Laugh Out Loud

Published on November 5, 2016 by beatingcowdens5 Comments

We use the phrase all the time. Anyone who texts or uses any social media understands LOL. But, today I got a more clear explanation of why it’s essential.

At Voice Therapy this morning we talked about “habits,” things I may be doing without realizing it to strain my voice.

I was told that both laughing and crying can be damaging.

Crap. I’m screwed. Laughing and crying are things I do- often.

But, she explained. Laughing, or rather “fake laughing” when you hold it in your throat is stressful and damaging. When you laugh, you should laugh full and from your belly. You should, for lack of a better phrase, “Laugh Out Loud.”

Well, ok. This I can do. My husband cracks me up. I mean most of the laughing I do in my world originates from him. And it’s the kind of laughing that’s so loud and clear that I often find myself praying there is no belt on my jeans. This laughing is just fine.

The laughing that is no good, is the fake laughing. Go ahead, try it. When you want to make believe you think something is funny and what comes out is a huge fake smile and a small throaty chuckle. This is no good. And you know what? I’m ok with that. Laughs, like anything else should be real. If I must be social, a smile will do.

I was also cautioned that crying can be damaging. This one worried me. I am not a depressed soul, but the way I stay sane is to live my emotions. I cry- when I am thrilled, nervous, sad, worried, happy, and other times too. This I could not give up. But I breathed easier when she explained. The crying we hold in, is the damaging kind. It ends up getting stuck in your throat and causing all sorts of problems. However, if you cry, and let it all out – it’s just fine. Makes sense really.

Live – out loud. Laugh out loud. Cry out loud. Don’t hold it in. I’m quite sure to do so damages more than your vocal cords.

Getting up early on Saturday bothers me a lot less. I like her. She makes sense. Good voice and life advice over a cup of tea.

And every day she makes

#beatingcowdens

a little easier.

Speechless

Published on October 30, 2016 by beatingcowdens2 Comments

Resting your voice is not like resting your knee, or your shoulder. Resting your voice is more like resting your heart, or your lungs.

Something is kicking my butt. And I’m not sure what it is, but I am so not in the mood anymore.

This has been one chaotic stretch.

FInally recovered, mostly from my way too soon implant exchange in August, and my broken toe 2 weeks after, I am battling with trouble in a place I least expected to find it.

This summer I heard, “vocal cord nodules” for the first time, after feeling somewhat hoarse since April. I was quickly reassured by tons of people that these are “normal” and would resolve if I was careful. The doctor didn’t say too much, besides directing me to begin vocal therapy and return in three months.

I knew enough to listen when I was told to start therapy, and I did. Begrudgingly, and convinced it was bogus, I made my way to the recommended therapist. We got in a few visits before school, and then had to switch to weekly as my schedule just wouldn’t allow more.

For about four sessions I felt utterly ridiculous. Then I started to “get it.”

I struggled when I started work, and was told to purchase a “tour guide” microphone. I did, and the small 20 amp speaker with its wireless microphone have been an incredible help. Despite looking like a frustrated pop singer, I am able to talk longer, and with less strain. I am learning to speak differently, and in ways that are often unnatural to me, all with the desired end result being to reduce the stress, impact, and inflammation on my vocal cords.

I saw the doctor for a follow-up on October 11, and I got a very “Cowden’s-like” mixed report. I was told that the vocal therapy had decreased the inflammation. (YAY!) However, the reduction of inflammation makes me a better surgical candidate. (I had really hoped I could just make it go away.) AND, there was now a new, or newly visible “striking zone lesion” on the other side. Both of the lesions were not “typical,” and would not resolve alone. Both lesions appeared to have vascularity to them. And, the “striking zone lesion” was irregular in shape.

Despite his 99% comfort that the lesions were benign, I left with instructions to continue therapy, and to plan on having surgery close to the summer to remove the lesions. I was told for the first time ever, that I would need to practice COMPLETE VOCAL REST for 7 days post operatively, AND for the next 7 days, I would speak approximately 1 minute for every hour. The next several weeks would entail a slow progression back to my full voice use. The thought of it completely freaked me out.

At voice therapy, there were conversations about Cowden’s Syndrome, and our tendency towards over-scarring. The very real possibilities of what excessive scarring would do were discussed in a casual conversation. By this time I am comfortable, and confident in the therapist. She is smart, witty, and honest. She’s real without being painful. She also cares – about me, as a human, a teacher, a mom and a wife.

So, I had really hard conversations with my husband about the future, and I strengthened my resolve. I charged my microphone, and I found the voice that exists out of my throat. I have started to shorten my sentences. I’m learning.

About 3 weeks ago it started to get worse. Slowly and steadily worse. Every day I would do my exercises, and I just couldn’t get the sounds. My air was becoming a battle. The inhaler became a part of many days. I slept as much as I could. I stayed hydrated and took extra vitamin C. I ran no fever, but my chest felt full. My head was pounding.

I stopped using the phone for anything but texting. That was NOT the turn of events I needed, as I was struggling to keep up with people anyway.

Finally, I went to the urgi-center. I was told I had “a lot of fluid” in my head. I changed the allergy medicine. I took a nasal spray. I got a short course of antibiotics because it was lingering, even though I had no fever. I upped the saline, and the steam.

I barely, and I do mean barely, got through the day Friday.

Saturday I sat at therapy, so frustrated. She was so patient. So wonderful. She told me she had been researching Cowden’s Syndrome, and there wasn’t a lot out there on its connection to the vocal cords. We had kind of established that even if the Cowden’s didn’t cause the lesions, we still have to proceed knowing my body has Cowden’s and it affects everything. We can NOT scar the vocal cords.

