The Struggle (for Silence) is Real!

Irony is spending 20 years wondering why your students sometimes struggle to be quiet, and suddenly, in one week, realizing how insanely difficult it is to be silent, AND, that it’s likely your need to talk constantly is part of the reason WHY you went into teaching in the first place!

Last Friday, March 3rd, this ugly thing was taken off my vocal cords.

Before – 3/3/17

And they, like so many other parts of my body, now boast scars.

After 3/3/17

So, I set up for a few weeks out of work, and a week of required silence.  I never actually thought I was ready, which is a good thing.   Because I wasn’t.

I do poorly on twitter,  Rarely could I get out what I need in 140 characters or less.  Absolute silence involved my cell phone in hand at all times.  A few times the thing almost learned to fly, as the fingers, and auto-correct could not keep up with my brain.  But, life lesson number, oh, I don’t know, 4 or 5, teaches us that life goes on around us.  Ready or not.  Even when you have to watch and not participate.

There have been many times since March 3rd I’ve been grateful that thought bubbles do not appear above my head.

On the 9th I headed to the city for my follow-up.  After learning the pathology was benign, and read only “polyp,” I was relieved.  The doctor was pleased with the initial healing and told me I could begin to use my voice.  Slowly.  He said 5 minutes an hour.  That sounded high, based on what the voice therapist had told me in the fall, but I was grateful.  I used the first 5 minutes up asking him questions.

I wanted to know whether this was connected to Cowden’s Syndrome.  I wanted to know if it was likely to recur, if I needed vocal therapy, and when my follow-up would be.

Apparently, kind as he is, he could communicate on Twitter much more efficiently than I.

Cowden’s Syndrome?  I don’t know.  There’s not a lot of literature.  This type of polyp is usually a traumatic event, something you’d remember.  But, you don’t.  And it grew really fast.  I’m not sure.

Recurrence? Maybe.  Depends how it came to be.  Be careful with your voice.

Vocal Therapy?  Suggested.  Start on the 13th.  (Whew… THAT I now KNEW I needed.)

Follow up – April 13th, a few days before I am scheduled to teach my first class post-operatively.

He was an outstanding surgeon.  Matter-of-fact.  Thorough.  Efficient.  But, I’ve known enough surgeons now to know, they don’t play with why.  They just fix it and move on.  He will “doctor” me, to the point that he will follow-up, and hopefully watch NOTHING ever grow there again.  But, in reality this is now just another vulnerable spot on this PTEN mutated body.  Because, I would stake certainty that it’s connected.  There just aren’t that many coincidences in life.

So I left Thursday feeling good.  I got 5 minutes an hour!  I tried out my voice in the car.  I tried it out at home.  And then, I picked up my daughter at school, and I was so excited to talk to her, I easily let the conversation surpass 15 minutes.  oops.

Later when I spoke to my husband I was well past 10 before I stopped.

This 5 minutes and hour thing was not for the faint of heart!

Sometime Friday I decided that stopping at 5 minutes was, nearly impossible for me to regulate.  It was quite possible I could lose my mind.

And then I texted the voice therapist to set up my appointments for this week.  And I mentioned the 5 minutes.  And that I randomly out of nowhere had vomited for 20 minutes that morning.  And her words were crystal clear. “DO NOT SPEAK AGAIN UNTIL I SEE YOU”

Sucker Punch

I went from a poorly managed 5 minutes back to a feeble attempt at silence.

I failed.

I spent 2 full days at a swim meet at with my girl.  7 hours each day away from home.  I got to rest my voice, except when I felt compelled to tell her how proud I was.  Or to wish her luck.  Or to just chat… a little.

Some people really love chocolate.  Me, I don’t mind chocolate, but I LOVE to talk.

We sat in therapy today and I got exercises for volume and pitch… all ironic because I struggle to tell the difference, but I’m an overachiever, so I try to do well.  I sound like a complete loser, but I imagine it’s the same as me attempting something that requires coordination, like kick-boxing, or yoga. My poor vocal cords may not stand a chance.

6 exercises, 5 times each.  Repeat 4x a day.  And during those 4 hours DON’T SPEAK at all.

The revised schedule she gave me had 3 minutes an hour till Friday.  Then, we’ll entertain 5 minutes again.

