Finding my “Happy Thought”

It was a few months ago.  I can’t quite recall the date.  It wasn’t my finest hour. (or day, or days…)

I was grumpy.  Worried.  Angry about the struggles my girl was being forced to endure.  Twisted about a future of doctors appointments and surgeries.

I had noticed she seemed extra down, and I took it as my cue to worry harder.

At some point, I broke down, expecting a clear answer to the question, “What’s wrong?” so I could continue the business of worrying some more, and searching for answers.

But the answer wasn’t even close to what I expected.

“Mom, you need to find a “Happy Thought” because you being like this all the time is really affecting me.”

Neverland happy thoughts

Um, ouch.  Wow.  And she sure told me.

She wasn’t being disrespectful in the least.  We have worked on honest speech and clear language, for survival – and to help us prep for the teen years.  She was doing exactly what I asked of her.  She was telling me what she was thinking.  And she was right.

Years of parenting a chronically ill and allergic child have left me in a permanent hyper-vigilant state.  The “other shoe”  has been known to drop without warning, and there is a constant need to search, study, learn, and discover whatever I can about whatever is plaguing my girl.  I am her advocate.  I am her voice.  We have between us undergone at least 17 surgeries in the last 11 years.  That doesn’t include countless hospital stays, tests and procedures.  There is always a pile to contend with, whether its bills to fight or file, prescriptions to order, reports to hunt down or appointments to make.  Life is very busy.

Neverland-HOOK

There was a time I used to walk for fun.  Hours on end with my music in my ears.  I would walk for miles.  I would walk everywhere.  There was a time I would read for fun.  Not medical books.  Just leisurely reading.  I used to watch “Law and Order.”

Now between working full-time, parenting full-time, chauffeuring to appointments, trying to make swim practice, keeping food in the house, keeping some semblance of order, including clean laundry, clean curtains, and clean cabinets – it was easy to get swallowed up by obligation and forget the joy in my life.

To be quite honest with you, there isn’t much I would change.  Do I sometimes miss those long carefree walks?  Definitely.  But, would I for one second trade one bit of my beautiful, tenacious, funny, stubborn, intelligent little girl?  Not a chance.

Hook movie

We watched “Hook” a few months back.  It was a rare occasion when I sat to watch a movie.  It is one of my favorites.  And for those of you who might not be familiar, it’s a “Peter Pan” spin off where Peter ended up all grown up – a lawyer.  He forgot his magical youth, and the story takes him back to Neverland to find it again.

I am sure this is where she got her admonition for me to find my “happy thought,” as Peter needed his to remember how to fly in order to beat Captain Hook.

I thought and I thought, long after she had said the words.  I was tempted to compare myself to other adults, and justify my grumpiness.  But I resisted the urge.  These words weren’t spoken to another adult.  They were spoken to me.  And what a gift she had given me.

peter-pan-best-quotes-sayings-faith-trust-good

Transformations don’t happen over night, but I have forced myself to become aware of the things that give me pleasure.

I love to write.  And so I have been trying to give more attention to my blog.  Therapy on a keyboard.

I have taken my feet instead of the car wherever I can, and wherever time allows.  I can’t walk for hours, but I can appreciate the short walks and relish them more.

I am realizing that a happy Mom is some of the best help I can give.  I won’t know all the answers.  I can only give her the same honesty I ask of her, and I can only do my best.

And while we focus on being positive, and its something I ask of her all the time – it’s not fair to ask it and not model it.

So we are all a work in progress.

And when I really soul search for what makes me happy, my pleasure really lies in seeing other people happy.


I am constantly telling Meghan that Cowden’s Syndrome does not define us.  But, in fairness, actions speak louder than words.

It’s been months since I was told to find my “Happy Thought,” and I hope I never forget that day.  While we still have our ups and downs it serves as a reminder for me that I am no good to those I love unless I find happiness myself.

Meghan and Felix – they will always be my happiest thoughts.

But I love my family, and God, and exercise, and nutrition, and cool breezes and music, and flying birds, and summer…

I strongly encourage you to find your “Happy Thought.”  It’s tough to start looking when a 10-year-old calls you out.

Loving my heart - outside my body- my biggest happy thought.
Loving my heart – outside my body- my biggest happy thought.

Portrait of Courage

You-Are-What-You-Think1

We have a short window of time from the point we meet someone to make an impression on them.

Think about it.  It happens all the time.  You pass by countless people, on line, in the grocery store, the receptionist at the doctor’s office…  And often, within moments you either remember a rude interaction, or you forget that they even existed.  The brain has to protect itself to some extent.  We can’t remember everyone.

But then there are some people you can’t forget.

I met her in the jewelry store a few months back.  I was buying a bracelet for my girl on a particularly tough day.  We struck up an easy conversation.  She was young, bright, and articulate.  She was friendly. She asked about my daughter and I shared.  I explained Cowden’s Syndrome and some of our most recent endeavors.  Then she nonchalantly told me she was a cancer survivor.  Melanoma she told me.  She was 22.  She told me she planned to be a teacher.  I imagine she will be a great one when it’s time.  At some point I brought up our trip to Disney, and how it might be time to take a break, and save some money.  She told me – wise beyond her years – that the bills will always be there.  Go.  Enjoy.

hope and spoon

Wednesday night I went into the jewelry store again.  I struck up an easy conversation with another employee.  I wanted to get a necklace repaired for Meghan.  It had a “hope” ribbon and a spoon.  She asked about it and I explained again about Cowden’s Syndrome, and the Spoon Theory.  When she brought me the necklace she wouldn’t take any money.  Instead, she offered me a “pay it forward” opportunity.  She showed me a “gofundme” page on her iphone.  She explained that this young girl, now 24, was battling stage 4 malignant melanoma, and if I felt so inclined, I could contribute there.