She had looked at my exams from July and October. Side by side. Frame by frame. And very clearly stating, “I’m not a doctor, but…” I hung on every word. I processed them with respect. Some of our best help through the years has come with the premise of “I’m not a doctor, but…”

Vocal rest. That’s where we’re at right now. I am supposed to rest my voice when I am not teaching.

This is NOT an easy task. I’ve been at it for 4 hours now and I may lose my mind.

This is isolation at its worst.

The lesions won’t heal themselves. I can just get ready for when I need to heal. I can prepare for a lifetime of speaking in a way that babies my voice. I can practice being silent when it is so much the antithesis of my nature.

This time beating cowdens will require patience, strength of mind, and stamina.

It’s messing with me. But I’ve got this. I’ve got this.

If you don’t hear from me… try my email. Or texting. My typing skills will be improving greatly….

#beatingcowdens

The Fine Line…

Published on October 30, 2016October 30, 2016 by beatingcowdensLeave a comment

** Finding the balance has been a real struggle of late. This has been in my drafts for 10 days…**

I’m writing from the floor in the hallway of the college gym. Meghan’s swim team practices below. For hours. One day I will be able to drop her off and get a few things done. But, not yet. Not now.

I sit in the hall, out of view of my girl underneath. Out of view of her coaches who undoubtedly must think me paranoid. There isn’t another parent here. These are the big kids- 8th through 12th grade. And I’m not here because I don’t trust her. Quite the opposite. I sit here for the unpredictable. For the moments that take us from 0 to 180 in the blink of an eye. And even as I recognize that emergencies happen to anyone. At any time. I am here. Because history, track record, can not be erased or forgotten. I will pull away, slowly.

In the mean time I FINALLY got all my classes together, up and running, and pretty organized. Formative assessment is in place. Lessons are polished up, and I can take the 50 minutes each week that I see the 575 or so chilren as seriously as I like to.

Which is timely because it fell right into High School application season. Yes, season. 30 years ago this was not even a process. Now it’s an ordeal. These are tests to take for every type of school one is interested in. There are then scholarship tests to try to pay for the non- public ones. Open houses, “shadowing” appointments, where she goes to the school for the day to “see.”

This all seems to culminate by some time in December and then be followed by 2 months of waiting. It’s amazing how much “hurry up and wait” there really is.

And I am left to sit here. Quietly. I will her body to do as she wants. I that the right high school for her, is the one she attends. And, I watch as 8th grade starts to pass by.

Your experiences shape you. Your disease doesn’t define you. But, in our case it provides, stamina, endurance. tenacity, grit, and a tendency to want to over-achieve. Not a terrible list of negatives.

“Normal” is a relative term, constantly changing. When we are on the brink of better health, we sometimes find ourselves guilty of waiting for the other shoe to drop. We are often guarded and on the defensive. It’s hard not to be.

This past month a former student buried his mother and father 2 weeks apart. He is Meghan’s age, and while he had step-siblings, he was the only child of his parents. I haven’t had him out of my mind much.

These warnings, these screenings, these appointments, these surgeries, at times leave me down. But, not for long. We’ve been ordered to be vigilant.

There are no promises.

Today bleeds into tomorrow. September just about swallowed up October. And October seems hungry for November.

Stop. Or at least pause. Enjoy the process, no matter how tedious or taunting it may seem.

Hug your family. Call your friends. Even if it’s only for 5 minutes. Send a text. Stay in touch.

And I, I will be working on taking my own advice!

Overlap and Regrowth – Living with Cowden’s

Published on October 5, 2016 by beatingcowdens1 Comment

So, the night I was recovering from my breast surgery on August 19th, I haphazardly checked my Email.

There sat an Email from Meghan’s endocrinologist that shook me out of my anesthesia recovery pretty quickly. There is no time “in between” because there is usually SOMETHING going on. Overlap is a way of life.

Meghan had had lab work drawn the 3rd of August. Routine thyroid labs, and some tests from the gyn worked in. On the 18th the EMail from the gyn told me she was suspicious of a few lingering “issues” and we would address them at her late fall appointment.

The endocrinologist’s EMail said he was concerned about the resurgence of her “thyroglobulin” levels. He wanted to now treat her as a “high risk” thyroid cancer patient.

I almost dropped the phone, alone in my dark room. The last paragraph said he’d be on vacation for two weeks, and we could talk when he returned. I read. And I reread.

Decoding step by step – “thyroglobulin” is created solely by thyroid tissue. Someone with a complete thryoidectomy would have non-detectable levels about 3 or so months post operatively. Only thyroid tissue generates thyroglobulin. If some was left behind after her surgery a small number would have stabilized early. But for it to be gone, and then show up… This meant there had to be regrowth. And yes, it happens. Maybe to everyone, but definitely people with Cowden’s Syndrome. We regrow lymphoid tissue.

It’s a superpower of sorts. Except instead of being a really fun, save the world, or generate sunshine and happiness, superpower, it’s more of the – hey let’s add some more worry to your life superpower.

While the pathology on the thyroidectomy was totally benign, the mind can play lots of tricks. Lots of tricks.

I’m not slow. I am pretty well read. I’m equipped with the knowledge that having faith and worry are counterintuitive. Except I’m honest. And with matter of my girl, worry sometimes overwhelms. I never claimed to be perfect.

So I spent the last 6 or 7 weeks retreating. I barely spoke of this fear, this nagging thought that not only could the thyroid be growing again, but what if… what if all those precancerous things that we took out with it were somehow festering.

