My wife's PND.

[Zafrull]

Dear all
Deborah asked me to modify this thread and move what was said under ACs thread to here.
I cold only do this by adding the posts to this first post and deleting them under ACs thread.
Hope no one minds?

Veritee
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Guest
Re: Y does my wife feel like this?
« Reply #256 on: May 2nd, 2004, 3:31pm »

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Dear All.

My wife went through a C Section sometime last year and immediately after that she was diagnosed with PND. It is now 9 months since she was diagnosed and she is coping rather well.

However there are instances when she ends up with a relapse and this relapses can be rather bad (she slitting her wrist). I am trying my outmost best but at times it just seems to be of no avail.

She feels that there is a gap between her and our son and she feels that she is not yet ready to accept the fact that we have a son! Is this normal for patients with PND?

As a husband, I am very tired and depressed of this as well as it took us 6 long years to have a child. Anyway if it is fated that we have got to go through this, I accept it as fate.

But does it take up to years for patients with PND to recover? I need the feedback of forumners on this.

Thank you.

Zafrull - Malaysia.

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yorkslass
Senior Member

Hi I am 29 have 2 children 5 and 2 yrs I have had PND since oct 01

Posts: 215
Re: Y do i still feel like this ?
« Reply #257 on: May 2nd, 2004, 4:30pm »

-----------------------------------------------------------------------HI Zafrull

I do not know what to say to you apart from you must be a good man to be concerned. Well done for coming on here to look for help.
Maybe you should start your own thread and there is lots of women and a few men on here that will try to help you. Some of use still have PND and others and got to the end and are now recovered.

Melx

Take care Mel x
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sutherjess
Full Member

Posts: 53
Re: Y do i still feel like this ?
« Reply #258 on: May 2nd, 2004, 4:58pm »

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Hello,

Does your wife use the computer, if so it may be a tremendous help for her to come on here and read about people in the same situation..

Good luck, time will heal.

Jessica



I'm 23 and have 2 sons aged 3 1/2 and 1 year. I have only recently been diagnosed with pnd after 4 months of struggling.
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Zafrull
Guest
Re: Y do i still feel like this ?
« Reply #259 on: May 2nd, 2004, 5:08pm »

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Dear Sutherjess.

Yes my wife does use the PC, but with the relapse things have been quite bad lately and I tried getting her involved in the mood gym session but it failed as well.

She basically feels that she cannot be recovered and I have got to get into the picture to assure her that this is only temporary.
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sutherjess
Full Member

Posts: 53
Re: Y do i still feel like this ?
« Reply #260 on: May 2nd, 2004, 5:25pm »

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hi again,

when she feels ready to talk she will, it is normal to feel withdrawn during a bad episode.

you are a good man to care so much and with your support she will recover, it is important to be patient and let her talk when she wants to.

keep talking and if you have any questions feel free to ask.

Jessica

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Zafrull
Guest
Re: Y do i still feel like this ?
« Reply #261 on: May 3rd, 2004, 07:52am »

Thank you for the kind words.

Can I know what is the midecation that is prescribed for patients with PND?

My wife is on a combination of:


Efoxor 300 mg.

Xypreza 10 mg.

Refoxon 10 mg.

Lapital 5 mg.

Is this the standard medication as well?


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yorkslass
Senior Member


Hi I am 29 have 2 children 5 and 2 yrs I have had PND since oct 01
Posts: 215
Re: Y do i still feel like this ?
« Reply #262 on: May 3rd, 2004, 09:08am »

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HI

There is lots of different kinds of tablets for PND the best person maybe is to ask deborah she was and is a nurse. maybe start a post and ask or email her. Sorry I can not help anymore but others maybe able to.

Melx


Take care Mel x
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Gender:
Posts: 148
Re: Y do i still feel like this ?
« Reply #257 on: May 3rd, 2004, 2:30pm »

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Hi Zafrull,
Well done to be posting on here! Your wife's symptoms sound very much as if she has PNI and the fact she had a c-section makes me think she is suffering from a 'problem' with bonding and (its possible) she may have traumatic stress experience.

This sows itself with 'episodes ' of stress eg self harm and depressive symptoms such as crying and feeling very low in her mood would i be correct on that?

