19 Dec 2015

Twenty Six Months (And One Day)

In October 2013, I took Jimmy to see a GP about his mounting behavioural issues. He was referred to a paediatrican.
In January 2014, Jimmy was referred for an autism assessment following a provisional diagnosis of Asperger's-type autism. We were told the waiting list was 3-6 months, which I thought seemed suspiciously brief.
I was right to be suspicious - after 8 months, I phoned the clinic and discovered they had no staff. None. No autism team to do assessments. It wasn't just us, everyone in Peterborough has been waiting months for their child's assessment. In May 2015, after a particularly awful spate of school and home based episodes, me and Jimmy's dad both tried to get his appointment expedited. Jim was self harming, hurting people in the class, spending more time out of class than in it. And there was nothing the hospital could do except assure me they were reassembling a team and his name was quite near the top of the list when they did this.

Imagine my joy when I finally got an appointment...for exactly the same date and time as he was due to have a herniorraphy in Norwich. I had to cancel - surgery takes precedence over lifelong development delay. I was expecting to have to wait another six months for a new appointment, but they actually made me a fresh one for just three weeks later.

And the nerves kicked in. You see, the problem with having a child with reasonably high-functioning autism is that you doubt yourself. You doubt there's anything wrong with them. You think...what if it's just my shitty parenting? What if I'm wrong? What if he's normal and I'm the problem?
The whole of society are hell bent on either pretending autism doesn't exist or pretending everyone's a little bit autistic, ergo autism is nothing to worry about. You may detect a note of weariness here. You would not believe the amount of times I have come up against people who think autism is a childhood illness, or an excuse for bad behaviour, or a symptom of Munchausen's by proxy. The people who think that because they get a bit anxious in crowds or trying new things, they too are autistic. The people whose idea of sensory overload is annoying levels of noise rather than hideous distress.

Jimmy, as I've mentioned before, looks normal. Until he's lying face-down on the pavement because of a dog, or screaming bloody murder because you've asked him to put toys away, or biting himself because he's worried, or gouging at his friends' eyes, or walloping his little brother over the head with a wheelbarrow, or wandering around a moving bus like it's his bedroom, or shaking the baby all over the place because he thinks that will settle him, or just until you try and have a conversation with him when he doesn't want to. He is full of surprises.
I've been rebuked for referring to him in terms of normal and abnormal. The truth is, to consider autism as an abnormality allows the world to marginalise autistic people as subhuman and unimportant. They aren't. Let's not do that. Let's embrace neurodiversity, because autistic people and their 'abnormal' brains are capable of everything you are, and more.
But when you're talking diagnosis, you have to look at what isn't normal, what isn't standard, what is strange and weird and difficult. It is awfully depressing, because the way you cope with the challenges of raising an autistic child is to concentrate on what they can do, what they are good at, what they can excel in, and you have to reverse this way of thinking entirely for the purposes of all things medical and benefits.

The first part of his assessment was an ADOS assessment. This stands for autistic diagnostic observation schedule, and involves a 45-ish minute appointment between a psychologist and your child, but (if your child can speak) not you. That was a bit jarring. Jim was lost in a world of his own when she came to collect him, building patterns out of blocks. But he went off with her quite happily and without any anxiety. He's getting brave. I asked him what they did - talked about feelings, acted out a play and played with Batman apparently.

The second part of his assessment was a week later, and is called an ADI-R or autism diagnostic interview (revised). This one was just for me, and Alex who's too small to leave for three hours yet. The night before, I was a terrified wreck. I collated all the letters and school bumpf I had, wrote out a timeline of symptoms because my memory is dreadful in face to face interviews, and tried to lose myself in the dreck of X Factor. It made no odds, I barely slept and then the kids wouldn't get up so I was all of a mess in the morning.
But, thanks to my dad, I made it on time. The psychologist was lovely, and the interview took four hours. It is so long. SO LONG. You have to talk about behaviour now, at 4-5 and at 3, to do a backwards comparison. You have to talk about every little thing that you stopped considering odd years ago, and try and make sure the salient points are included. If you're reading this because you've got an ADI pending, fear not - they include EVERYTHING and ask for more stuff at the end. It was actually pleasant to sit and talk about him without any focus on "and how do we fix this" for a while. Everything ends up so goal focused in SEN that you sort of forget that there's a real person under it all.
At the end, she added up the myriad totals and told me the result. Jimmy scored highly on his ADOS, mainly due to communication difficulties. Jim is so very verbose that I forget that his communication is abnormal - he doesn't converse, he makes a speech at whoever listens.
His ADOS scores were
Reciprocal Social Interaction: 5
Communication: 3
Restricted and Repetitive Behaviour: 1
I don't know what the normal levels are, but this combined gave a score of moderate autism-related symptoms.

The ADI-R scores were as follows:
Social Interaction: 22 (normal is below 8)
Communication and Language: 29 (normal is below 10)
Restrictive, Repetitive and Stereotyped Behaviour: 9 (normal is below 3)

I was shocked. I knew Jimmy has problems, you would have to be without a head to notice them, but to have them spelled out in black and white was a strange, disorientating feeling. I have been waiting for two years for this. Two years of wondering what if I'm wrong, what if he's fine, what if it's just me, what if he's just made wrong. And then there it is.
Autism.
Not Aspergers, because his social and communication difficulties are quite profound. Moderate, because he can speak and function well within his own spaces. But otherwise, a textbook, classic autistic boy (her words, not mine).

I got home and I wept.
I wept for the six years I have spent worrying, advocating, fighting, shouting, wondering, hoping, hating myself for hoping, listening to bad advice, listening to good advice, listening to any bloody advice. I wept because I love him, regardless of how hard it is sometimes. I wept because I should be grateful he's not ill, and this isn't an illness, and he will be OK. I wept because it was a shock, even though it wasn't a shock.I wept with relief, and with pain, and with love.

Then I had a cup of tea and got on with it, because nothing has changed. Jimmy is exactly the same as he was a week ago, a month ago, a year ago. He was born autistic, he will die autistic, and he will live autistic. He is autism, autism is him. There is no separation. A label cannot change brain chemistry.
But now we can learn to cope with him better. He can get the help he needs in school. We can modify how we teach him things.We can help him

This is not the end of anything, although the journey to this point has been long, but the beginning of lifelong learning to help Jimmy.

20 Nov 2015

Roast Chicken For Your Soul

When I am sad, and stressed, and wrung out like a filthy bit of kitchen rag, I make roast chicken. I made it yesterday when Jimmy came out of hospital. I made it on the first day Tom went back to work after the baby was born. I make it on Mondays, when everything sucks. I make it on Sundays, when everything will suck. I make it on Tuesdays because nobody likes Tuesdays. Tuesday feels like the entire week has risen up in front of you, defiant.. I make it because my children will clear their plates and I feel like I've done something right for once. I make it for no reason other than it tastes good and I feel better for creating something so quintessentially domestic.

My mother taught me to make a roast dinner, but she would spurn this as incomplete. Many people would.  Where is the bread sauce, the stuffing, the cauliflower cheese, the carrots, the mash, the proper roasties? BISTO GRAVY? Heathen. You can add all those things and more, and I do when the mood takes me, but this is not for then. This is for comfort; not the stress of a thousand things in the oven at once, of mashing, and mixing, and burning hot fat sploshing all over the place. This is the easy base from which all else can rise. This is for days when chopping things up is about all you can manage. And the washing up isn't too evil either. 

You will need a chicken, a lemon, some butter, some waxy potatoes, some garlic, some dried rosemary, some salt, some green vegetable and Bisto.

First, get your chicken. I would rather eat good chicken once a month than shit chicken every week, so I buy a free range one from a supermarket. It costs about twice what a battery chicken does, and it's not guaranteed to be twice as ethical, or even twice as tasty, but there is nothing more depressing than some poor pale creature that has lived out its six weeks of life up to its eyeballs in shit, crammed into a tiny space. If you are minted, buy an organic chicken. But try free range as a minimum. 
If you get your chicken from the supermarket, it will have the cooking time in minutes on the front of the packaging, if you cook it at 180 degrees. Note this. If you don't, there are sundry guides to cooking times on the internet. Preheat your oven. 
Get a roasting pan. I have two medium sized ones that are differently shaped, to accommodate chickens which are fatter or longer. Put a massive sheet of baking parchment in the bottom of the pan. This serves two purposes - it collects the juice, and it stops the chicken sticking to the bottom of the pan, which is a shitter to wash up.
Put the chicken in the baking parchmented-pan. Cut the string tying its little legs together, and untuck them from the cavity. The legs will spring open, like a birthing woman. Leave them there.
Get some salted butter. Cut a chunk off - how much depends on how sad you are - and blast it for five seconds in the microwave. Take it  into your paw and smear it about your chicken. All over the breast, the legs, the wings, the weird bits between the legs and breast. Wash your hands before you absent-mindedly wipe them on your jeans.
Take the lemon. Cut the lemon in half. Don't spray yourself in the eye as you do this. Take one half of the lemon and squeeze it all over your buttery beast. When that half is well emptied, shove it up the chicken's arse. Yes, you read that correctly. Keep the other juicy half; you'll need it later.
Sprinkle a little salt over the breast. I use a small amount of sea salt for this, because it makes the skin taste even more delicious. Saxa table salt is fine though.Don't overdo it.
Remember the cooking time for the bird? Stick your bird, uncovered, in the oven, and note (mentally or on your phone or on paper or whatever) what time it will be finished, and when it will be an hour from finished. 

Go do something else for a bit. A bath. A read. The telly. After half an hour, the house will begin to smell of chickeny goodness, and you will get hungry. 

