My Most Special Gift

Lucky, Meghan and Allie – My three girls

I am sitting on the couch, alone.  Unable to sleep because of the pain in my knee.

My left knee and I have quite a history.  Pretty much told it was “arthritis” as a young one, but that was never confirmed with lab work.  A car accident in 1991 banged it up and started the swelling on and off.  Arthroscopic surgery in 2000 to “clean” it out, gave me relief for a few years.  Now it, along with the horrendous varicose veins that plague my legs, are temporarily at the bottom of the triage list.

There are other things that we need to do first.  Plus, we can’t spend our WHOLE life at the doctor.

So, when I am in my worst pain.  The kind that causes me to actually ice and elevate the leg, and I start to feel sorry for myself I look at my daughter’s face and find my perspective.

I will be 40 in a little over a year.  My joints have had some time to wear and tear.  She will be 9 in a week.  She can’t run or ride a bike without pain in her knee.  She deals with a mass almost 3cm x 1cm intertwined in the side of her knee.It is always there.  Even on the “good days.”  She lives with he reality of the AVM that will continue to exist- to grow, and then be worked on, likely to only grow again.

As I climb the ladder closer to “middle age” thinking in terms of pain and management for the “rest of my  life” is less scary.  Then there is my girl.

Soon to be 9 years old.  Gluten, dairy, soy allergies. Pancreatic insufficiency,chronic herpes simplex infection, immune system deficiency, early puberty, Cowden’s syndrome, gall bladder removed, tonsils and adenoids removed (and now growing back), lipoma removed from her back, excess gum tissue removed from her mouth,  precancerous thyroid nodules, and an AVM that even after 4 surgeries just won’t quit.

Yet she finds plenty of time to laugh and smile every single day, and precious little time is wasted complaining about anything – from the one who could complain all day.

Life isn’t fair, but I am going to sit here with my ice pack and reflect on the fact that God is good – all the time.  And He gave me one heck of a sweet gift in my little girl.

Stick Your Face in an Air Conditioner and Deal With It!

Window air conditioner, from left side

Maybe that should be the slogan for 30 something (ok closer to 40, I know) women who have been thrust into menopause.  Kind of like the equivalent “Put on your big girl panties…”

Estrogen loss and menopause.  Two more things I can thank Cowden’s Syndrome for, as I learn all the side effects connected with both – one at a time.   At least I can relate to… well, not really ANYONE in my age bracket.  But that’s Ok… I am getting used to it.

Fortunately it hasn’t been THAT bad yet, but I have found myself a little sweatier than normal, and I have been known to stick my face in an air conditioner lately while throwing an ice cube down my back.

I am not one to complain too much, but really, the reality of this one took a little time to catch up with me.

Yeah, I know it had to go.  Blah, Blah Blah… Cowden’s Syndrome, uterine cancer, suspicious polyp.  I get it.  Oh, and your ovaries are way too big, too many cysts, let’s take those too.  Sure – why not?

Nothing would have changed if I had asked all the questions in the world.  It had to be done.  And I am learning sometimes it is better not to know everything at once.

So, I am hearing words like calcium supplements, bone scan, and osteoporosis, while I have friends my age going for 20 week ultrasounds.  Don’t misunderstand me.  I never wanted another baby – but it just seems wrong.  Like I have warped into a different reality.

That’s what these last few months feel like sometimes.  A bad sci-fi movie.  I am the girl who gets all her body parts cut out, one or two or three at a time. 

I wonder how it ends. 

And, most importantly I hope the movie theater has air conditioning.  It’s HOT in here!

What do these three have in common?

Many simple species, such as the star fish, have the ability to regenerate severed appendages. [©Jupiter Images, 2008]
Many simple species, such as the star fish, have the ability to regenerate severed appendages. [©Jupiter Images, 2008]
The leopard gecko, like many other lizards, is able to voluntarily shed its tail as a strategy to escape predation. These lizards are able to develop a replacement appendage through epimorphic regeneration that resembles the original, complete with nerves, blood vessels, and skeletal support.
Days after the tonsils were removed in 2008

So, what do these three have in common?   Give up?  I bet a few of my Cowden’s Syndrome friends could guess…

They all can regenerate tissue that has been removed!

Except the first two tend to do it in a much more productive way.

I had heard tell that lymphoid tissue (especially the thyroid and tonsils) could regrow – especially in Cowden’s Syndrome patients.  (It makes sense in a way, PTEN is a tumor suppressor gene that is broken, so cellular overgrowth is common.) But, I chose to ignore it.