I made it my job to access the lab work. And it was a JOB. You would have thought what I was asking for just to see a list of messed up thyroid numbers. We live in a pretty crazy society. But, finally, after 2 weeks of labor, and getting increasingly vocal, I received 4 copies. All on different days. All from different people. But, I got to look at the numbers.

I am a numbers person, so I took some relief in the thyroglobulin being only 3. Undetectable was better, but 3 was on the better end of things. It was clearly well under that “10” I had found. So I took to waiting and ticking away the days until the next blood test. There was a thyroid dose change, and 6 weeks.

I broke my toe while recovering from the implant exchange, a few weeks after learning I was suffering not only from a single vocal cord lesion, but vocal atrophy secondary to premature aging, the latter which was likely due to the hysterectomy that became necessary after the breast cancer diagnosis in 2012.

And yes, I meant that to be a run-on.

It all kept me as occupied as I could while I hid in the start up chaos of September. I hate September. But, when you’re suffering personal angst and need cover under which to hide – it’s September for the win. I poured myself into setting up 25 classes, and over 550 students, logistically, and academically. It took some time.

And I kind of just ducked. Phone calls, texts… I played along.

“High Risk” thyroid cancer patient… like a recurring nightmare.

One of the reasons I was afraid to talk was the fear that someone would talk to be about thryoid cancer being the “best” cancer. Please, no one ever do that. When it comes to my child, a survival rate in the 90%s doesn’t soothe me. When it comes to my child, I, like every other parent want 100%. Nothing less.

I was scared.

We got the labs drawn at the hospital on Weds. the 28th.

On the 30th I was exploding. Every second seemed like an hour. Every scenario was playing through my head. So when I got the call that the test wouldn’t be ready till Monday I dissolved into a tiny puddle.

And then I did what every other mother does. I put on my big girl pants and got through the weekend.

Then Monday there was a brief phone call.

The thyroglobulin has returned to undetectable.

WHAT? How does that even happen? I sent out a million questions rapid fire. Most of them had no answer.

Crisis averted. Prayers answered.

I explained to Meghan why her Mom had been a bit extra on edge. She’s really growing up because she was grateful to have not traveled that mental journey with me, and appreciated me letting her in when it mattered.

Next blood test November 11. And we’re going with the theory that the thyroglobulin was a one time deal. An error. A miracle. Whatever. A win.

We’ve got 6 weeks. Some Mommy doctors. Some swim meets. 6 weeks. Sometimes that feels short. Right now it’s blissfully long.

On my knees in gratitude, we remain…

#beatingcowdens

Miles to Go…

Published on September 27, 2016September 27, 2016 by beatingcowdensLeave a comment

September is a marathon of sorts. Although all the training in the world can never quite prepare you for the twists and turns needed to navigate it through to completion.

September is establishing new routines, in my own classroom, and in our lives. September is learning new students, and new teachers.

Each year, it is about pushing our bodies farther than we have ever been able to. It is not just about surgical recoveries, or broken toes, it is about swim. So much swim. It’s about swim before sun-up, and afternoons too. It is about drama and singing and doctors in between. It’s about finding the inner strength to press on.

It’s about balancing it all. Work, school, after school, meetings, and the like. It’s about stopping to find the beauty, and the sunrise, and the simple pleasures along the way.

This life, this chronically ill life is lonely. I’m not going to lie, or even try to sugar coat it. It is lonely. But, we three in this house embrace and press on. Because, really, there is no alternative.

There is no fault, no anger, no resentment. Reality is that every moment is spent using all the “spoons” we have to get through. At this moment there are no extras. Family and friends who comprehend will still be there with open arms when there is a “spoon” or two to spare. The rest will have found their own way, and that is a loss we will have to take in stride.

Everyone has something. All lives are busy. All lives have joy, and angst. All we can do is take what is in front of us and do the best we can with what we have where we are.

The worry in my heart runs deep. There is reason for it, yet I battle it all the time. It can not, nor will it, define me, or our lives. Regardless, it lingers always, lurking in the shadows.

My girl continues to amaze and impress with wisdom beyond her years.

For her birthday Meghan had a very specific request this year. One of her gifts was, “The Unabridged Poetry of Robert Frost.” I was familiar only with one of his most famous poems. Meghan read this book fervently for most of August. I think I understand why now.

Lab work tomorrow to keep those thyroid hormones in check. We need our strength to remain

#beatingcowdens

Type A, and Then Some…

Published on September 18, 2016 by beatingcowdensLeave a comment

Calm down. Relax. It’ll get done. Take a breath. Why do you get so worked up?

These words could be spoken in several alternate languages for all the good they do for me. They make no sense. I mean, on a cognitive level I understand the words. And even the context. But, they hold little practical application for my life.

I am Type A. Yep. For it’s highs and lows, positives and negatives, I am a Type A personality. Although like everything in life, the transition between Type A and Type B is a spectrum, I’m still honest with myself.

16 Signs You’re a Little Type A

Go with the flow.

I have a dear friend who has promised to make a t-shirt that says,”I am Flo,” to guide me. She has 4 boys. (She used to be full on Type A. Now she shoves that in a drawer for most of the year, but the chaos sometimes still makes her cringe.)

I am high-strung. I am focused. I am task oriented. I am all about getting it done and getting it done well. I get pissed when other people fall behind on their jobs. I want order, structure, and routine. I make lists on top of my lists, while putting alerts in my phone to avoid missing anything. I have a hard time forgiving myself when I do.

I am a work in progress.

But to some extent, regardless of your personality type, I guess that’s true of all of us.