My heart began to race.  I recognized this girl.  She was the one, the cancer survivor who had helped me months prior.  I asked a million questions, rapid fire.  The kind woman answered them.  I was stunned.  A melanoma survivor, she found a lump a few months ago, which led to a CT and PET scan, and the determination that the melanoma had spread.  There will be treatment.  She is tough.  She will fight.

24 years old.

My sister is 25.  My brother is 25.  My cousins are right about that age.  They are all at various points of setting up their lives, not fighting for them.

She could have been anyone.  This girl in the jewelry store.  But she was dynamic.  Because apparently that is who she is.  She is the person that sticks with you.

Read her story here. http://www.silive.com/sports/index.ssf/2014/06/college_of_staten_island_to_ho.html#incart_river

And if you are so inclined, do what you can to help.

be the change

That is a conversation Meghan and I have all the time.

Life is not easy.  It is often unfair.  Frequently she feels like crap, and always she seems to hurt.

Yet, I tell her all the time, you have a short window where people will make a judgement about you.  It’s not fair either, but it’s true.

And when you live your life chronically ill and/or in pain, you may sometimes feel like you have to lie.

But I am helping her find the balance.  Ways that she can still be honest about what she’s going through, and say what she means, with an upbeat delivery.

i am one

Meghan has been blessed with a beautiful elementary school experience that spanned  6 years and 2 schools.  And although we elected to change schools at the very end of fourth grade, she can reflect and see the positive experiences gained in both places.  It seems everything happened as it should.

And in third grade, one of the roughest years of her life, she was met with one of the most compassionate women I will ever know.  A gifted teacher who cared so much more about the child than the curriculum.  And this year, when there was loss, deep loss, and surgery, and more major struggles there were several excellent women in her path as educators, and sources of strength.  And again, there was one with a sick child of her own, who just “got it” from the beginning.  My gratitude knows no limits.

to teach

Today we sat for a beautiful moving up ceremony.  Everything was perfect.  The length and content of the ceremony carried out through the careful precision of true professionals.  The children were calm and well-behaved.  Everything was smooth.  They all made it look easy, but I know all too well that its not.

Thirty years ago I walked across that same stage.  Today a lot of things came full circle, and after 17 plus years of teaching in my school, I sat in the seat of a parent, and I could not have been more proud.

She received two medals for school service, and she was beaming.  Then they called her name for the “Portrait in Courage” Award.  And the tears flowed.  Mine – not hers.  So touched by the time it took to match my child with an award that was a perfect fit.

See I always knew she had courage.  And I think most people who meet her would never deny it.  But lately, struggling with the pain, there have been some dark days.

couraqge 1

So we talk alot.  And I hope and pray that my words get through.

I tell her what a gift she has, that people view her has positive, and courageous.  I tell her that just because I happened to agree doesn’t mean the responsibility ends there.  When people view you this way, they look to you.  They feed off of your energy.  You inspire them to be better people.

It doesn’t mean you have to be positive all the time, because we all have our days – but it means most of your work has to be upbeat.

Today she hurt.  As she always does.  And I could see it.  But she never said it.  Tonight I felt her knee, and that all too familiar pulsing seems to be finding its way back.  She asks me not to hug her.  Especially in the morning – because my touch hurts.  There are dark circles under her eyes.  But we went out all day today, as a family.  And she was amazing.

She held that plaque in her purse.  She wore her medals.  She smiled.  She looked people in the eye.  She spoke.  She lit up rooms.

Danielle, from the beginning of my story, has never met Meghan.  Yet to me there are so many similarities.  I told Meghan all about her.  She gets it.  She gets a lot of things.  And as I struggle to help her find the gentle balance at 10 years old, of being positive and honest – I see role models for her in our small community.

“Portrait of Courage” indeed.  As her teacher said, she has endured more in her first decade of life than most, and is a force to be reckoned with.

meg awards

For Meghan, for Danielle, and for the others who we cross paths with every day – you inspire.  You lead by example.  You ARE changing the world.

Thank you.

Groundhog Day

“Groundhog Day” – who doesn’t remember the movie?  There have been plenty of days I have thought of it.  I may need to watch it again soon.

Groundhog_Day_(movie_poster)

Pediatric Endocrinology is a ridiculously small sub specialty.

There is this web of interconnections, and all sorts of people who have lost sight of the patient.

web

Ultimately I may need to head out-of-state to try to get a clean opinion.  But, I have to take that and so many other things one step at a time.

But, after the travesty on Thursday, I was left with little choice but to keep me appointment with the surgeon at our current hospital.

You remember the surgeon?

He’s the one who did a great job on the surgery.  The one who said, when we went for the follow-up, that he only needed to see her ever again if she felt anything in her neck.  And when she did feel something in her neck I had to jump through 12 hoops to convince him he should see her.  And then when he saw her, he proclaimed the lump a salivary gland and told us to return “one more time” in a few weeks.

But then there was that horrendous week in the hospital.  And while she was being treated for gastritis, a hematologist felt her neck and said, “It’s a lymph node.”  So they sent her for a sonogram which said it was a lymph node.

So when we went back to see the surgeon and brought him the sonogram report he got annoyed and ordered his own ultrasound, which we got to wait 3 hours for.  And then he called me to tell me everything was fine, even after the 45 minute exam where the tech measured the lymph node in her neck.  So we were good to part ways until I asked for a copy of that report too.

confused

And 10 minutes later my cell phone rang telling me doctor “I am sure it’s fine, but just in case,” wanted to see her again.  So after some haggling we arranged for June 16th at 1.  Which was ok.  Until they called me Friday to tell me I could come in at 9:30 or 10:45.  “How about 1, like you said originally?”

