“A mother who has had a baby in the hospital should insist on keeping him with her 24 hours a day. Unwrap the baby, keep him in your bed, and don’t allow a pacifier to be given. Watch for your baby’s subtle signals that he’s ready to nurse again–trying to suck on his hands or the blanket, turning his head from side to side as though searching for the breast, making smacking or sucking noises, or whatever cues your individual baby uses to signal you. Responding to these messages and feeding the baby will help prevent engorgement and encourage the development of a good milk supply”[1]
A child who has had a mother in the hospital will insist on keeping the mother with her 24 hours a day. Wrap up the mother, keep her by your bed, and don’t allow your father to annoy her. Watch for your mother’s subtle signs that she is in pain–furrowing her brow, sighing loudly, making a hissing sound, white knuckles, or whatever cues your individual mother uses to signal you. Responding to these messages and helping the mother will help prevent discord and encourage the healing process.
When a person you love is sick, you want to find a way to make them better. When you have already spent time inside that person, you want to crawl back inside once more to take the pain, poison, rot away. That’s what I was doing in the days following my mother’s mastectomy, when I stripped the drains of her incision, carefully peeling tape, replacing bandages, drawing the blood and seroma fluid away from her body, milking her wounds with more precision and focus than her babies ever drew milk from her now absent breast.
“Milking the drain may seem like an odd expression, but ‘milking the drain’ keeps the tube from getting clogged…WIth one hand, hold the tube where it enters your body. Keep this hand in place so you do not tug on your skin…With your fingers pinched, slide your fingers down the tube…Milk the drain every three hours during the day while you are awake. You do not have to wake up and do this at night.”[2]
The connection between stripping the drain and breastfeeding cannot be ignored. Mothers pour their bodies into their newborns unselfishly, it seems, but there is an invisible tubing that leads from that tiny body to the adult hands that will one day strip that drain, pulling the clots, tissues, blood, seroma fluid away from mother’s body.
Before my first baby, Tali, was born, I acquired a book loftily titled The Ultimate Breastfeeding Book of Answers: The Most Comprehensive Problem-Solving Guide to Breastfeeding from the Foremost Expert in North America. This book is authored by Dr Jack Newman and Teresa Pitman, and together they take a no-nonsense, listen-up-you -silly-ninny tone with the new mother. This tone seemed to work for me, as leading up to the birth of my first child I was confident that of course I would nurse her, it would work out fine, and I knew exactly what to do. I had read enough of the book to get to the passage “Put Part A into Part B” (perhaps oversimplifying the steps in my reading). I looked at the pictures of the various holds.
Cradle hold: Baby’s round tummy atop your own jiggly middle, sweet button nose right at the nipple for a good latch, baby’s head cradled in the crook of your arm.
Cross cradle hold: Similar to the cradle, but this time the arm opposite your breast cradles baby.
Football hold: Now baby is tucked under your arm, allowing your horrific GERD to stay silent for a few moments.
It all made sense.
I knew what to do. No problem. This is what mothers do to take care of their babies.
In anticipation of your mother’s surgery, you’ll want to watch a Youtube video of how to strip the drains. You won’t want to, but you will. There are many–you may want more than one just to feel like you’ve had the full experience before you stand in front of your mother. She will be frail after 14 weeks of chemotherapy. She will be rumpled, from a night of discomfort. She will smell like toothpaste and unwashed hair and hospital disinfectant. You will smile. You will tell her to sit down on the toilet seat while you take care of this. You will begin. “This will be no problem,” you tell her. “This is what daughters do for their mothers,” you think. It pales in comparison to the millions of things she has done for me over the years. I remember her carefully selecting the right paper cups and plastic table cloth for my 5 year old birthday party–how she poured the vivid red drinks for the children, the red liquid a shocking strawberry color, matching the lurid red cap that Strawberry Shortcake wore on my bakery cake.
You will look at your mother, her careful hands, small fingers, artfully manicured, the same hands that smoothed your wedding gown, that held your arm to steady you after a fall, that cradled your infant head.
You will wash your hands as if you are praying. Al netilat yadim prayers aside, you are about to do something holy. Every video instruction you watched prompted you to wash your hands well, faucet at full throttle, soap breathing life into suds. You will wash away your skin as the surgeon did, flesh becoming absence.