September is chaos. True, unequivocable chaos. Here, in this house. Here, in my mind. September is the toughest month of the year.

And apparently I’m not alone, because this article really cracked me up. September Is The Worst

If I could jump from August to October, it would be smoother. And I’m not a big fan of wishing my life away. But, transitions are especially tough on the Type A among us.

And, when you’re a teacher – well. That’s just a whole other story. But, for the sake of brevity simply organizing class lists for 25 classes and 500+ students while they are going through new admits, discharges, and interclass transfers is a feat not to be taken lightly. With the knowledge that 9/11 took place just a few days into the school year, I am always filled with a super sense of urgency to try to know who I have, and what their needs are as quickly as I can. Figuring out who has allergies, and who has an IEP is another struggle. Establishing rituals and routines for the classroom of a Type A teacher in one period a week is a bit taxing. Not as tough for the bigger kids, but those tiny kindergarten faces are still in shock. There’s no way they even remember my name, let alone where they should sit in my room. Substitute plans must be prepared, because emergencies don’t have the courtesy of always waiting till October. Copies of the schedule, printed, Emailed, and hung everywhere. Supplies, traffic patterns, expectations, all need establishing and reminding. That’s after the room is set up, and the bulletin boards are complete, and evening back to school night is squeezed into the agenda.

The agenda that is busting at the seams. Because, I know all you moms of multiple children may laugh at me, and whisper about how easy I have it, but that’s ok. Setting up the school and after school schedule for the child(ren) is a full-time job on its own. August looks so nice. The calendar lulls you into a false sense of security, as one by one the activities start-up again. And then all of a sudden you are trying to figure out when you will shower, or fill up the car with gas, or eat, or grocery shop. Never mind hair cuts! There’s the one time deals, like back to school night, and “returning parents swim meeting,” Every minute of every day seems to hold something. I know I have only one kid, but that doesn’t mean she can take herself to swim practice. Or pick herself up. Or that most of the time I can even leave her there, as lingering fears about her health are always present. And on the days she stays late at school for Drama, that’s a little easier, except when it crashes into a meeting at school. And there’s morning study, set up for the intense schedule for the 8th graders, as well as Friday night Youth Group for stress release. I think there’s a few minutes on Wednesday between 3 and 4 for sunshine. Oh, wait… groceries…

And to the left of me sits the Open House Schedule for High School. Still shaking my head as to how THAT happened, I am trying to figure out their days of the week. Because, I think we can make the Staten Island Borough Fair AFTER the swim meet that morning in October. There is the TACHS test, and the Specialized High School Test. Although I’m not really sure when there would be time to prepare. Unless, maybe there’s and app for that?

I haven’t even mentioned our health. Isn’t that just funny? It hasn’t rested one bit. And the most ironic thing, is people don’t realize you shouldn’t mess with a chronically ill Type A. Chances are good they like to excel at EVERYTHING. And in my case, I am willing to throw it at them. Hard.

Some time towards the end of August I had surgery to replace my implants. Far earlier than the 10-15 year life expectancy they had been given, one had moved, and it was time. That night as I lay recovering I picked up an Email from Meghan’s endocrinologist that we should raise her thyroid meds. Her levels were off again. Now raising the meds in and of itself every once in a while is not a huge deal I guess, but Meghan struggles with synthetic ANYTHING, and the fact that we were now 2.5 years post op from her thyroidectomy and she has had more dose changes than I have had in over 20 years can be unsettling. More unsettling was when I read to the bottom of the letter that he would be on vacation for over 2 weeks. So, here I was left to make a dose adjustment without clearing my list of “Type A mother of a chronically ill kid” questions, which, in case you wondered, are far more intense than the typical questions I ask. I scraped together the new dose from the closet, because I think we have Synthroid in EVERY dose known to man, and started her on it the next morning. My local pharmacy informed me that the insurance wouldn’t cover the new script even though it was a dose adjustment and we would have to mail order it. But mail order takes 2 weeks. And there was no telling whether she’d be on the dose for more than 6 weeks. But, whatever. I set my sights on getting a copy of the lab report to learn the magic thyroid numbers.

And then the real battle ensued. I tried to get it from one doctor. They couldn’t release it because they weren’t the “ordering” doctor, even though she had added labs to the order. I called the office of the endocrinologist. Twice that Monday. And again on Tuesday. I got a call back late Tuesday while I was on the phone complaining that I couldn’t see her labs through the “MyChart” system set up at the facility. The ‘ office said they’d send them. The MyChart people said they’d look into it. I waited.

Exactly a week. There were no labs in my mailbox. I called the endocrinology office again. I got someone who promised to send them and did. I called the MyChart people again. No answers, except that some one told me it was hospital policy not to allow parents access to records of their children ages 12-17.

REALLY???????????????????

Listen, while I may not like it, or even agree with it, I can almost understand that there are SOME situations where teens have the right to keep their records. But, this, this is THYROID blood work. She doesn’t want it. TRUST ME. She just wants me to give her what she needs to feel well. That’s it.

I processed all I could about this at the same time that I got ANOTHER bill from this hospital. The date of service looked familiar. I keep copious records. (Type A… :-)) And I was able to see that a bill for the DOCTOR, the PHYSICIAN Group, and the HOSPITAL FACILITY all billed, and were ALL paid to the tune of over $1000 for a 15 minute visit. And NOW, they were asking me for 2 additional Co-Pays. Notwithstanding the fact that we have 2 insurances, so our secondary picks up the co-pay at many of our visits. I called the primary carrier. They reversed the charges, but told me the billing practice was not illegal. Ok, then its immoral. And it preys on people who are sick, or who have sick kids. The insurance company also told me it was ON ME to call them when this happens. ONLY when I call them will they reverse the charges because as per my plan I am to pay one co-pay per visit.