Tonight I pulled back into my office.  To be silent I must be alone.  I put some “breathe” into my diffuser, and tried to get my thoughts together.

Then I realized they ARE together.  I just have no place to put them.

Tomorrow the house will be full for the snow day.  Normally this would make me very happy.  Tomorrow it is likely to make me a hermit.

Grateful the voice works.  Grateful I tend to heal well….  But, some days

#beatingcowdens

is a real trip!

To Do Lists, Digital Footorints and Random Thoughts

I’m not one for New Year’s Resolutions.  I don’t believe in waiting for a specific day to make changes.  If they are needed, wanted, or warranted – we make them.  Right then.  Otherwise, I’m all about just being your best you- every day.

Parenting a teenager is tough stuff.  Even when your teen is just a good soul, a hard -worker, a good student, and a compassionate human.

persistence4

There are people who would challenge me that we have it easy.  They give me the default model, that raising one child has to be easier than raising 2 or 3 or 4 or 5 or more…  And maybe they are right.  I will never know.  But, they won’t either.  That’s the point.

Raising our children, or living our lives is not meant to be a discussion of “harder” or “easier.”  There are challenges present in every single scenario that comes to mind when I think of EVERY family I know.  In this house we  talk a lot.  My girl and I, we talk about those other lives we know, and their battles.  And we send love and prayers and warm wishes, as they do for us.  It’s not a contest,  it’s real life.

2016 saw the results of two uterine biopsies of my then 12 and 13 year old, with results that left us uneasy, and in a perpetual state of “cautious waiting.”  It also saw me back in surgery, replacing less than 5 year old silicone implants because one had “fallen”  And then, it saw my clumsiness as I spent 6 weeks booted with a broken toe.

2016 saw loss in my family, as we mourn Pop, and are readjusting with Grandma in her new living space.

Yet, we made it.  We came out with a few bumps and bruises, but we made it.

2016 ended with 8th graders we know taking High School entrance and Scholarship Exams.  The next weeks will bring jubilation, laughter, and tears.

Yet, we WILL make it- all of us.

The “To Do” list on the yellow pad to my right is busy.  The fundraiser is about a month away and there is lots to be done.

There is also an MRI, a vascular surgeon, an orthopedist, an endocrinologist, and a gastroenterologist for Meghan, as well as Pre-surgical testing, a tentative surgery date, and a breast surgeon follow-up, an oncologist, and an endocrinologist for me.  All before February 22.  That’s IF no one requires additional testing for anything…

We will fit in the “regular” stuff too, like swimming, and meets, and school projects, and drama… well you know what I mean.

We are working hard to fit Cowden’s Syndrome into our lives, and not to let it RUN our lives.  It’s a subtle difference on paper, but a HUGE one in practice.

And when the thought of running a house that contains TWO people with a rare genetic disorder becomes overwhelming – we try to step back and count our blessings.  Because at the end of all days, regardless of our struggles, it is good for us, and those around us, if we can remain positive.  I’m not saying we’re perfect at it – far from it actually, but it is a goal, and an on-going work in progress.

It came up this week when we were preparing for the fundraiser and talking about social media.  Actually, it has come up a bunch of times since the iPhone became attached to her hand almost 3 years ago…

digital-footprint7

Digital footprint – how are you presented on the internet?  What if someone “googled’ your name?  Now?  5 years from now?  8 years from now before your job interview?  The whole concept of this blog has been discussed in depth.  Meghan, whether she likes it or not, at the age of 13 has an identity that is connected to her rare disease.  Now, don’t misunderstand me for a minute – a close read would CLEARLY indicate, she is NOT her disease, but she will never have the opportunity to deny the diagnosis.  That’s forever, and its important.

What she does with it, well that’s ongoing.  She’s made some pretty dynamic choices to date.  Sometimes she feels a bit like she has something to prove- so she does.

She’s been asking me for “snapchat” lately, and eventually I’ll give in.  But, I’m one of the mean moms who makes her wait.  Instagram is plenty to manage for now.

This week Meghan was nominated as “Inspirational Staten Islander of 2016.”