About an hour before your chicken will be ready, get an ovenproof dish out, the sort you do pasta bake or cottage pie in. Get your waxy potatoes. I use Charlotte ones. They're a quid a bag from Tesco, but use whatever you like. Guess how many you might like to eat - we will generally eat a whole kilo between two of us. Adjust for numbers and greed. Chop them up. Doesn't matter how. I take the ends off, then slice them into rounds. Sometimes I do them as chunks, which tend to crisp up a bit better in the oven. However you do them, they need to be not-too-thin. Too thin makes the equivalent of crisps, and that is not what you want right now. Too thick and they don't quite cook through. Between a penny and a pound in thickness. When they are chopped, put them in the ovenproof dish. Slosh some olive oil over them. Squeeze the other half of the lemon over them. Sprinkle a little rosemary over; not too much or you'll just taste rosemary. Crush some garlic. How much garlic? How much do you like? One to two cloves gives a pleasant waft to the thing. Five gives a punch. Add that to the dish - I use a garlic crusher because then it melts into the potatoes and you don't get the nasty crunch of an unexpected slice. Add a good sprinkle of salt. Then mix it all up with your hands. Make sure each potato piece gets a bit oiled. If you think it's too wet, drain a little liquid into the sink. If you think it's too dry, add a little more oil. Cut the juiced lemon half into half again. It will be all sad and squidgy and dead, but it gives such life to the dish. Chuck it in. 

Put the dish in the oven. It will take between 45 and 60 minutes to cook, which should align with your chicken being cooked. Give them a stir if you think they're burning, but I always forget to check them, and they never do. Your hands will smell so good, you will want to eat them. Don't eat them. Wash them before you wipe them on your jeans. 

You have an hour-ish to kill. Go and do something relaxing. My god, your house smells amazing now, doesn't it?

I don't know what green vegetable you like. I tend to cook broccoli, green beans, peas, asparagus in season, or a mix of all of them. If you want them to be ready at the same time as the chicken, you'll need to be ready to cook them around 15 minutes before the chicken is done, but the nice thing about this is that unless you get stuck on the phone to someone or fall asleep or have an asthma attack, an extra ten or so minutes in the oven won't hurt. 

Is your chicken ready? You can skewer it to check - in the deepest part of the thigh, shove something sharp and then observe the juices that bubble forth. If they're clear, you're good. If they're pinkish, give it another five to ten minutes. I tend to trust the supermarket, and don't check. I deserve food poisoning. If your chicken is ready, remove it with a flourish, close the oven door and turn it off - you can leave the potatoes in there for a bit, they won't spoil. 
This chicken had twenty minutes longer than it should have, thanks to screaming children. Still tasted amazing. 

Leave your chicken on the side for a moment while you put a load of Bisto into a bowl. How much Bisto? I don't know. I like my gravy ludicrously thick, so I put in a fair bit. I don't think Bisto is really an exact science. 
To get your chicken from pan to plate is not necessary if you feel like just ripping the chicken off the carcass and shoving it into your face, and this chicken is so good, I wouldn't blame you at all. But I move mine out of the pan and onto a plate using a big spoon and a fish slice. I take the lemon out of the cavity, put the spoon in the cavity, and then use the fish slice to lift it from the pan onto the plate. Truly, I am an elegant genius. Should you drop your chicken on the floor...pick it up with a tea towel. You won't though. If I, clumsiest of women, can do this, so can you. You can put a foil tent over it if you don't think everything else will be ready for ages, but a cooler chicken is much easier to attack with hands and knife. 

You should now have a pan of delicious chicken juice and buttery lemonyness. Put some into your dry bowl of Bisto. No water yet, just juices and Bisto. It will look deeply unappetising and nothing like gravy. Fear not.
Mmm, slurry au Bisto avec jus de poulet!

Boil the kettle. While it boils, drain your veg and take the potatoes out of the oven.Give the potatoes a bit of a prod, to check they're cooked. They should YIELD. I love that word - yield. Give way. Fall to the sword that is the point of your little knife.

Your chicken should be covered in a golden skin, with speckles of crusty salt and generally look and smell beautiful. So beautiful it may be difficult to come to terms with the necessary carving. Do yourself a favour: rip some chicken skin off and eat it. Eat some more. Stab any wandering hands trying to steal your chicken skin with a fork. This is the definitive cook's perk. By the time you've eaten the skin, you should have a beautiful white breast looking up at you with a bone running down the centre. Put a sharp knife down either side of this bone. This parts the breast off the skeleton of the bird, making it far easier to carve. Men like carving on the bone, all knives and dead beast. I do not. Should this technique fail you, rip it off any which way you can. It all goes down the same way. 

Plate up. Chicken, potatoes, veg. Now pour just enough boiling water into your chickeny Bisto slurry to turn it into the consistency you want. In our house, that's basically meaty custard. Stir it vigorously with a fork. Pour it over your chicken, potatoes and veg. Eat it. Eat it all. Wonder why you ever feared roasting a chicken. It tastes good. It tastes safe, and comforting, warm and homely. It is balm. And you made it all by yourself. 

I have a confession. This chicken dinner didn't have gravy, I just lobbed some pan juices over it at the end because I was tired. And I made Ellabell Risbridger's amazing garlic kale instead of plain greens, but god it was good. It is always good. 

Leftover chicken mixed with mayonnaise and mango chutney make the best sandwiches I have ever had the pleasure of eating. You can also use them to make some sort of stir-in-sauce meal the next day. The leftover carcass, boiled in plain water for a few hours, makes the most delicious jelly of a stock. A chicken is a useful thing. But firstly, you get this meal, and that is always worth the effort. 


With thanks to Nigella Lawson's roast chicken in How To Eat, which is a must-read for food lovers, even if you have no idea how the oven goes on. 

19 Nov 2015

Love Your NHS

I am not afraid of hospitals. In fact, they are almost a second home. The NHS has saved my life twice, mended me in various small ways since then, and also seen my three boys safely into the world. I worked for the NHS for eight years, in various administrative and minor healthcare roles. My degree's mainly focused on healthcare delivery. The NHS has been my lifeline, employer, coworker, chief educator, and friend.
I get exasperated by the NHS. Sometimes, I get thoroughly pissed off with it. But mainly, I adore it and think it's the greatest thing our country does.

My eldest boy, Jim, had his second ever surgery yesterday; a reasonably routine hernia repair. The hospital were completely amazing. Once admitted, the play therapist was on hand to run through the preop procedures with him, and then went off to find him colouring to do to distract him from his raging hunger and anxiety. His nurse then found him a portable TV to watch The Lego Movie on as his surgery was delayed for several hours, and a starving autistic kid does not a happy patient make. We were left alone to watch it, and as it finished, the orderly came to warn us it was almost time. The same orderly made going to the theatres fun, and held an ipad with Angry Birds up to Jim's face while he was cannulated and put under, so he would keep still. He then explained where to go, how long it would be, and gave me a pager to summon me at the end. The recovery nurses explained why he was in so much distress, answered my slightly-too-clinical-for-a-parent questions, and calmly gave him extra pain relief. One of the students made him four rounds of toast, which he declared the greatest thing he'd ever eaten. The handover to the main ward was smooth, and everyone was happy to wait long enough for Tom to come back with some food for me, and to let him stay with us until we were all ready for sleep. They turned a blind eye to me keeping Alex on the ward with us on account of breastfeeding. A HCA took Jim's cannula out this morning and he didn't even wince. Everyone asked us constantly if we were ok, if we needed anything, if everything was OK. And it was immensely, enormously reassuring in the circumstances.
And that's 'just' the nursing and support staff. The surgeon, anaesthetist and various registrars and house officers we saw were equally amazing. They took the time to ask if we had questions, to listen to those questions, and answer them. They had god-knows-how-many patients to cover, but they didn't seem rushed.
Doing anything out of the ordinary with Jimmy can be difficult and stressful, but this was astonishingly easy. Exhausting, and emotional for me, but not harder than it needed to be, mainly because the staff were so wonderful. The day was fairly standard, a child admission, a routine procedure, their daily bread, nothing unusual or exciting here. They could have been blasé about it. They could have been dismissive of our fears. They weren't, not once. We felt safe. We felt reassured. We felt OK about something parents generally find very difficult to be OK about.

I support the junior doctors strike absolutely. I would support a strike if every single clinician in the NHS was involved, because the NHS is the greatest thing we have, and the government seems absolutely intent on destroying it, through a carefully considered strategy of underfunding care and undermining clinicians.
Fight it. Support your healthcare network. Love your NHS.
Image via telegraph.co.uk


15 Nov 2015

National Bigot Day

You don't need me to tell you how fucking indefensible the Paris atrocity is. Equally, you shouldn't need me to tell you that not all Muslim, immigrants and refugees are terrorists. Frankly, if you honestly cannot get your head round the fact that IS are to Muslims as Hitler was to Christians, and Stalin to atheists, then I don't want to be friends.

Because it's that merry time of year once more, when all your friends who you thought were reasonably rational, intelligent people out themselves as right wing bigots. Now, as any fool knows, for the average bigot, being CALLED bigoted is far more offensive than ACTUALLY BEING BIGOTED. The statuses abound with people stating a really nasty opinion ("Fucking Muslims should all be shot! Refugees are really terrorists! Close the borders or they'll come over here AND KILL US!"), being called out on it, and then getting upset and claiming it's their opinion and they have a right to state it.

And, my right leaning friends, you do. You have EVERY right to state it. One of the greatest aspects of Western society is freedom of speech.
However, that doesn't mean everyone has to agree with you. It doesn't mean you're right; factually, morally or ethically. It doesn't mean you shouldn't expect to have to defend that opinion. It doesn't mean everyone else has to listen to it without right to reply.

