Catch-22

catch-22 is a paradoxical situation from which an individual cannot escape because of contradictory rules.[1][2] Catch-22s often result from rules, regulations, or procedures that an individual is subject to but has no control over. 

-Wikipedia

 toxicworld

You know a person could go crazy trying to keep themselves free from toxins.  These days it seems to be an all consuming, and virtually impossible task.  Sometimes I wish I knew a lot less.  Sometimes maybe ignorance is bliss.  And cheaper.  And a LOT less stressful.

But then again, I think my girl would be a whole lot worse off.  And therein lies the “Catch-22.”

Meghan has been seen by a “biomedical specialist,” (insert voodoo, witchcraft, flawed medicine – whatever makes you happy) since she was about 2.

Back in the summer of 2005 things were definitely NOT ok here.  I knew it deep down where that Mommy gut nags at you.  We had speech therapy.  We had occupational therapy.  And we had a child who had already been hospitalized twice with chronic viral infections, was not sleeping, was not playing, was not talking, and was most of the time flat out uncomfortable.  We also had a vast array of doctors who dutifully collected my Co-Pays and did absolutely nothing but tell me they “didn’t know.”

So, I read.  I researched.  I altered her diet.  I added some key supplements.  I started to see results – but not enough.

This doctor, whose office we just left a few hours ago – over 8 years since our initial meeting- got to know Meghan.  He told us he could help.  And he has.

We have worked together through dietary interventions.  Supplements.  IV treatments.  Countless blood tests.  And, when we needed it – Xrays, and guidance towards the diagnosis of “milk of calcium” of the gall bladder at age 3.5

He has been my sounding board through lots of ups and downs.  I have never, and will never take any one person’s word on what I should do for my daughter – doctor or not – but he is one of the opinions I value highly.

He had the gumption to prescribe digestive enzymes after YEARS of horrendous stool and horrific stomach aches.  “We don’t need to biopsy the pancreas. Sometimes we just need to use our heads to see what works.”  Not too often these days will you find any medical professional with that confidence or drive to do what is right.

Through the years we have visited his office at least 3 times a year for lengthy consultations.  He has suggested countless things to help aid Meghan’s immune system, her pain, her tendency towards chronic fatigue.  I have listened to many, and ignored a few.  Conversations have evolved over the years as we have each stayed up to date on current research.

The initial diagnosis of Cowden’s Syndrome seemed to bother him a great deal.  He was bothered by the ramifications of the syndrome, but also by the fact that there was no way this was “all of it.”  Meghan “doesn’t fit in a box,” he would always tell me.  Never let them try to put her in one.

And, perhaps truer words have not been spoken.  As we have navigated the world of Cowden’s Syndrome, I have been acutely aware that there is still “something else.”  But, since we are yet to put our finger on it – we continue doing the best we can.

Cowden’s Syndrome involves screening tests.  Regularly.  For cancer, and vascular malformations that can form anywhere at any time.  X-Rays and CT scans are discouraged because of radiation exposure and a fear that cells can be “tripped.”  So MRI is the test of choice.  MRI with contrast that is.  Gadolinium to be exact.

I’ll get back to why that is important in a bit.

We have spent the last 2 years especially, (but really the last 5 or so for Meghan considering the AVM in her knee was discovered LONG before the Cowden’s Syndrome diagnosis) being scanned.  In July Meghan had an MRI ordeal that involved 4,000 images, 3 hours, 2 tubes, and 3 doses of contrast dye.

We have spent the last few years dealing with a rapidly growing child whose pains seemed to be increasing exponentially.  We have gone from treating with Advil to treating with 200 mg a day of Celebrex.

We have spent the last few years trying to help her stay calm- only to watch her anxiety mount.  In September she was diagnosed with Alopecia Areata– an autoimmune condition that causes hair loss.  Fortunately for us it seems to be contained to a small area, but it is an unnerving diagnosis still the same.

We understand the role of autoimmune disease and stress, and toxins.  We understand the role that stress can play on a genetic mutation of the PTEN (tumor suppressor) gene.  We understand that there is external and internal stress.

We do what we can to control stress on the body.  We make sure she has “down time.”  We try to help her get rest.  We got her involved in swimming, a sport she loves. We make sure she eats a largely organic diet free of the foods she can not tolerate like gluten, dairy and soy.  We eliminated almost without exception preservatives and dyes.  We bought new pots and threw out the plastic plates we used to use sometimes.

We started giving her ISAGENIX, the organic superfood that is as pure as I seem to be able to find.

And even at that – there is an awareness that we can NOT control it all.  There is an awareness that by whatever mechanism that is broken, our girl does NOT detoxify properly.  We are aware of toxins in the air, in our soil, and even in our filtered water.  We are aware that her body is confused by this world we live in, by the GMOs that are even hidden in her organic diet.

GMO safety-testing

We run, like Indiana Jones, out in front of the boulder, in constant motion.  One stride ahead…

Chelation

Chelation therapy is a proven treatment for lead poisoning and poisoning from other heavy metals.

http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/chelation-therapy

The term has been spoken over and over again by the “bio medical doctor.”  Chelation is the concept I found every single excuse to overlook and ignore.  The idea  shook me to my core.