So the appointment was set for 1, and I punched out of work at 12.  We got to the hospital at exactly 1 (a 20 mile drive) after some typical traffic, and a near miss of a three car accident in front of us on the highway (thank you angels) on line for the parking garage.  I called up to let them know we’d be a few minutes.  And we sat.  And we sat  And we sat.

Finally we began to inch forward just a bit.  Then there was just one car in front of me.

And he was not paying a bit of attention, as a large black SUV cut right into the front of the line.

Now at times like this I try to focus.  Maybe there was a medical emergency. Maybe… Maybe…

So as much as I wanted to get out of my car screaming, I held my composure and talked about all the reasons they might have done that.  Until a hospital employee, likely late for work, surfaced as the driver.  He left his car across the sidewalk, took the ticket from the attendant and raced into the hospital.

It was 1:35.

And then I noticed some scurrying.

I thought the car was stuck.

It turns out the self-important line cutter had taken his keys- blocking the entrance and causing the line of 20 cars behind me to continue to grow.

The car was booted and moved.

We got to the appointment around 2.

As usual...
As usual…

The doctor spoke to Meghan.  He asked her how she was doing.  She told him about her pain.  And about her throat clearing.  And about how tired she is.  She mentioned working hard to get so swim practice.

I don’t think he heard a word.

He felt her neck and proudly proclaimed he felt nothing.  By now I was so tired of this I just wanted to get out.  I figured we were done.  I was glad he could feel nothing.  If only I trusted him.  Truth be told, I haven’t put a hand on her neck in 4 weeks.  There is just no point.

“I want to see her at the end of the summer.”

WHAT?????????????????????????????????????????????????????????????????????????????????????????????????????????????????

3 visits ago he never wanted to see her again.  Now he has ultrasound and 2 visits at which he told me she was fine.  Let it go.  Unless of course, he just doesn’t quite trust himself…

“I’m glad she’s feeling so well.”

EXCUSE ME??????????  Did you just see MY kid?  Because MY KID is incredibly polite, and often very positive.  She is articulate and bright, but she will NEVER tell you she feels WELL.  She doesn’t believe in lying.

Some days this is like a bad movie. Or a dream where your finger is stuck in the door and it keeps closing over, and over, and over again.

4740897520_door_jam_xlarge

August 18th.

Damn.

So much for a month without doctors.

When do you, as the Mom, put an end to it?  Knowing that any “miss” falls right on you, it’s so hard to defy their recommendations, even when their competence can be questioned.

Rheumatology on the 30th.  GI on July 2nd, and Pediatric Endocrinology AGAIN on July 3rd.  And that’s just the first week.

I guess I better plan something fun for the 1st.  Something worthy of a stepping stone for that bridge…

Her entire right side hurts to the touch tonight.  Every natural pain remedy I research has something her reflux doesn’t allow.

She fell asleep tonight reading her Bible.  Our Pastor sent her a long letter with some great verses of comfort.  She hasn’t stopped rereading it.

Sigh…

Two hours to get in.  Two hours to get home.  Less than 30 minutes on the floor of the hospital.

“This is getting old Mom.”  Wise kid.

“‘Cause what if your blessings come through rain drops
What if Your healing comes through tears
What if a thousand sleepless nights are what it takes to know You’re near
What if trials of this life are Your mercies in disguise” – Laura Story

Snow Boots

The winter boots are still in the closet.

It’s June 12th.

Actually Meghan’s room has a basket of winter boots that are not only off-season, but are too small for her.

It’s June 12th, and that is definitely a new record for me.

june12

In my old life clothes got changed systematically in April, and early October.  Jackets got washed, shoes got put away.

That was my old life.  I don’t remember it much.

I don’t really have a big closet.  The spring shoes are upstairs in the hallway.  All over the floor.  I’ve been getting one pair at a time as I need them, but if I don’t hurry and make the switch soon winter shoes will take over my bedroom floor.

Thankfully, Mother Nature seems confused about the season.  That is buying me some time.

Mother-Nature

In my old life, nothing was really on the floor – ever.

We went to the doctor today.  Shocking news really, I know.

We went to the doctor today in hopes of replacing the endocrinologist with someone more open-minded, and “outside the box.”

EPIC FAIL.

What we got instead was a closed box, closed-minded,”I won’t take on your kid, so stay where you are” doctor, in a really bad suit.  (And I’m not much about fashion – so you know it was a REALLY bad suit.)

I had lots of time to look at her, and the suit while I used my hand to keep my mouth from spilling out my actual thoughts and embarrassing my daughter.

I brought the 3 page synopsis of tests, hospitalizations, and medications.

I brought the 3 INCH binder full of lab tests and pathology reports.

I brought the CD of the neck sonogram.

She glanced at her most recent blood work.  She told me her TSH was too high.  She told me she needed more Synthroid.  She told me her current team was just fine.  Then she told me twice they were better suited to treat a Cowden’s Syndrome patient than she.  Feel like a leper much?

I asked all sorts of questions.  I asked about T3, and potential problems with synthetic absorption.  I reminded her that in addition to PTEN she has an MTHFR mutation which impacts her ability to process B12.  I asked if there could be anything else she has trouble processing. (Hint Hint… synthetic thyroid hormone?)

“You’re very smart,” she tells me.  “You know a lot,” she says.  Yet, she deflects my questions like a goalie with a hockey puck.

Hockey-Stick-and-Puck-Photographic-Print-C11950881

News flash.  I don’t need stroking – just answers.

But I watch my tongue.  And I watch my tone, because my daughter is watching my every move, my body language, my attitude.  She is using my response to gauge whether she needs to be uptight.

I asked what was the upper limit for synthroid.  I was told there was none.  I was told that the dose would just continue to be increased.  I was told she would likely reach .200 mcg.  I expressed concern.  I was told not to worry.  The body only absorbs a percentage of the synthetics.  Um, that would be the point of my worry.  She doesn’t have a good history of secreting junk.

