Monthly Archives: February 2009

The numbers – Oh, the sobering numbers

sobering-numbers14.1 million people watched last week’s Private out-of-Practice.

88% of Americans get health information from TV shows.

20% of new moms will suffer a Postpartum Mood Disorder.

What does this mean?

12.4 million Americans who watched last week’s show were left with the indelible impression that what they saw was ACCURATE.

And let’s say that all of them were moms for the sake of argument. If that were the case, then 2.8 million of them experienced a Postpartum Mood Disorder.

If those numbers don’t drive home how utterly irresponsible ABC’s behavior was during last week’s Private Practice episode…

I don’t know what will.

Sharing the Journey with Michael Puline

A couple of weeks ago, we shared the journey with Amber Koter-Puline. Today we’ll get her husband’s point of view. It’s important to include dad in the postpartum experience because his support is invaluable to recovery. I want to thank Michael from the depths of my heart for sharing his story so openly and for supporting Amber so wonderfully during such a difficult experience. I hope this provides invaluable insight for new or expecting fathers who may either find themselves in a similar situation or know someone who is already there.

What makes you tick? Tell us a little bit about who you are!

I enjoy business – specifically the retail real estate business.  I enjoy all aspects of my business.  I spend a good portion of my time dedicated to being successful in my work so that I can provide for my family.  I also enjoy spending time training Gracie jiu jitsu; its something that I have always wanted to get into before but didn’t have the opportunity.  When we moved to Atlanta and I found a place to train and I immediately began.  I am a morning person!  I like to get up very early before others to accomplish things.  I am generally waiting for the gym to open at 4:45am when I arrive.   Sometimes they let us in early.  On nights that I am not at jiu jitsu, I play the guitar and enjoy spending time with my family.

You’ve walked the dark path of Postpartum Depression with your wife. Share with us what it was like to watch the woman you loved seemingly slip away into a dark shell.

It was awful.  I saw a highly motivated and capable person become so helpless and undergo such a radical change.  It is almost as if you no longer know the person.  They are someone else.  It was very difficult for me because I didn’t really believe it was happening.  I thought that it would go away on its own.  But, when Amber came to me and recognized that she was in need of professional help I knew that it was serious.  It was  very difficult to deal with.  I had to change my work schedule and Amber had to even come with me to work some days.  It was almost as if she had regressed mentally to a 4 year old.  She had to be at my side almost 24-7.  You can’t believe it until you experience it.

How did your faith support you through Amber’s recovery?

It helped in many ways.  One of the biggest was seeing the outpouring of help from our church community.  Even people who we did not expect to come through for us came and truly tried to make a difference in our lives and help us with this difficult situation.  As a result of having gone through this, my faith has grown stronger and I can now see why God chose this to happen to my wife.

What has it been like to see your wife take something so painful and turn it into such a point of strength and grace?

It has been really nice. I know she enjoys it. Anytime you go through a challenge and are able to transform it into a positive aspect of others lives I believe it is the ultimate blessing you can receive.  Amber has done this.  She has put her heart and soul into a blog, website, communicating with others, and constantly trying to reach out and help others. It is very commendable. I love her for it. It feels really good to know that she wants to help others. She took the situation, transformed it, and is giving it back to God by helping others. It’s the only way to live.

Did PPD affect your marriage? If so, how?

Yes, in many ways. It has changed our plans for future children (we had previously wanted a larger family.) We had to change our schedules and had to change the dynamics of our child-rearing than we had previously planned. You see, Amber and I had initially thought about having several children, however when she went through such a severe PPMD it really changed her desire and made her feel as if she could never handle more than one child, as she could barely physically and emotionally handle this one. As she had continued to get better, I believe her opinion continues to change slightly. For the first 3 or 4 months I had to do the lion’s share of the night-time wakings, because she needed to rest. At first I think I resented her for it, but now I think it helped me to build an irreplaceable bond with my son. While it was difficult at the time, I am very much thankful for the opportunity to do that because the benefits clearly outweigh the sacrifice I made. Hey, whats a few hours sleep for a guy who gets up at 4:30am anyways? I think as a result we take specific time in our day to better ourselves- praying together, reading and discussing books together, etc. We truly want each other to grow and develop everyday as individuals and parents. We are much more committed to each other. Not just to having our marriage be ok or something we endure, but to flourish. It also changed how we now interact. We have a different relationship. It’s much stronger.
Fathers need to remember not to lose themselves in the process of parenting. What is it that you do to just hang out and be a “guy”?

Jiu Jitsu.  I train.  For me, jiu jitsu offers me the opportunity to escape.  Going to the gym is similar, but jiu jitsu provides me the one on one competition that drives me to do better every day.  I think one of the reasons I like it so much is that I wrestled as a child.  I always enjoyed wrestling and jiu jitsu is similar, but you wear a gi instead and the object is to submit an opponent vs. pin them.  Outside of that, I really like to watch football.  College, NFL, it doesn’t matter!  My wife will watch “our teams,” but can’t understand at all why I would watch other games.  For me, this is how I relax…sitting on the couch or in my chair, with a cold beer Sweetwater 420 (shameless local beer plug!) in my hand.  That’s my release.