The turning point – Alopecia Areata and the words I had heard him say to me for years, “She is primed to become an autoimmune train wreck.  Let’s try to clean her out.”

toxic

She went for her first treatment last month.  After the treatment there is an 8 hour urine test to measure the toxic metals excreted.

She went for her second treatment today and I got to look at the printout of last month’s urine analysis.  So, even as I held her, and she wailed in pain, and two veins rolled before they got a good one, my resolve was strong.

There are several metals that were high.  None of that made me happy.  But the most disconcerting of all…

The reference range for that MRI contrast dye Gadolinium I mentioned earlier is <0.4.  Her output was 190.  No I am not forgetting a decimal.

Gadolinium.  Necessary for the cancer and vascular screenings set to be part of her life forever.  Except apparently her body can’t seem to excrete it.

Toxic metals

Catch-22

Keep Swimming…

 

 

Stuck in the middle

The  sermon in church this morning had many parts.  And I am never sure if what I take away is the intended meaning, but the idea of being “stuck in the middle” spoke to me.

I don’t mean it in the sense you might think.

See, we are not poor by any means.

We are not rich by any conventional standards either.  But, if you asked a person who lives in poverty – well to them we would likely be affluent.

It goes back to a concept that I think about a lot.

It’s really all about perspective.

perspective 1

There are many angles to every situation.  The angle, or the lens you choose to view it from determines the outcome, and to a large extent the path you follow.

Now, as my daughter and I live with Cowden’s Syndrome, and all its ruthless cancer causing, malformation growing, pain invoking perils, I do NOT mean that if I look at things the right way, or if I am positive enough that that is any guarantee of good health.

never give up

What I do mean is that HOW we handle, not only the illnesses we encounter, but the threat of those illnesses will largely determine who we are, our level of happiness, and the effects we have on the people we encounter every day.

We have all been blessed.  We all need blessings.

The middle can be a powerful place to be.

There are choices to be made every day.  These choices change our lives, and the lives of others.

September is Childhood Cancer Awareness Month.

childhood cancer awareness

The fact that childhood cancer even exists is appalling.  Meghan and I live with the imminent threat of cancer in this house every day.  I don’t go a single day without remembering my daughter’s namesake, my cousin Meghan taken from us by Leukemia at the age of 6 over 20 years ago.  But, we could bury our heads in the sand, or we could choose to try and do something to make people realize the number of lives touched by childhood cancer.  We can quietly hope it doesn’t happen to us, or we can help the people it HAS happened to.

Friends of mine chose the latter this week.  They scheduled a “Cookies for Cancer” fund raiser, and are donating over $1000 to childhood cancer research.  I couldn’t be more proud to call them friends.  They said we were their inspiration.  I find them pretty inspiring.

October is Breast Cancer Awareness month.

october breast cancer

I know very few people unaware of Breast Cancer.  As a matter of fact some have become sick of seeing the marketing connected with “Pink Ribbons” everywhere you turn.

Breast cancer is an ugly reality.  Mom is still fiesty, many years after her battle.  Breast cancer messed with the wrong woman there.  And me, well, my scars have healed, and I have found all the benefits to these replacements I have to the “superfluous tissue” that was trying to take my life.  I cringe when I think of my daughter, and the foreboding reality that this will be part of her journey.

Choices.

I choose to empower my daughter with stories of strong powerful women.  Those she knows and those she does not.  I choose to teach her about early detection, awareness, and victory.  Together we are empowered to TALK about our story.  The more people who hear about Cowden’s Syndrome, the more people will realize.  Lives can be saved.  Breasts, well maybe those can’t be saved – but let me tell you about the freedom of being almost 40- perky, and often braless.  I’ll bring you over to the bright side.

sunshine

Choices.

Meghan’s health has been a struggle since birth.  Our treatments for her have evolved over time.  Long before we could afford it we took a credit card and a trip to an integrative medicine doctor who is still a huge part of our lives today.  We learned that for her, pure, natural, gluten, dairy, and soy free food was as necessary as sneakers and clothing that fit.

leap of faith

Slowly we evolved into a house that ate better.  We took what we had learned about Meghan’s needs and transferred them to our own.

Except habits die hard, and in the months following our Cowden’s Syndrome diagnosis, and my mastectomy, and hysterectomy, my husband ate his way through the stress to the unhealthiest I had ever seen him.

Realizing we need him- healthy — all the time.  We connected with Isagenix, initially to help him lose weight.

www.meghanleigh8903.isagenix.com
http://www.meghanleigh8903.isagenix.com

Well he did.  Fifty pounds.  And its still gone.  And then I read and read about the company and things came together for me.  I realized everything I had learned that Meghan needed was here, all in this organic superfood.  So we bought her some too.  And then there was stamina and endurance to complete workouts in the pool.  So my husband told me it was my turn.  Nutrition, simple, quality.

Choices.

The first 10 months on Isagenix we told no one.  Then we felt guilty NOT telling everyone, about the health we were experiencing,  The first year we paid for the products, and sacrificed where we could.  Now, Isagnix pays us because we share what we have learned and experienced.

This week Meghan’s pain was bad.  So much so that she was finding it difficult to walk on Friday.  We are trying desperately to lower her NSAID medication, but her body won’t allow it.