And people arguing with your opinion is not an attack on your right to free speech either. An argument on facebook is not akin to being flogged for a blog, or shot for wanting an education. It is literally people disagreeing with you, for a good reason, and you not being able to deal with that.

Over a hundred people going about their daily lives got killed for nothing on Friday night. They hadn't done anything to deserve it. They didn't know they were going to die. They were at a gig, out for dinner, having a walk, normal weekend activities. And now they're dead.
They're dead because a viciously bigoted organisation believe that there is only one right way to live, and anyone who doesn't subscribe to their viewpoint deserves to die. So as you weep over someone telling you why you're wrong on Facebook, remember that IS have taken that weeping and turned it into hate, into death, into control. They want you to hate all Muslims - it strengthens their us vs them message. They want you to view refugees with suspicion and alarm - they are the ones who drove them out in the first place. They want us to close our borders - it proves their point.

You are playing into their hands.

11 Nov 2015

Anxiety

If I start to think, then I will die.
That's how it starts, how it always starts. I think about what's to come, whether it is a party, an appointment or just seeing a friend. And I become convinced that way lies death. Or illness. Or disaster. That nothing can ever go right again in this world, because doom.
It is not rational. If it was rational, I would not be unwell. I would be normal.

It started when the baby was born. It started when I found out I was pregnant. It started when we decided to get pregnant. It started when I got knocked out. It started when Jimmy was diagnosed. It started with the divorce. It started when Jack was born. It started when he left. It started when Jimmy was born. It started when I bought the old house. It started when I lost a baby. It started when I left school. It started when I started grammar school. It started when I was at primary school.
I can't put a date on it. It's only recently that I've realised fear has haunted me since I was a child. But there is a chasm of difference between a child's fear of monsters, of bullies, of loss, and an adult's all consuming terror of the vagaries in life.

I am frightened of tiny things, like the buttons you use to call a lift, and the postman's knock. I am frightened of massive things, like cot death, and accidents, and horrible life changing illness. I have daily intrusive thoughts about bizarre things; whole hideous scenarios play out in my head and I live them in a little side room of my brain.I haven't had a panic attack in over a month, and this is a major achievement. I feel like I am getting better, although sometimes I have a blip. I am currently having a blip.

I decided a while ago, that talking about anxiety and fear was BOUND to make the things I feared most come true. I kept it all inside. I thought, believed, knew that if I told anyone what I was afraid of, or discussed things I was looking forward to, everything terrible would happen. And I made myself ill. My anxiety manifested as burning joint pains, as terrible headaches, as weakness and exhaustion, because I wouldn't let myself express it. Being pregnant changed that, because my terror of losing my baby was a real fear I could talk about, and channel all the extraneous fear into. It was a rational thing to worry about, although the fear paralysed me at the end, making me angry, agoraphobic and terrified.

I felt like I was destined to have postnatal depression after Alex was born because of the all consuming terror of his pregnancy, but instead I have postnatal anxiety. And that is a very different beast. I had PND after Jimmy was born, and all I wanted to do was die. Or run away. Mostly die. I didn't feel anything towards my baby, myself, or anyone. I didn't have the energy to do anything about it, and eventually it lifted. Postnatal anxiety is much easier in some respects, because I love my baby. I interact with him. I take immeasurable pleasure from what he does, and cuddles, and feeding. I am able to function reasonably well, to get work and chores done and to look after the big boys as well. But it taints everything. It is like a sad gauze I have draped gently over everything. My mind runs at a thousand miles an hour, trying to sort the rational from the irrational. I try to talk it out when it's particularly bad, because other people can tell me the difference between legitimate fear and crazy fear.

This blip has been triggered by incoming essay deadlines, a surgery date for Jimmy, an appointment for my eye, socialising, Christmas, breaking my laptop-that-isn't-technically-mine, Jimmy's DLA form, parents' evening, the dentist, and a hormone shift, which are all legitimate worries that mount into one giant elephant in the brain, sitting on the sensible bit, squashing it flat.

And it feels like horror. A tight chest, breathlessness, getting too hot, visualising everything awful, wanting to stop everything, paralysing fear, no concentration, feeling snappy, guilty, angry and hopeless.

And it sucks. But it's getting better.

23 Oct 2015

NHS Bureaucrazy

I am cross.
Last year, I had a head injury that led to concussion and whiplash. I had all sorts of terrifying symptoms at the time like slurring, amnesia, dizziness, nausea, night blindness, peripheral vision loss and anomic aphasia. I couldn't stand up for a week, but I was back to normal within a few weeks.
Except that I still have a small blind spot in my peripheral vision. At first, I thought I was imagining it, and ignored it. Then I went for an eye test a month ago, mentioned it, had all the tests done and was referred because I wasn't imagining it.
Normally, if you have a dodgy eye test, the optician refers you directly to the hospital, but (presumably because of the head injury) I had to go and visit my GP first and talk about it to decide whether to send me to ophthalmology or neurology. The GP thought it was either caused by damage to my retina, optic nerve or visual cortex. The initial injury was on the right side, but it's my left eye that's affected. She referred me to ophthalmology. This was early last week, because GP appointments are gold dust.

Now, the bit that's made me cross.
Today, I got a letter that looked suspiciously like junk mail. I get a lot of junk mail at the moment, thanks to foolishly letting the Bounty woman have my details in the hospital after Alex was born. So, I opened it, expecting yet another life insurance offer because PARENTS DIE, and instead found a letter from some random fucking 'care innovations' company who the LGC apparently employ to triage ophthalmology referrals. Obviously, GPs cannot be trusted to refer to the right people, so this company in Henley-on-Thames does it for them.
The letter told me I needed to be triaged by an optometrist, and gave me a list of four clinics to go to for triage. In order to select one, I had to either ring up and tell them who I wanted to be referred to, or go online and do it. WHY NOT JUST SEND ME TO THE NEAREST? WHY THE FUCK WOULD I WANT TO GO TO A CLINIC 30 MILES AWAY?
Ahem.
So, I did this, only to be told that my 'chosen provider' will send me an appointment in the post.
*jumps up and down in a rage*

In ye olden days of eye referrals pre-NHS-sell-off, you saw your optician, they sent a referral to your GP who passed it on to ophthalmology, who trusted their secretaries to triage it and send you a suitable appointment. The process took perhaps a couple of weeks. This has already taken a month.
Now, I don't talk about it much because it's evil, but I am suffering quite severe postnatal anxiety at the moment. The very IDEA of going blind, never exactly appealing in the first place, has been preying on my mind like a giant wasp that will not stop hovering by my face. All I really want is an appointment to be told what the hell is up with my eye, so I can work my flailing anxiety into something like a sensible approach to the whole thing. And now I have to go and see an optometrist, who will then probably send me to ophthalmology anyway, lengthening the whole process into one of months rather than weeks.

Not to mention how confusing this must be to people who are perhaps less computer savvy or presume the crappy junk-maily scam-ish letter is junk mail, particularly if their sight is poor. I mean, it doesn't even have anything visual to suggest it represents the NHS:
SEEMS LEGIT!
It's almost like they're trying to get people to ignore the letters so they can cancel the referral (she said, cynically).

15 Oct 2015

16th October 2010

"When you're stuck in that spiral, you reach up". 
"What if there's nothing up there?"
"Just reach up."

Five years ago, the world stopped spinning and I fell down a hole. And there I stayed for two weeks. A very long, very dark two weeks. Two weeks of starved, quiet shock. Two weeks of hiding. Two weeks of numbness all day and sobbing all night. Two weeks of waiting to die.
Then I reached up.

I can barely believe it's been five years. Both light years ago and yesterday, and yet so much has changed. My uni module asked me what I considered to be the point at which I became an adult. For many, I suppose it's a birthday, maybe becoming a parent or buying a house. For me, it was getting divorced. Turning 18, moving out, getting a job, turning 21, buying a house, getting married, having a baby, none of that made me a grown up. I was a child playing house, playing mummies and daddies. Then overnight, I became entirely responsible for myself, for my toddler, for my unborn baby, for the bills, for our income, for cleaning, for meals, for locking up every night, for closing the curtains on the world and opening them again the next day, still going, still alive.

People told me then and tell me now, they don't know how I coped. As if I had a choice. Never tell me you wouldn't cope in the same situation. You have absolutely no idea what you can cope with until you must. Then you find your ability to cope is almost limitless, but that there is an emotional tradeoff. It's the tradeoff that makes people bitter, angry and depressed. It's the tradeoff I still fight with.

For me, I am glad it happened. I am glad my heart was broken. I am glad my security was shattered. I found myself in the darkness, and I liked who I found.


 I'm posting this today because I don't want to think about it tomorrow. 

7 Oct 2015

The Hell Of The School Run

Horrors
As you may know, I have three sons. Eldest (Jim) is in year 2, middle (Jack) has just started foundation and the baby is three months old. Oft have I heard "Oh, you're so lucky, now you've got them in school - you have the whole day to yourself!" Well, yeah, if you discount the fat baby who acts starved every couple of hours while the sun is up, I suppose that's sort of true. Except the school run is the world's most exhausting hour of the day, and brackets the sweet taste of freedom with the sour taint of awful.