3 things that made me laugh…

Telling others a story about how a rock hit my windshield.
My son saying “mango” as one of his first words.
Remembering when my wife saw a coyote walking down the middle of our street when she had PPD.  I asked her if it was real.  She replied, “I am crazy, but not THAT crazy!”  The next day we got a notice about a neighborhood coyote spotting.  :)

What do you find the most and least challenging about fatherhood?

Having patience with my son has been challenging.  I sell things…I am a salesman.  I have absolutely NO patience for anything and I don’t care to.  For me, patience was not important at all.  But now, with my son, I start to realize that there are times where it is needed.  I think that because my love for him is so strong I am able to be more patient and give him the attention that he needs.

I think just having fun with my son comes easily and naturally to me.  Ball, guitar, piano, wrestling, etc.  If there is one thing that I know how to do, it’s how to have fun!  I have spent my whole life enjoying every moment.  Get the fullest out of life.  I want to look back and say I wouldn’t have done anything differently.  It’s the only way to live.

Amber’s PPD Support means…

Alot to me because it means a lot to her.  I think it is important to her.  It helps her grow as a person and move past this terrible part of her life that occurred.


This is REAL.  It can happen to anyone.  Don’t feel badly.  Don’t try to hide it.  Don’t ignore it.  Seek professional help right away.  Be more proactive in finding out how your spouse is feeling postpartum.  Ask her- Are you feeling overwhelmed?  Are you feeling depressed?  Can we go for a walk and talk?  Observe her.  Is she getting enough rest?  She is human, too.  She needs more than 2 hours of sleep a day.  Is she getting it?  You are much better off taking the necessary time off in the beginning to try to avoid a PPMD getting worse than to let it evolve untreated.  It will get worse before better.  In closing you’ll note that in the beginning it may be harder to detect, but easier to cure.  While left untreated, it will become VERY apparent and much more difficult to cure.  My suggestion is to be proactive.  It really can happen to your family.

A round-up from the Blogosphere: ABC’s PPD Mis-practice

A lot of you have been blogging your hearts out about last week’s episode of Private Practice. Here’s the low-down on what’s being said around the blogosphere regarding ABC’s PPD Mis-practice:

Katherine Stone shares an important perspective from a reader: Warrior Mom & Postpartum Psychosis Survivor: Why it’s Important to Educate the Public about Postpartum Psychosis

Natalie Dombrowski, a recent Sharing the Journey participant, is asking folks to BAN Together.

C Shell also shares her opinion on the show. C Shell is recovering from PPP and also offers a unique insight.

Karen Kleiman over at the Postpartum Stress Center explains why PPD and TV don’t mix.

Shane at Heart Reflections offers a Penny for Your Thoughts.

Tara Mock renames the show – Private-Out-of-Practice.

And Ivy at Ivy’s PPD Blog chimes in and calls ABC’s Private Practice an outright failure.

Also, I want to encourage you to check out this post over at Katherine’s blog about How to Contact the Media regarding Responsible Mental Health Representation. Take a few seconds and shoot off an email to ABC (and advertisers).

By the way, if you’re interested, the following companies had ads during Private Practice (at least here in ATL):

  • Nuva Ring
  • Bank of America
  • McDonald’s
  • Kay Jewelers
  • Nights at Rodanthe(movie)
  • AT&T
  • Hershey’s
  • Ashley’s Furniture
  • Dove
  • Taken (movie)
  • Pepsi
  • All laundry detergent
  • Alli (weight loss)
  • Target
  • Breathe Right Nasal Strips
  • High School Musical 3
  • AlamoCar Rental
  • Arby’s
  • Air Tran
  • LongHorn Steak House
  • Toyota
  • Cherry 7 Up
  • Madagascar 2
  • Electrolux Appliances
  • Zaxby’s
  • Infiniti

More irresponsibility from ABC regarding PMD’s


ABC has really outdone themselves on the stigma and ignorance angle. Before we go any further, yes, I realize this is a fictional show. BUT keep in mind that ABC approached PSI to attempt to be responsible but didn’t follow through and instead jumped straight through the flaming media sensationalization hoop. Why? Because that’s what brings in the almighty dollar. Shame on ABC for selling out on responsibility.

A quick visit to Katherine Stone’s blog this morning got my juices revving again. And Susan Dowd Stone was not happy about the display either.

Bad enough that Private Practice chose not to air the carefully crafted PSA but they didn’t provide proper direction for the PSA to even address the right thing.

Then, ABC now has a poll up at the Private Practice website asking if a mother who is being treated after attempting to drown her baby should have access to her baby. The answers available? Yes, it would motivate her to get better and then No. Totally insensitive and irresponsible.

And let’s not forget the attempt at being “professional” by Private Practice with their Researcher’s Blog which is supposed to explain the weekly episode with facts, etc. This week’s entry blows. The researcher explains mania and manic behavior yet offers no insight into how the dad missed mom’s behavior. (Hello! Unless Dad knows what to look for and has been educated by professionals around him AND mom is communicating because she too has been educated, it’s very easy for dad to miss the signs and symptoms – I know I hid my symptoms pretty well for awhile the first time around because I knew how I was supposed to be acting.)