Sometimes ignoring things for awhile allows you to deal with other things.

When Meghan had her tonsils and adenoids COMPLETELY removed in May of 2008 she was in the middle of a 12 week strep infection.  Three months of antibiotics, and they were still pulling “heavy positive” cultures every 2 weeks.  By the time they were to be taken out she was admitted for several days of antibiotics prior for fear of rheumatic fever.  She was a chronic, almost constant strep sufferer.

Then for about 2 years – nothing.  No strep.

I don’t remember the first time it came back.  It was about 2 years ago.  A full year before I ever heard of a PTEN mutation, or had any idea what Cowden’s Syndrome had in store for us.  I thought it was odd, the strep coming back without the tonsils, but I chalked it up to a rotten immune system.

Slowly the cases have become more frequent.  It is almost constant.  We don’t leave the pediatrician without a throat culture and a script for an antibiotic.  Not all the cultures come back positive, but you can tell.  The food avoidance, the tough time swallowing, the swollen glands, the puss in the throat.  You just know.

Lately it has been about once every 3 weeks.  Way too many antibiotics to be good for anyone, but strep is way to serious to ignore.  So, we keep treating, and wondering.

Today we had a routine visit to the oncologist.  I mentioned the strep.  She looked in the throat.  She said, “Have you ever considered having her tonsils out?”

That’s when I knew we were in trouble… again.

Guess I should schedule that visit to the ENT!

No Regrets

Photo found on the Facebook Page “Perpetual Optimism”

Isn’t that just the truth??  Goes along with the idea that “Everybody has Something.”  Now if we could all just find a positive way to channel it.

Not always so easy.  I cried today.   I finally found a nice oncologist who takes my insurance.  I saw her on Tuesday, but she wants me to get right on scheduling the colonoscopy.  So I called to set up the appointment with the GI doctor and the first appointment was the day after our vacation.  As I hung up the phone cried – overwhelmed by ANOTHER doctor, ANOTHER appointment.  But it was my very smart Meghan who said, “Mommy if it is going to make you cry, just make it the next week.  You can still go, just a little later.”  I rescheduled.

My girl is in bed.  Sick and feverish.  We ducked an ER visit tonight, and am hoping to do the same tomorrow.  Along with the Cowden’s she just has a rotten immune system.

Who knows what tomorrow will bring, for any of us?

Tonight I will not be angry about the past, the diagnosis, the syndrome that has taken so much of our time, freedom, and spontaneity.  I will instead be grateful.  For the geneticist who cared enough to find me an oncologist when I couldn’t.  For the pediatrician who has called 3 times since we left his office at 2.

This past year has changed us, for sure.  Cowden’s Syndrome has transformed us into different people.  But I will never look back at this last year with eyes of regret or sorrow.  I look back with gratitude.  For the health I have, for the friends that have stood by me, for the new friends I have made, for my family.

Constantly changing, none of us are ever the same.   The question is WHAT do you want to change into?  I know what I pick…

Image credit google.com

I Am Blessed

This cartoon is on the front of Meghan’s 4 inch medical binder. We have sometimes decided whether or not to keep a doctor by their reaction to this TRUTH!

It is late.  I should be asleep.  Morning comes fast and it is already after midnight.  I just can’t seem to find a way to unwind. 

I just had a long chat with a ‘new” friend.  That helped a lot.  But still here I am, trying to get these racing thoughts out of my head before I rest.  

I saw a new oncologist today.  The geneticist insisted I have one to follow me and one for Meghan.  Except I was having a hard time finding one who didn’t think Cowden’s Syndrome was contagious.  (Ok, perhaps I exaggerate, but they weren’t anxious to see me.) 

So the geneticist sent out an Email on Tuesday to some of his friends.  By Friday he had a name for me, (which means the genetecist is a KEEPER!) of a doctor IN network, and I met her today. 

She is lovely.  Of course, by already having the double mastectomy and the hysterectomy, I have made her job much easier.  Now she gets to push me to the fun stuff.  Next up- colonoscopy, and kidney MRI.  So tomorrow I will call to get the GI appointment, while they work out the authorization for the MRI. 

And all the while I will mourn a bit for the summer that wasn’t meant to be.  This was more, a necessary doctor “catch up period.”  I think by the end of August we will have at least 25 appointments done between us.  And those are just the ones scheduled right now. 