5am Baby wakes up for a feed and doesn't settle for an hour
7am My husband escapes to work, silent as a ninja, to avoid waking the noisy ones. He fails.
7:10am - 7:30am Stampede of screaming elephants, bed-invasion, fights, head-injuries
7:30am They vanish downstairs and grow suspiciously quiet. Stupidly, I nod off briefly
7:40am Alarm goes off. I prepare to get up. I doze off again.
7:50am Alarm goes off. I start to get up. Baby wants feeding AGAIN.
8am Baby releases me, I run downstairs, tripping over my stupid nonfunctioning ankles, and get them breakfast
8:05am I get dressed, and use the bathroom, shouting down at the boys to get dressed
8:15am Me and the baby arrive downstairs. Both the big boys are playing Lego, ignoring their neat piles of clothes
8:16am After being shouted at, Jim begins dressing, I start sorting out the bookbags and doing my hair
8:20am I notice Jack is still in his pajamas playing Lego
8:21am I bellow
8:22am Jack is now floating around, naked but for one sock
8:23am I dress Jack and shout at Jim to put his shoes on
8:25am The phrases "WE SHOULD HAVE LEFT BY NOW!" and "SHOES!" become my entire vocabulary
8:26am Jack asks which way round his shoes go on. I show him.
8:27am Jack's shoes are on the wrong feet. Jim gives him a lecture on correct shoe wearing.They fight again.
8:28am Jim asks why I'm so angry. The baby starts to whinge.
8:29am I throw coats at them while I get my shoes and coat on
8:30am I drag them out of the house, pulling the pram through the hall filled with toy cars, lego and Angry Birds, yelling about the mess. We get to the top of the path and Jack has left his bookbag behind.
8:32am We try again.
8:38am We arrive at school, picking our way through large groups of teenagers going into the high school at the slowest pace they can bring their teenage legs to go. Jack has just shouted "HELLO, FAT MAN" at a random stranger and I'm trying not to burst into angry tears. The playground is deserted. The caretaker hoves into view, gate keys in hand. Jim wants to kiss the baby goodbye, while I scream "MOVE! GO IN! THEY'RE LOCKING THE GATES!"
8:40am We get round to the foundation area. Caretaker is standing by the side gate looking disapproving. The baby is screaming. Jack wants to kiss the baby. I lob him at his classroom door and run, lest I get locked in and have to navigate the narrow labyrinth of the school with the pram.
8:45am I get back home and vibrate for fifteen minutes, trying to calm down. The dining room looks like a bombsite. I spot a letter I should have responded to three days before. I eat breakfast, at last. The baby is still crying.

Six hours later..
2:45pm I start thinking about leaving. The baby is asleep. I'm warm and comfortable. It's raining. I give it five minutes.
2:55pm SHIT! TOO MANY MINUTES!
2:56pm I throw the sleeping baby in the pram and take off at a run.
3pm Panting, I pull up at the door of foundation. Either all the children have already been picked up, and Jack is stood mournfully at the door, OR the door hasn't opened yet and it's like a pushchair circus.
3:05pm I walk round to the main building to pick Jim up. His teacher wants a word. He's been naughty. He gives zero fucks. The teacher clearly expects me to do something about it right there and then - like what? Belt him round the head? - and is disappointed when I nod, smile and try and work out why. The children run amok.The baby is starting to get grumpy, being dragged from his warm slumber into the freezing outdoors. Eventually, I round them up and we leave.
3:10pm - 3:15pm We navigate the gauntlet that is a high school kick-out time. Children on bikes who think I know they're coming up behind me! Swearing, shouting adolescents! Terribly bloody music! The police! School leavers with enormous pitbulls sat near the bus stop waiting for their sixth form girlfriends! Drivers that do not know what this strange lever is on their steering wheel that would give me some idea of their direction while I wait to cross the road! Jim starts shouting about what he wants for tea. Jack runs off. I catch Jack and make them both hold the pram. They promptly drag on to it, slowing me right down and getting their feet run over.
3:20pm We get home. The baby is screaming. The children abandon coats, bags and shoes in front of the pram, apparently without thinking I might need to get through the hall. I put the kettle on. I wish it was acceptable to have tequila.

We only live a five minute walk from school. My heart goes out to those who live further away.

27 Sep 2015

Going Out-Out With An Autistic Child

Sometimes, as a parent of a child with autistic spectrum disorder, discussing autism with other people can be a bit irritating. First of all, they will sometimes seek to educate you on autism as though you know absolutely nothing. Watching The Autistic Gardener does not make you an expert (although I love Channel 4 for mainstreaming it). Then they say things like "everyone's a little bit autistic" or "everyone's on the spectrum". I suppose they say it to normalise autism, which is great, but sometimes it feels like they are minimising the very real struggles you and your child experience every day. I'm quite sure most people are uncomfortable with new situations, and dislike change. They don't hurl themselves to the floor screaming in agony when it happens.
Never is this more apparent than when trying to organise days out. Not just going out, but going out-out. This can be going to other children's parties, a wedding, or a school trip, or a family day out. Jimmy is rarely invited to birthday parties anymore, partly because we never go, partly because he's been in the same class of kids now for two years - they know. There is nothing worse for an autistic child than forty kids running round an indoor echo chamber (/play area) screaming, without at least one to one supervision. Jimmy has had a school friend over to play once, and it went fine, until the friend left and Jim had a meltdown of house-shaking proportions. The same thing happens with school trips - he copes fine while he's there, getting gently more manic as the day goes on, and then has a massive meltdown when he gets home and is thrown off balance for the rest of the week. He's got a trip on Tuesday. I am prepared. As for weddings, just nope.
Now, naturally, this impacts on your family life. Every time we know we are going out, even if it's just to my in laws for a meal, we have to decide how far in advance we will tell Jimmy. Do we tell him the night before and risk him being up all night worrying about what we will eat? Do we tell him nothing until we get there and then have to give him several hours to get used to it? Do we tell him a couple of hours before and then have to cope with his mounting, swivel-eyed excitement that swiftly merges into anxiety and panic? And this is all to visit people he's seen on a regular basis since he was two years old. Going further afield is a much more difficult proposition. But he's not my only child. He has a neurotypical four year old brother, and a baby brother. They too deserve fresh air and exercise, and anyway, Jimmy has a profound interest in the wider world. He may not give a fig for other people, but he is desperate to know how the world works.
We have tried family holidays to varying degrees of success when he was younger. He didn't cope, and these were pre-diagnosis, so we didn't really know what the hell we were dealing with. Then, after a long gap, we went to Whitby at Easter for a short pre-baby break. We gave him plenty of warning, put it on his calendar, let him help plan meals (he is absolutely fanatical about food, with an eidetic memory for what he's eaten), told him what the menu was every day, told him the plan, and he coped beautifully even though he was still intently focused on the next meal. It was far and away the best holiday we have ever had. Planning is everything.

Do you have a relatively new diagnosis of autism in the family? Would you like some tips on going out with an autistic child? No? TOUGH!

1. Choose places that fit your child's interest. 
Yeah, it sounds obvious, but the best way to get the kid through the day is to guarantee there's something in it for them. You may well have always dreamed of visiting the Tower of London, but you won't enjoy dragging an over-stimulated, meltdowning, violent beast around it. You are highly unlikely to suddenly convert an autistic child into a deeply committed monarchical historian when they are so unhappy. We have the problem that our big two have totally different interests. If we want to take Jack to the National Railway Museum, we will find Jimmy a babysitter because you can soon spend far more time managing the autistic child's behaviour than looking at anything. And you have to constantly do that anyway, so why make it harder?

2. Plan your route
I'm not talking about getting there, I'm talking maps of the actual site. Jimmy's obsession is food, so I try to find out what food is available, and where. We took them to Duxford Air Museum, and it was lovely until we walked past the cafe to get to the other exhibits. Jim's focus was instantly lost and we went home shortly afterwards. Had I realised this, I would have tried to bypass it to get over the other side. Equally, had I known quite how much walking through empty space there is at Whipsnade Zoo, I probably would have gone elsewhere.

3. Contact the site 
I tweet a lot of attractions to find out how autism friendly they are. Attractions are slowly becoming more autism aware, which is great, and since they always want to look good on social media, they usually reply fairly promptly, often with better advice than you get on the website - Enginuity tweeted me this morning describing the site acoustics as a 'swimming pool with sirens'. This level of detail is far more instructive than anything you can glean from their website. They can also tell you about wristband schemes to avoid queuing (essential at theme parks), and whether you can get in as a carer at a discount.

4. Warn your kid
Only you can really gauge how far in advance you need to tell your children about things, regardless of their neurological state. I tend to put things on Jimmy's calendar at the beginning of the month (unless the event is right at the start), talk about whether we're going to have a picnic (yes, always) and sometimes show him websites so he knows where we're going. I try and frame things so he can understand them. He doesn't know the M6 can take years to traverse, so there's no point talking about the journey too much, nor about pinning it to exact times. I use meals as a frame - "we are going after breakfast, we will have our pcinic at X spot and then we will have a snack at the site". Of course, then I have to tell him exactly what snacks we are going to have, and STICK WITH IT because he won't forget. But it's not enough to plan a day out, I also have to plan him.

5. Be prepared for the worst
Take snacks. Take weighted jackets if you use them. Take comforters. Be prepared to use pressure therapy constantly while you're going around. Watch your child for signs of meltdown and go in early, rather than letting it escalate. Don't be embarrassed to tell staff he's autistic, if you need a quiet place to calm him down. Be prepared for something you never even considered suddenly being an enormous trigger. We took Jimmy to a theme park and expected him to freak out at the noise and the people and the food. We did not expect his total terror at the mascots, and spent the day studiously diverting him whenever they approached.
Be prepared to leave early if you have to, even if it feels like a massive waste of time and money, and be aware your child is probably going to be utterly exhausted by the whole shebang. It has taken a while to get used to the fact that Jimmy isn't ungrateful when he screams and cries and freaks out at the end of a day out - doing something out of his comfort zone is not a little psychological disturbance as it would be for most, it is a painful ordeal that he happens to enjoy at the time. It doesn't mean it's never worth doing it again.
And if you prepare for it all to go to shit, you will feel a sense of elation when it doesn't. HE CAN DO THINGS! WE DON'T HAVE TO STAY IN THE HOUSE FOREVER! HOOORAAAHHH!