I got a lesson on the pituitary and the up and down regulation of TSH.  I was told when to dose the medicine.  I reminded her I have been on thyroid replacement for 27 years.

She asked me if she had answered all my questions.  In my old life I might have politely said, “yes.”  But, this is not my old life.  I smiled, shook her hand, and said “No, actually you didn’t, but I don’t think you know the answers.”  Then we left.

In my old life things were neater, and more orderly in every aspect.  Sometimes I miss the order.  But not for long.  There is nothing orderly about this kid, except her behavior (98% of the time,) and I am learning to embrace the chaos.

She woke this morning feeling like real crap.  Exhausted from swim practice (she made it almost through) and fifth grade trip yesterday.  She hurts.  She is mellow.  She has fun with the kids, but she’s not herself.

Maybe it will just take time, but hours and weeks and months of childhood seem to be ticking away.

I pushed her today to start making dates with friends for the summer.  Her friend’s parents must think I am weird.

It’s as important, or MORE important to plan pay time as it is to plan doctor’s appointments – for so many reasons.  And since we have so many appointments, I want to start with the friend time – NOW.

We live in the middle of New York City.  One would think finding pediatric endocrinology in the mood for a challenge would be much simpler than this.  Instead I am left to return to the surgeon on Monday, so he can validate himself by telling me he doesn’t feel anything in her neck.  And then, back to see the resident of her endocrinologist in July.  (The actual doctor takes off February, July and August – so he has yet to see her since the surgery.)

Life is not ours to plan.  But, we have to try to schedule the fun stuff before the days get away.

We RSVP while holding our breath.

There is more “One day at a time…” than I have ever known.

one day at a time

Maybe there will be some time to get those snow boots away.  In the mean time, if you do stop by- don’t judge the hallway.  Or the closet.  Or the dog fur.

I took a walk yesterday, and another one today.  I listened to music.  It’s a slow process, but I am working on my emotional health.

It seems to be the only thing I can control.

I am working on those foundation stones for Meghan’s bridge.

And in the mean time, if you happen to need any snow boots – I can get them for you in a hurry.  I know exactly where they are.

snow boots2

 

 

“Dear whatever doesn’t kill me, I’m strong enough now. Thanks.”

I needed today.  For so many reasons.

Even thought Meghan had 2 appointments today – 11:15 and 12 – it was a good day.

We all slept.  Late.  All three of us.  I mean 10:00.  A good sign that we – all three- are shot.

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I mean, not a whole lot changed from yesterday, in that it took a full 10 minutes before Meghan’s pain subsided enough for her to walk.  And she was sensitive to the touch, so it was even hard to rub her.  But everything is a little better at 10 AM.

And there was the Isagenix shake – blessed by her GI doctor, back in the mix made with blueberry and coconut milk – that went down smoothly as she took the new regimen of pills.  I finally have a doctor who understands quality nutrition, and who “gets” that you can be sensitive to one type of milk protein and not another.

meghanleigh8903.isagenix.com
meghanleigh8903.isagenix.com

And after the appointments, even though I got the frustrating news that the “it’s broken, it’s fixed, it’s broken, it’s fixed” 1996 Saturn has likely advanced to “deal with it – it’s done” status, it was still OK.

Because we got home, and then Felix made lunch.  I stayed home with Meghan and her “better but not gone” stomach pain.

After that he took the working car to get the wood for the deck railing that has completely rotted out.

No one can really explain that – but we are kind of used to it.

The deck – pressure treated wood – was put together between 2000 and 2004.  By all accounts it is falling apart.  And its not from faulty construction.  The base is solid.  The center is stable.  But the galvanized screws are literally wasting away – and the wood, especially the rails, is rotting.  Maybe it’s too much sun.  Maybe it’s a stain product we used early in its life.  It really doesn’t matter.  It’s done and has to go on the budget list for a full replacement in the near future.  But for now we patch.

Triage.

triage

The bay window wins.  Installed in November of 2000 – on my birthday to be exact- the lower left corner of the center window has rotted out completely.  The entire window – hole in the house and all – needs to be replaced.

So while Felix was getting the wood, he priced the window  Tonight we have to do some comparison work.  Then the order has to go in.

But this afternoon I sat still.  For a few hours.  And I really, really, really liked it.

It’s easy to feel guilty.  That there are things that need doing.  There are people who could use our help.  And there are people who need to be visited.  And there are phone calls that need to be made.  But, last week my Mom told me if I didn’t take some time for myself I might lose my mind.  She’s right.  Although I could say the same to her, and most people I know.  It’s hard for any of us to just stop and sit still.

I haven’t written since Monday.  The arrogance I encountered that day kept me stewing for most of the week.  And… I don’t think I’m over it yet.  But I wanted to pull my thoughts together and go at it with a clear head.  But if I keep waiting for a clear head I may have to stop writing forever.  Because the pain my child endures – regularly- is horrendous and worsening.

If the purpose of this blog is to create a chronology of our experience with Cowden’s Syndrome – then it all has to be shared.  The good, the bad, and the arrogant.

A friend who endures more than her share of struggles with her children placed this on my wall this week.  I can’t tell you how many times I laughed out loud.

what doesnt kill me

 

Tuesday I called the surgeon’s office after school to inquire about the sonogram.  He spoke to me – to tell me that there is absolutely nothing wrong with her neck.

Insert sigh of relief here, right?

So I said thank you, and requested a copy of the report.  It was to be emailed to me within 10 minutes.

And while I was processing the conversation I had with the surgeon, I was contemplating what I would see on the report.  You see, the local sonogram bothered the surgeon.  So when we went to have it done I watched the screen like the hawk I am.  I watched every measurement, every angle for 30 minutes.  I SAW the exact dimensions from the local sonogram recorded.  And yet the report was the most incomplete one I have ever seen.  It simply said “normal” several times.  It was contained on one sheet of paper, unlike the three I had become used to.

