C-section date

Here is my medical news:

• I am now booked in to have a c-section on Monday 4th March, though that date could change
• The bean is no longer transverse, or breech, but head down in the right position
• I'm having a growth scan on Monday to see quite how whopping he is
• I'm not allowed to have ECT before the birth unless I tell them I'm suicidal, so I'll be having it 1-2 weeks afterwards
• I've muffed up squeezing a spot on my chin, Logie is fascinated by it and keeps pointing it out

Jon and I met my consultant obstetrician today, and she was lovely. She'd read all my notes before I entered the room, was incredibly sympathetic, explained things in detail and gave us choices.

So I hope she didn't think that my sobbing all the way through was anything to do with her. In fact, I hugely appreciated the 50 minutes she spent with us, and I trust her. I wish I'd met her earlier on in my pregnancy, when depression first loomed, as it turns out that I probably could have had ECT  then after all, with the right people pushing for it.

I've been thinking a lot today about the difference between doctors, and how I rate them. Because the impact that seeing a top-hole doctor - or other sort of medical professional - has on one's outlook is very significant, especially when mental health is involved.

Perhaps it shouldn't matter if you like them or not, so long as they make the right clinical decisions. But it depends on the circumstances. I couldn't give two hoots if a surgeon operating on my back was a racist, misogynist arsehole if he was going to do a better job than anyone else (and I would be mostly asleep in his presence).

But in most cases, doctors and patients agree that better outcomes are secured when the patient feels reassured. This is especially important in mental health.

I've been trying to define what, in my personal view, makes a 'good' doctor. It starts off with them being intelligent. Now obviously, a doctor must be pretty clever to have qualified and been allowed to practise. I'm afraid this doesn't apply to a few nurses and midwives I've met recently - though I've met some brilliant ones too.

I'm quite bright, Oxford scholarship (much good it's done me in terms of glittering career or thinking my way out of brain meltdowns, so forgive the brag) and I don't have much patience with people who can't keep up.

But on top of this they need emotional intelligence. To understand what you're saying, maybe even put themselves in your shoes, and most importantly - TO ANSWER THE ACTUAL QUESTION THAT YOU'VE ASKED. There is nothing more annoying, or instantly disheartening, than someone dodging a question or remark. It demonstrates that either they didn't understand, they don't care or they don't think you're capable of hearing the truth. It's insulting and it kills your confidence in them like a shotgun to the head.

So if you ask me why I'm crying upon learning that I have to wait two weeks for a decision about whether a procedure will be allowed, let alone any action, and I say "I'm sorry, it's just that two weeks feels like an awfully long time at the moment when I feel this bad, but I guess there's nothing else you can do", don't say (with a hint of a shrug) "Well, if you get any worse you can call our out-of-hours crisis line or go to A&E". Do say "I know, it's frustrating, but I promise I'll ring you the minute the decision is made" or "Why don't I see if we can ask someone else to get an answer a bit sooner" or "You're right, I wish it could be sooner but there's nothing else we can do - that's hard to hear, but I promise we'll get things moving after that".

If you insist on visiting me in my home, ostensibly to offer support and talk about 'coping strategies', but really to check whether I'm dressed and have no obvious signs of self-harm, don't just repeat back to me the things I've just told you. If I update you on all recent developments with various doctors and midwives, inform you of when my next appointments are and say that the only good thing is that I'm sleeping much better at night thanks to the pills, don't tell me in response to anything else I later say that "Your appointment is at X time with Y and you can discuss Z" because I just told you that. Don't say "Getting more sleep will help you feel better" because you are totally stuck for anything else to say. It's bad enough repeating yourself, or things that I've just said, but I will brain you if they are totally self-evident things that a nine-year-old wouldn't need explaining.

If you notice from my maternity notes that I have a history of depression, but that I am not currently having any problems on that front, I am normal and sane but exhausted after 24 hours of contractions on a syntocin drip which makes them all the more violent and painful, don't tell me patronisingly that you will generously let me have an epidural just 'because you can see from the notes that I am an anxious person'.