11 Sep 2015

Online Only Sucks

My uni materials arrived yesterday, and the course website opened at the same time. And I am bloody annoyed to find it is another online only course. I have a rather thin textbook of theory, and that is it.

The thing that pisses me off about online-only courses is that it makes the whole process of studying so bloody convoluted. Instead of being able to pick my books up,find somewhere to settle and get on, I have to either sit upstairs on my desktop (difficult with a baby), or try and make my elderly netbook cooperate. Last year, I downloaded my module materials onto my Kindle using the service provided by OU. Except they're really not optimised for Kindle and don't make the experience any easier - I missed several key elements of the course on first read through last year because of the way the Kindle docs were set up. And switching from Kindle, to DVD, to book, to website, back to Kindle is not my favourite way of studying. My last module had an EMA at the end, so I could collate necessary material throughout the year, but I doubt my ability to revise properly from online only resources.

I can see online-only being brilliant if you are able to manage your time and study alone for a while, but being a breastfeeding mother, I will have to grab what time I can (often with the baby on my lap, like he is right now), and studying from a book would make it feel more cohesive than going back to a website.

This module is the last one of my degree, and it is SO important to me to be able to study and revise effectively that I will probably utilise the print on demand service. But that costs money. I have had my whole degree for £5, because I was the last intake that still got it free based on income, so I don't mind paying. Some people will have paid over £1000 just to do the module; to make them pay more to have a hard copy of their study materials seems grasping.

Harumph.

2 Sep 2015

Dead Children Win No Arguments

If you haven't heard about the refugee crisis going on recently, I can only assume you live in a cave. Thousands of people are trying to escape from hideous situations in Africa by coming across the Mediterranean. They're not coming over on nice Sealink ferries either, but on overcrowded tiny boats and dinghies. And they are dying in droves. They are drowning. They are hiding out in lorries, suffocating, and then being abandoned. Some of them have survived long enough to get to Calais, where they are trying to get here (some by running through the Channel Tunnel...which...bravo, sirs), and England takes umbrage because their holidays are being slightly cocked up by it. NOTHING GETS IN THE WAY OF AN ENGLISHMAN'S BOOZE CRUISE! NOTHING!

Now, being a fairly insular, bigoted, if not downright racist island, there is a lot of anger at these refugees. Fucking up the borders, causing queues (QUEUES! QUELLE HORREUR!), stopping Only The Young's first single being released on time. Trying to get in here and steal our jobs AND benefits, or whatever we think people come here for. The media and government are doing their best to inflame the situation by describing people as 'swarms', dehumanising the reality of thousands dying in desperation, and thus making it easier to overlook it.
So, this po-faced grumpiness on the right is then tempered by increasingly flailing arguments on the left. It's a humanitarian nightmare, and needs resolving, but it won't be resolved on Twitter or Facebook. Twitter and Facebook however didn't get that memo, and an image of a drowned toddler is now circulating to convince the right of the error of their thinking. "LOOK!" they scream "CHILDREN ARE DYYYINNNG".

Now, this is awful. It's awful on several levels. Since this is the internet, have it in bitesize chunks:

1. The death of any child is awful. The death of a child uprooted from their home to travel across the sea in the night, in circumstances adults describe as terrifying, is unimaginably awful. That's the problem with the entire refugee situation - it is unimaginable to the majority of even the poorest British folk. Showing a dead baby isn't going to suddenly make a lightbulb click on in their heads. Stories from the refugees themselves MIGHT, but it is generally beyond our national ken.

2. The bulk of the "SHOOT THE FUCKERS" brigade are a bit thick, let's be honest. Shooting unarmed people solely for wanting to come into your country is what they might do to you in North Korea, and is not in any way a logical solution. The people voicing this sort of argument are the sort of simplistic idiot you really are not going to convince with a thousand dead child pictures. They don't want a debate, they just want it to go away so they go back on their booze cruises, and refill the papers with nice titty pictures of some bird from Big Brother instead of all this suffering and horribleness.

3. If the only way you can win an argument about a horrendous situation, that really doesn't need any embellishment, is by showing dead baby pictures, then you need to RETHINK YOUR DEBATING STRATEGY. The problem is not necessarily the person you're debating with, but your own tactics. Or they are a slightly better educated version of number 2, in which case, cut your losses.

4. Now this picture is in the social network domain, you can guarantee that in a year or two it will be recycled as some god-awful clickbait meme. "THIS CHILD DROWNED BECAUSE THEY DIDN'T PRAY TO JESUS AND WEAR SUNSCREEN, LIKE AND SHARE FOR A PRAYER". You know the sort of fuck awful bollocks that's endemic on Facebook. The identity of the child is currently unknown, but surely deserves a better memorial than that. Which brings me to the most important point...

5. That's someone's child. A family is bereft right now; on top of everything else, their baby didn't make it. It's likely the parents didn't either, but we don't know for certain. Nonetheless, if your child had just died, in any circumstance, would you want their photo shared around social media, without your knowledge or permission, solely to make a gloating, political point?

During the Vietnam war, a photo was taken of a napalmed child and became emblematic of the futility of the struggle. Sometimes a photo can speak louder than a million pointless arguments. But that was in the time before the ubiquity of media.Anyone who really cares about the refugee situation - with a positive or negative bias - has thousands of sources at their fingertips, video footage, political commentary, individual stories, photos.
It is not your job to educate through sensationalism.Leave that to the tabloids.

UPDATE: The tabloids seized upon that photo with glee the very next day, and behold, David Cameron changed his policy on immigrants. It's a strange state of affairs when our government can only do the right thing when The Sun and Daily Mail tells them to.

26 Aug 2015

#NotAllMen

The majority of media is very against Jeremy Corbyn at the moment. I'm not sure why - if he becomes Labour leader, they will be able to stir the right wing readership into apoplexy on a weekly basis, generating ample clickbait. Corbyn said, when discussing policies, that he was interested in reducing public sexual harassment experienced by women and it had been suggested to him that introducing women-only carriages on train might help.
WELP. UPROAR.
It's being claimed he's trying to depersonalise women, that it's inherently misogynist, that segregation is evil, and most importantly to the (white)(male)(affluent) journalists, NOT ALL MEN ARE SEXUAL PREDATORS.
Waaah, they cry. Why do women hate us? Why do sites like EverydaySexism exist? NOT ALL MEN rape. NOT ALL MEN sexually harass women. NOT ALL MEN are evil.

To which a swathe of women roll their eyes, because once again, men are making it all about them.
Guess what? Over a thousand women reported sexual assault on public transport to the BTP last year. The number of individuals assaulted is probably far higher, since women tend to be reluctant to report sex crimes. It's not unique to Britain - in fact, Japan have implemented women-only carriages to prevent groping on trains. Trains and stations are really good hunting grounds for sexual predators. Smaller stations tend to have very few, if any, staff milling around. Trains can be enormous, with only one or two staff circulating. Nobody wants to make a fuss on the train, because stopping it causes major delays and inconvenience, not to mention embarrassment. If you travel on the train reasonably frequently, it's likely you've been stuck in a carriage with someone you really don't want to be, whether through their aggressive manner, their overbearing demeanour, or just sitting far too close to you. And what you do is focus really hard on your phone or ipod or whatever, and hope they go away.

I was alone on the train to London a while ago, at 9:30am on a Saturday. Sat behind me were six pissed young men, who had reservation for a four seater table and the seat next to me and in front of me, but preferred to all lurch around the gangway around the table. They weren't being aggressive, just high spirited, but they were harassing any staff who needed to make their way past and anyone sitting by themselves. As I was sitting next to one of 'their' seats, they kept sitting down and trying to talk to me. Then one of them gave me a big, unsolicited cuddle. Yay me.
Now that's not a sexual assault. Annoying, embarrassing, inappropriate but not criminal. But it still scared me. I've been sexually assaulted a few times to varying degrees of awful, and it never ceases to amaze me how many men think that just being a woman by yourself means you DEFINITELY want their attention. Perhaps it is from some misplaced sense of chivalrous protection. I once had some men on a bin lorry leap off and 'cuddle' men in the middle of the street. I was 14 and in school uniform, I'm not sure what part of that they read as sexual availability, but there we go. I'm not sure why some men think cuddling women they don't know is acceptable behaviour. But they do.

And that's the real problem. It's not women whining and moaning and claiming all men are rapists. It's men thinking their attention, however benign, is a gift to women in their vicinity, combined with women being taught (mainly by the media) that all men are just waiting to drag them away and rape them. It's a culture where women who are raped or assaulted by strangers are then asked WHY they talked to this strange man in the first place. Women are expected to prevent themselves being raped or assaulted by PSYCHIC MEANS. The only sensible way for women to do this is to not talk to strangers.
It is time we flipped the narrative. A lot of men complain that feminism is unnecessary in the modern age, that men and women ARE equal, and the gynocracy is emasculating them. They want to be allowed to open doors for women, and carry their bags and not be called a rapist. They want to be viewed as chivalrous, not predatory.
So how about we start teaching men how to recognise and react to social cues? That when a woman is studiously staring at her phone or has earphones in, she doesn't want to talk? You certainly don't get to pull her earphones out unless the place is literally on fire.
That a woman has the right to not talk to you, if she doesn't want to, and that doesn't make her a stuck up bitch? She doesn't even have to give you a reason.
That feeling awkward and rejected doesn't give you the right to shout or hurt or do anything other than feel awkward and rejected?
That there is literally no silent social contract which makes unsolicited sexual contact OK?