Katherine is calling for a boycott of the show and I have to wholeheartedly agree. Pull the Plug on Private Practice and their sham of attempting to represent the medical world. How dare they drop the ball on such a sensitive topic! No voice will have a louder effect than a sudden drop in viewership because that means decrease in advertising and then well, if a show isn’t profitable anymore……. Spread the word – and stop watching.

Pregnancy hormone predicts postpartum depression, study finds

I know, I know – old news, right? I thought I had posted this but apparently it never made it to the “majors” and got stalled in the wings. So here ya go.

I have a few gripes with this research starting with what doctors will do with the results once they have them. One would hope they would go ahead and set up preventive care and educate the patient and her family if she did have the elevated level. How reliable is this test? Should it be implemented? Should it be mandatory? Who would be responsible for care if results were positive? Would a team approach be created? This really raises more questions than it answers.

Women with elevated levels mid-pregnancy at higher risk, study finds

Irvine, Calif. – Women who have higher levels of a hormone produced by the placenta midway through pregnancy appear more likely to develop postpartum depression, a study authored by a UC Irvine researcher finds. The discovery could help identify and treat women at risk for postpartum depression long before the onset of symptoms.

Ilona Yim, psychology and social behavior assistant professor, and colleagues found that women whose levels of corticotrophin-releasing hormone started to increase more rapidly around 25 weeks of gestation had a higher incidence of postpartum depression. Normally secreted in very small amounts by the hypothalamus, this hormone regulates the body’s response to stress. During pregnancy, large amounts are produced in the placenta and are associated with delivery.

“The hormone we studied plays an important part in pregnancy and has been linked to depression,” Yim said. “Many factors may cause some women’s bodies to produce more of this hormone during pregnancy. Evidence suggests that stress early in pregnancy could play a role.”

The researchers studied the hormone-postpartum depression link using data from a larger study funded by the National Institute of Child Health and Human Development. They took blood samples from 100 pregnant women and assessed symptoms of depression throughout pregnancy, then again nine weeks after delivery. Of the 100 women, 16 developed postpartum depression symptoms during follow-up visits. Three-fourths of those women, the study concludes, could have been identified in mid-pregnancy based solely on hormone levels.

ABC’s Private Practice misses the mark

Like many other members of the PPD advocacy community, I watched Private Practice tonight. It’s a show I don’t usually watch but tuned in because the storyline had to do with Postpartum Depression. It said so right in the description: Cooper, Violet and Pete treat a woman with postpartum depression. But she didn’t have postpartum depression which affects up to 20% of new moms.

A jump was quickly made to postpartum psychosis and mom was sedated and put on meds that were not compatible with breastfeeding (even though she WAS indeed nursing). There was also no clear cut consent shown to this course of treatment.

Then Violet didn’t want to give the baby back to the mother for fear that THEY would be the ones thought of as “what were you thinking!?” We work SO hard to fight against the myth that a mother’s baby will be taken from her if she seeks help. I can’t help but think about how many new moms saw this show and may possibly avoid seeking help because of this portrayal.

There were a few things they did get right. Cooper pointed out how rare psychosis is and stated that it’s NOT normal. And he’s right – postpartum psychosis affects 1 to 2 moms per 1000 births so no, it’s NOT normal.

And the portrayal of the mom with psychosis? Her behaviors and irrational beliefs? The fast talking and incoherent babbling? Totally on point. In fact, the one scene where she admits to how she’s really feeling got me right there. All of the sudden I was back in bed, curled in the fetal position waiting for my husband to get home. My breath caught and my eyes watered up. I’m nearly three years past that point but man it came rushing back in a heartbeat. It’s SO hard to forget that fall yet at the same time it has become a very empowering memory for me because I know how far I have journeyed since then.

The PSA was missing from the end of the show as well. If you go to ABC’s website and click on Private Practice then go the The Ex-Life (I think that was the title of tonight’s episode), the PSA is the first of the scenes you can select to watch. Hopefully your computer works their site better than mine does – I had two video audios running at once which made it really hard to hear what Amy Brennan (Violet) had to say (and thanks to Katherine Stone over @ Postpartum Progress for working with ABC on the PSA! Good job!)

Overall I have to give them credit for trying. They got a few things right. It could have been better but hey, it is a fictional drama, right? And just as here, not everything is perfect there. I suppose we’ll just have to be happy that they even bothered to broach the topic and consulted PSI in the process, right? Right?

No interview today….

I apologize that there is not an interview today.

We’ve been having a rough go of it lately – Chris has another horribly unco-operative kidney stone. He’s been to the ER twice within the past two weeks and goes to a urologist today because it’s getting worse. We do not have health insurance either so everything is coming directly out of our own pocket. To make matters worse, his new job has not gotten his check right yet so we’re still flat broke.

I had planned on trying to post the interview this morning but will instead spend my day running around – Chris to work @ 11, picked up at 145 and to the urologist at 2, Alli from Pre-K @ 230, back to the urologist to get Chris, then home to collapse.

Pray for us. We could certainly use all the strength that brings.