their lives have made this impossible. I have friends whose beautiful, precious children didn’t survive.

Sometimes life just is unrelentingly hard and cruel. We will all face unquantifiable hardship and pain at some point, as the words of the late Robert Fisher of Willard Grant Conspiracy Theory say in his Suffering Song :

“Suffering's gonna come

It's as old as the world

It's as old as the world

Suffering's gonna come to everyone, someday"

Nobody knew if my injuries would impact my ability to give birth. My antenatal physio had advised me that I should try to avoid C- section as it would cause further injury to the already damaged area of my hips and pelvis and further exacerbate my recovery process. A consultant informed us that he felt I would be ok to have a natural birth also. Retrospectively it seems insane that I didn’t just opt to have an elective section however, we wanted to trust the advice we were given, we wanted to hope. So we decided that we’d at least try for a natural birth, with the option of intervention if needed.

The outcome…

After a week of complicated labour (including back to back labour / 2 failed inductions/ failed epidural as I bled into the line/ physical pain beyond anything I can find words to describe/ the baby’s heart rate going down and many more struggles and complications along the way, our daughter was finally delivered, 15 days after her due date by emergency caesarean section.

Then I suffered a major post partum haemorrhage.

“There’s a lot of fluid, she’s losing a lot of fluid,” I heard urgency in the tone of the surgeon’s voice.

It was moments after my daughter was pulled from me. I had just found myself incredulous that she was 9lbs10! The nurse carried our not so tiny newborn over to me and I desperately wanted to hold her but suddenly I found I was shaking uncontrollably. I looked at Bill and asked him to hold her instead. I knew that something was going very badly wrong. Lying fully conscious on the operating table I experienced a violent physical turbulence as my body lurched and shuddered, while I bled out.

There have been many moments in my life when a work of art has reached into my consciousness and helped me to survive my brief stint here on this planet. A few months earlier when I was awake at 3am in an Italian hospital bed following my fall, I had one of these moments. I remember reaching for my iPod and putting 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, comforting and a much needed, distraction. As track 3 'Bring Me My Queen' began to play the tears rolled down my face- it felt so affirming and spiritual, like a sort of prayer calling to the deep parts of myself, to awaken and just bring me my own queen and I'd be able to do what I needed to do and find the strength to travel and make it back home to Wales the next day. The morning light dawned through a gap in the curtains in sync with the words of the final track to Abigail Washburn’s old folk Americana "Day Is A Breaking In My Soul.' 

Here on the delivery table I was about to experience another such moment and I will forever be grateful to the kind and compassionate human who made that happen. My anaesthetist, stood up and left my side to speak with the Drs and see what was going on. He had a worried look on his face when he returned. Earlier in the birthing room, during my failed inductions we’d had a brief chat about music and musical tastes. He’d commented that he’d really liked the playlist of music that we’d put on in there. Now in an act of inspired human kindness he asked, “Would you like to listen to some music? I have Beth Orton on my phone,”

“Yes.” I nodded.

I hadn’t told him how much I loved Beth Orton.

I gripped his hand as lightheaded panic and fear flooded my mind. He played “Sugar Boy” a song where Beth is sarcastically telling her lover that “…it’s all over now…” I know, initially that sounds like the worst possible thing to hear, but it wasn’t at all. It was in fact the very best thing for my panicked mind and heart to hear right at that moment as Beth continued defiantly singing a repeated chorus of,

“Do you want me to lay down and die for you?

Well I'm not gonna lay down and die,

No I'm not gonna lay down and die,

Oh no I won't lay down and die,

Never gonna lay down and die…”

I looked across at Bill holding our daughter. She was alert and calm, eyes wide, looking around at everything. I knew that I would be ok. This was just turbulence, the flight was not going down that day. I felt the hands of my surgeon working to stop the bleed.

Beth continued to sing…

“Oh no I'm never gonna lay down and die for you,

Oh no I'm never gonna lay down and die for you,

I'm never gonna lay down and die.”

Several hours later in the recovery ward, my daughter was finally placed on my chest.

She was still so alert and curious. She gave me a good long stare with a look that seemed to be sizing me up.

I felt relief.

I’d made it to the finish line.

Or so I thought.