I wanted to be relieved so badly.  I wanted to take a breath and say “whew!”

But I feel the lump in her neck.  And she feels it.

What I needed was a doctor to say, “It’s there and it’s fine.”  THAT would have been OK.  THAT would have settled me down.  But, to say it’s NOT there….  THAT leaves me with a whole other set of unsettled nerves.

And then the phone rang.  Again.  And it was the surgeon’s office.  His secretary told me we needed to go back for a follow up.  I was stunned.  And perplexed.

Why a follow up?  He just told me everything was fine!

The doctor just wants to see her one more time before the summer.

This from the same surgeon who three visits ago NEVER wanted to see us again.

So I set the appointment for June 16th.  And I wondered really what I am supposed to think.

So I got the number for medical records and I got a CD of that exam placed on CD.

I’ll bring the CD with us for the endocrine consult at ANOTHER hospital on June 12th.

And this isn’t even the pressing problem right now.  Or at least we don’t think so.

The next set of thyroid labs are going to be next week.  We need to see if this new dose is making ANY difference in her thyroid hormone.  If it is, well great.  And if it isn’t… someone needs to start figuring out what’s going on.

There is pain.  All the time.  Terrible pain.  Worse when she wakes up.  And, when she tries to walk, up the stairs.  Or down.  Or if she tries to lift something.  Or bend to pet the dogs.  Or run.  She made it through 18 minutes of swim practice on Weds.  Then I had to help her get dressed.

The pain varies in intensity.  But it doesn’t leave.  And she is frustrated.  And frightened.

Holding my head in her hands, looking me right in the eye, I received the admonishment a few days ago, “I am telling you I can not do this forever.  I can handle this pain a bit longer, but you NEED to help me.  I CAN NOT do this forever.”

worried mom - FBI

No pressure.

I get it Meg.  I get it.  I don’t really get your pain.  But I get the urgency.  I am all over it.  Trust me.

But that kind of pressure will wipe you out.

The GI on Weds. was happy with her progress.   The pathology showed cellular changes all through the GI tract.  She told us of the spot in the stomach she chose not to biopsy because it bled as the scope passed over it.  She gave us the “reflux” diet.  She reviewed medication and supplements.  She made sure I have an ENT appointment – for June 3rd.  She things the upper esophageal damage is caused by a chronic post nasal drip.  And maybe “fingers crossed,” that will be the throat clearing too.  Because if not there is another diet – with more restrictions on the horizon.  But we can’t race.  We will see her in the beginning of July.  We are clear on the directions.  Especially the one that said, “no pain medicine by mouth.”  The damage done by 4 years of NSAIDs will take months to reverse.  If we are lucky.  Her Cowden’s Syndrome cellular overgrowth reacted to the insult by thickening the esophagus at spots, inflaming the stomach and causing a real mess.

That doesn’t leave a whole lot of options.

So from 200mg a day of a strong NSAID to nothing…

celebrex100mg

I ordered some herbs.  Some that have anti inflammatory properties.  I have read and researched them and have sold them to her as the best thing since Celebrex.  They will be here tomorrow.  Let’s all pray I am right.

Some people think she exaggerates, because there are glimmers of smiles.  There are times when she laughs.  There are people who want her to feel better just because time has passed.  Trust me no one wants this more than her parents.

I would not trade her – or a moment of the last almost 11 years, but this constant struggle is wearing on us all.  We are isolated.  Family and friends alike are often unaware of what to say, or do.  We are afraid to eat anywhere other than home, afraid to be too far away in case her stomach hurts, afraid to be away from home for too long because the pain is often too much to bear.  We are lucky, fortunate, blessed, to have each other.  We are acutely aware of the struggles of so many, and we know we are far from alone when we say we are exhausted.

I needed today.  I did random things like taking the 5 gigs of pictures and video off the iPhone.  I uploaded them to shutterfly.  I combined them with the family photos and I placed the first print order since August of 2012.  We are up to August of 2013 now.  You see I used to be all over this kind of thing.  But life… it gets in the way.

And the nicest part about today was looking at the memories.  The smiles.  The happy times in those photos.  You see today I needed to be reminded…

And that is what today was about.

Because next week there is Field Day, with prayers that there can be mobility by then.  And next week there is blood work.  And next week there is swim practice, and so many things that we want to go very, very well.

Today, I needed today.

 

 

The Arrogance Epidemic

arrogance3

Truly. Under diagnosed, and under treated. Spreading wildly. Seems especially prevalent among experienced medical professionals.

Not all are affected. Some are immune. Some resist with all their might.

Some embrace the arrogance. They seem to enjoy spreading it to those around them.

Others hide the arrogance, carefully and efficiently. Until the moment they are challenged. Then they unleash the beast full force.

arrogance

We met again with the thyroid surgeon today. Two weeks ago we requested an appointment because Meghan felt something in her neck. I have learned from experience not to question Meghan. She has proven time and again to have an awareness if her body that defies explanation.

Two weeks ago he felt her neck and declared the lump she felt to be a salivary gland. He said some small lymph nodes surrounded it, but when we came back in two weeks it would all be gone. He said it with a good amount of authority- but not arrogance. He reminded us of her clean pathology report. He directed us not to worry.

And maybe we would have paid it no mind, except that’s not how life tends to go around here.

So, three days after the surgeon declared the “salivary gland” in her neck, we ended up inpatient at a local hospital with an attack of what ended up being severe gastritis.

While they were sorting themselves out, the pediatrician (who is as far from arrogant as they come,) remembered feeling the neck a few days prior. He had deemed it a lymph node, and figured while we were there he’d have a colleague, a hematologist/oncologist give it a feel. She deemed it a lymph node too and sent Meghan for ultrasound.