Because it's not all men. It really isn't, and women know that. But it's enough men to have no idea who is safe and who isn't. It's enough men that in any given ten women, two will have experienced a sexual assault.

The women suggesting segregated carriages aren't generally man-hating lunatics: they are simply trying to find a way to protect themselves while our culture continues to do very little to stop men harassing women.

5 Aug 2015

Breastfeeding Tips

So, since my Alex was born last month, I've restarted breastfeeding. It's only been a year gap since I weaned my middle boy (aged 3, where's my fucking medal?) so I wasn't expecting it to be too big a deal. Indeed, the hospital were so taken aback by my willingness to feed and reluctance to be 'shown how' that they wrote "declined support" in the breastfeeding part of my notes.
But it's actually been harder than I expected. Not because of Alex: he's a good feeder and ACTUALLY SLEEPS PRAISE GOD. But because I forgot about feeding newborns and how exhaustingly full on it can feel. So, here's some top tips on establishing breastfeeding that you didn't ask for.

1: Get comfy
It is a lot easier to relax and feed your kid if you're comfortable. First, grab a drink, and your phone. Go to the toilet if you need to: baby won't actually scream himself to death in 60 seconds. If you're not comfortable feeding in front of people, go find a more private space. If you're leaning up in bed, support yourself with pillows. If you're in a chair, sit back and put the telly on. Bring the baby to your boob, rather than your boob to the baby because that way lies stiffness and aching which might just be too much in the postnatal awful. Some babies take 20 minutes to feed, some take 5, some take bloody hours. You don't know how long you're going to be in that position, so start right.

2: Lanolin cream is your new God
Your nipples are not used to being sucked in the vice like grip of a baby's maw, and can get quite sore even from one bad latch. Lanolin cream is safe for the baby to suck, so you don't have to worry about it poisoning him, and it turns nipples bulletproof in days.

3: You don't have to put up with a bad latch
Babies, in their desperate haste to eat yet more milk, will occasionally snap onto your boob wrong. You know it's wrong because you shriek, and then sometimes, you bleed. If you do bleed, by the way, it won't hurt the baby but if the blood is coming from inside your nipple, tell your midwife or HV.
Should the baby latch go awry, pop a finger between baby's mouth and your nipple, and try again. Do not leave the baby latched wrong, however much he squeals in indignation that you've stolen his food. Aim your nipple at the back of his throat, wait for him to tip his head back with his mouth like a baby bird, and shove it in. You won't hurt him. Even at a month old, Alex still needs a bit of a prod to stop him sucking his fist or arm instead of the perfectly good boob millimetres from him.
A good latch might feel a bit uncomfortable and strong, but it shouldn't make you scream. Ask for help if you cant seem to get the hang of it.

4: Engorgement feels like hell, but it is normal.
When your milk comes in, fuck a duck it hurts. It is often accompanied by the three day blues, which make you hate the world and weep over nothing. Giant, rock solid boobs, with fluey symptoms and uselessly unsupportive nursing bras make everything worse. But guess what? It lasts about 24 hours and then it's done. Cold cabbage leaves really do work and so does a warm shower.
You GAVE BIRTH: you can do this.

5: Cluster feeding is also normal
Cluster feeding is how babies tell boobs to make more milk, usually in response to growth spurts. But I have never seen it mentioned in breastfeeding help from official sources, and it nearly drove me to despair with my eldest. Basically, your baby will feed pretty much non-stop for four to six hours, commonly in the evening when you are tired and wanting the baby to get off and let you sleep. It can, however, prompt relatives to ask if you're SURE the baby's getting enough, and suggest that maybe you should stop feeding (see 9 for more on this). It is a recipe for crisis if you're not sure of yourself. But know this my friend, it is normal. Your boobs are amazing at responding to the baby's needs and it only lasts a day or so at a time.

6: Breastfed babies get wind
Some people think they don't. Trust me, they do. You can feel it in their solid little bellies after a feed (normally, there is squidge). Sit them up, let them sick it up a bit and then offer some more if they're still rooting.

7: Don't be afraid to ask for help
Birth can make women feel incredibly insecure and stupid. Midwives can (if you're unlucky) exacerbate this by making it look SOO EASY to feed babies. They come along and force the baby's head on your boob as if by bloody magic, leaving you none the wiser as to how to do it. Then they want to observe you feeding, which is hardly confidence inspiring. Then they give you conflicting advice. So, assert yourself a little. Ask them to slow down and show you properly. Personally, I found the pictorial guide in the NCT booklets better than anything anyone could tell me. If you're worried about anything - bleeding nipples, sicky baby, baby who won't stop crying, baby isn't interested in feeding, baby who never stops feeding, the way you feel - talk to your midwife or health visitor. Remember,  they want you to breastfeed too. You're not on your own in this.

8: Eat. Bloody eat! And drink!
You are a milk factory. You cannot make it out of thin air. Eat! Drink!

9: You are allowed to tell people to piss off if they're being shit
If your baby latches, wees and poos and seems happy, then you're doing great. Family, particularly when they haven't breastfed themselves or if it's been ages, can be surprisingly pissy about the choice to breastfeed. THEY WANT TO FEED THE BABY DAMMIT. Well, they can't, and if they could it's not like they're going to come round and do bottles at 2am for you, is it?
If they're really getting you down, suggest they:
- Sit under the baby for two hours while you have a nap/a bath/a leap around the garden because your arms are finally free
- Bath the baby
- Cook you some food and stop being so fucking negative
This also applies any time people decide you are Doing Parenting Wrong because you're doing something they didn't.

10: It's OK not to breastfeed
Fuck knows it doesn't feel like it, but sometimes it just doesn't work, or isn't compatible with the way your life is. And that's OK. The baby needs feeding, you need your sanity, and these are both more important than the method. I was formula fed myself, so I can vouch for its life giving properties, and nearly starved to death first*, so I can also vouch for breastfeeding going wrong having severe consequences. Do what is right for your family.

Here, have some handy links:

* This was due to supply failure. This is a very unusual breastfeeding problem, that your HVs or midwives will pick up on through failure to thrive rather than just thinking the baby's not feeding enough. Don't mistake cluster feeding for not producing enough milk, but do get your baby weighed if you're concerned they're losing weight.

29 Jul 2015

Results 2015

I genuinely didn't think I would care about my results. I thought I'd either have just given birth or be extraordinarily pregnant, and Thu beyond such minor concerns.
I was wrong. Our gorgeous boy was born at the beginning of July, and results were released a week later. I got to the point of obsessively checking for them within a few days of release. It suddenly felt important to have succeeded after successfully delivering my baby.

And I did.
In biology (SDK125), I gained a pass 2. Considering I was immensely pregnant when I took the exam, I am really proud of this. But, ultimately, I only needed a pass, as it doesn't contribute to my final classification.
So, I was absolutely fucking ecstatic to gain a DISTINCTION in public health (K311).

I have one module left, and start K319 (Adulthood, Ageing and the Lifecourse) in October. It will be the first time I've just done one module in several years. I figure that's the way to compensate for a tiny, breastfeeding baby and his two brothers stealing all my time.
It feels strange to be coming to the end. But I already madly miss studying, so bring it on.

6 Jul 2015

Birth Story - Alex, 2015

IN BRIEF:
Gestation:39w 5d
Site: Hospital
First Stage: 1hr 35min active labour
Transition: One contraction's worth
Second Stage: 10 minutes
Third Stage: 20 minutes
Tearing: Mainly external second degree tear
Weight: 8lb 10oz