Friday I was discouraged – and inspired.  Stuck in the middle I guess.  I was so heartbroken for her agony, and so proud of the tenacity to get into the day, and DO IT.

Choices.

They are tough to make.

We are faced with countless ones each day.

The choices we make are directly connected to the quality of the life we live.  Our desire to do the best we can with what we have, where we are – essentially defines WHO we are.

Maybe we aren’t “Stuck” in the middle, but rather placed there gently through grace.

Choices.

Perspective.

You-Are-What-You-Think1

Worn

“Worn”

I’m tired
I’m worn
My heart is heavy
From the work it takes
To keep on breathing
I’ve made mistakes
I’ve let my hope fail
My soul feels crushed
By the weight of this world
And I know that You can give me rest
So I cry out with all that I have left
Let me see redemption win
Let me know the struggle ends
That You can mend a heart
That’s frail and torn
I wanna know a song can rise
From the ashes of a broken life
And all that’s dead inside can be reborn
Cause I’m wornI know I need to lift my eyes up
But I’m too weak
Life just won’t let up
And I know that You can give me rest
So I cry out with all that I have leftLet me see redemption win
Let me know the struggle ends
That You can mend a heart
That’s frail and torn
I wanna know a song can rise
From the ashes of a broken life
And all that’s dead inside can be reborn
Cause I’m worn….

This has been the summer that… well…

It has definitely been a few extra stressful weeks, and not at all the relaxation we had so desperately hoped for and needed in June.

But, like it or not time marches on, and here we are in the middle of Labor Day weekend.

When we started the summer my daughter had 2 basic requests.

1. Go to the beach.

2. Go to Philadelphia.

Not so hard right?

And then we looked at the calendar about to change to September and realized between appointments, procedures, tests and surgery – we never got either one done.

Stress is very individual in how it affects each of us.  We all have stress.  We all deal with it differently.  But I think that the reality that stress can, and does manifest in real physical illness is often lost on us.  Especially lost is the harsh reality that stress can make our CHILDREN sick – until it smacks you in the face.

Stress1

It became clear this week that the stress is weighing heavily on Meghan.  She is one tough chick, but there is only so much the mind and body of a really cute, smart, well behaved 10-year-old should have to endure.  It is now the top priority of her father and I to actively work on lowering her stress level.

We started today.

Months ago we purchased tickets to see the Contemporary Christian band, “Tenth Avenue North” in concert in Ocean Grove New Jersey on August 31st.  We decided to make a day out of it – or a half day at least!

We let Meghan sleep as late as her body needed.  (Falling asleep has become terribly hard again.)  Then she got to watch some TV.  I ran a few errands, and around 3 with a cooler full of cold cuts for “dinner” we set out to surprise her with a trip to the beach.

We never told Meghan our plan, although it was obvious she was secretly hoping for the beach.  We just know too many factors can get in the way on a moment’s notice.  So, it wasn’t until we were looking for parking that we even told her.

By then it was 4:15.  The perfect time to take a kid who is not really sure she likes the beach, to the beach.

Crowds were waning, and as we set up our blanket she had some time to adjust to the seagulls, and the sand between her toes.

Forever my texture phobic kid, truth be told the sand in the toes was the reason I stopped really bringing her to the beach years ago.  But today there was a mission to put her toes in the water and collect shells with Mom and Dad.

beach day 3

She walked with Mom.  Then she walked with Dad.  And for a few glorious minutes I laid my head on the towel and remembered my childhood days in Ocean City,NJ.  I listened to the waves, felt the sand between my toes, and felt such PEACE!

Don't hate my polka dots - my husband did them for me! :-)
Don’t hate my polka dots – my husband did them for me! 🙂

We have a small bag with some beautiful shells.

We even played some with her Nerf frisbee.  There was laughing, and smiling, and a good deal of stating and restating that the sand on her toes does NOT feel nice.

With some gentle prodding she came around, but was perfectly happy with 2 cool hours on the beach.  So glad I didn’t get a full day plan in place!

beach day 4

What we did NOT do was have a picnic lunch on the beach as planned.  Instead, we ate in the car.  Sea gulls, being nothing more than glorified pigeons would have undoubtedly created significant reflux for my girl.  So, we had Board Head chicken breast in the car, with potato chips, and had a great conversation – minus the sea gulls.

We walked the streets of Ocean Grove for a bit, and I saw the sign:

troubles and blessings

And somehow I knew we had done things right – today.

We headed over to the Great Auditorium for the concert.  We happily bought our girl her first concert T-shirt, and her “Tenth Avenue North” Bracelet.  In-scripted inside the bracelet are words from the cover song off their newest CD, “The Struggle.”  It reads, “We are free to struggle, but we’re not struggling to be free.”  She is sleeping with it on right now.

beach day 6

The show was amazing.  Meghan was enthralled.  They are quite the performers.

Meghan and I often sing along to their songs on the radio.  Our favorites are “Worn,” and “Healing Begins”

“Healing Begins”


So you thought you had to keep this up
All the work that you do
So we think that you’re good
And you can’t believe it’s not enough
All the walls you built up
Are just glass on the outside

So let ’em fall down
There’s freedom waiting in the sound
When you let your walls fall to the ground
We’re here now

This is where the healing begins, oh
This is where the healing starts
When you come to where you’re broken within
The light meets the dark
The light meets the dark…

The lead singer also spent some time talking to the audience about God’s plans.  He told the story of a car accident his Senior year of High School where everyone thought he would die, and no one thought he would recover fully.