Just sitting around the hospital with tons of time as they tried to figure out the root cause of the GI pain, we were amenable to a neck ultrasound.

arrogance4

Now I am not taking sides- I have experienced great sonograms and horrendous ones- and witnessed them- in the best and worst locations. So I take reports as point of information, and never shun clarification. But this one clearly said lymph node- almost 2cm. Subsequent blood test ruled out the salivary gland theory as well.

So Thursday, after we were discharged I contacted the surgeon’s office. We had an appointment today, Monday the 19th. I spoke to the staff. I sent the ultrasound report. I asked them to schedule a sonogram at their facility for us to compare the one we just received. I figured we’d see the doctor and then have the sonogram.

Except as we entered the exam room he was agitated. Looking at the ultrasound report clearly for the first time, he said,”this must have been taken before the surgery.” Seeing it was Meghan’s report I interjected- “No it was taken Thursday the 8th.”

arrogance2

Enter arrogance. I swear his whole demeanor changed and it was like the arrogance bubbled up from his toes.

Now I will be honest- I don’t have a history of playing nice in the sandbox when I am pissed, and I don’t do arrogant well.

So, I may not have been the sweetest. But two weeks ago he was very concerned if she’d had fever, or vomiting. He made it a point to weigh her. Now- she spent 6 days in the hospital and no scale? Somehow I let that go.

What I couldn’t let go was his statement that there was nothing in her neck that was enlarged. See, you can tell me there is nothing to WORRY about. That I will take happily. But you can’t tell me nothing is there. Because 2 doctors an ultrasound my daughter and my own fingers tell me there is.

So we’ll get an ultrasound and then I’ll call you tomorrow to tell you nothing is wrong.

From your arrogant lips to God’s gentle ears…

So they had the girl, who just made her way back to school after a week in the hospital wait for three hours. We made it home around 7.

I know the treatment for arrogance when it overtakes common sense. Time to be done with it. A new consult has been established but we wait- so as not to cut off the nose to spite the face…

In the mean time I know we are not the only ones. There are so many good medical professionals. There are so many who take the time to think, and care, and treat. And then there are others.

The problem with Cowden’s Syndrome is the sheer numbers of doctors we see. The problem is hard to avoid.

Plus- as my grandfather once told me- I can be a little difficult to work with.

It’s all about my girl and whatever she needs….

arrogance (1)

The Spoon Theory

While we were in the hospital last week, a good friend, who is chronically ill herself, sent Meghan a very interesting article.

It was about “The Spoon Theory,” and explained chronic illness from the perspective of one who lives it every day.

hopeful spoon

Meghan being incredibly literate, and a master at figurative language, picked up the analogies quite quickly, and while the author wrote about lupus, a disorder Meghan does NOT have, she found the text and related analogies very meaningful.

Our dialogue this week has already begun to include questions about how many “spoons” she has today.  As someone who lives with my own share of issues, but none as severe as my daughter, this has opened up communication in a fantastic way.

The author has copyrighted the story, so I have permission only to link you to it, but I encourage you to give it a read.

http://www.butyoudontlooksick.com/wpress/articles/written-by-christine/the-spoon-theory/

And thank you my dear friend for sharing.  Thank you.

Glorious Unfolding

Lay your head down tonight
Take a rest from the fight
Don’t try to figure it out
Just listen to what I’m whispering to your heart
‘Cause I know this is not
Anything like you thought
The story of your life was gonna be
And it feels like the end has started closing in on you
But it’s just not true
There’s so much of the story that’s still yet to unfold

And this is going to be a glorious unfolding
Just you wait and see and you will be amazed
You’ve just got to believe the story is so far from over
So hold on to every promise God has made to us
And watch this glorious unfolding…

Steven Curtis Chapman

 

I believe in God.  I believe in the power of prayer.  I don’t believe in a predestined life, but I don’t believe in coincidence either.

This song was playing in the car last week one night.  Meghan was having a tough time of things, and I had gone to clear my head.  When I came home she was still awake so I downloaded it to her Ipad.  We laid together in her bed and held each other.  The tears flowed.  The comfort of each other, and the comfort of the knowledge that we were not alone – not abandoned – ever – eventually allowed her to rest.

The song is in her playlist for “bed.”  It is a beautiful compilation of songs with a purpose.  And as I sit, in a dark hospital room, on our 6th night here the songs play in the background.  Their messages soothing for my tired soul.

I didn’t want to be here.  I mean not in any hospital, but especially not in THIS hospital.  Somewhere along the line I had decided that I would NEVER want to be HERE.

Well that was my first mistake.  Cause really, it’s not up to me.  And that is a hard reality to accept.

I-plan-God-laughs

The pediatrician works from here.  They respect him.  We adore him.  He loves Meghan like a granddaughter.  She was really sick.  If I headed anywhere else I would have been flying blind.

They moved at a pace I sometimes felt was too slow.  But, I as an anxious Mom, am in no position to judge pacing.

There were staff I could have done without – so I excused them from our room.  But not most of them.  Most of them have been kind and compassionate.

Being local allowed for FAMILY and FRIEND visits, and even a visit from our pastor, which mean so much to Meghan on really long days.

The tests were run one at a time, but they all mattered.

Once they realized how much the IV – and all its complications – caused her grave anxiety, they took extra care.

The dietary team has done their best with a complicated kid.

The GI doctor has been thorough, professional and meticulous.  She had read about Meghan and about Cowden’s.  She TALKS to the pediatrician, and our hematologist in NYC, and the ENT we will soon see.

The lab tests were all inconclusive.

The sonogram didn’t tell us anything.

The CT scan was essentially normal.