Details:
As some of you know, I had been quite terrified of going into labour with this baby. My history of short labours and PPH (post-partum haemorrhage) plus generalised anxiety genuinely made me fear we would both die if I went into labour with nobody around to help. I think my body knew that, because despite two weeks of prelabour, nothing kicked off properly until the older boys had gone to their dad's and Tom was home from work.
Early on Friday evening, I started to get a burning cervical pain. I'd been getting a lot of pressure for a few days, but this was really uncomfortable and specific, so I could barely sit. I rang the hospital and they said it was more likely to be thrush or a UTI than imminent or silent labour, but considering my history, to come in to be checked. I didn't really think it could be labour because he wasn't due til the 6th, and other people have their babies early, not me!
Off we went, and had to wait for HOURS to be seen because they had several emergencies - Friday night is party night in delivery. I had a normal CTG. The obstetrician thought it was probably a UTI as I had a lot of leuks and protein in my wee, but my cervix was still thick, and 2-3cm dilated, as it had been for the previous two weeks. I got some antibiotics and left, starving and tired at 11pm. When we left, I didn't want to get out of the car. I had a strong urge to be safe at home, so Tom took me back and went into town to try and find some food. When he rang to tell me he couldn't get anything, I started to cry, which is rather unlike me. He went to McDs and then came home, knocked on the door for me to let him in and as I stood, my waters went CATASTROPHICALLY. It was a veritable DELUGE. I must have lost two pints in the first gush. I managed to get the door open, and then started giggling for joy. I rang the hospital who were sceptical about my need to be admitted immediately until I told them that my consultant had told me to insist on it. I couldn't eat because I knew I was likely to be sick in labour, and leaked about the house while Tom ate his burger.
My waters broke (the first time) at 12:10am.We got to hospital around 1, were seen around 1:30am in triage. I had some fierce backache, but no real contractions. I'd wodged a huge towel between my legs to try and catch the river, and the midwife asked if I hadn't got any pads. My waters had already soaked through two pairs of trousers and pads, I thought a towel might be more dignified...
I went on the monitor, and had a couple of painful contractions. On VE, I was 2cm stretching to 5, and admitted on the basis of previous precipitate labours. I wasn't in much pain, and was still quite joyful at the prospect of incoming child.
I was moved into a delivery suite around 2am, and nothing much was happening aside from the BIBLICAL STORM outside. If you missed it, shame on you - chain lightning, forked lightning, drunks outside A+E stumbling around in the rain. Gorgeous. Ahem. I was cannulated in case of PPH, and had some bloods done. I was then monitored for bloody ages. Alex's heart rate was ALL OVER the place. He was decelerating and accelerating and generally being very worrying, but because I wasn't technically in established labour, they were happy to wait and see if he settled down when labour settled in. I spent most of the next three hours alternating between being monitored and jigging about the room in soggy trousers, trying to get labour going. My waters didn't stop breaking until around 6am, and there were pints and pints of it. I can't believe how much there was. Me and Tom both kept nodding off, although I was getting one contraction every 15 minutes. They prepped my syntocin drip ready for afterwards. I explained that my cervix did not dilate as they're supposed to, but I only actually had two VEs from when my waters broke, which was great.
At 5:15am, I had another VE which was 4cm, stretching to 7 or 8cm, but this still didn't put me in officially established territory.  Nonetheless, the VE got me going, to about one every four minutes. Annoyingly, I had to stay on the CTG throughout because he was still decelerating. I had the same midwife with me (Nina) throughout, and she only left for breaks (in which case someone else came in) or to get someone else to check his trace. This surprised me - I thought I'd be left to get on with it, and I did find it a bit inhibiting to begin with. Once I got going, there could have been a circus in there and I wouldn't have noticed.
The contractions lengthened and got a lot more painful. I was starting to get quite vocal during them, and hallucinating between them as I did in strong labour before, and my official labour start time was 5:55am. However, Nina kept telling other midwives I wasn't established, presumably so they didn't panic about the CTG. It didn't feel like my other labours because I had to be lying down - it made me feel rather detached, and although they were more widely spaced than if I'd been mobile, they were also more difficult to cope with because I couldn't use my body position to cope. Also, the CTG was registering my thunderously vicious contractions as 30-40, instead of 100, which made me wonder if I was actually progressing at all.

The next hour or so is a total blur. I had to stay on the bed. Tom was there the whole time, but I had my eyes shut through most of it. I got onto all fours, so I could let gravity do its thing, while staying on the CTG. Then I asked to go to the toilet, for a wee, because I was feeling pushy and I badly wanted to stand up for a minute. Going for a wee was an agony of blood and pain. Nina gave me some dextrose tablets (I hadn't eaten since Friday lunch) and I got back onto all fours, leaning into the back of the bed. She rubbed my back, while Tom held my hands. I remember telling Tom it was nearly time. A midwife came in to review the trace and organise shift handover, and said I was going to be referred to the coordinator for a caesarean, because of his heartrate (this wasn't actually discussed with me or stated explicitly, but I know the drill). I hit transition around then, and my legs started shaking uncontrollably, I felt sick and I told Tom he wasn't allowed to go and I wanted to go home and I couldn't do it anymore.
Then I began to push, so Nina got between my legs to monitor him, and just let me get on with it. I tell you now, giving birth without people telling you if you're allowed, or what to do is the best bloody way! Two other midwives  came in then to take over the shift from Nina (who had already told me she wanted to stay until he was born) and were quite surprised to find me pushing since they'd been told I was 4cm and not established. I felt like it was very much my party - nobody told me what to do.  It didn't take long at all, only ten minutes. I started screaming that it burned when he crowned, but otherwise I tried to be quiet and just pushed. I managed to mostly pant his head out and his shoulders took a bit longer to be born than I was expecting, but then out he came! He was a bit wrapped in cord, but I had my back to them so I'm not sure how bad it was.
I had him at 7:41am, four minutes before Nina's shift finished! I went a bit "Oooh, I had a baby", because it didn't really feel real. They helped me get onto my back and I started to haemorrhage immediately. They gave him to me and I haemorrhaged some more, so they plugged my syntocin in quickly. I lost about 500ml, so not as bad as last time. Alex was quite bluey purple and still properly covered in vernix. He took a while to go pink, but his Apgars were fine.
Then came the placenta. Even with the syntocin and syntometrine injection, it took a while. It was a bit tangled up in membranes and my body did not want to push it out. They got it out in one piece after about twenty minutes, while I was feeding the baby.
Then, bloody horrible stitching. I didn't tear too badly this time (2nd degree, mostly exterior) but being examined by a student with shaky hands was deeply unpleasant. However, when they'd finished and gave me the best tea and toast in the world, I was much improved.
They weighed and checked Alex. He is 8lb 10oz, so a little smaller than we expected but not much. His head circ is only 36cm, which is MUCH smaller than I expected, and quite a relief.
We sat around waiting to go. My drip took 3.5 hours to get through and they wouldn't uncannulate me until it was time to go in case I suddenly had a haemorrhage again. He passed his hearing test first time, which surprised me because he had such a soggy labour. The paediatrician (who I'm sure I went to school with) didn't come round til gone 2pm. Alex is all normal. Then my midwives started to discharge me, got halfway through and called to an emergency, and then we sat for an hour waiting for someone to finish it off. He pooed all over the discharging midwife. We finally left around 5pm, by which time I was heartily sick of hospital having been there (with a break) for almost 24hrs.

I think this was probably my easiest birth. It was frustrating being hooked up and immobile for hours, particularly as I'm sure he would have been born sooner if I'd been allowed up and I couldn't really tell how I was progressing because it feels so different from being active in labour. BUT his actual delivery was really good and felt much more natural and easy than the other two and I didn't have quite as bad atony in the third stage as before. I didn't want or need any painkillers, which totally shocked all the midwives, but what's the point for two unbearably hard contractions? That's all it was as well - and they didn't seem to get to the point where they rolled into each other, so I was still getting breaks right up to transition. I was worried before that having him on the consultant led unit would mean a lot of intervention and trying to make my body go by the book, but despite being monitored, the midwife was quite happy for me to get on with it on my own terms.
Alex is beautiful and looks just like his brothers.
I never want to do it again, but I'm so glad it went well.


3 Jul 2015

Prescriptions

So, Jeremy Hunt, who will best be remembered as the man who attempted to demolish the NHS (and will probably succeed) has a new idea. He has decreed that the wholesale cost of drugs costing more than £20 should be printed on the prescription label, to tell the person taking those drugs that they are funded by taxpayers.

I used to work in a rural dispensing practice. I absolutely loathed working in the dispensary, and only did during very busy periods, but sometimes I helped unpack the drug order upon which the wholesale cost of drugs is printed. This is the cost your CCG actually pay for the drugs, which you then pay £8.20 per item for, if you pay at all.

Now, in some cases, the price of the drug is less than the prescription cost, so you can bet Jeremy Hunt isn't going to put THAT on your drug box. It would not do for people to know they are paying £8.20 for a drug which has cost less than a quid. They might lose their faith in the prescription charge altogether, and then there would be issues.
However, many drugs cost an absolute fucking fortune. I used to use an asthma drug called Seretide, through an accuhaler (which is a type of inhaler where you don't have to co-ordinate breathing and squeezing). They cost £75 each, wholesale. I often used two a month when my asthma was severe, because I was on double dose. I paid standard prescription cost for it (£6-something back then). My GP recently changed it to the much cheaper Qvar, which is nowhere near as effective, but considering I'm "poorly compliant", it's cheaper for them.
One of my least-favourite jobs when working for the NHS was changing people's drugs, in batches, to something cheaper (usually statins and contraceptives) because the CCG had decided X drug was exactly the same and 5p cheaper, so upsetting hundreds of people's medication routines was worth it. And I could see their point, because that 5p multiplied by a few thousand people per month was a large saving. I hated the impersonality of it.

Now, Jeremy Hunt claims that this new measure will reduce drug wastage. Drug wastage is a HUGE problem for the NHS. If you take your drugs out of the chemist, change your mind and pop back in, those drugs have to be thrown away. They cannot be recycled. They cannot be put back on the shelf. Once they've been signed over to you, they're gone whether you take them or not. Sometimes, an elderly patient would die and their relatives would bring in binbags full of unused medication, hoping we could recycle it. Medication collected month on month, for which they'd paid nothing, never used because they hadn't told the GP they'd stopped taking X four years ago, or they didn't trust the new packaging and weren't sure it was the same drug, or they didn't NEED a fresh bottle of psoriasis shampoo every month, or they weren't sure if they were supposed to take the red tablets with the little white ones. Regular medication reviews may be a pain in the arse if you're on repeat prescriptions, but they're designed to stop this sort of thing happening. I daresay it still does, particularly with older people who live alone and struggle with transport.
But I doubt Jeremy Hunt's measure will make any difference. In fact, if I know elderly, often anxious patients on numerous medications, it's more likely to make them scared to get their medication at all. They don't want to make a fuss. They don't want to cost anyone £80 a month. They don't want any trouble. They'll just leave it. If they only take the pills every other day, that'll help save the NHS money. And that calcium tablet, they only take that once a week anyway, so maybe they don't need it at all?
And you can imagine the damage.

Well, if you can't, increased falls, increased stroke, increased heart attacks, increased extremely expensive operations and intensive care therapies, increased inpatients, increased A+E attendance, increased premature death. None of which will particularly save the NHS money. Except the deaths, I suppose.