Good, cause I needed something else to do.

By the first Friday in September I had had it. I found the CEO and Head of Patient Relations. I fired off a 14 page Email, 7 page letter, and 7 attachments about everything wrong at their facility.

I have since received 4 copies of the blood work by mail, and 2 phone calls asking it I needed it. One mail even came second day express. Of course it was addressed to my minor child, whose signature means nothing, and who is not legal to vote, or to drive, but who apparently in some alternate universe should be making health care decisions.

I received a letter from Patient Relations that they were reviewing my concerns. I’m not holding my breath.

That same Friday I tripped and fell and did some number on the pinkie toe of my right foot. A clear fracture, although there is some debate as to whether it is displaced, and it will warrant another opinion. The 3 hours I spent visiting the last podiatrist was a waste of my time. So, I am in a post op shoe for some infinite amount of time going forward. Because there is little chance in heck the right foot is getting into a sneaker any time soon. Good thing it’s the perfect month to “take it easy on the foot.” (Insert sarcastic grin here.)

Last Saturday the vocal therapist told me that I have one irregular shaped nodule on my left vocal fold. It still gets to be called “benign appearing.” I was also told I have “significant vocal fold atrophy secondary to premature aging.” Well, that sucks. Because I thought atrophy took place when you didn’t use something. And oh, I use my voice. And the premature aging, well, that’s likely thanks to the 2012 hysterectomy that was a necessary preventative move. It all comes back to Cowden’s somehow.

Over the weekend I noticed that the knots from the implant exchange were getting irritated. This doctor like all the others had been warned, I don’t dissolve stitches. But, as wonderful as he was, he also needed to be shown. I clipped one of the knots myself and there was immediate relief. Then I second guessed myself. By Monday the site I hadn’t touched was red and warm, while the other was healed. I took a photo and sent it to the PA. Come in tomorrow she said. So Tuesday afternoon, my surgical shoe and I trekked into Manhattan. She pulled the stitches, read a low-grade fever, and marked the redness. She scripted me with 5 days of antibiotics but told me to wait 12 hours. Wednesday morning I sent her a photo. “Looks better, right?” I said. “Start the antibiotics,” was the reply. So, I did.

Friday, Meghan made it to morning swim practice. 5:15-6:30AM. I dropped her off, and headed home to shower. I met her with breakfast. We stopped off to drop her bag, and were at her school by 7:22. I picked her up at 2:20 and she made afternoon practice. I was tired. She made it to youth group too. I was in bed by 10.

Friday I spoke to the endocrinologist – finally. I really do like him, but I think we’ve established now that I can’t wait 4 weeks for communication. I don’t think it will happen again. We talked it through. Wednesday the 28th we’ll head to the hospital lab to repeat. We are going there because then there is no chance for anyone to blame a variation on a different lab. But, that’s ok cause there is that free hour on Wednesday… He will call me on the 30th with the results. I believe him.

I also believe that when I take his call on the 30th I will have a tall glass of wine celebrating the END of September.

This morning Meghan woke up with a sore throat. She had to skip practice. That’s always a tough call for her, but the right one. She’s beating Cowdens like a champ, but part of winning is knowing when to slow it down.

Slow it down.

Hmmm.

I am so wrapped up in the have-tos, and the just getting by, that so much life is just on hold. We have to gather enough spoons to save for something fun. Anything. But there are no spares. Especially not in September. (If that last paragraph confuses you – you can Google The Spoon Theory)

Sometimes, when I have a minute, I think about calling some of the friends I miss a lot. But, I don’t. They have crazy wild lives of their own. My fears and anxieties and worries exist, and so do theirs. But for some reason right now, they largely exist separately. I miss them. And I am forever grateful for Social Media and the few minutes I can take, at swim practice or the doctor to catch up, at least on the surface.

I am super-blessed with a husband who not only tolerates my Type A, but works with me. He cleans, and cooks, and remembers to make me laugh. A lot. Often at myself.

I am three years deep into nutritional cleansing that I have no doubt is keeping me fueled for this crazy life. One day soon I intend to find a way to shout from the rooftops and share this secret arsenal of nutritious fuel with the world. Because without it, I’m not sure exactly where this Type A, broken toe, infected boob, woman, who needs a tour guide microphone to teach her classes would be hiding.

Instead of hiding, we remain,

#beatingcowdens

forever!

Yep, it’s broken. But, not me… Nope, not me!

Published on September 5, 2016September 5, 2016 by beatingcowdensLeave a comment

Friday, I tripped over something in my hallway. I wasn’t looking. I ended up against the wall, screaming all sorts of words that I am sure were inappropriate for my daughter to hear. But, for about 60 seconds I let them go. I screamed while the pain was too intense for me to breathe. I screamed about my stupidity. I screamed with certainty that the foot, or at least the little toe, was broken. Because it was that kind of pain. The kind that makes you sure.

After some ice, I tried my best to jam it into a sneaker. Less than 2 weeks post op from the implant repair, I was not interested in losing my ability to walk to relieve stress. However, my efforts were in vain. That toe wasn’t even close to making it into my sneaker. No way. No how.

I took Meghan to swim practice, and called my husband to meet me. I figured when he tagged in I could go for an x-ray. Just on the off-chance it was more than the toe. Because every memory I had was of “you can’t do anything for a broken toe,” I was hoping…

I kept busy in the hall above the pool. I had my laptop and all I needed to continue to pepper NYU with what I really feel are immoral and unethical billing practices. Along with 2 weeks worth of a records retrieval nightmare, where I could not gain access to Meghan’s lab work from earlier in the month while her doctors were on vacation, and the online system was a classic, epic failure.