The medications, continuously adjusted, have provided little relief.

confused-face

So as we prepared for the endoscopy we were anxious.

See, you never WANT anything to be wrong.  But then there is a point where you KNOW something is.  Then you worry about finding out what it is, or NOT finding out.  It’s hard to know what to be more worried about.

Heading into the test today we were both anxious.

They say a picture is worth a thousand words.

We have pictures now.

Pictures of a GI tract so damaged by SEVERE Gastritis that it will take months to years to recover it.  She has damage from the top of her throat straight down into the beginning of the small intestine.

Inside the stomach is evidence of ulcerations.  Many.

The esophagus that should be smooth – a mess of bumps and sores.

Remind me to NEVER EVER EVER doubt her tolerance for pain.

This one is a favorite of a dear internet friend :-)
This one is a favorite of a dear internet friend 🙂

The pictures make me ill.  Because they are evidence of MORE suffering in my young girl.

To her they are vindication.  And that makes me sad too.

She hurts every day.

She says it.  And I tell her I get it.  But I don’t think I do.

Pain like THAT has to be isolating.

Because every day she has to get up and function anyway…

And not too many people her age would even try to relate.

The GI told me she sees damage like this “every once in a while” in patients, but they are always 50 and older.

She told me the biopsy will likely show it to all be medication induced.  The medication I have given her for years.  The miracle drug that kept her mobile.

We will wait until next Wednesday in her office to look at the pathology, and to review every prescription and supplement that crosses her lips.

In the mean time there is medicine to control the spasms in the stomach every 4 hours.  There is medicine to try to control the acid so maybe she can start to eat.

There is more time off from school.  At the tail end of 5th grade.  When the days are supposed to be fun.

 

There are MORE dietary restrictions.

But somewhere in the pain is vindication.  For the girl who knows her body better than any doctor.  There is proof.  There are pictures.

Wishes 1

But I don’t believe in coincidence.

This is her second GI related hospitalization since her thyroid was removed.  That’s weird.

Her thyroid numbers are NOT normalizing.  So she has been “hypothyroid” for three months.

I mentioned it a few dozen times this week.  No one bit.

I’ve hit google. And my sister’s friend hit on an article too.  I will keep looking.

never never give up

Somehow this is all connected.  The thyroid.  The medication.  The pain.  The gastritis.  The Cowden’s Syndrome.

But I have to be patient.  The pieces will come together.  In time.  With hard work.  And good doctors.  And prayer.

We prayed today for an explanation.  We asked for an answer to explain her pain.  Our prayers were answered.

perspective

Now we pray for healing.  Of her tired body.  And her tired mind.  We pray for the development of a TEAM of smart doctors who communicate, and we recognize with gratitude it all began where I never wanted to be.

There is work to be done.  There are more concerns to be addressed.  The road will continue to have bumps and twists and turns.

But somewhere along the path there is time to be grateful – for the GI who trusted her gut and did the scope TODAY.  For the anesthesiologist who repaired a failing IV while she was ASLEEP.  For my girl who gets to say “see this is WHY my stomach hurts.”

And that’s all I can process for one very long day.

I think I’ll sleep between the midnight and 4 am doses.

God's got this

The IPad is playing our song…. this is going to be a “Glorious Unfolding.”

Lay your head down tonight
Take a rest from the fight
Don’t try to figure it out
Just listen to what I’m whispering to your heart
‘Cause I know this is not
Anything like you thought
The story of your life was gonna be
And it feels like the end has started closing in on you
But it’s just not true
There’s so much of the story that’s still yet to unfold

And this is going to be a glorious unfolding
Just you wait and see and you will be amazed
You’ve just got to believe the story is so far from over
So hold on to every promise God has made to us
And watch this glorious unfolding…

Steven Curtis Chapman

The Productive Struggle

Tomorrow I was scheduled to attend a professional development workshop entitled “The Productive Struggle.”  I was kind of excited to go, as it sounded like quality PD right up my alley.  “The Productive Struggle” is supposed to focus on helping students find their way through the rigorous problems and questions of the Common Core Learning Standards (CCLS.)  And regardless of your opinion on standardized testing, when you break down the basic principles of these standards to their center, there is much value, and much to learn.

As a math teacher I like to focus on having students “Persevere to solve problems.”

productive struggle 3

This is in no way as easy as it sounds.  Children are programmed to wait.  They want the “right” answer.  They fear trying and making mistakes, and learning, and trying again.

As a teacher it is my job to give them the skills they need to solve problems.  I need to make sure their knowledge of math is broad.  I need to tap off the skills their classroom teachers have taught.  I need to set firm boundaries and standards for not giving up.  Then I need to step back and let it happen.

Some days it is like a well rehearsed symphony.  And other days it sounds a bit like an early childhood music class.  But I try, and try again, and we make progress.  Because giving up is not an option.

I have had some time to think, being cooped up here in the hospital this last week.  And tonight it is easy to understand while I am glad to be by my daughter’s side, I am sad to miss any lesson in the “productive struggle.”

productive struggle 2

In many ways it is what is missing in our lives as patients with Rare Diseases.

Follow my logic, using my Meghan as an example.

So Thursday she woke up vomiting bile, and in tons of pain.

Virus?  Nope.

Flu?  Nope.

Terrible reflux, awful stomach cramps.

Appendix? Nope.

Fever, back pain.

Kidneys? Nope.

productive struggle

And so it continued, and still continues.  We have met many nice, well intention-ed doctors and residents.  And we have met a few that should really use their intelligence to become researchers and stay far away from people.

But 5 days later my daughter still sits with stomach pain, difficulty eating, and some pretty significant GI issues.

We have had ultrasound, CT scan, and countless lab tests.  Tomorrow she will have endoscopy at 2 PM.