So, just when I start to get whiny and cranky about wanting some alone time to shop, or some fun time to swim, I remember.  Were it not for the work of the angel on my shoulder, that pushed my “prohylactic blilateral mastectomy” in March, I would have likely been spending this summer prepping for cancer treatment. 

So, we still get our trip to Disney, and there is always NEXT summer… 

I spent the last hour preparing for Meghan’s oncologist visit on Friday.  We haven’t seen this doctor for months.  There have been a few things going on.  So, I faxed her 32 pages of what we have been up to.  She wanted to review it before the appointment. 

I posted the cartoon because I had her binder out while I was preparing the fax.  I laugh every time I read it because even after all these years it is still true.  Even with our diagnosis of the PTEN mutation, and Cowden’s Syndrome, even with the precancerous thyroid nodules in Meghan, and her early puberty, she still has pain.  Every day.  And not one of these doctors that we take her to can tell us why. 

I thank GOD every day for her stamina, and her spirit and her spunk.  She is my love, my reality check, my perspective, my reason for being.  I feel displaced right now, from my church, my comfort zone – but not from God.  Even in the midst of all the chaos and uncertainty, I have a husband and a daughter that are beyond compare.  God has us in the palm of His hand.  We are blessed.  And it WILL be OK!

Family Photo!

Family Photo

This year I am obsessed… well with quite a few things, but one of them is not (directly) medical.

This year I am focused on a high quality, everyone looks their best, everyone is smiling, family photo.

We are a family of three.  Immediate family that is.  (Not including our furry friends Allie, and Lucky.)

Our extended family includes his parents, two sisters, a brother-in-law, and three nephews.  On my side, there are my grandparents, (Mom’s parents, my step-dad’s Mom, and my father’s mom) as well as my mom and dad, my father, my two sisters, a brother-in-law and a half-brother, and two nephews. That list doesn’t begin to address aunts, uncles and cousins galore on both sides.  Yes, they are all family, but reality will never put them all in one place at the same time, and there are probably some blessings to that.  While I love them all dearly, I often say you shouldn’t mix drinks, or extended family!

We have been fortunate enough that we have been able to travel to Walt Disney World in Florida for the past 4 summers.  We will be making it a 5th this year.  We save and budget all of our “fun” money for a Disney vacation because for their extremely high pricing, we get “allergy safe” meals wherever we eat, and unlimited access for Meghan’s push chair, which she often needs when we travel more than about a half mile. It is the best week of the year for all of us.

It is usually the week of Meghan’s birthday.  It is doctor free, no needles, just be “normal” week. We take LOTS of pictures.  Usually it is of Meghan alone, or of one of us with Meghan.  They are great photos and I treasure them.  The few photos we have gotten of all of us in Disney usually have us in sweats, and sneakers – SWEATING. This year we are going to go to the photo studio, and I don’t care how much it costs.  Meghan and I have dresses picked out, and matching sandals too.  (We just need to pick out something for Daddy who after deciding “stress eating” isn’t the way to go, is down over 20 pounds!)

There are so many reasons why I am focused on this photo. It is FUN to focus on something FUN.

I have been smacked in the face with the reality of the frailty of life.  In March I was given a “second chance” as I was told the breast cancer that was “sneaking up on me,” unbeknownst to any doctor – was gone.  Gone after a “prophylactic bilateral mastectomy.” Gone before it had a chance to wreak havoc on my life.  Gone.  But I will not forget the words of my surgeon, “If you had waited until July to do the surgery you would have likely been in a fight for your life.” Instead, I will go to Disney World.

Not lost on me is the reality that 15 years ago next month my Mother finished up treatment for bilateral breast cancer.  She is strong, a survivor, still here, enriching our lives.

Not lost on me is the cancer scare AGAIN in May, as they worried about a malignancy in my uterus, before performing a hysterectomy.

I am vividly aware every moment that the thyroid specialist who monitors Meghan’s “precancerous” thyroid nodules, took back his invitation to come back in a year, and said, “we better see you in 6 months.  One nodule is starting to dominate.”

I am painfully aware every moment that after one of the strongest, and longest battles I have ever witnessed, we lost GGPa in June to cancer.

My stomach, and my heart hurt for the victims of the senseless attack in Colorado this week.  Families out to see a movie – life ended so tragically.

I love to look at pictures.  In an age when people have stopped printing them, I have shelves FULL of albums.  I love reliving memories, and smiling at al the good times. The albums remind me, that no matter how tough things seem, there ARE LOTS of good times.