That 32-year-old man with a wife and 2 daughters spoke definitively tonight about believing God will use the adversity to grow greater things.  He told us he touched a guitar for the first time at 18 while he was waiting to heal from his accident.  Clearly, God had a plan.

I was touched by the story, but more moved by Meghan’s reaction.  She HUNG on his every word. She was thinking – deeply.

Then she asked if I had any of the “Cowden’s cards.”  And, God bless this girl she walked right up to the stage and handed them to one of the back up band members… alone.

“I just thought they should have them Mom, in case they want to read…”

This card was created out of her need to "teach" others about Cowden's Syndrome.
This card was created out of her need to “teach” others about Cowden’s Syndrome.

You know the irony with this darned Cowden’s syndrome is that what you NEED is to be away from doctors, because they cause STRESS which prompts other conditions that cause you to NEED doctors.

So, a few days after the hand became free, we are on the hunt for the solution to more developing problems.

Stress.  We do what we can to deal.

We use music.  We enjoy time together.

We try harder to get it right.  We hug each other.  We hold each other.

I still haven’t given up on a road trip to Philly.  (If only I can get my navigation system to work…)

I Know Why The Caged Bird Sings

I Know Why The Caged Bird Sings

The free bird leaps
on the back of the wind
and floats downstream
till the current ends
and dips his wings
in the orange sun rays
and dares to claim the sky.

But a bird that stalks
down his narrow cage
can seldom see through
his bars of rage
his wings are clipped and
his feet are tied
so he opens his throat to sing.

The caged bird sings
with fearful trill
of the things unknown
but longed for still
and his tune is heard
on the distant hill 
for the caged bird
sings of freedom

The free bird thinks of another breeze
an the trade winds soft through the sighing trees
and the fat worms waiting on a dawn-bright lawn
and he names the sky his own.

But a caged bird stands on the grave of dreams
his shadow shouts on a nightmare scream
his wings are clipped and his feet are tied
so he opens his throat to sing

The caged bird sings
with a fearful trill
of things unknown
but longed for still
and his tune is heard
on the distant hill
for the caged bird
sings of freedom. 

Maya Angelou

 

I am sure this is not what Maya Angelou had in mind.  And really for the safety and sanity of my friends and family, I don’t sing – ever.  Yet the phrase about the caged bird keeps running through my mind.

Being caged is an illusion in some respects.  I have a beautiful house, and a lovely family.  We have two cars that work sometimes, so we do have access to the outside world.

Yet sometimes life with Cowden’s Syndrome can make you feel caged.  It takes away the freedom, the ability to go as you see fit.  It robs you of the carelessness that should be an inherent part of a 10 year old’s day.

And even as some days I want to cry with frustration – my young caged bird continues to sing…

caged bird

This is the summer of irony.  All over the place and in our faces.

Not lost on us are the numbers of family and friends whose privacy I respect too much to mention, but whose lives are upended, and who are in their own right “caged birds.”

All summer we sat at doctors.  One after another.  Hours upon hours upon hours.

Now- we don’t have any appointments.  But the broken wing- the wrapping on her hand and the stitches prevent us from getting too far.

The hand has to be elevated with a Carter Block, until the stitches come out Thursday.  Then we can talk about resuming therapy.  Today the calendar is empty.  The sun is shining.  And here we sit.

Not exactly alike - but you get the idea
Not exactly alike – but you get the idea

The pool is crystal blue under the bright sky.  Taunting.

I can take her out but if we go too far, or do too much, the throbbing begins again.  Maybe we will make a quick trip somewhere just to get out.

I have a million things to do.  No shortage of work to keep me busy.  But, I can’t seem to get anything done.  Irony.  You want and want for time to get things done, and then… it’s like I developed a full blown case of ADHD.  I can’t keep up with my mind, and the list just grows.

If I take responsibility, some of this feeling comes from my general lack of spontaneity.  I am a planner.  Much to my detriment.  I long to be the one who just gets in the car and goes.  But even though I struggle with this and try to gain a glimmer of impulsive behavior, the reality of our lives seems to tether us close to home.

Allergy meals are tough to come by and can’t be taken for granted.  Food and enzymes must be planned….The consequences are dire and painful.  I won’t take the risk.

So, here we sit.  God bless her, and her patience as she alternates reading, TV, and playing with the iPad.

I am working on laundry and the floors, and cutting some 100s charts out of laminate for school.  Always moving, and accomplishing precious little.

I am breaking out into a cold sweat as I schedule our next round of appointments.  What a feat.  Distressing, disturbing, necessary waste of time.  I have about 8 scheduled for us from December to February already.  And a few others sprinkled in for good measure.

worry 2

We see the doctor on Thursday.  She should get some freedom then.  Just in time to set up my classroom.

Maybe I will just open the cage long enough to sit on the deck, or take her for a walk around the block.