If you want to reassure me about 'measuring big' don't tell me I am 28cm when I'm 32 weeks, because when I go to the obstetrician five days later and she measures me with a tape measure rather than with her fingers and karmic intuition and finds me to be 36cm, I will know that you were trying to make some sort of point, or were just grossly inept.

Oops, didn't meant to get ranty. What I meant to do was to share with you my honest inspection of my own ideas and attitudes about what sort of person makes a good health professional, for me. We've already established I am an intellectual snob. I worry/wonder whether I am racist and sexist too, I'm ashamed to say. Plus classist, and unreasonably pro-private vs NHS.

I do find it frustrating when English is obviously not someone's first language, and they can't spell or seem to understand long words. Maybe it's my posh voice. I do feel uncomfortable when there is a blatant wide gap between the sort of backgrounds that we have - I feel embarrassed and as if they can't possibly get me; they probably think I don't know how lucky I am.

I occasionally feel uncomfortable with a man, especially if I am really boo-hooing at top volume, or having to talk about vaginal discharge, or if he has just followed the midwife into my home with no attempt to check that I'm okay with him being there and rubbing his hands on my lower belly.

But two of my best (okay, favourite) psychiatrists have been men, one of whom was Pakistani, treated me for ten years, and for whom I have immense respect. We developed a relationship where we had a sort of shorthand. When I saw him when I was well we laughed and talked about cricket. I've interviewed him as a journalist. It cost a lot of money to see and be treated by him. Sure, I felt frustrated with some of his advice sometimes and dreaded going to see him when I was ill, but I always trusted him.

The other man was just very clever, very experienced, looked me in the eye, told me in tremendous detail what he thought, and prescribed decent amounts of valium when I was anxious and speedy ECT when I was depressed. He was NHS.

The one-to-one midwife I had when pregnant with Logie was so nice, and sensible, and like me (white, middle class, bright, sense of humour, often had a ladder in her tights) that I wanted her to be my best friend.

The three doctors I have seen recently who have 'got me' the most have all been female, at consultant level (anaesthetist, perinatal psychiatrist and obstetrician), one white, two Asian, all had that emotional intelligence X factor. All have written letters, made follow-up phonecalls and gone the extra mile to see if they could really and truly do anything else to help. And all on the NHS, I should add.

So make of that what you will. I often think about how I would behave if I was a doctor, and maybe that's what I look for - someone like me. And maybe that's short sighted. But I think it's only human to want someone nice, knowledgeable and who you can imagine being a normal person outside of work. A bit like when you were at school, and despaired or mocked at the teachers who were clearly subhuman freaks, but warmed to and wanted to impress the ones you could imagine down the pub, or bantering with their own children round the kitchen table.

I've gone on for far too long. So here is a lovely picture of my own child, at our own kitchen table, celebrating his second birthday and being totally thrilled at the candles on his Ben & Holly fairy cakes which I scraped together. He is the light of my life, and in less than five weeks I will have another.

Depression 3

I feel like I'm living a double life.

Not as dramatic as Walt in Breaking Bad, though it has made me realise that I have no practical skill or knowledge to fall back on, should I need to make a shedload of money secretly after being diagnosed with cancer. I can do pretty good roast potatoes, but not cook a pound of crystal meth worth $35,000.

I could see if there are any lucrative competitions for reverse parking, but somehow I doubt it. And I'm not all that good anyway, just determined.

The nature of my double life is that I seem okay most of the time with friends or family. At least, I think they think I do. I can converse brightly, and wipe runny noses, but maybe they notice that I don't smile or laugh. My face feels frozen.

But when I'm on my own - when Logie is at nursery, or I'm driving, or have retreated to the loo for ten minutes - I cry. I sort of store it up. It is my underlying condition.

I saw a perinatal psychiatrist about ten days ago, who was very helpful. Talking to her made me feel like less of a fraud. This depression isn't like others because I am functioning - because I have to. The only other time I've had it since Logie was born, I was able to have ECT quickly, while I was on the downhill slope, and that nipped it in the bud.