Cowden’s Syndrome, PTEN mutation, cancer, NOTHING can take away the memories or the good times.  So since 2012 has been quite the year, we will take a “fancy” family photo.  One that will hang somewhere in our house and remind us that we can endure the tough times.  One that will remind us to hug each other tightly, and to kiss each other when we leave, and to never stay angry over nonsense.

One that will remind us that we are defined by our spirits, and not by the sum of our parts.

We are family, and a pretty special one at that.

Family Photo!

One year…

One year…

It just sounds better than 6 months.  It feels better too. 

“Six months” says, we are still a bit concerned.

A year says, “You got this.  I’ll just check back and make sure it’s all good.”

One year from now I will visit the plastic surgeon.  She will check on my fake boobs, and make sure they are still doing exactly what they are supposed to do.  (Which near as I can figure is stay still.)

Next month I visit the breast surgeon.  Hoping to get “one year” from her too.

Eventually my life and Meghan’s will be in some type of maintenance cycle.  We still have some time before we get there, and there will always be doctor’s appointments – but for now it’s a big win.

The cancer is long gone.

I heal pretty well.  Especially on the outside.

Cowden’s Syndrome is good for something.

The Cowden’s Syndrome Roller Coaster

Maybe if I could attach my cell phone right here…

I can not tell you for the life of me why Spiderman was on my mind today, but I was thinking I could use one of those web shooting things.  It could be modified to hold the cell phone that is constantly in my hand!  I remember when Meghan was so colicky, and I used to carry her all day in that Baby Bjorn carrier.  I LOVED having my hands free again.  I hated that she just kept crying, but at least I could move around a bit. I am starting to feel painfully tethered to my phone.  I waited forever for the vascular surgeon to call.  Now Dr. K from Boston called Saturday, and we still haven’t connected.   

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Paranoid to miss his call, I carry my phone EVERYWHERE I go. I am not kidding, that is my cell phone in the plastic bag at the beach today.

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Today was a banner day. 

It was the FIRST time we have been to the beach since before her first birthday.

  This child was so sensory sensitive that we were both deeply traumatized by the first trip.  It took us almost 8 years to work up the nerve to do it again, and boy has she come a LONG WAY!

 We only stayed a few hours. 

Long enough to get into the sand and build a castle.  Long enough to find a few shells.  Long enough to jump a few waves.  Long enough for her to say, “Mom my knee is clicking every time I step and it hurts.” 

Clutching my old scratched up cell phone like it holds the answers to all life’s problems I silently, desperately, wish it would ring. 

But then what? 

Will Dr. K have a single answer? 

Will he want us to drive 5 hours just so he can say, “I don’t know?” 

Yesterday we saw Dr. P – the geneticist at NYU who started all this about a year ago.  

It was a friendly visit, catching up on all we have done.  I had a chance to thank him for “catching” the Cowden’s Syndrome a year ago.  It was his desire to dig deeper, and to solve the puzzle, that undoubtedly changed the course of our lives, and likely already saved mine.

 He asked a lot of questions again.  He looked closely at Meghan, especially her legs.  He pointed out again the 1/2 cm discrepancy.  He pointed out the swelling in her LEFT knee, likely the result of her favoring her right knee. (The AWESOME PT Dr. Jill, already called that one!) 

He listened to my concerns about her avoidance of activities.  He said the fact that the Celebrex is working means to him she likely has arthritis due to deterioration from small amounts of blood circulating the knee joint.  Not JRA, but degenerative arthritis.  He said she can’t stay on Celebrex forever. And although I knew that I was busy shuddering at the alternatives. 

He will nose around, and see if he can get a closer orthopedist to take a look.  Then he will look for an oncologist for me.  In the mean time he said, let’s just get a screening sonogram of her kidneys, to be safe.  Just a baseline. 

3 hours later we had word that her kidneys are “beautiful” and untouched by Cowden’s. We left NYU exhausted, and relieved, but still waiting.  Always waiting, and wondering, and worrying.  What next?  Can we fix it?  Wait… nothing new please!  We haven’t fixed the last thing yet… and so on and so on. 

 Tomorrow we will go back to the pediatrician to recheck for the recurrent strep.  Then, a much anticipated play date for Meghan.

Then Friday, its to the plastic surgeon for my recheck, with another playdate for Meghan. 

All the while my cell phone will be close at hand. Last year at Disney they finally got me on Big Thunder Mountain Railroad.  Good thing.  I think it’s a case of life imitating amusement park here. 