Have to remember the little things, because they really are the big things, right?

the-little-things

Staying focused…

When Pigs Fly

Penelope
Penelope

At the very end of school I received this gift from a 4th grade student of mine.  I think it is probably one of my favorite gifts in my 17 years teaching.  Small and delicate, yet tough and determined.  Not much for collecting things, but this was a keeper.

Meghan continues to battle her way through the pain of recovery.  She rests and reads and watches TV to pass the time.  She is tolerating the pain a bit better, although the reality there was a scalpel scraping scar tissue off the ligament and nerve in the center of her palm is not lost on her every few hours as the medication starts to wear off.

The day we came home I explained to her (again) about how Cowden’s Syndrome likes to “overgrow” things.  We talked about “hyper-healing,” and her body’s desire to overproduce cells to try and solve a trauma.  That is a crude explanation of our tumor growth.  That same crude explanation can be used to explain why some Cowden’s patients have a prevalence of scar tissue.  Every time there is a surgery, or an injury the body over works, and sometimes the result can be just as bad as the original problem.

pigs fly

Overcoming impossible odds.  I like the way that sounds.  The overcoming part, that is.

So, we talked about range of motion and the need to keep on moving those fingers so the scar tissue doesn’t form and stiffen things up.  She knows she will need therapy.  She is used to that.  She did not like the thought that her range of motion could be affected permanently if she didn’t move.

With raw determination she wiggles her fingers.  Several times an hour I watch her wince in pain.  No one tells her to.  She just knows she has to, and she doesn’t like the thought of the alternative.

See its all about the swimming.  Her sport.  Her niche.  Her comfort zone.  Nothing will keep her out of the water for long.

The pain exhausts her.  She has circles under her eyes, not from doing much other than being in pain.  But for those of you who live with chronic pain – you know that it wipes you out.  So she sleeps.  13 hours when she can.  Better for the healing I am sure.

When I was dusting this afternoon I came across my friend Penelope Pig, and I thought of how relevant she is.

I thought of all the times in my young life I uttered sarcastically the phrase, “When pigs fly!”

I thought of my arrogance and how little I knew about the important things on life – the things worth fighting for.

I realized in all its ridiculousness, it can  actually be a poignant phrase.

I’m going to let this surgery stand in my way – WHEN PIGS FLY!

I’m going to stop swimming – WHEN PIGS FLY!

It fits for so many things in life.

So many other things on my mind.  So many thoughts all garbled up inside.

Sometimes I feel like we are running on raw nerve, on sheer will and determination.

And guess what – we will give up….

WHEN PIGS FLY!

when_pigs_fly

 

Future Doctor, Meghan

If they would just listen to Meghan.

I mean really listen, and stop dismissing her.

Since before she could talk we have been working to help this kid become more aware of her body.    She can troubleshoot what works for her.  She can tell me what foods and medicines help her or hurt her.  Every day she becomes more keenly in tune with herself.  Its necessary.  That is how we keep her healthy.

My heart always gets heavy for my friends whose children, despite everyone’s best efforts can not articulate their needs, pains, desires, or emotions.  Those are the situations where doctors might miss something- even if they are trying.  Those poor children might suffer needlessly if no one can determine the source of their discomfort.

But not Meghan.  If you will listen.  She will tell you.  If you pay attention.  You will understand.

If she hurts- the whole world might know.  If she doesn’t hurt anymore, even 5 minutes later, its like it never happened.

That’s it.  Plain and simple.

So when she hurt her hand June 4th, I kept waiting for it to get better.

I played tough for a few days, but it still hurt.

Then we tried ice, heat, brace, no brace, different brace – but the pain persisted.

Dr. Jill, our Physical Therapist kept saying, “I think it’s vascular.”

Meghan kept saying, “It pulses like my AVM.”

And on we went – to the vascular surgeon, for the MRI/MRA, to the orthopedist, to the local hand surgeon.  Each one finding a reason to dismiss her, and this pain that persisted.

Pain doesn’t persist.  Not like this.  Not with her.

And, when you have Cowden’s Syndrome, any pain that persists more than 10 days consistently really should be evaluated.  You never know where those tumors may grow.

But the MRI, the three hour MRI with 4,000 images was negative. (Although I still have my doubts.)

And, Meghan calmly told the vascular surgeon she thought it was an AVM.  He said no.

As the pain mounted over the weeks that followed, and we bounced through other routine follow ups that seemed to swallow up our summer, Meghan took solace in Dr. Jill.

You can’t put anything over on Dr. Jill, but she knows kids, and she knows Meghan.

“Look at this,” she said to me.  “It has its own blood supply.  That’s why it stops hurting when she puts pressure on that mass.  She is cutting off the blood supply.”

watch me

Meghan would smile, knowing she was understood – at least by someone.

“Vascular pain goes up the arm, orthopedic pain doesn’t,” she would almost  mutter to herself.

And I knew if they were BOTH sure, then I was sure they were right.

I emailed her oncologist, and her genetecist.  I sent them pictures.  “Biopsy those,” I was told in no uncertain terms.

So Dr. Jill wrote a detailed professional letter to a local orthopedist.  I am still not sure he understood all the words.

Then there was the local hand surgeon, who read the letter, and just spent the visit looking perplexed and bothered.  The MRI report was negative, his Xray was negative, and there was this bump below her middle finger.  He sent us away – apologizing for not helping, but convinced there was no need for surgery.