I propped the foot to the side, and used the hotspot on my phone to send the 14 page document I had compiled off to the CEO of NYU and the head of Patient Relations. Then I copied one of her doctors, a lovely woman who I doubt has any clue how these things are done.

When I finished that I called on a bill I had just received. Same doctor for Meghan. Two dates of service. No evidence of my secondary carrier billed. My $30 copay times 2 requested as payment. I asked, innocently why the secondary isn’t mentioned. I was told they didn’t pay. Didn’t acknowledge the claim.

I made my notes, to follow-up. I did. Amazing what technology will do me. This facility was paid THREE times for the January visit alone. A visit totalling about 20 minutes generously. They COLLECTED over $1,000 from the three separate claims. And they were STILL hitting me for money. My older, weaker self would have paid. Just to shut them up. I’m not that person anymore. I am strong. I am tough. I am morally and ethically strong-minded. I will pay what I owe. The rest I can do with as I decide, not them.

They are sneaky. They prey on those who can not figure this out. I am developing a spread sheet I will have to enter all data into to stay on top. But, I will. And when I have enough I will expose them. I will do it for the people who can’t. Because some things are just flat out wrong.

I thought of all this as I found my way in the x-Ray machine Friday evening. The tech was sweet. She was kind. We laughed. Without saying anything, she said it all. “I think you might want this CD. Why don’t you just wait for it?” Sure…

An elevator ride up I was informed of a displaced fracture of my right small toe. They can’t be sure if it’ll need to be properly set. I need to wait about a week. Until oh, I don’t know, the FIRST DAY OF SCHOOL?

Saturday 9/3 - I did manage a polish change! — Saturday 9/3 – I did manage a polish change!

I spent Saturday morning in vocal therapy. Apparently she’s waiting for confirmation that I don’t actualy have nodules, but rather some type of vascular lesion on the left vocal cord. Tiny. Benign. Therapy the same. Prognosis not quite as good in terms of self-resolution.

Stitches sticking through the streri strips on my newest boobs, a boot on my right foot while I track down a doctor. A voice that may work, or not…

School starts for teachers tomorrow. A hot mess of me headed in to meet my schedule.

I am bent, bruised and strained. My toe may even be broken. But, not me. I won’t be broken. Ever.

It’s mind over matter in so many ways. And this mind. Well, it matters. I’m all over it. #beatingcowdens is not for the faint of heart, but we’ve got this.

For right now, with a little help from the Captain… 🙂

Set Up Surgery on Safari – check

Published on August 20, 2016 by beatingcowdens7 Comments

Last Tuesday, on Meghan’s 13th birthday, we woke early and headed to the airport for what has become an annual family vacation. Disney World is a “happy place” for all of us. Despite crowds, and heat, we seem to be able to locate so much magic there. Plus, it’s not here.

I like it here. In my house, with my family. But being “here” in a broader sense means doctors and tests, and appointments and procedures. And traffic, and waiting. And bills, and phone calls, and all sorts of obligations that often keep me tied to my desk chair.

In Disney someone produces allergy safe meals for us. In Disney there is no driving. In Disney there are fireworks and parades and shows. While we are in Disney Mom watches the dogs and the house.

Those 8 days designed as a respite. A safety zone. A doctor free area. And we look forward to it every year.

This year was even more special because Meghan brought a friend. She got to bring a kind, compassionate, witty young lady who had been by her side through some ups and downs the past year. There is not a long list of people who Meghan trusts enough to take into confidence, and I can’t say that I blame her. But, this young lady has similar loyalty standards, and held her composure as Meghan threw some tough stuff at her. Meghan is forced to think about things and process things that are not even remotely acceptable to have to deal with at her age. Most peers are overwhelmed. Many shy away. This young lady did not NEED Meghan as a friend, they CHOSE to be friends. As different as they are, they compliment each other nicely. So we set off on our adventure this year as a party of 4. The Ortegas plus one!

Once we found our groove, (adding a wheelchair takes finding a balance) we were off and running. Great food, lots of laughs, and the highs and lows you’d expect from two spunky teenagers.

I was distracted Friday when my cell phone rang, while we were on the Safari at Animal Kingdom. I should have seen the NY number and known what was coming. But, I answered quickly.

It was my plastic surgeon’s office. The one who had told me they could fix my implant some time in the spring… well, they were offering me a spot on August 19th.

If you don’t have the back story on this I’ll give you the quick version. After a double mastectomy in March of 2012, I opted for immediate reconstruction. I was very pleased. Then in November of 2012 I was in quite a car accident. I took a good hit to my totaled Hyundai. The implants were intact, but likely never quite the same. By the summer of 2015 I had been experiencing some pain and discomfort on the right. I went back to my plastic surgeon in November of 2015. She told me the right implant had fallen a bit, and I should have (non-emergency) surgery to pull it back up. Except, she was no longer accepting my health insurance. The year that was had Meghan in the OR I believe 5 times. I struggled to get the courage to call the new plastic surgeon. I was annoyed to have to do all this again so soon. The initial estimate on the implants was 15 years. This was under 5. I finally got an appointment with the new plastic surgeon a full year later, in July of 2016. He concurred that a surgical procedure to “tighten things up” was a good idea, and that I could schedule at my convenience. So, I tried to get it scheduled for the summer. Then I tried for October when we have a few days off. Then I tried for December… and before I knew it I was looking at spring break, almost another year of what had transformed from pain, to just an odd sensation, all the time.