Did she have her first baby girl thingylly? This may account for her feeling a 'failure' and having these symptoms.

I was a bit concerned at her medication.All drug companies have the same medicines maybe under another name but they are the same in their composition.
Efexor- this is venlafaxine 300mg is a heavy dose to help her with the thoughts, and has she been feeling very agitated and active day and night?
It works by 'slowing you down' and helping you sleep.

Xypreza- is an antipsychotic medication which makes me think either she was diagnosed as psychotic (not able to think or function properly) but this medication should be given under strict medical supervision.

Refoxon, and Lapital are brand names which do alter from country to country so what is the generic or tablet name on the packet? Haqve a look on the inside leaflet it should give you the name of the drug for example EFEXOR is the name for the drug VENLAFAXINE. Do you see what i mean?

Can you start a new thread by clicking the button at the top of the page 'NEW THREAD' and tell us what happened to her behaviour when she had the c-section and afterwards?

From what you have said i can only work out that perhaps she was a) psychotic within a few days of the birth or
b) she has traumatic stress syndrome/experience as a result of the c-section.
Was the c-section an emergency one?
Was it performed in a private hospital or a government one?
I have seen these birth done in both types of hospital when i was in africa Mombassa in 1992.
it may help me to understand what is going on so i can help you the best way i can.
Much respect my friend,
Deborah


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Dear Deborah.

Thank you very much for your reply. Going back, we did not have a child for about 6 years and eventually my wife conceived and she was extremely excited about her pregnancy.

However, 3 weeks before her due date, her gynae informed us that her placenta was very low and a C section was required (the C Section was done in a private hospital).

5 days before her due date, her water bad broke at home and we rushed her to the emergency department and a C Section was done promptly.
The doctors did a wonderful job and the staff at this private hospital were excellent.

My wife was doing very well and she bonded well with my son. The turn of events took place about 5 days after the C Section was done and her symptoms are as follows:

A. Crying for no apparent reason,

B. Very low self esteem, feeling fat etc.

C. Did not want to partake in any family activities and kept to herself most of the time.

We took her a doctor and the doctor prescribed Luvox to her, this drug was of no help and by then it was about 4 weeks since the C Section was done.

By then she began to have suicidal thoughts and she started taking overdoses of prescribed medication.

This being the case, we then took her to a government hospital and she was given 6 rounds of ECT, this helped a bit and I could see subtle changes in her.

She then went back to work and she was prescribed with the following:

Efoxor 300 mg.

Xypreza 20 mg.

She was on these 2 drugs for about 5 months and she was doing well. As she was doing well, the doctors decided to reduce her Xypreza gradually and finally she was on a mere 5 mg a day.

However, things took a turn when my wife stopped taking the Xypreza without my knowledge fearing that she was putting on weight and bamm! she had a relapse. I then got her admitted once again and another 6 rounds of ECT was given to her last February. The doctors then increased her medication to the following:

Efoxor 300 mg.

Xypreza 10 mg.

Lamotrigine (Lapital) 100 mg &

Mirtazapine (Remeron) 30 mg.

She has been on these drugs for the past 3 months. Overall she was fine up until last Thursday when she went to the bathroom and slit her wrist for no apparent reason.
Till now she has the faintes idea as to why she did this but she complains of feeling horrible and feeling restless. She does not like being in a crowded place such as malls etc.

As a husband, I am just so lost as to what I should do and I really sympathize with my son as the poor boy is just missing out so much from his mummy.

Anyway please let me know what is your opinion with regards to this matter.

Do you think warding her once gain would do justice to her?

[alonemum]

I dont really know what to say

She is very lucky to have such a wonderful husband. Mine thinks I'm putting it on, and wants me to get help, but dosent want me on any meds.


I am thinking of you and your family. I hope things are good for you all again soon

Love Nta
xx

[yorkslass]

hi

I wish my partner was as suportive as you.
I too can not deal with crowded places, can not go on buses or in busy town or even go to daughters school for that reason we are always late when other mums have gone.

I so do hope you get the help you need.

Melx

[sutherjess]

Hiya,

It sounds like your wife really needs someone to talk to, unfortunately she won't talk until she's ready..

It must be hard for you as you obviously love and care deeply for you family. Keep talking to us for as long as you need to and hopefully your wife will get involved too down the line. Most women on here see this site as a life line.