That was the day Meghan coined the phrase “Donkey Butts!”  And I couldn’t blame her.

donkey-butt 2

I went right home from that visit and sent a desperate EMail to the oncologist again.  This time I asked for a referral.

She is a woman of few words.  Her reply was a link, and the words “Go here.”

hand 2

So, I called and made an appointment.  They took our out of network benefits.  We got in the day before vacation.

He looked at Meghan.  He talked to her.  He sent her for more Xrays.  They were negative.  Then he looked at her hand again.  He told her that he knows all about kids and how well they know their bodies.  He told us he treats a few boys who grow bone instead of soft tissue tumors.  He told her that the boys ALWAYS know where the problems are.  She brightened.

Then he drew a very logical picture of the hand, and traced out the main ligament and tendon.  He showed the connection from the soft tissue tumor to the painful wrist spot.  He let her feel it, and he told her she made sense.  She smiled a huge smile.

Finally a doctor who DIDN'T remind me of this one!
Finally a doctor who DIDN’T remind me of this one!

The he said to us that even though the Xray is negative, sometimes surgeons have to use their heads.  Clearly the tumor on her hand was causing trouble.  Clearly it had to come out.  Exactly what that would mean once he got in there would have to remain to be seen.  Relaxed and encouraged that someone was using their head, we scheduled the procedure and left for Disney.

Disney had its ups and downs, and one of the struggles was the frequent hand and wrist pain. Meghan is in pain so often, she can differentiate between the chronic pain, like her hips and knees, and the pain that she can’t stand, like her wrist and hand.  Chronic pain is absolutely exhausting.

Today was the surgery.

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We went to a LOVELY outpatient facility on 42nd Street.  The place was clean, the reception was smooth and effortless.

The nurses were darling, every one of them.

The anesthesiologist instilled comfort, and the surgeon, Dr. R was warm and calming.

The procedure lasted longer than I expected – almost an hour and a half.

time-warp

I wasn’t surprised to hear the words that have become normal. “It wasn’t exactly what I imagined, but I am pretty sure I got it all.”

A soft tissue tumor, with roots, AND an AVM (arteriovenous malformation) with its very own blood supply!

So many thoughts went through my mind – including, “SHE KNEW IT ALL ALONG!,”  and “THANK GOD FOR DR. JILL!”

I was grateful for Dr. R, his patience, his trust in Meghan, and his ability to get it done.  I was also instantly tossed into a new level of worry.  See, all along they have been insisting the AVM in the knee was an isolated incident.  I shouldn’t worry about more cropping up.  Well one just cropped up.  Game changer.

I was thinking about the rock wall she climbed June 4th, and even after all this turmoil, I am still glad she did it.  Although we now almost undoubtedly know that the AVM was under the surface all along, and the bruising her hands took caused her body to “hyper heal,” and likely led to more blood being pushed towards the AVM.  The soft tissue tumor erupted some time later.

While the exact sequence of events doesn’t matter, a few things do.

Meghan and Dr. Jill are really intuitive.

AVMs can take place in multiple spots.

Dr. R had to scrape the scar tissue off the ligament, and tendon and nerve in the hand.

Meghan will need quite a bit of therapy (after 9 days of keeping the hand wrapped) to get her mobility back.

I absolutely can not wait to get the pathology report and share it with a few doctors who blew off my girl.

And, most importantly – NEVER DOUBT MEGHAN!

meg doctor kid

It Never Gets Easier

They say “practice makes perfect.”

I disagree.

No matter how many times we practice this scenario, for surgery, for biopsies, for tests- it is no easier now than it was the very first time.

And boy have we had practice!

This morning, as Daddy walked with her to the operating room,(our routine firmly in place – Daddy does the OR and Mommy does any overnight stays) I was still struck with the distinct feeling that I had been kicked in the stomach with a large pair of steel tipped boots.

This one should be ok. 9 days wrapped and dry. Stitches removed, and we should see progress.

As long as…

Well now we fidget and pray and keep busy. There will be time for the rest.20130820-090603.jpg