It prompted me to “google” my daughter.  So when I type in her name connected to our home town, these are the first links to surface…

How Meghan Ortega saved her Mother’s Life

12 Year Old With Rare Genetic Disorder Chosen as Inspirational Islander

Staten Island 9 Year Old and Her Mom are on a Mission….

12 Surgeries in 11 Years- Living with Cowdens Syndrome

Meghan Ortega- NYS Senate

I’ll take that top five any day.

And just for good measure, I switched to an image search.  These 5 were on the first page…

Meghan in her elementary school with one of her idols- Borough President James Oddo
Meghan in her elementary school with one of her idols- Borough President James Oddo
An old one - when Meghan was named "Hero of the Month" by Child Life after an early surgery
An old one – when Meghan was named “Hero of the Month” by Child Life after an early surgery
SI Children's Museum Achievement Luncheon Award
SI Children’s Museum Achievement Luncheon Award
Rare Disease shirts from the PTEN Foundation
Rare Disease shirts from the PTEN Foundation
One of my most proud - NYS Woman of Distinction, nominated by Senator Lanza in May 2016
One of my most proud – NYS Woman of Distinction, nominated by Senator Lanza in May 2016

And, just to be sure, I even tried Youtube.com, only to find a video made in February 2016

Apparently she has listened, carefully.  I don’t know what the future holds for my bright eyed activist.  I know she’ll continue to take heat from a few along the way.  I also know she’ll find the strength to rise above and press on.  Because, that is what we do.

Would she like it is she were named “Inspirational Staten Islander of 2016”?  Sure.  Will it break her spirit one way or another, absolutely not.  Her focus is, “If I win, we could get publicity to help raise money at the fundraiser…”

2017 Event Flyer
                                                                       2017 Event Flyer

If you’ve read this far I’ll tell you what I know about the poll I’ve linked you to below.  The voting takes place like a reality TV show.  I’m not sure how valid it all is, but there is a week of lots of voting.  It ends January 11th at noon.  Apparently you can vote many times before it stops you.  And then you can vote every hour.  So pretty much, if it crosses your mind, and you find Meghan inspirational, save the link and vote whenever it crosses your mind, until your device tells you to stop.

Regardless of the outcome, life will go on.  And we will continue on the same missions we’re on right now.

#BeatingCowdens together

Inspirational Staten Islander Poll – Vote all the way at the bottom

Pathology…

About an hour ago I got off the phone with Meghan’s gynecologist.  It seems we dodged another bullet.

Mostly.

Once again we got to spend about 45 seconds in a deep breath as we were told there was no evidence of malignancy in the uterine biopsy from last Friday.

BUT…

There is always a “BUT…”  I’ve come to expect it now.  After she spoke, she paused.

I asked her why she sounded happy and hesitant at the same time.

“Well I just got off the phone with the pathologist…”  and her voice trailed off.

So much was what she expected when she spoke to us Friday.  But, it was still bothering her that there are polyps.  And more than one.

“It just shouldn’t be…”

Sigh.

We’ve heard this so many times before.  “It just shouldn’t be…”  But, in fact it is.

So the polyps were benign.  The tissue sampling was benign.  This is a good thing.  A very good thing.

Digitally generated My brain has too many tabs open

But, this whole situation.  The whole scenario that causes all sorts of conversations a 12 or 13, or even a 19 or 20 year old for that matter, should NEVER have to have, is just not ok.

There are thoughts, decisions, trade-offs, conversations, risks and benefits that make deciding on a high school seem trivial.  Strange that THAT will be the toughest thing most girls her age have to do this year.

Soul_Darkness_Light_Stars_Night

And as I look at her, it kills me inside the things she has to go through, and the thoughts she needs to think.  All I can do is thank GOD, that He trusted me with this beautiful, dynamic, witty, young lady.  And I promise to take good care of her until the rest of the world figures her out.

 (and really, for FOREVER. as we remain #BEATINGCOWDENS together!)

Counting… Our 400th Post!

“Count your many blessings, name them one by one…”  Grandma used to sing years ago when we would complain about nonsense.  She was a little tough sometimes my Grandma, and maybe that’s where I got it from.  But, many times she was right, whether we listened or not.  (Maybe that’s where I got that from too? ;-))

Count your Blessings 1-03

I like numbers.  They are logical.  They are what they are.  In a world that often makes no sense at all, I find order in numbers.