“We always hold the tubing close to the body to prevent unnecessary tugging that can be painful to the patient”[3]
You will need to have confidence as you grip the first drain, as close to the incision as you can get. Do not be squeamish. Do not be overconfident. You might hurt her more than she has already been hurt. Pinch the drain at the top with one hand, and use your thumb and forefinger to drag the fluid, mostly blood and seroma, down the length of the tubing. It will be surprisingly warm. The blood will reluctantly part from the tubing. It will smell like sickness but not death. You will coax and pull that fluid out of your mother’s wound, and you will collect it in a plastic bulb.
You will relish the stripping of the drains, because it’s measurable. You keep track of the milliliters of fluid in a little journal, like you tracked the diaper changes of infancy. Much of cancer is measurable–stage of the tumor, weeks of chemo and radiation, length of incision, number of stitches–but you can measure this yourself. Everything else has been done to your mother, but this you can do for her.
You could do nothing for her tumor. A rosette that pulsed and glistened and bled.
“Mom,” I joked over the phone when she was first diagnosed, “How about I just do an at home extraction with nail scissors?”
Frustrated that the process of cancer treatment seemed to drag on, I (only half joking) suggested she just go and sit at the hospital until they agreed to cut it out.
Normally the biggest fan of my outrageous declarations, my mom did not indulge my humor. She would follow the oncologist and the surgeon’s recommendations.
Certainly, I thought in my desperation, there was a way to strangle the tumor, to let it wilt and die before my mother had to. Die.
You tried to help out by sending books, cards, a mastectomy camisole with special hook ups for the tubing, hats to keep her naked head warm, v-neck t-shirts for easy access to the port, robes so fuzzy they clogged the dryer vent. You’ve made chicken soup five different ways, for healing; brewed batches of lemon ginger tonic, for soothing; assembled custard slice, for nostalgia. But nothing feels as good as stripping the drains.
“You are going to open that little stopper in the drain. Make sure to open it away from you because you don’t want it to splash you in the face”[4]
You will pour the fluid into the measuring cup, hands shaking almost imperceptibly. You will write down the ccs of fluid in a log. Completing the drain log feels industrious. You will write the numbers crisply, entering dates, times, amounts.
December 13, 2020. 8:15 am. L: 8ml R: 5ml
December 13, 2020. 9:45 pm. L: 7ml R: 6ml
December 14, 2020. 7:46 am. L: 10ml R: 6 ml
My handwriting is shaky, and my mom notices when I’ve written the information in the wrong column, chiding my careless work. I am reminded of the earnest way I kept track of those early nursing sessions.
April 4, 2003. 7:05 am. L: 35 min R: 25 min
April 6, 2003. 11:45 am. L: 60 min (fell asleep) R: 20 min
April 7: 2003. 1:00 pm. L: 25 min R: 15 min
The fluid will look like the Kool Aid from your five year old birthday party. Almost delicious but also terrible. The videos even use the word Dixie Cup to describe where you should pour it to measure. While your mother poured so many cups of Kool Aid to the already over-stimulated and over-sugared party guests, you fill only two cups with red.
“This fluid can then go down your toilet” [5]
You will empty the measuring cup in the toilet, and it will look like so many bowls full of menstrual blood, postpartum blood. Blood that blooms and shimmers in the clear waters of the toilet. Vibrant, living, the inside turned out.
You will help your mother replace the drain bulbs, zip up the compression garment, carefully snake her arms back into a button up shirt. She is tucked away before you wash out the cup in the kitchen sink, because where else will you do it? You will think about your mother’s cells, her body going down the drain, and you will think about the other parts of her that are now gone, in a dumpster or incinerator somewhere, and how much of her has been dispersed already. How many ounces her four babies sucked away, how many ounces of her breast, her tumor, disposed of.
In order to encourage milk production, new mothers should keep their calorie intake up. “In northern Europe, brewer’s yeast and beer were thought to increase milk supply. In southern China, fish and papaya soup. In various places, different herbs, probably depending on what was available locally. Borage, alfalfa, fenugreek, raspberry leaf, fennel, blessed thistle, goat’s rue–these are just some of the various herbs that have been thought to increase milk supply”[6]
I remember going to A Southern Season, a mecca of delicacies, and buying Izze sodas. I needed sweetened beverages–I needed to tantalize myself to keep up the milk supply.