Some of the medication changes have been beneficial.  And we may see a slight decrease in the severity of her pain tonight.

But, what is the root of the problem?

She didn’t develop GI issues so severe they require a lengthy hospital stay without there being any connection to the rest of her body.

I have a 4 inch thick binder with medical history.  It reads as a chronology of 11 surgeries, several hospitalizations, outpatient procedures and more.  There is lab work, sonograms, MRI reports.  I actively cataloged the whole thing by date.  And I brought it.  And I offered it to the doctors.

And then I took it home.  No one even laughed at the cartoon on the cover.  I’m not sure it was ever opened.

binder cover

See the problem we have, Meghan and I, and so many others, transcends Cowden’s Syndrome.

The problem is that most practicing doctors have never encountered, experienced, or worked through the “Productive Struggle.”  So when a tough case hits them – they only do what they would normally do.  And when all those tests are fruitless, instead of thinking outside the box – they assume OUR box is broken.

Meghan and I went through the chronology of the last year together last night.  We spoke about the AVM on her hand.  We continued through the MRIs that exposed her to extreme amounts of gadolinium.  We talked about the two rounds of heavy metal chelation, and how even though she excreted significant heavy metal, the rebound effect triggered crippling migraine headaches.  We recalled the neurologist, and the instant diagnosis of migraine without much history, touting them as “very common.”  We remembered another MRI to make sure the brain was clear.  We talked about the medicine for the migraines and whether it really worked, and how it kept getting raised every time she had another headache.  Raised, not changed.  We talked about the tickle in her throat that started in November, and the neurologist’s flippant remark that it might “just be a tic.”  We talked about the neurologist telling us to increase the Celebrex to stop her last migraine – which it did, but it was never his drug to change to begin with and he never consulted the prescribing doctor.  We talked about the thyroid nodule, and the subsequent biopsy and thyroidectomy.  We talked about the surgery and the hospitalization that followed with GI issues in February.  We spoke about the throat clearing “tic?” that we had hoped would resolve after the thyroidectomy.  Then we spoke about thyroid hormones, and what having a body in a hypothyroid state for months can do.  We spoke about the ENT and his determination that there was inflammation in the nose.  We discussed his nasal spray and admonition to double the reflux medicine.

And then, after ten minutes of talking out the medical highlights of the last 10 months we realized NO ONE had asked about any of that.

It was like she is here being treated for a totally separate problem as a kid who “happens to have” Cowden’s Syndrome.

So they order their tests.  One at a time.  And they watch and wait.  And we go for ultrasound and CT scan.  And we change-up some medications.

But no one asks what the effects will be of her stopping Celebrex.  No one asks why her body required such a dose, even as I start to see the initial effects of the NSAIDs  being totally our of her system.

They come in and tap her belly.  It still hurts in the same spots.  But that’s not what they want.  They did what they know.  Now they want it to be better.

I have to be here with Meghan tomorrow, but there are a few of them that could stand to attend the PD on the “Productive Struggle.”

Goodness, work for it people.  It’s not always easy.

But she’s young.  And she’s bright.  And she’s frightened.  And she’s worth it.

You Never Know How Strong You Are Until Being Strong Is The Only Choice You Have

 

Passing time….

So here we sit.  Again.  For the second time post thyroidectomy, we are in the hospital. meg hospital May   The girl doesn’t feel well.  She just doesn’t.  End of story.  But, not too many people seem ready to listen until she’s in a full on physical crisis.  Even then sometimes the numbers are frighteningly low. Yesterday she knew.  She NEVER tells me to stay home from work.  She KNEW.  And my pediatrician heard it in my voice.  She was admitted soon after he saw her.  He wanted it to be the flu.  In some ways I did too.  A little Tamiflu and some rest.  Buts she’s negative for flu.  No real surprise.  Too simple a diagnosis for my girl. Since her surgery in February,  her TSH (Thyroid Stimulating Hormone) which is supposed to rest somewhere between 4. and 4.0 has been lingering well over 10, despite numerous medication adjustments. The TSH is supposed to be down regulated when the synthetic thyroid hormone takes the place of the T4 and T3.  Enough thyroid hormone and the TSH decreases.  Not enough and it increases causing hypo (under active) thyroid symptoms which can range from bone crushing fatigue, to generally feeling unwell and a whole host of issues in between. He medication has been adjusted upward with no effect – several times. I know it takes time.  I barely remember my own battle with thyroid hormones over 20 years ago.  The veterans of this surgery tell me 6 months, a year…  I get it.  I do. But then there is the reality of watching your kid feel crappy every day.  The reality of watching her FIGHT with all her might to do the normal things others take so easily for granted.  And then I get impatient. impatient smiley To complicate things it may not just be the thyroid hormones keeping us hopping. That “lymph node” turned “salivary gland” is now back to a lymph node in the neck.  We are awaiting the ultrasound that I feel should have been done with her appointment last Monday. And there is a fever.  She never gets fever.  Not really.  And yesterday it was 102.  Today around 100.  No answer why.  Not even the White Blood Cell Count gave a clear indicator. And the reflux.  Painful.  Like fire. Lack of desire to eat much of anything leads to weakness. fire And the throat clearing.  Reflux? or lymph node? or something totally different? So we temporarily stopped the celebrex to try to solve the GI issues.  The medical equivalent of robbing Peter to pay Paul.  The joint pain – managed for now – is rearing its head. And why does a 10-year-old, with no gall bladder and a week of the worst reflux of her life – with no dietary changes – begin vomiting bile? Maybe just maybe we will meet up with a decent GI.  Girls can hope. So I sit.  We sit.  Waiting for answers to questions.  Waiting for answers to more questions than we will ever get.  But we are hopeful.  Anxious. At least right this minute the worst part of being here is passing the time with the stupid IV.

They got it the second time!
They got it the second time!