Manatees, cell phones, and hidden blessings

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There was a moment yesterday when I thought seriously about dropping my cell phone into the tank with the Manatees and walking away. It had rung twice in the last 30 minutes. The  first brought news that my husband (yes, the not PTEN affected one) needed to go back in for further testing of some skin issues. The second call was to put the car claim on hold.  They won’t arbitrate until the field tech services the car.  I do hope he brings his magic wand. This was supposed to be vacation. And a respite from the cares and worries I had left miles behind. My mother graciously agreed- again, to live at my house and care for my dogs, even though she is in dire need of a rest herself. As I felt my blood pressure escalate, I held on to my phone. I thought slowly and deeply. I turned the phone off and tossed it in my bag. We had waited too long for this… This morning I woke up early all by myself. I rode to the Magic Kingdom alone. I spdone some time readjusting my head. I rode Space Mountain alone. Haven’t been near that ride since 2000. But heck, if I can Beat Cowdens- I can do anything. So I did. And the day continued just fine as we prepared for the anxiously anticipated archery lesson. There were times when things really stunk over the last few weeks, we would talk about this archery lesson. And then, as it will often do in Florida in August- it rained. It was one of those bone soaking thunder and lightning storms that come out of nowhere at exactly the wrong time.   And just like that archery was cancelled. Quite aware that I am supposed to be the grown up in such things- I did the mature thing. I cried. Tears if frustration for weather out of our control. For circumstances that couldn’t be changes, and for yet another disappointment  for a child who has had way more than her fair share. But, as God so frequentdie does, He heard my desperation. Something that could seem so silly if you didn’t know the back story- yet another blow to our shaken cores. And then. The supervisor, and one if the instructors, pulled us into a back room and for 30 minutes gave Meghsn a 1:1 lesson of the basics of archery. She held the bow- just never shot it. And, maybe with that soft tissue tumor it was for the best. Grateful we headed back to meet my very dear childhood friend and her family for dinner. The conversation was light. Relaxed and fun. The kids were excellent, and we ended the night at the Main Street Electrical parade. Blessings abundant. Maybe we will appreciate them even more because we have to look extra to find them. Yet- they are always there. I decided to keep my cell phone. But now I turn it off for large parts of the day. I figure the manatees wouldn’t like Candy Crush anyway.

Rare. Invisible. Real.

Those are the words that come to mind every time someone asks me to describe Cowden’s Syndrome.

Most people, even most doctors, understandably, have never heard of it before.

With an occurrence of 1 in 200,000 that is not a surprise.

There is always hope...
There is always hope…

What is a surprise is on days like today, where the sun shines a bit brighter.  The traffic is a little lighter.  Daddy is home on vacation.  And, we met a doctor who had heard of Cowden’s, understands it, and is compassionate, likable, and easy to talk to.  Yep, imagine that?  A POSITIVE experience!! 🙂

We saw an NYU affiliated hand surgeon today.  I am sure God heard the chorus of prayers storming Heaven for an answer for this kid, and today He delivered.

NYU

We were early for our appointment and waited in an uncrowded waiting room, while a pleasant receptionist organized the paperwork.

We were taken promptly at our scheduled time.  We met with a friendly, competent PA.  She had the hands Xrayed.  The doctor was in the room 10 minutes later and immediately had Meghan on his side when he started to talk about two of her favorite things – Disney and swimming.

competition_pools

He examined her hand.  He easily recognized the soft tissue tumor that is typical in Cowden’s Syndrome.  He told her stories of another young boy he treats with a rare disease who grows bone instead of tissue.  He validated her.  He was confident.  He drew a picture, and explained why that tumor was causing pain.

With every word he spoke her smile grew.  The hope went back into her eyes.  She waited anxiously for him to tell her he was going to take it out.

She almost leaped up and cheered.

happy girl

August 20th in the early morning hours. my then 10 year old will prepare for her 10th surgery.

That’s how you know a kid is at her wits end.  When surgery is an exciting option.

He told her it wasn’t going to be better right away.  He asked if the PT from the letter we showed him (you know – the PT who had it right ALL ALONG! 🙂 could rehab her hand.  I told him I was quite sure she could, but I would ask. (Actually – I have no DOUBT she can do anything.  Dr. Jill NEVER gives up on Meghan!)

He said the pain may be worse for a bit after he “messes around” in there, but that gradually she will feel the pain lift and the range of motion return.  I wanted to hug him.

All it takes is someone who “Gets it.”

We all want to be validated.  As adults we often struggle to have our concerns made valid by those we love.  When you have a rare disease, where the symptoms are often invisible, you struggle to be taken seriously.  People are quick to pass judgement.

She looks fine, why can’t she walk?  She must be lazy.

She is complaining again?  Attention seeking,

So when you are just trying to have your voice heard, at the same time that you are trying to find your voice -life can feel extra challenging.

Cowden’s Syndrome is a struggle.  We are buoyed by the fact that we have each other.  I have Meghan as my inspiration, and she has me as her advocate.

I will NEVER give up.  She will continue to get the care she needs.  She will continue to see doctors who validate her.  She will continue to inform an under informed public with her “cards.”

She is my heart and soul, my sunshine.  She deserves nothing less.

sunshine

We can’t change the “Rare.”  The “Invisible” or the “Real.”  But we can open the eyes and hearts and minds of more and more people every day.  Ours is one of so many other Rare Diseases.  We are grateful.  We are blessed.   Even through our pain we have gratitude for our blessings.  And we will move forward with our mission of awareness.

Cowdens information card

 

 

I don’t know anything about “Cowden’s Syndrome…”

After last night’s late night strep diagnosis, there was no way I could send her to Bible School this morning.

But, I had an appointment with the breast surgeon – a routine follow-up that I knew would take 5 minutes.

(That is why I had scheduled it July 16th when I was ALREADY IN the city- but last-minute doctor vacations are just one of the many inconveniences of life these days.)

I knew it would take 5 minutes – after I drove through an hour and a half of traffic, parked the car, walked a half mile, and waited to be called.

traffic

Truth be told it was lest than 5 minutes.  A three-minute groping of my silicone implants and surrounding lymph nodes.  The proclamation was made that everything looks “great” and I should return in 6 months.  I actually was probably dressed and on my way before 5 minutes were up.

fake boobs

But, I HAD to go.  It would have been too easy to cancel.  It would have been too easy to blow it off.  And what if?  What if that one renegade cell…  Nope, I HAD to go.