I ordered the chicken salad on croissant the first time my mother-in-law and I took baby Tali out to a cafe, even though my mother-in-law would never order that lunch for herself–too fattening. I could tell she was pleased for me to eat it though. She looked forward to seeing the baby’s cheek round out, the rolls on the little thighs.
I got the premium ice cream–Ben and Jerry’s Chubby Hubby or New York Super Fudge Chunk. If I only had a few minutes to spoon it up before my baby cried for me, I had to make it count.
I got Morning Glory muffins from Whole Foods, Chocolate oreo cake from the Mad Hatter, full fat Brown Cow yogurts from Harris Teeter, things I could eat standing and with one hand, because if you don’t nutrify, you may not have the energy to take care of the baby the way you need to.
In order to fight the cancer, patients should keep their calorie intake up.
The scene of my mother’s cancer diagnosis and treatment was Eau Claire, WI. Eau Claire is at once the same drab big box stores along depressing highways as every town in America and a unique and beautiful mix of old industrial town and modern art and music hub, all at the confluence of the Eau Claire and Chippewa rivers, two mighty streams of water like tubes connecting to form one channel, pulling towards an outlet.
There’s not a lot to do in Eau Claire, especially during the Covid epidemic. When I arrived in town to be a support person during the early weeks of my mother’s treatment, I learned quickly that there are only two things I could do consistently in Eau Claire, WI: walk, across bridges and trails following the rivers, and eat.
When I say eat, I mean eat treats, because there is no shortage of delicious baked goods in the upper Midwest.
Among the delights that I bought for my mother to encourage her calorie intake include:
Kolachkes-those filled Czech rolls that could be sweet or savory. How my father loved the sausage and cheese. I ate them too.
Raspberry swirl coffee cake, also chocolate chip coffee cake and rhubarb coffee cake.
Olsen’s ice cream: Chocolate monster, brownie batter, Raspberry truffle, butterscotch swirl, butter pecan.
Pies! Lingonberry, strawberry rhubarb, pecan, fudge pecan, death by chocolate, chocolate peanut butter, raspberry sour cream. From the Norske Nook, only.
My mother didn’t want most of the goodies that my father and I purchased. Dad and I would leave them on the counter, offer to cut a slice and put it on a plate–bring it to her on the couch, in a chair. She might accept the offer, but she would leave it to grow stale and brittle. Dad would ask again, “Can I get you anything?” and she would decline. Not interested. Dad would look stricken, and then I would cut a hunk for myself. I needed all the calories I could get to be the caregiver, just as I had upped the calories I needed to keep my milk up for those all night nursing sessions.
“The first question we should be asking is, Why are we concerned about weight gain? More particularly, why is it necessary for babies to gain a certain amount of weight each day or each week or each month?”[7]
Successful feeding is a way to quantify wellness. Every checkup is a victory for a nursing mother, every weigh in, when you gingerly place your baby atop the infant scale, carefully removing her diaper so as not to confuse the scale, each added ounce is a sign that you are doing your job, feeding that baby. My babies were gloriously fat with neck rolls and bracelets of chub around their wrists. Their cheeks ballooned, weighing their heads down, and they were perfect, so perfectly healthy.
“Proper positioning and latching on are crucial to success. For most mothers and babies, this is the most important step. “Latching on” refers to the way the baby takes the breast into his mouth. A good latch means pain-free breastfeeding; it also means that the baby will get the milk he needs and you will be on your way to a successful breastfeeding experience”[8]
I have no memories of myself as a nursing babe, but I do recall nursing my own three babies.
My babies were quick to master the latch, and before the lactation consultant could even suggest the football hold, they were putting on the ounces, surpassing birth weight, before we even left the hospital. I watched their cheeks work and heard the whoosh of milk, their happy grunts fading as they fell into milk drunk slumbers. I let them sleep on the breast, because why not. It felt good to nurture them, to give them what they needed. The milk bar was open all night long, and we took to sleeping side by side, me dozing on and off as baby kept a full tank all night long.
“How tiring is it, really, for a mother to lie in bed with her baby beside her, sucking at her breast?. . . As long as mother and baby are together, there is no rush”[9]
In the first foggy weeks of my babies’ lives, I spent hours, days, eyes locked on their tiny wrinkled faces, hands like miniature starfish, nails tiny translucent daggers, impossibly hairy foreheads, breathing them in, memorizing their tiny bodies, mesmerized by their heady scent, nursing, and nursing, and nursing. They all had their different habits: Tali reached out to “protect her treasure”--guarding the idle breast until she was done feeding on the first; Zev would get so excited to nurse, he would tense his legs so they stood out straight, rigid; Davita scratched rhythmically as she nursed with gusto–you could hear the milk gushing into her mouth from across the room.