Cowden’s Syndrome is a great big roller coaster, so I better get a stronger stomach!

Mommy is on a mission…

I am dating myself now, I know.  I was definitely one who watched the “A-Team” in the 80s. 

I have no real idea as to how my subconscious works, but tonight as I sat through a few hours of sorting out that $750 bill, I kept thinking of Mr. T.

I PITY THE FOOL WHO MESSES WITH THE MOM OF A MEDICALLY FRAGILE CHILD!

I have it all straightened out.  Clipped together and ready.  It took me 2 hours, but I figured out the billing error they obviously haven’t rectified in 3 years.

I know exactly what they need to do.  But tomorrow I think I will mess with them a bit.  Make them send me a few detailed, itemized bills.  Then, after they send it all to me, I will let them know if they bill my medical, not my hospitalization (like it says in the fine print) they will get paid the deductibles they are looking for.  See, we are fortunate enough to have 2 insurances, and smart enough to use them.

No doubt we could pay the bill if we had to.  But, why?  There will be something else… like superhypoallergenic sunscreen… that I can better spend it on.

Tomorrow.    I will start with the garden.  Move on to the billing department, and finish by calling Boston, all before PT at 11:45. 

No time for tears of frustration tomorrow.  I am a Mommy on a mission.

Photo: LOVE THIS! <3

The Mommy Monster is BACK!

The “Mommy Monster” is back in focus – eye on the prize!

See…  all it really takes is for the wrong person to tick me off, and the tears just dry right up!

 We went out today.   I told you I like Saturdays.  Family days.  No doctors.  We went to visit my parents, and my grandparents.  Saw my sister and my nephews.  Then we spent the afternoon with friends at a birthday party for  3 year old twins.  Good times. I was even able to eat a slice of pizza.  I have had less than no appetite these last few months, so I was impressed. Feeling pretty good we got home around 6 – and took in the mail. 

   Mail symbol

 It was clearly a bill, but I wasn’t prepared for it to read $750, “previous balance.”  Followed by an admonishment that we should pay immediately. 

Again I repeat, “HAS EVERYONE LOST THEIR EFFIN MINDS?” 

There are things we don’t do in this house.  We never give money to phone solicitors, and we NEVER pay a non itemized bill – ever.  Not even if it is for $7.50. 

So I went down to my very thick “pending” file, to find that on November 29, 2010 (because this is for surgeries in December of 2009 and April of 2010) I sent them a LONG and detailed letter with all the EOBs attached, stating why I owe them nothing. 

Really, stupid people who choose not to do their job, and make work for other people REALLY annoy me!

As I got all fired up for Monday’s battle, I noticed the answering machine was flashing.

Checking the message I saw it was a Massachusetts number.  At 4:30 PM today, apparently Dr. K from Boston was in his office reviewing Meghan’s MRI.

I sent him the report yesterday after my visit in NYC.  I also sent him a cover letter which essentially said, what Dr. R had concluded – that there was no mass in the knee, and that Meghan is still having some pain in the knee.  I closed the brief cover letter by asking him to keep the report in her file should I need him at some point in the future.   I made a point of telling him “If I do not hear from you I will assume you are in agreement with Dr. R’s findings.”

SURPRISE!  More opinions weighing in from up north in Boston.

 Dr. K’s message said the knee MRI “looked good” in terms of him not seeing blood on the joint.  He said, ” I know what you wrote about Dr. R not seeing a mass.  I just think if she has symptoms you should bring her to me for evaluation.  Give it another few weeks and come up in the early fall.”  (Sure…. no conflict with the school calendar there)

Sunrise over Childrens Hospital

 Relieved to hear the “old boys club” doesn’t supersede professional opinion in this case. 

As for  what happens next – who knows?  Every day is a great adventure for sure.  At least the Mommy Monster is back in full swing.  Looking forward to fighting the good fight Monday morning. 

I will probably call Dr. K – just to be clear on his thoughts too. It’s Saturday night.  Monday’s agenda is set.  And I have set my own internal countdown to Disney – the family vacation.  Keeping my eye on the prize.  God willing the doctors can’t find us there.

 Headed to bed now.  Tomorrow I will take my family to a cute little church a few miles away from the one I grew up in.  The people I love aren’t there, but they are nice people too.  And we will thank God for the blessings that have come from a week of ups and downs.  

Cowden’s Syndrome is exhausting… but we can take it!