And, Meghan had to come with me.  She trekked like a trooper to the main hospital to get another copy of the CD of the MRI of her hand for the orthopedist appointment at 2:30. Then, we traveled on the journey to the Clinical Cancer Center.  I had to push her in the push chair today.  The strep was knocking the wind out of her this morning and the hips and knees were bothering her.

push chair

It was also bothering her that people were staring at her.  So it was a great opportunity to give her LOTS of really LOUD pep talks.  I hope a few people overheard.  Some people are really dumb.  Others mean well – but for goodness sakes, don’t just stare at the child.  Say “hello,” “good morning,”  ANYTHING… UGH!  But anyway…

And after the 5 minute appointment there was another hour in travel time back home.

time-warp

Just in time to let the dogs out and run to pick up some chicken breast cold cuts for her to eat before physical therapy.

As she inhaled the chips and chicken I spoke with the therapist.  I am always just so impressed by how smart she is, and how much she actually cares about Meghan.  She took the time to READ about Cowden’s and to try to understand WHY and HOW the small fatty masses on her palm are affecting her.  If only there were more…

Right after therapy it was off to the orthopedist looking for a few answers about the hand and the wrist.

That’s where things unraveled.

Ok.  I understand it’s a rare disease.  I do.

I get that with an occurrence rate of 1 in 200,000 you may not have touched on it in medical school.

rare-disease-day-feature

But, you insisted on the paperwork completed online a full 10 days before the appointment.  You could have read it, or had someone flag it.

And, I made the appointment with the doctor who had been prepped already.

Bait and switch?

The orthopedist today was amazingly young.  I guess the big 4-0 is approaching fast, because I could scarcely believe he was out of medical school.  Everyone seems to be looking younger and younger.

No need to remind me of what that implies.  I get it.

We have seen LOTS and LOTS and LOTS of doctors.  MOST would rather make something up than admit they didn’t know something, which is a problem in and of itself.  Not this guy.

He examined her hand.  Validated the pain.  Looked at the MRI report.  Declared there to be “nothing orthopedic” about her problem.  And then he said,

I don’t know ANYTHING about Cowden’s Syndrome, so you’ll have to tell me what it is and what it does.”

Cowden's Syndrome

I almost asked him to repeat himself, but that would have just been to buy me time for my response.  So, as I was gathering my bags and looking to exit as fast as I possibly could, I gave him a brief lesson on Cowden’s Syndrome.

This doctor was far younger than me.

This is the technology generation.

Step out of the room and hit google.com

The first link is this one http://ghr.nlm.nih.gov/condition/cowden-syndrome

What is Cowden syndrome?

Cowden syndrome is a disorder characterized by multiple noncancerous, tumor-like growths called hamartomas and an increased risk of developing certain cancers.

Almost everyone with Cowden syndrome develops hamartomas. These growths are most commonly found on the skin and mucous membranes (such as the lining of the mouth and nose), but they can also occur in the intestine and other parts of the body. The growth of hamartomas on the skin and mucous membranes typically becomes apparent by a person’s late twenties.

Cowden syndrome is associated with an increased risk of developing several types of cancer, particularly cancers of the breast, a gland in the lower neck called the thyroid, and the lining of the uterus (the endometrium). Other cancers that have been identified in people with Cowden syndrome include colorectal cancer, kidney cancer, and a form of skin cancer called melanoma. Compared with the general population, people with Cowden syndrome develop these cancers at younger ages, often beginning in their thirties or forties. Other diseases of the breast, thyroid, and endometrium are also common in Cowden syndrome. Additional signs and symptoms can include an enlarged head (macrocephaly) and a rare, noncancerous brain tumor called Lhermitte-Duclos disease. A small percentage of affected individuals have delayed development or intellectual disability.

The features of Cowden syndrome overlap with those of another disorder called Bannayan-Riley-Ruvalcaba syndrome. People with Bannayan-Riley-Ruvalcaba syndrome also develop hamartomas and other noncancerous tumors. Both conditions can be caused by mutations in the PTEN gene. Some people with Cowden syndrome have had relatives diagnosed with Bannayan-Riley-Ruvalcaba syndrome, and other individuals have had the characteristic features of both conditions. Based on these similarities, researchers have proposed that Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome represent a spectrum of overlapping features known as PTEN hamartoma tumor syndrome instead of two distinct conditions.

Some people have some of the characteristic features of Cowden syndrome, particularly the cancers associated with this condition, but do not meet the strict criteria for a diagnosis of Cowden syndrome. These individuals are often described as having Cowden-like syndrome.

Read more about Bannayan-Riley-Ruvalcaba syndrome.

How common is Cowden syndrome?

Although the exact prevalence of Cowden syndrome is unknown, researchers estimate that it affects about 1 in 200,000 people.

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Was that so hard?  Meet me half way people.

It’s still hard for me to believe that cost me a co-pay.

Let’s see if the hand surgeon on Thursday can offer us something better.

Or maybe the rheumatologist will actually call me back.

Taking bets?

Every day is a great adventure!

Exhausted