Lisa Tremayne

Children Were Everything I Ever Wanted

6 years. 72 months.

72 times I got my period and was so disappointed that my body had failed me again. That’s how the inability to conceive feels and the words that we in the medical field – I am a maternal child health nurse use – the inability to conceive. Just to make sure you know that your body doesn’t even have the ability to get pregnant. This is risk factor number one (infertility).

Struggle with Infertility

When most of your friends are in the same specialty you are – maternal/fetal medicine – you know right where to go to fix the problem. Which is exactly what I did. My story begins in May of 1998. After six years of infertility, being of “advanced maternal age (34), and one round of IVF, I am laying on a gurney having my beautiful, large, round eggs extracted. Twenty two eggs to be exact.

The eggs meet the sperm in a perfectly warm environment and each day we get updates as to how they are “doing”. Three days later, six zygotes are implanted back into my body. Six. The doctor tells me not to get hopeful; one was looking good but the other five were really being placed back inside me to increase my chance of pregnancy. I lay on another gurney for an hour, willing that little strong little group of cells to stick. To find a home inside me and fulfill my dream of becoming a mom. These are risk factors number two (infertility treatment) and three (my age).

Pregnancy – Finally!

Seven days later I’m in the hospital for ovarian hyper stimulation and I find out I am pregnant. I. Am. Pregnant. My body didn’t fail me again. Though I’m alone when I find this out, which is not what I pictured for this momentous occasion, I’m so thankful and happy that it didn’t even matter. This is the first time it’s mentioned to me that there is a real possibility I am pregnant with twins. Twins!  I am overjoyed and so proud of my body for finally doing what it’s supposed to. One week later this possibility is confirmed, and we see two tiny little egg sacks. This is what they call them, egg sacks. This is risk factor number four (pregnant with multiples).

Another week later and I’m vomiting each day, all day. At the same time we see another egg sack. Three. There are triplets inside me and I am somewhere between super impressed with my body, and absolute terror. As a nurse in this field I know all the risks that come with “higher order multiples”. We’re 4 weeks from implantation and the doctor looks in utter disbelief at the ultrasound screen – there are now FOUR embryos. FOUR.

I cry. I cry for me. I cry for these babies who are so desperately wanted. I cry because I know too much and because I  haven’t stopped vomiting in over a week. I am officially diagnosed with Hyperemesis, vomiting all day, every day, and requiring hospitalization for dehydration. These are risk factors number five (Hyperemesis) and risk factor number six (hospitalization during your pregnancy).

Hospitalization and Health Problems

Fast forward to Christmas Day and I am now 30 weeks and 1 day pregnant with triplets. One of the babies was lost somewhere between the 12th and 14th week. I was hospitalized almost my entire 30 weeks of pregnancy, eventually being diagnosed with Pancreatitis. I had been in labor five times by Christmas Day but it had been stopped with medications. I was done. I wanted them out – I had nothing left to give. I was a shell of the person I was just 30 short weeks ago.

Though I wanted to be a mom, I felt like was a host – being kept pregnant to grow these babies as big and strong as possible. I delivered two baby boys and one baby girl later that morning. One of my babies is born not breathing, while the other two are so tiny weighing barely over 2 pounds each and in need of around the clock care. They are wicked away after I catch the briefest of glimpses. These are risk factors number seven (traumatic birth experience) and risk factor number eight (premature delivery of infant).

Time Stops in the NICU and ICU

Time gets really fuzzy after that. I remember them taking me to the NICU on the stretcher to see all my babies. The shear volume of emotions that go through my heart and mind are indescribable. There is one son a ventilator to assist his breathing. The other two of my babies are in incubators – fuzzy, yellow, and heavy with IVs. The day is a blur but I remember thinking, and knowing that something is wrong with me.

I remember looking at the bag holding the urine coming out of the catheter inserted into my bladder, trying desperately to remember what would be a sufficient amount. My heart felt like it was racing all the time. I remember being so cold.  That same day I’m transferred to ICU in kidney failure and with too much fluid around my heart. Once again I’m alone and I am praying for my babies’ birthday not to be the day they lose their mommy. I don’t remember the next 5 days in ICU. These are risk factors number nine (NICU stay for your baby/babies) and risk factor number ten ( a significant illness suffered by the mother).

The First “What if” Thought

On New Year’s Eve day I’m brought out of my drug induced haze in the ICU and begin lying to get to my babies. Yes – lying through my teeth. I tell hospital staff I am fine, that I can get in a wheelchair, and I can be moved to the step down unit. Yes, yes, yes. Whatever you need me to say. I’ll say it so I can touch my babies. I get to them. My heart explodes with love. I can feel my body wanting to lose collapse from pushing it too far too fast. But I will it away.