Except sometimes I’m faced with the question of what to do when numbers become overwhelming in and of themselves.

This marks the 400th post on this blog.  While it’s by no means a masterpiece, when I sometimes poke through old posts I remember so much of where we’ve been.  It’s a definite roadmap of our journey, and Meghan and I take great pleasure when people from around the world reach out to us and cite the blog as a source of comfort and strength.

Cowden’s Syndrome is rare enough that it can be a lonely diagnosis.  Being able to reach people the world over has been a victory for us, and them.

With over 170,000 hits on various posts I know we are getting the word out.  Slowly.

a-170000

I might have wanted to celebrate this post.  I might have wanted to make it really special.  But, I’m counting something else today.

Today was the 17th time I’ve gotten off the phone with the nurse, giving me pre-operative directions for my daughter.  Today, I listened as I always do, reciting the directions in my mind before she spoke.  Really my only interest was the time.  The rest is routine.  I want to stop counting.  I want to just go with it.  I can’t give you an exact count on mine anymore – because once you’re a mom, well, you just focus more on what’s important.  And you become less important.  And that is a gift, denied to many, cherished and appreciated.

seventeen

Somehow though,  if I stop counting for her, it makes her struggle feel less valid.  The numbers give her strength.  A badge of courage.  Something concrete in this world of abstract.

My post last night was about “Patience”

https://beatingcowdens.com/2016/07/20/the-waiting-place-2/

And as I poked around the blog this morning I was taken back years, through so many similar posts.

https://beatingcowdens.com/2013/01/10/blessings-and-patience/

https://beatingcowdens.com/2012/07/02/the-waiting-place/

https://beatingcowdens.com/2015/05/06/hurry-up-and-waiting-rooms/

https://beatingcowdens.com/2015/08/28/losing-count/

Their similarities are uncanny.  I guess the story doesn’t change much.  Hurry up, wait, surgery, wait, recovery, wait, follow up, wait…

So I’ll leave this 400th post as unremarkable.  Nothing has changed.  Nothing will change.  And that’s the precise reason we keep counting, and keep telling our story.

Tomorrow, surgery number 17.  9:15 arrival.  As usual, prayers always appreciated.

#beatingcowdens 400th post!

400

The Waiting Place…

A quick Google search brings the definition below when the word “patience” is entered.
pa·tience
ˈpāSHəns/
noun
 