Jessica

[Catherine]

Hello Zafrull,
I know that you are going through a terrible time at the moment but everything you are doing is right. You are watching over your wife and child and trying to help in the best way you can. PND is a vicious illness and causes terrible suffering to the person who is ill and those who love them.
Your child, although his mother is ill, has a kind, loving and responsible father and he is less likely than the adults involved to know exactly what is going on, as long as you are there for him he will be cushioned from all the adverse affects of PND.
I know when I was very, very ill (like you wife) my partner's help saved our whole family from collapsing, so you probably dont realise the good you are doing.
PND, although it is emmensly frightening and an incredible strain , does eventually fade away, it's like a vicious virus that the mind and body fights until the symptoms (after a lengthy attack and a long struggle) begin to subside and eventually disappear.
I know my partner was terribly concerned and lost loads of weight when I was ill but without him I could not have got through. He didn't do anything dramatic like tuck me into bed each night and feed me grapes, but he just held the fort and told me he was watching over me. I couldn't express any gratitude at the time because I was so ill I didn't know what day of the week it was, but now I am completely well, I love him even more for just staying with me and not leaving me and I know that he in many ways shared the pain with me.
You may feel that all you are doing is not helping, but it is, your wife just needs to be told over and over that the way she is feeling will come to an end whether she believes it or not and that she will DEFINITELY feel good again, there is NO DOUBT about that.
Patience is the only thing you need to work on when you are suffering, patience is definately a virtue that is developed through this illness and knowing that there will be a return to normality is what helps you to wait and wait until you get back to normal.
If your wife has suffered from Postnatal psychosis she is likely to make a quicker recovery than those who suffer postnatal depression.
Zafrull, keep writing to the forum as you need support through these extreme circumstances.
Kind regards
Catherine

[deborah]

Dear Zafrull, i have printed off your reply so i can answer each area in detail.

Her symptoms 5 days after her c-section, was she able to communicate ie did she understand what had happened to her? Was she able to know the day date and where she was?
It sounds like severe PNi/psychosis as there is some thought that women can't have psychosis if they are aware of there surroundings and can take care of themselves but the dividing line of severe PNI and psychosis is a difficult one because if you are so ill as to be unable to cope with your life and wishing to take your life then it is very severe and debilitating.

Was the doctor you saw a specialist in this area of medicine? I ask this because she was 'back at work' and prescribed antipsychotic drugs which really she should not have been back at work when so very very ill.

Also has she had the oppurtunity to speak with a psychologist/someone who can give her counselling and find out perhaps why she is feeling the way she does? It would be very gentle at first just listening to her.

But i feel she needs some rest at home preferbly with someone with her at all times, a freind, her mother, whoever can stay and help her with the house and children.

Then her medication needs to be reviewed- a minimum of at least 6 weeks ideally longer to assess how they are working and see if they need increasing.
The fact she was doing well and then the dose was reduced this was a mistake. She should be on this drug for a MINIMUM of a year as her symptoms are so severe.
No drug should be reduced if she is seen to be doing well. She will need to be assessed as her life slowly gets back in order and she needs to be coping well with ALL that life offers her, including the house, her child, her family. This is before she ever thinks about returning to work. She ideally should not be in work until she is stable for a minimum of a year and depending on what she does for a living- the drugs can impair her ability to drive a car, her ability to operate machinery, etc etc.

It sounds as if the drugs were reduced too soon. The slashing of her wrists is a usual PNI symptom of frustration it is not the same as women who self harm for other reasons. With PNI the self harm disappears as soon as the problem is relieved eg help given or her symptoms treated with the correct drugs at a level which allows her to function at home with the minimum of stress.