There is another issue here. If there is one thing I could not loathe more about this toxic fucking government, it's the buzzwords of taxpayer and hardworking families. As a former taxpayer, married to a current taxpayer, in a hardworking family (I assume we're hardworking, I haven't ACTUALLY sent the kids to work down the mine yet, but it's only a matter of time) with fuck all money, I can honestly say that if I get ill, paying for a prescription vs waiting to see if I get better is often a genuine ethical conundrum. I frequently don't bother ordering asthma medication because it costs me almost £17 a month in prescription fees that I don't feel able to justify. It's not a problem at the moment because I have a maternity exemption certificate, but in another year, that'll be gone and I'll be back to poorly managed asthma and recurrent chest infections. Woop. If I was on multiple therapies, the problem would be multiplied. SOME people with life-threatening conditions get their medication free, but not all. And most people who have to pay for their prescriptions ARE taxpayers. This is the sheer bloody idiocy of it.
Taxpayers aren't IMMUNE from illness. Indeed, in the current economic climate, taxpayers are more likely to need antidepressants, anxiolytics and painkillers than usual. Wealth directly correlates to good health, less disability affected years, and longer life expectancy. The poorer you are, the sicker and more disabled you are likely to be (see The Black Report, The Marmot Review for more info) regardless of whether you work enough to pay tax or not.
Not to mention that the elderly, who probably cost the NHS the most in free prescription charges, have been taxpayers. Just as the government like to put pensions in the 'benefits' bracket of government spending, they also put them in the 'workshy' bracket of usefulness. Bloody old people, living too long and costing us money. Let's have a cull.

The money raised by prescription charges helps pay for everyone's medication cost. You might pay £8.20 for your one pound pack of painkillers, but the old lady behind you in the queue has paid nothing for her monthly bag worth £80 or so. And there is a massive deficit, because people live longer thanks to a regime of drugs aimed to hold chronic illness at bay. One day, you will probably need one of those chronic disease drugs, be it aspirin, insulin, a statin, a betablocker, or inhaled steroids. Maybe you're already on them, but begrudge having to pay for it because you'll die without it. Or you begrudge having to pay when you already pay your tax. But National Insurance doesn't just cover medication.
As a five year old, I cut my arm in half, lengthways. The NHS sent an ambulance, X-rayed my arm, cleaned all the glass out, fetched a plastic surgeon in on call to repair tendons and stitch a ligament back together, sewed it back up, gave me two days of inpatient care and then sent me home to recover, with painkillers. The staff, equipment, anaesthetic drugs, bedspace and care were not cheap. Without it, I was unlikely to have died from my injury, (unless it got infected) but I would have lost the use of my right hand, effectively disabling me for life. The NHS has emergencies like that every single SECOND across the country.

Chronic disease causes heart attacks (for which you need intensive care, heart surgery, specialist care, rehabilitation and sometimes intensive care transport), strokes (see previous, but with brain surgery instead of heart), progressive lung disease (home oxygen therapy, home care), and of course, death. The medications used to tackle chronic disease attempts to reduce the need for these expensive interventions. They are ultimately cheaper than inpatient care.Which is also funded by the taxpayer. Perhaps if this measure is a success, we will have balloons at the end of each inpatient bed telling us how much our stay has cost the taxpayer. I mean, I'm due to have a baby any day now, and that'll cost the NHS between £800 and £1000. Perhaps I should go and thank my husband for his taxpaying contributions that will allow a (hopefully) safe birth.

Personally, I think the prescription charge should be reduced, and means tested. If more people paid it, it would be both more profitable even if it were cheaper for individuals. I don't think it's fair that (lifelong taxpayers or not) some very rich people get their medication for free while people scraping the barrel have to choose between food or drugs.

But I don't actually think Jeremy Hunt's new scheme is anything to do with reducing wastage, and the cost of medication to the NHS. If he was that bothered, he'd aim his ire at pharmaceutical companies, who never shy from making money out of the sick. I think this is an early attempt to frighten us into accepting the eventual demise of the NHS, and the use of health insurance.

17 Jun 2015

The Postnatal Survival Kit

I'm now 37 weeks pregnant, and at that point in pregnancy when people start asking if I've packed my hospital bag yet. Yes, yes I have. After seven months of refusing to buy anything for the baby (mainly out of terror), I've bought practically everything in the last 4 weeks, and shoved it in a rucksack.

But nobody ever asks if you've got everything ready for afterwards - nobody wants to remind you of the traumatic week after having a baby when everything seems to be falling out of you. Or they assume you're ready, one or the other.

Anyway, as this is my third baby, I'm READY! SO READY! And here are my postnatal essentials...

1. Painkillers.
It doesn't matter if you have a fast labour, a caesarean, or an instrumental delivery. It doesn't matter if you tear or not. Having a baby hurts like a fucker, particularly afterwards. "But oh", they tell you, "as soon as the baby's out you forget the pain!" Not if you get afterpains you don't. Birth carries a payload of hormones to carry you through the delivery and into the euphoria of YAY! BABY! Then the hormones settle down, and it's bloody sore and crampy and weep-inducing. In addition to this, it's ingrained into you from CONCEPTION that only the weakest paracetamol is safe to take, and even that's a desperate measure. Once that baby is out, embrace the painkillers. I have got DELICIOUS, FORBIDDEN ibuprofen and some co-codamol in.

2. Maternity pads. Lots of maternity pads.
Another thing often neglected to be mentioned in The Joy Of Birth is that you bleed like a stuck pig for some days afterwards. Maternity pads are advised over regular pads partly because of the chemical crap they put in normal pads (floral menses, yum!), partly because no regular pad will stem the postnatal flow. And no, you really can't use tampons. With my last baby, I used 12 pads a day to begin with, despite having had a postnatal haemorrhage. Mothercare, wondrous place, do maternity pads with wings. I cannot praise them enough.

3. Breast pads. Lots of breast pads.
It doesn't matter if you're planning to breastfeed or not, most women will still pour forth milk for some days after the birth (weeks, if you do breastfeed). And it happens at the most irritating and unexpected times, like you smell the baby and you boobs go, or you think about how small the baby's toes are and your boobs go, or you're in Tesco and you see a pregnant woman, and your boobs go. It is annoying. I'm a lucky beast who doesn't tend to pour forth milk after the first four weeks, because my letdown only works during feeding, but I still get through boxes of the things to start with.

4. Lanolin Cream
If you do breastfeed, this cream is a marvel. What nobody tells you before you have a baby, probably to try not to terrify you out of it, is that breastfeeding can give you sore, cracked nipples. It's really quite an obvious thing when you think about it. My first baby had me bleeding all over the shot to begin with, until I got some magic Lansinoh, and within days my nipples were bulletproof. I used it again with baby 2, and will use it again with this one, although I've got Medela Purelan this time because it was much cheaper. Stick it on after every feed, and you should be fine.

5. Anusol and Lactulose or Fybogel
When you push a baby out, you can end up with piles. Piles are enough of a problem when you're pregnant, but after birth they can get really quite annoying. Anusol is your friend. Then there's constipation. I've torn badly with both previous babies and become so terrified of crapping that I've made myself ill. Even with the time honoured advice to hold yourself with a damp flannel while you go has been insufficient to get me through. So this time, I'm not risking getting ill - Lactulose from day 1, thank you.

6. Iron
If you're on prescribed iron when you get close to birth, make sure you've got enough to last a couple of weeks postnatal (yes, you do have to assume you'll go overdue). If you think you'll run out, get an extra prescription. If you're not already on iron, get either supplement tablets or Spatone/Floradix\Feroglobin liquid iron. You lose a lot of blood when you have a baby. It's blood you can afford to lose, because of the extra that's been sustaining your little one for months, but it is a sudden drop and can make you feel much more tired and crap than you necessarily need to.

7. Pajamas and Slippers
This may seem a bit of an anomaly in this litany of postnatal woe, but I always treat myself to nice, new pajamas for after I've given birth. I don't believe in getting dressed for the first week postnatal - anyone coming round is going to find me boobs akimbo, hair everywhere, stinking of lochia, covered in children and possibly weeping, so whether I'm fully dressed or not makes little difference to their perception of me. Mothercare do really lovely nursing pajamas (with button down fronts). I'm still wearing the pajamas I got from them in 2011, so well worth the investment.

8. A Nursing Pillow or Extra Pillows/Cushions
A boomerang shaped pillow is amazing when you've just had a baby, regardless of how you feed them. It gives you a way to support their useless neck without actually having to hold them up too much. Extra pillows will also do the job, but I find a boomerang useful for all sorts of things, not least propping me up to eat in bed.

9. Canned Drinks
I get bloody thirsty feeding a baby. This time, I have a husband to make me endless tea and drinks, but I assume he will also want to sleep occasionally, so canned drinks are the way forward. Unhealthy, yes, but this is about survival.

10. FOOD
You have to eat when you've had a baby, and yet it seems to be something easily forgotten among the chaos of screaming, poo and a baby who has no idea how to tell the time. Nothing will help your recovery quite like loving support, sleep and food, and if you can't get enough sleep, food will do. Fuck your postnatal diet. Fuck any pressure to fit back into pre-preg clothes. That can wait at least a month (or forever, if you're me). Eat what you fancy, when you fancy it, moreso if you're breastfeeding - you really do need a LOT of calories to get the milk factory going. If you've got other people in the house to feed, make some meals in bulk for the freezer before your due date. You can find recipes on the BBC Good Food website, including cook-from-frozen instructions. Write these instructions down on the frozen food container, so anyone can reheat them. If people are coming to see the baby and have the courtesy to ask if there's anything you need - food. I think baby cuddles for cake are a fair exchange ;-) If family offer to bring you round meals, accept gratefully. It's been months since you could eat normally, so take advantage.

For a less miserable postnatal view, you may also like my post on things to look forward to.