“Once the baby is sucking but not drinking, just nibbling, the mother should start with the breast compression. The baby should be sucking, but not actually drinking (open mouth wide–pause–close type of sucking). As the baby sucks, the mother, who is holding her breast with one hand, the thumb on one side and her other fingers on the other side of the breast, with a good amount of the breast in her hand, should just bring her thumb and fingers together, compressing the breast. This should be done firmly, but not so hard that it hurts”[10]
In 2003, as I waltzed my fussy baby Tali around our tiny bungalow in Durham, North Carolina, my husband asked, Is any baby held and cuddled as much as our baby? Without much consideration, I replied, I just don’t want her to be a serial killer one day.
Is it as simple as that? I don’t want her to be a serial killer. I don’t want her to self harm. I don’t want her to be cold, withholding, cruel. 20 years later, in a space where my babies approach adulthood as my parents approach infirmity, I’m acutely aware that the baby I once nursed all night long may one day milk my body once more, stripping the drains.
For some people, nursing is painful and short lived. I nursed all of my babies for over a year because it was easy. It felt like that’s what I was supposed to be doing. I both wanted to and had to do it. For the baby, and for myself.
Taking care of my mother in her illness felt the same. It was easy to take care of her. I both wanted to and had to do it. For my mother, and for myself.
As a newborn, our physical self is determined by the other, the mother. As a mother, in many ways our physical self is determined by the nursing babe. As a cancer patient, recovering from surgery, our physical self is determined by the surgeon, the physical therapist, the caregiver. As the adult child, caring for the mother, our physical, emotional, our psychic, self is determined by the other–the mother–and our proximity to her.
“I don’t want you to leave,” my mother says, as I gather my things.
Don’t leave me
I know she doesn’t really mean it, that she knows the rest of the family has been missing me at home.
Don’t leave me
I’ve been here at her side with those words on my lips all week. Those words on my lips for the past six months. Those words on my lips, falling out of my throat, for the last forty-five years.
Don’t leave me
[1] Newman, J., and T. Pitman. The Ultimate Breastfeeding Book of Answers. Three Rivers, 2006, p. 102.
[2] “Going Home after Breast Cancer Surgery with Drains.” YouTube, YouTube, 19 Mar. 2021, https://www.youtube.com/watch?v=PnZP94A8psA.
[3] “How to Properly Care for Your Surgical Drain - Moffitt Cancer Center.” YouTube, YouTube, 12 June 2017, https://www.youtube.com/watch?v=OUzMN63faf4.
[4] “How to Empty a JP Drain | Edina Plastic Surgery.” YouTube, YouTube, 7 Feb. 2022, https://www.youtube.com/watch?v=JvpAieP1C-k.
[5] “How to Empty a JP Drain | Edina Plastic Surgery.” YouTube, YouTube, 7 Feb. 2022, https://www.youtube.com/watch?v=JvpAieP1C-k.
[6] Newman, J., and T. Pitman. The Ultimate Breastfeeding Book of Answers. Three Rivers, 2006, p. 73.
[7] Newman, J., and T. Pitman. The Ultimate Breastfeeding Book of Answers. Three Rivers, 2006, p. 64.
[8] Newman, J., and T. Pitman. The Ultimate Breastfeeding Book of Answers. Three Rivers, 2006, p. 50.
[9] Newman, J., and T. Pitman. The Ultimate Breastfeeding Book of Answers. Three Rivers, 2006, p. 45.
[10] Newman, J., and T. Pitman. The Ultimate Breastfeeding Book of Answers. Three Rivers, 2006, p. 72.
Rachel Lutwick-Deaner enjoys a bookish life. She earned a BA in English from Colgate University, an MA in English Literature from North Carolina State University, and a MFA from Queens University of Charlotte. She currently resides in Grand Rapids, MI, where she teaches college composition and literature at Grand Rapids Community College. Rachel delights in writing essays that challenge and affirm her readers, and her ultimate goal is to make people laugh, even uncomfortably. When she’s not writing or teaching, Rachel loves reading, and her book reviews can be found at Southern Review of Books and on Instagram @professor.ld.
Comentarios