ECT is a treatment of last resort. If nothing else works then this is given but not as a routine treatment for PNI.
Her feelings of restlessness and not wanting to be around people is understandable. Her mind is overstressed. But if you can ask her doctor to put her back on her tablets (at the dose she was feeling better on), then to let her gradually go back to doing things like playing ,reading and being with your little boy just for a start.
Then get her gradually to do things around the house, with her friends, shopping and just resting (this is very important she must have time to herself to sleep and just to read or do whatever she wants to do each day)

When she is coping with all of this, she should carry on with her dose of drugs ideally the efexor 300mg for a year or more if possible.
If she is coping well and no symptoms are comming through on that dose eg the self harm and low mood etc then and only then should her doctor be thinking of reducing her drugs.
That is done by a very very slow method of reducing them one drug at a time, and usually the one which is the 'weakest' or has the least effect out of the group of tablets. In this case it will be the Xypreza.The xypreza and the efexor are working for her and that is important.
I understand her weight is causing her a problem. I understand this as i was on the same drugs as her and i did put on 4 stones in weight. BUT it did come off as soon as i stopped taking the tablets.
The drugs increase her appetite by stopping the hormone responsible for stopping your appetite from working, so your brain wants you to eat.
However when the drug stops the hormone comes back again and her weight will come off.

Telling her this will not help her at the moment.You could tey suggesting to her that her mind must get better first so she can feel better, and reassure her you will still love her no matter what size she is. Reassure her she will get bettter from the PNI and she will go back to her usual size of clothing.
Don't push this though if she gets upset. It may be the case of having her take the tablets in hospital but only if she can be with the baby to help her get close to him -which she will given time.
I am not sure if there are special units for mothers with babies who need this kind of help. But it may be she needs to be admitted in order to make her take the tablets as she wont get better without them.
Only you know what to do in this case. You must be strong for her and help her make decisions as she is unable to at the present time. Do all you can to get her back on the tablets she was on before which worked.
Have her spend some time with your son even if its just to give him a feed and cuddle him at night.That may be all she can cope with right now.This will improve as she gets better. She does love him- its just lying underneath this illness.She is so taken over by this PNI that she cannot think of anything else at the moment.
BUT it will get better -she will recover fully i can promise you that. PNI is treatable.

You too will need support to cope with all of this as it is not easy for you it is very stressful. You will get your wife back to how she was before but it will take time, try and be patient, take one day at a time, have her take her tablets. Leave the ECT- it isn't really useful in this situation at the moment, let the tablets work, together with the advice i gave you earlier in this posting.
Keep on here and let us know how she is doing. If there is anything else i will post it on here.
Best wishes Zafrull.
Deborah

[Zafrull]

Dear Catherine.

Thank you so very much for your kind thoughts. It is now 1142 pm here in Malaysia and my wife is so fast a sleep, oblivion to what is happening.

I just hope and pray to God that she'll wake up tomorrow morning feeling well once again, forgetting the terrors of the past!

Only God knows what is inside my heart and I have come to a stage where I take the day as it comes, not looking into the distant future anymore.

Take care and good night.

[yorkslass]

HI

Mt thoughts are with you

take care of your self and your family


mel

[Zafrull]

Dear Deborah.

Thank you very much for your speedy reply.

Yes my wife was very well aware of what was going on after the days of the C Section.

With regards to the doctor who was treating her, the doctor is in fact a Professor and she specializes in PND here in Malaysia.

How odd it may seem, here in Malaysia, a PND patient is always encouraged to get back to the society once she feels OK to do so. But I myself disagree on this point as it back fired on my wife!

Your points are priceless and I totally agree with you. Please keep me in your prayers and I will keep you posted with the latest.

Take care and have a nice day.

Zafrull - Malaysia.

[deborah]

Dear Zafrull,

I hope all goes well for you and your wife. I wanted to say how PNI is treated over here in the UK.
I am so pleased your wife is seeing a professor of PNI in malaysia. I want you to understand that i am answering your post as a mother who has had PNI twice now, and both were quite severe episodes.
My background is that of a graduate nurse as i have studied both general and intensive care, special baby unit care, and all other subjects as a part of my training.

I have read extensively about PNI, Psychosis and all forms inbetween about the illness' women can develop mentally/psychologically and emotionally from having a baby.
I am in total respect for the professor who is treating your wife. But sometimes their ways need to be (gently) challenged as they are not always for the best as you have found out.

If you can help your wife to be taking things easier in order to get better- well done. You have to do what suits you and your family after all?

All my very best wishes to you and your family,
Deborah

[Zafrull]

Dear Deborah.

Thank you very much for your kinds words of advice. I will be meeting up with the Doctor who is treating my wife this Thursday and I will raise certain issues with her then.

I will keep your up dated.

Cheers.