I’ve heard of moms lifting cars off their children and this was my version of that experience. I stay with them the rest of the day.  It’s at that time I’m struck by my first “what if” thought. “What if I lose one of these babies? How will I survive that?” My mom tells me not to worry. They are in the best hands, in the best unit, and that I have always been a worrier. This is risk factor number eleven (history of anxiety or depression).

Bringing My Babies Home

The next 6 weeks are rotation of going to the hospital during the day to be with the babies, and going home at night and crying because I had to leave them there. They all come home within five days of each other. I go from no babies to all three babies in five short days. “No problem”, I thought. After all, I have been the nurse in charge of the nursery so often, and at any given time there were 15-20 babies. What I didn’t is remember sleep. I would leave work as a nurse, go home and sleep and then start again at work the next day.

Within 72 hours of all my babies being home with each on a three hour feeding schedule, and each feeding taking about 2 hours – I’m a total mess. My worried thoughts turned to non-stop racing thoughts. I was unable to sleep even if all the babies slept at once. Unable to swallow from anxiety. Unable to control this bubbling rage I felt. I mentioned my racing thoughts to my OB at my post op check – he assured me it was nothing, and that a shoe shopping expedition would bring me back to normal. Based on all my risk factors, I should have been screened for depression and anxiety immediately. But I wasn’t.

Silenced By Fear

My OB’s face and eyes looked worried and alarmed but I knew then to never say another thing. I didn’t want anyone thinking I was unstable and taking my babies from me. That is how it went on for months, and months. I was so broken and ashamed of how I felt and the thoughts I had. When I mentioned it my (then) husband he looked at me in disgust and said, “you got everything you ever wanted”.

I was a monster, and I didn’t deserve these babies. I became obsessed with death, and how many ways they could die. In a house fire (which I solved by buying a ranch style house), driving my car off a bridge (which I solved by no longer going over bridges) and many more. But I could always fix it. I always set up a safety net.

The Long Road Towards Recovery

I would like to tell you it got better sooner, but I didn’t. I had a severe case of untreated postpartum anxiety/OCD and intrusive thoughts. It didn’t get better for years. Years later working as a floor nurse on a postpartum unit, I’d see the face of new mothers who I knew were feeling what I felt. My pain was so deep and life altering I vowed that I never wanted another mother to feel that way, to feel like a bad mom, a monster, again. I started giving out my cell phone number to keep in touch with these women. At the same time I started getting them to the help they needed – therapy and medication. All without owning my own story with anyone but these soul sisters. Women who were feeling what I had felt.

In 2007, New Jersey became the first state to mandate depression screenings for new moms before they left the hospital. It was thrilling. At the same time I started volunteering for a consortium that was getting PPD resources into the hands of moms. In 2011, I started an official postpartum depression support group at my hospital, and it quickly became the most attended support group in the hospital.

Helping Other Moms

My phone number was passed around and I became something of an urban legend: if you call/text this number, she will help you. In 2013, I presented an idea to my hospital for an actual PPD program. There were none in the state – hell there were only a handful in the whole country. It took 2 years but I got the go ahead, and began building the very program and services I know would have helped me.

The program quickly took off and in less than two years we officially became an interdisciplinary Perinatal Mood and Anxiety Disorders Center. Specialized treatment given by the right team, for any new or pregnant mom. We can easily see 50 new moms a month. We have days we get 10 phone calls – from moms, from husbands/partners, from grandmas. All are asking for help, and we bring them in and we heal them. We validate what they are feeling immediately. I tell each and every new patient that this is the most common complication of childbirth. One in five new moms will experience this. PPD is both temporary and treatable, and we can help you – you will get better.

Peer to Peer Support

Our peer to peer support group is the absolute crux of our center. It’s an honor to have been able to make this happen. Thrilling that I’m part of a hospital system that feels the responsibility to take care of mental health as much as physical health. It’s a blessing to be part of an amazing team of women who are selfless and tireless in helping moms. This job has no clock and we are on all the time. Because in taking care of a new mom, you are taking care of the baby and the family. You are keeping everyone together and intact, which is vital for recovery.

If a new mom isn’t doing well and she is not bonding/attaching with her baby, it can have devastating effects on the whole family unit. Our calling is to keep moms healthy in every way. New Jersey is the first state to mandate postpartum screening and will be the first state to offer pregnant and new moms help – no matter where they are in the state. It’s my dream that one day these same supports will be offered to all moms across the country.

Lisa is one of the Maternal Mental Health Research Collaborative’s Patient Expert Advisors. Click here to find out more about this amazing group of moms.