But if you take away the "if I didn't have Jon, or Logie, or the prospect of ECT" my mood and illness are the same. It was a relief to share this with someone. This psychiatrist has done what she can to get the ECT ball rolling again, and while I am not to get my hopes up, I'll find out on Monday if they'll do it pre-birth after all.

As I've always known, the risks aren't associated with the ECT itself, but with the general anaesthetic. So if we can get an obstetric anaesthetist, who does nothing but anaesthetise pregnant women every day, as many have to be for all sorts of things, then we could proceed.

Cross fingers.

Given that I seem okay with certain people, they sometimes ask what it feels like to be depressed. Apart from the obvious things like sad, numb, incapable and ashamed, I have always felt it as a very physical, obvious, otherness. Imagine if you lived on a planet with no liquid, and you didn't need it to survive. Then you went to sleep and woke up drenched. How weird, and unpleasant, would it be to be wet?

Or if you had never experienced cold before, or that heavy sensation in your body when you have flu and everything aches? Depression is a differentness that we can't yet describe. We all know what physical pain feels like, and can point to where it is. But mental pain we know less about. It exists though, in a different form, and believe me it still applies to your whole body. And is just as painful.

The good news is that I am sleeping again. I have some lovely blue pills (totally safe for the baby - just strong antihistamine) and I now look forward to going to bed. Sleep really really helps. I am very grateful.

Logie is living something of a double life too, now he's back in the nursery routine. For example, we have been having a real battle with jumpers recently. He simply will not wear them. I know that sounds silly, I just ought to force him when it's snowy. But he is big enough to kick and run away, and take them off (mostly) himself.

But at nursery he will put them on like a lamb. No fuss. Nursery Logie also eats a lot more vegetables. I wonder when they'll start teaching him basic chemistry. I don't want him to end up like Breaking Bad, but a working knowledge of medicine and pharmaceuticals would be very useful in this house.

Diabetes test

Did you know that some pregnant women refuse ultrasound scans because they believe it will make their baby left-handed?

Normally I am quite respectful of other people's decisions, but honestly, there are some cretins out there.

I discovered this by accident when trying to look something up on mumsnet, which is always fatal. Though it's great if you like finding out worst-case scenarios or reading a good slanging match.

I was attempting to discover why the nurse called yesterday afternoon to say I had to go back to the hospital for another blood test, because the sample had clotted. Actually, she had such a thick west African accent that I thought she said "flooded", and had visions of a Nanny Plum style 'jelly flood!' (if you haven't got into Ben & Holly's Little Kingdom, you must do so now - much funnier than Peppa Pig and twice the length).

Earlier that morning I'd had my glucose test, which involves fasting from midnight, having some blood taken, drinking a bottle of warm rank Lucozade, waiting two more hours without food, then surrending more blood. It's a test for gestational diabetes, which is standard for anyone who had a large baby last time (Logan was 10lb). Although I couldn't help noticing that most of the women in the waiting room, including me obviously, weren't exactly a size ten.

But the nurse said I didn't need to fast again, and there was no rush to come in, so I was puzzled about repeating the test, as I wouldn't be duplicating the empty stomach/Lucozade circs. And looking up clotting issues in pregnancy online only yielded lots of scary things about miscarriages.

Anyway, I've just been back and it turns out to be no biggie - they also do a 'group and screen' test on the leftover blood to determine your blood group and screen it for something or other, and by the time they'd got to that my sample had clotted. The nurse cheerfully reassured me that it wasn't really necessary, because they'd already determined my blood group during two previous tests. It's in my notes and on the system. They just like to "have a bit extra"...

Plus I don't have diabetes and my iron level is fine. This is a good thing, as a reducing my impressive intake of carbs and sugar right now would not improve my mental health. There are still three mince pies left in the packet to dispose of.