1. the capacity to accept or tolerate delay, trouble, or suffering without getting angry or upset.
I’ve been thinking a lot about patience these last few weeks.  It’s something we work on from a very young age, yet I’m not quite sure it can ever be attained in its purest form.  At least not by me.  Not if I’m honest.
patience 5
And I tend to be honest right here.  Which some might think is an odd place to make that choice, but that’s for another conversation.
We work on patience when we are young.  Waiting for play time.  Waiting for school to end.  Waiting for a party.  Waiting to get there.  Waiting for the game to finish. (Waiting at ‘the waiting place’ like Dr. Seuss in “Oh, the Places You’ll Go”)
We learn that patience will help us get things faster.  If we are patient our parents are more likely to bend.  If we do what we’re told and wait, things are more likely to go our way.  That ice cream cone has a better chance of landing in our hand if we’ve exercised patience than if we’ve badgered.
When we get a little older there are less overt rewards for patience, yet it’s still a necessary virtue to master.  Those without patience are deemed immature.  If we are overly demanding it endears us to no one.
patience 2
I know this.  I know all of this.  And generally I am a pretty patient person.  But, I must tell you I have thought long and hard about the amount of patience required to navigate Cowden’s Syndrome and its ramifications, and it seems to be an inordinate amount.
I get it.  I’ll say it a thousand times to anyone who will listen.  Of all the “rare disease” cards to draw, this is by far among the better ones.  I know of the suffering of so many who are diagnosed with torturous terminal diseases.  I know of so many who would trade places with us in an instant.
If the PTEN mutation causing Cowden Syndrome is found early, a lifetime of vigilance can often ensure longevity.
It’s just that with that vigilance, you need to much darn patience.  So with my gratitude, I sometimes battle frustration.  Which is ok.  Because I am human.
patience1-1
In the last 21 days I’ve been to Manhattan 4 times for doctor’s appointments, and another 2 to Long Island.  The average roundtrip for these appointments is about 5 hours.  5 hours to travel in insane traffic regardless of the hour.  To Manhattan the distance is only 13 miles and I can not tell you how many times 2 hours hasn’t been enough time to be on time.
But, I should never worry, because they are rarely, if ever on time.  And while I understand the myriad of reasons doctors run late, still the patience sometimes runs thin.  Especially when we are anticipating another traffic filled journey home.
The patience wanes when I call offices and 2 days lapse without returned calls.  I struggle when I have to spend hours explaining what test I need insurance authorization for, only to have the person speaking to me become hysterical with laughter, presumably because they are being told a joke.  I’m not against laughter.  I actually like it.  But, when I have to now cancel the test ordered by the doctor I never wanted to see in the first place, sometimes I just can’t find it funny.
patience 4
When I call for an appointment and I’m given a 3 month wait time.  And an appointment smack in the middle of the work day.  I lose patience.  I don’t expect special treatment.  And its a good thing I don’t.  But its sometimes hard to stay patient when you’re juggling over a dozen specialists (each) and a full-time job, and academic honors.
So in the summer I try to be even more patient.  But by default I have to get a lot of things done in the summer.  We are actively trying to shove in some fun, in between a boatload of appointments.  I try to squeeze in time in pockets of my day to regroup and relax.  I try not to cringe when my Facebook news feed is full of play dates and day trips.  Why shouldn’t it be?  I don’t WANT anyone else to have to sort through this mess.
Friday is Meghan’s second uterine biopsy.  PTEN mutations tend to cause most of their cancers, although not exclusively, in the thyroid, breast and uterus.  The fact that she hasn’t hit her 13th birthday yet, and this will be her 17th round of operating room, general anesthesia procedures is taxing.  But, we will be patient.  We will be patient tomorrow when we wait for the time of Friday’s procedure.  And we will be patient on Friday as there are often delays.  We know.

time concept, selective focus point, special toned photo f/x

We will be patient over the weekend as she adjusts to the discomfort and pain from the procedure.
We will be patient while we wait.  And wait.  For the critical pathology report.
We will be patient while she heals enough to return to the pool.  Her happy place.
Patiently we will continue to navigate the road of vigilance, peppered with mines that need to be avoided at all costs.
We will pretend, each time we meet a new doctor, that they are the most important.  We will not even try to explain the full complexity of the scheduling of life.  They have their own problems.  They don’t need to hear about ours.
When we each face our own lives we know the challenges presented to us.  I don’t want any of yours.  At least I understand the task at hand here.
I have gratitude that I am given the opportunity to allow my vigilance to matter.  I am patient.  Mostly.
pa·tience
ˈpāSHəns/
noun
1. the capacity to accept or tolerate delay, trouble, or suffering without getting angry or upset.
Usually I take a deep breath.  A bunch of times.  I’ve learned patience gets you farther.
So if some days are harder than others, I ask you to have patience.

#beatingcowdens can be exhausting.

persistence

Justifying Our Existence

There was a post that showed up in my news feed this week from http://www.themighty.com.  Read The Secrets of People with Chronic Illness here

I can’t seem to shake some of the thoughts from my head.

chronic illness

As I write, school ended for the summer 9 days ago.  In those 9 days we have seen 4 doctors between us.  There are 9 more SCHEDULED in the month of July, including a biopsy for Meghan on the 22nd.

And, while I did take some time over the weekend to reconnect with some dear friends, and I have accomplished a few mundane tasks like routine car maintenance, the vast majority of every moment of those 9 days has been spent justifying my existence.

Fortunately, I have enrolled Meghan in a theater camp where she is from 10-4, spending some time with kids her age.  Of course, the wear and tear on her body, even after only 3 days is evident.  She struggles with pain so badly.  On her feet, determined to fit in.  Determined for me not to say too much.  Sometimes I have to let her go.  I have to let her try.  I have to let her decide.  But, it hurts.  It hurts her, and it destroys me to watch her battle with her body.  I watch her put that game face on in the AM, and not take it off until after swim practice follows camp.  No one will ever tell me she is anything but driven.  But, no one would ever know to watch her…

chronic illness2

Usually by this point in the summer my work bag is unpacked, washed and tucked away.  Often my lesson plans for September are mostly framed out.  I am yet to take the list I frantically formed as I packed my room the last day of school out of the bag.