I listened as I was told I could have the date one week away. I looked around at the animals on the African Safari. I tried to keep my conversation low enough to make sure the girls, and no one else on the vehicle was following along. I promised to return the call in an hour.

I hung up and managed to share the story with my husband. Then I called my Mom. Then I called the plastic surgeon back. “Let’s do it.”

So the following Monday was spent ducking away to make phone calls to set up pre-operative appointments. Because the plane was due to land at midnight Tuesday. I needed blood drawn, and a physical Wednesday in order to hold the spot.

Tuesday we left Disney. The step count on my FitBit was over 142,000 I had covered over 62 foot miles. I was tired, but happy.

We did have a great week, and while I was bothered on some level that the surgical planning creeped in, I am skilled at managing many things from my cell phone. And, the thought of getting all that straightened out months ahead of schedule was exciting.

Tuesday it rained. In NY and in Florida. There was lightning. There were delays. Lots of them. Our plane landed well after 1 am. I hit my bed hard at 3 and was on the bus to NYC for the lab work by 9. After battling NYC traffic there and back, I went for the physical. Passed, and papers faxed to the plastic surgeon by 4:00. Success.

Life moves quickly. We have to keep up.

The call came Thursday to be at the hospital at 6 AM Friday. While I am not a morning person, only the surgically experienced would realize that is like hitting the jackpot. It means you’ve got first case. And that is a giant win.

There was little time to share the plan with anyone.

Yesterday morning I had bilateral implant repair between 7:30 and 10 AM. I slept till 1, had some ginger ale and crackers and was home by 2:45.

Last night I laid in my bed catching up on Email and I caught one from Meghan’s endocrinologist. The thyroid numbers have gone a bit off again. He wants to play around before repeating labs in 6 weeks.

Medication readjusted. Again. Illogical. Like so many other things.

Apparently #beatingcowdens involves scheduling surgery on an African Safari and readjusting medications hours post-operatively.

We’ve got this.

Thank goodness for our time in the “Happiest Place on Earth.”

On Your 13th Birthday…

Published on August 8, 2016 by beatingcowdens1 Comment

August 9, 2016

Dear Meghan,

As I sit to write this some time in the middle of the night, I am reminded of the early years, when so many of the middle of the night hours belonged to the two of us. Yes, Meg, I said YEARS.

You struggled my girl, but your determination was evident early, like the day the NICU nurse called you feisty. She was right. And it has proven to be one of your finest and most valuable attributes.

When I look back on pictures of those early years, it doesn’t seem all that bad. I guess I never had time or desire to photograph some of those tear-stained days. And maybe. if it wasn’t for the colicky cry seared into my brain, I might have even come to forget that you considered sleep optional, crying and screaming mandatory, and that carrier pouch a requirement for all things. At one point we had even taken to calling you a kangaroo baby…

But, I look at the babies in those pouches, And I think to those mother’s “enjoy it.” You might find this hard to believe my dear, but there is not a single minute I would change or do over. Every step along this journey with you has BEEN the journey. And I have the deepest gratitude that God selected me to be your mother.

The path hasn’t been easy. Sometimes it’s been rocky, and a little unsettled. Other times its been like traveling through fire. On a bicycle. With no handlebars. Backwards. But, I think we’ve all found pieces of ourselves we never knew existed, and there is a family bond between you, and me and Daddy that so many envy. Not for what we’ve done or where we’ve been, but rather the fact that we have done, and continue to do it all together.

At eight years old, you were tossed a diagnosis of a Rare Disorder, a 1 in 200,000 PTEN Mutation called Cowden’s Syndrome, that has leveled many grown adults. But, by eight years old, you were already seasoned at doctors, OT, PT, and speech. You’d been there, and were still doing dome of that. At 8 you were intimately aware of what it meant to spend hours waiting for doctors, and you had a clearer visual of an operating room than anyone should ever have. So really, in reality, that diagnosis just pushed us in the right direction to continue to help you become who you were meant to be.

It’s rotten to be the “unusual one” the one with all the risks and the need for that “hyper-vigilant” surveillance. But, I’m thankful.

See without Dr. Jill to push us to your diagnosis, without all those things falling into place, it’s likely I wouldn’t be here to write this. Your diagnosis led to mine, and while I am intimately connected with the reality there is no guarantee of tomorrow on this earth for any of us, my heart is sure that you, my angel, my gift, you my dear saved my life.

I watch you with each passing year, and the challenges pile on top of themselves. And we both sometimes want to stop the presses and scream, “IT’S NOT FAIR” and the top of our lungs. but then we laugh. “Fair” is just a silly word anyway. It’s not the perspective we use. It’s not worth our time.

You approach this birthday with 17 operating room trips under your belt, and too may ER visits and, tests, and hospitalizations to count. You have had to make decisions, and think thoughts that are beyond the scope of what you should contend with. But with grace and dignity you proceed, because none of that is what defines who you are.

Grace,. Poise. Strength under pressure. — Grace. Poise. Strength under pressure.

Despite unimaginable pain, you press on. Your body would not allow for dancing school or soccer. But the competitor in you was not to be silenced. Running was out of the question, so now you “fly,” in the water, 11 months a year 4-5 days a week for hours. You pull energy out of the crevices of your toes to push through when most would curl up and give up.