The reason I feel so shit is because I'm getting about three hours sleep a night. So to ease the strain at the weekend, Jon cooked. He doesn't cook often, not because he doesn't like it or can't, but because it's my thing. The division of tasks in our household goes something like this:

Jon:

• Dishwasher
• Opening post
• Fanatical recycling and bins
• Earning all the money and paying for everything

Me:

• Cooking
• Laundry and housework (or supervision thereof)
• Reverse parking
• Planning and organising all 3.5 of our lives

If cooking goes over to his side the imbalance will be even more apparent, though I do find it rather sweet how carefully he follows a recipe. If it says 'fry onions for ten minutes' he meticulously sets the pinger, then announces incredulously that they appear to be done after six minutes.

He is also hugely self-critical, even though it was delicious. Pork and mushrooms and tagliatelle. All adding to the girth of my ginormous bump, which must be measuring big now, despite the midwife's assurance it is in the normal range.

Then again, Jon did read something the other day about a new set of recommendations for midwives, which include not using elastic tape measures any more. Cretinous? Blindingly self-evident? Someone should start a thread on mumsnet.

Depression 2

I don't really have an answer to the question "How was your Christmas?". Does anyone?

Unless you say "Eventful - our house burned down on Boxing Day", as happened to someone I used to work with, not many of us truly want more detail.

Suffice to say I found it really comforting to be around family, especially Jon, whose very presence makes everything markedly better. We had mild tummy bugs but escaped the worst of the winter epidemics. Logie got thrilling presents, including:

       ·      A balance bike. On Christmas Eve I asked my Dad whether it needed assembling, and he said cheerfully "Yes, but we've already wrapped it up in the box". So when it came out the next morning, Logie nearly had coronary with excitment, and kept trying to climb on the saddle bit and steer the handlebars bits while Jon frantically tried to build it quickly. By the time it was ready, and Logie was kitted out in wet weather gear and helmet, it had all become too much, and he simply wailed when we put him on it. And hasn't been on it since. I think he is making a point.

      ·      A kitchen. Unlike his girlfriends, he doesn't do any elaborate cooking, but he will make cups of tea, and if you're really special you get a fish head in it.

      ·      A flashing bouncing ball. This may well have been his best present.

      ·      A pillow and duvet with trains on them. Going to sleep with the trains is terrishingly exciting - he can't believe his luck. But how long will it be til he realises he is now more capable of climbing out of his cot now that he's not in a bag (for lunchtime sleeps only)? He hasn't attempted it yet, but the day will surely come, and I want to postpone it for as long as possible.

To say he is full of beans at the moment is an understatement. Every action requires a supplementary couple of laps around the kitchen, getting up or down or from A to B must be jumped, many things must be thrown on the floor from a great height.

And he keeps hitting me. Often in the face. Jon too. It's a stage, I know, and maybe he is picking up on something, but I'm finding it upsetting. Any suggestions?

I still manage not to cry in front of him, but yesterday, day three of pretty much solo, full-on childcare, a few tears slid out as he sat on my lap on the stairs, putting his shoes on. I was exhausted (it was only 9:30am and I am still not sleeping much at night), knocked about and overwhelmed.

I'd thought perhaps that I was a bit better over Christmas because I was behaving as if I was, even if I didn't feel convinced inside. But the last few days have been back in the depths. Ho hum.

This stage of pregnancy was never going to be easy with a toddler. My bump is ginormous, and it would be physically testing for anyone. But as ever, I have plenty to be grateful for. It's actually a lovely time, my friends and family are all supportive and kind, I'm not working - why am I making such a meal of it? Frustrating.

One more note on the jumping, which is Logie's defining activity. (Ironically, he is refusing to wear jumpers at the moment, which is a shame, as he got some lovely ones as presents.)

When he comes across someone in the park or the soft play area that he wants to befriend (usually a bigger boy, his heroes) he sidles up to them and does some small jumps by their side, like a penguin trying to fly. It's so sweet, especially if they don't notice and he carries on in hope. Then he does a few log rolls on the floor. Then experiments with some bigger, falling-over jumps, which usually do the trick. I look forward to the day when I can jump for joy with him again - physically and mentally.