Instead, the yellow legal pad sits near my computer.  I write, and cross out, and rewrite, as I call, obtain records, set appointments, and clarify tests required by various doctors.  I rearrange schedules to allow for coverage for Meghan as I trek to my own appointments at the most inconvenient times.

On the 18th I will meet a new plastic surgeon, as the old one no longer accepts our insurance.  I never imagined needing a new plastic surgeon only 4and 1/2 years post op from the mastectomy, but it seems I do.  I’ll wait until I meet him to elaborate on that…  Sometimes, although not often, I do feel like this…

chronic illness3

I can often count on 4 hours minimum round trip for the 10 mile trek.  Never mind the cost.  We just don’t even add it up.  Instead, we thank God for our jobs and the insurance we do have.

I received a phone call yesterday from a lab that was running insurance information to obtain testing for Meghan requested by one of her doctors.  Except it’s not covered at all.  $16,000 they said.  I, who denies my child nothing politely said, “we’ll find another way”.  And we will.  Because that is just insane.

I’ve sent 3 emails to the office manager of the office doing her procedure on the 22nd.  I simply want to know what date to leave free for the follow-up.  I know there will be one, and I want to plan a few summer adventures in the time that my fish will have to be out of water.  I also asked for the pathology from her December procedure.  For about the 8th time.  Just keep adding checks and dates to the list.

When things get really bad, like with the bills I’m fighting in collections, they get a folder of their own.  The SUPER troubling places, like the mail-order pharmacy, have a notebook.

We do our best to stay upbeat.  We count our blessings regularly.  We know it could be worse.  We know the anguish others suffer far surpasses our daily struggles.  But, no matter how much we focus on a positive attitude, and believe me we do, it does not decrease the pain, both physical and emotional.  The struggle is real.  Whether we like to admit it or not.

chronic illness4

I reached out to our genetecist this week.  Darling man said he would always help, and didn’t want us to waste a trip on him.  I told him I was having trouble with my voice.  I’ve been getting very hoarse for 8 weeks or so.  No infection.  Three allergy meds on board.  But, I do have Cowden’s Syndrome, that tumor growing thing I sometimes forget belongs to me too.  And I have a history in the neck.  A 3.5 pound lipoma in 1988, and multinodular goiter on the thyroid in 1993.  Both removed.  Both benign. But…

He referred me to a head and neck surgeon.  I finally mustered up the courage to block out at least one more day of summer, and call for an appointment.  I was met with the inquisition on the phone.  I never got past the receptionist.

“This doctor is a head and neck SURGEON.”

“Yes, I know he’s a surgeon, I was referred for consulation.”

“Well, he doesn’t just SEE people, you need a diagnosis and a referring doctor.”

“I have both.  C-O-W-D-E-N Syndrome.  A mutation on the PTEN gene that causes benign and malignant tumor growth.  I was referred by my genetecist, also a doctor at your hospital.”

“Well, what tests do you have?  He will want a report, a CD, something…”

Sigh.  I just don’t have the fight in me today. “Ok, you win.   I’ll find someone else.”

“Come back to him when you have a diagnosis.”

 

Whatever.  Just whatever.  Sometimes I get a little tired.

chronic illness5

Thats when I shake it off with a quick walk.

I emailed the genetecist back.  I’ll wait.  Again.

I have this pool in my backyard.  And plenty of people I’d like to reconnect with.  And some lessons I’d like off my plate.  And a book I’d like to read.

I’ll get there.  In the mean time, I’ll be at my computer.  Emailing.  Arguing.  Advocating. Communicating.  Researching.  Justifying my existence, and

 

#Beatingcowdens with whatever it takes.

Local Newspaper Coverage

This is already all over for my local friends, but for anyone else who is interested, this article was written for our local newspaper. It will publish in print Monday, but is in the online paper today. Click the link below.

http://blog.silive.com/gracelyns_chronicles/2016/01/post_23.html#incart_river_mobile_home

 

JFRGflyer7