First season swimming, a few weeks in. Spring 2013

2016 Working on her "fly" — 2016 Working on your “fly”

You press on in the community, focused to raise the necessary founds the PTEN foundation will need to create our patient database. But, you will not turn your back on the charity where you began, Global Genes, “for the babies who can’t speak for themselves,” you tell me. You make flyers, select venues, advertise and collect raffles. You speak at schools and organizations across the Island who will have you, to raise awareness that rare diseases are everywhere. For the last 2 Februaries we have celebrated Rare Disease Day with almost 200 people, gathered because you have a mission.

Youngest “Woman of Distinction” recognized in Albany by Senator Lanza in May. Proudest parents.

I watch you talk to people and I swell with pride. When you’re intermittently stuck in that wheelchair you hate, you decided to help the doubters, the starers and those passing judgment. A simple business card with a phrase you helped create “Cowden’s Syndrome – Rare. Invisible. Real.” It starts a conversation, or it ends the behavior. Either way you manage with grace to rise above.

You take the high road so many times a day. I know it’s not easy. And I know there are people in your path every minute determined not to make it easy. But, truth be told, as we are learning, there are others out there. There are real people, at swimming, at youth group, at SICTA. There are real people who are finally recognizing that you are pretty spectacular. And I don’t mean that in a ‘who is better than who’ way. I mean it in it’s best sense. Everyone is spectacular in some way. You just learned it a little early.

As you turn 13 this week, I wish you so many things, from the depths of my heart and soul;

*Never lose the magic. Ever.

*Never compromise yourself for anyone. Remember that doesn’t mean to be brick wall stubborn. It means to keep those morals. Rise above.

*Always remember no matter how wild and crazy the world gets, you’ve got two parents who will love you regardless… and that is a PROMISE.

*Smile, sing, laugh, act, dance, be sarcastic, and sensitive, and guarded and silly, with a healthy touch of humor thrown in. Do it all always with respect.

*Continue to constantly take every obstacle tossed at you, and it toss it back, or walk past it and move on. When they tell you you can’t, find a way to show them you can.

*Never let anyone make you feel less than. You, you are enough. You are always enough. God said so, and He is smarter. Trust.

*”Be the change you wish to see in the word.” – Ghandi

Your teenage years will be a giant path of self-discovery. It won’t always be smooth. But nothing is.

Be you, and it will fall into place. And in the off chance that none of that works, I’m not going anywhere.

I love you from the bottom of my heart. You truly are the child I was meant to have, and there is NO ONE I’d rather be #beatingcowdens with, than YOU!

Happy 13th Birthday! You will always remain, “My Most Thankful Thing!”

I love you ALWAYS,

Mom

*Thanks for bringing out the best in me. I love you more than you know.*

I have nodules WHERE???

Published on August 3, 2016 by beatingcowdens4 Comments

It took me over a week to actually wrap my head around this one.

The summer is not just time for Meghan to get checked and cleaned up, it’s time for me too. And this summer I tracked down a new doctor.

Sometime around the end of April my voice started to bother me. I was getting hoarse easily. I explained it away as allergies, season change, dust, “I must be getting sick,” and everything else I could think of. Except it bothered me. And that creepy voice that sneaks in sometimes to remind me that my body has already betrayed itself once, started to take hold.

After almost 20 years of teaching, and never ever struggling to use my “teacher voice,” I couldn’t project. Simultaneously with the pain in my right implant, and the nodule being watched on the remnants of my thyroid, it started to get in my head.

I went to my primary doctor, and wasted several hours to get nothing that resembled an answer. They suggested a thyroid sonogram. I never went back.

I started researching ENTs locally. I found very few who took my insurance, and fewer who seemed to have any voice experience.

I turned to the internet and found a voice specialist at a facility I trust in NYC.

I don’t really know what I expected from the exam. I filled out the preliminary papers, and gave the basic Cowden’s rundown. They did a few tests externally with a microphone, and another with a camera in my nose. Not pleasant, but incredibly informative.

And there on the screen was a “benign appearing” nodule on the side of my vocal cords, causing them to briefly lock together when I make certain sounds. Fascinating. But bothersome all the same.

Not mine, but they looked a lot loke this. — Not mine, but they looked a lot like this.

They reassured me several times that the nodules were “benign appearing.” I appreciated that, but reminded them many of my scars are from “benign, and benign appearing” growths. I asked about the prevalence, and if it was linked to my Cowden’s Syndrome. I got a very definitive, “Maybe, or maybe not.” These nodules occur in the general population, they can be caused by overuse, but what had me perplexed was the problem seemed to start when I did the LEAST amount of teaching for the year. I was out of my program for quite an extended time between spring testing and other professional obligations. So, why now?

And, what to do? September is looming, and my life will be in the classroom many hours a day. I need my silly voice, my sing-song voice, my stern voice, my loud voice, my quiet voice, and my serious voice. Elementary school students expect, and deserve nothing less.

I was given a number for a “voice therapist.” And as of now my voice is getting a workout leaving messages for her. I asked the doctor what are the chances this “voice therapy” could control the nodules. He told me it “couldn’t hurt.” I asked if this was like giving me compression hose for my horrendous veins? Is it going to be a situation where voice therapy delays an inevitable surgery? Because any scar tissue on my vocal cords seems scarier than the painful legs I’ve contended with for years.

The answer is, there is none. I will persist and connect with this voice therapist. I will hear her out and try my best. And in 4 months or so I will follow-up with the doctor to evaluate. That is assuming the fall semester goes off without incident, and all my new students can hear me loudly and clearly.

For now, I’m using mostly the quiet voice. Often mumbling to myself. Because whether this is Cowden’s related or not, the whole “growing things” in my body is incredibly old.

Watch. Wait. Check. Recheck. Remove if necessary. That’s how we roll.