A Good Doctor is Hard to Find

Today I cried.  (yes again)

I cried because I had to say goodbye to a GOOD doctor.  Finding a good doctor is a nearly impossible task.  But when you do find a good doctor, you want to hold on to him or her for dear life.  And this doctor, in particular, well, we love him.  He has been a part of our family since 2005.  He has tried his hardest to keep my children healthy.  He has overseen 5 sleep studies, 3 adenoidectomies, 2 tonsillectomies, one bout of pneumonia and numerous battles against asthma and allergies.

He is a good doctor in the sense that he takes the time and he LISTENS!  He doesn’t just listen, but he understands my concerns and fears.  He will investigate my concerns and either reassure me that I have nothing to worry about, or he would say “Yeah, you know what mom?  Your instincts are on target, and this what we will do…”

But today I had to say goodbye to him.  He is no longer accepting our insurance.  Which means I have to pay out of pocket for his services. Which is expensive.  And he treats not one, but both of my children, so it gets expensive very quickly.  So it breaks my heart to have to say goodbye to a good doctor.  Having a good doctor in your corner, makes the journey so much easier.  We will miss him terribly, and I can only hope that the next doctor will be just as knowledgable, patient and understanding.

 

Don’t Judge This Book

“I don’t know how you do it.”

“I give you so much credit.”

“You are like Super Woman (Super Mom)”

Ummm, no.  I am not any of the above.  Not even close. When I hear people, friends, family, say this to me, I just want to be so honest with them.

Hey, do you want to hear how I cried yesterday.  I cried hard.  I cried over hamburgers.

The night before any of her procedures, my daughter gets to pick her favorite dinner.  She wants to fill up her tummy with her favorite dinner because she knows that after midnight she isn’t allowed to eat or drink anything until her procedure is done.

But even after the procedure is done, the anesthesia leaves her feeling nauseous and fills her belly with air, so she usually isn’t too hungry.  And then the post surgical antibiotic and steroid upsets her tummy.  So in short, the last meal before her procedure has to be yummy because she won’t have much of an appetite for several days following.

All she wanted was my “delicious homemade hamburgers with bacon” and the usual side fixings, mac ‘n cheese and a vegetable.  Simple right?

It would have been simple if she had a stay at home mom.  Or at least an “I can leave work early” kind of a mom.  But no.  Instead, she has a mom who couldn’t leave work early when the school nurse called to say that her daughter was in so much pain that she couldn’t walk and finish out her day.  Luckily, she has an awesome grandfather who was able to get to the school in record time to pick her up and get her home and resting comfortably.

She has a mom who was sobbing at her desk, and in the car on her way home from work, and again before falling asleep, all because she couldn’t leave early to take care of her baby girl who was in pain; and couldn’t get home early and make her daughter’s favorite meal because she had too much to do before taking off 2 days from work so she can stay in the hospital with her daughter while she undergoes her procedure.

She has a great dad who ordered burgers from the best burger joint in town, only to be cooked by a new chef who burned the burgers…to a crisp.  And just like that her pre-surgery dinner was a disaster.  But then it was saved by a trip to the local ice cream shop.

Ice cream for dinner!

She has a mom who loves her children so much, and tries so hard to make their difficult life easier that when things don’t go right, this mom feels like she failed her children.

So no, I am not that special.  I am not anyone’s super hero.  I am not someone who gets it all done.

I am someone who is Just. Like. You.

 

 

 

Once is Enough

A few months ago, I received an invitation in the mail.  As I read it, I was flooded with sadness.  Invitations generally are not supposed to invoke sadness, especially invitations to reunions.

I set the invitation aside and contemplated whether or not I should attend.  I knew that in my heart I really wanted to go, but at the same time, the thought of attending just overwhelmed me with anxiety and sadness.

I called my mom and asked her if she wanted to be my date for the event, as always, she agreed.  She thought it was wonderful that the NICU was hosting a reunion.  She thought it would be great to see all the doctors and nurses that saved my children’s lives when they were born.  Of course she was right!  It would be nice to see everyone and show off how big the children have gotten despite their scary start, but I was sad that I couldn’t share her excitement and joy.

I am incredibly grateful and indebted to the all the doctors and nurses that cared for me and my children.  There is nothing that I can ever do or say to repay them for giving me my children’s lives.  I still send Christmas cards to the NICU and am still in contact with 2 very special nurses.  But I don’t like to think about those dark, dark days.  I guess this is why I haven’t really kept up with this blog.

Having spent so much time in the NICU left me traumatized.  I don’t want to put too many more words into trying to describe my experience, so I will only use one: traumatizing.

The morning of the reunion I prepared my mom and told her that I was going to try to keep it together, but I knew that it would not be easy.

Walking into the event hall I already felt the lump forming in my throat.  I scanned the room and found the doctor who performed the emergency chest tube insertion on my son who was 3 days old and weighed a little over 3 lbs. at the time.  My son’s lung developed a small hole, and the doctor had to make an incision into his chest and insert a tube to suction out the air being forced into his small body by the C-PAP machine.

So much time had passed since I had last seen this man.  Thirteen years ago this doctor saved my son’s life.  I walked up to him and began to cry.  And I could not stop crying.  I could not even speak.  The doctor has no idea who I am, or my son’s name.  All he could gather was this woman (me) walking up to him, crying, and trying to stammer out “Thank you.” and hugging him.  There is so much I had wanted to say, and so much that I could not.

Thankfully, my son was able to speak for me and introduce our family.  I looked over to my mom, but she was crying too.

I was just very emotionally overwhelmed by the number of people in that room who were alive because of the doctors and nurses who saved their lives.  I was overwhelmed by the number of parents who are also hurting due to the losses they endured, and yet, so eternally grateful for their beautiful children that are alive thanks to these doctors and nurses.

I came across a woman who was proudly sharing her pictures of her baby in the NICU with the various doctors and nurses.  She assumed that I had pictures as well.  I firmly told her that I did not.

I do not regret my decision of not haven taken any pictures of my children while they were in the NICU.  In fact, I refused to allow anyone to take pictures.  It was awful enough to witness my babies being attached to machines and IV’s and heart monitors and blood pressure cuffs and PIC lines and a chest tube.  NO!  This was not something I wanted to record.  Or remember.

I had only 2 pictures of my children in the NICU.  They were taken by the NICU staff.  They are blurry Polaroids and they are enough of a memory for me.

It wasn’t until about 2 years after they were born that my dad was having trouble with his computer and he asked me backup his computer and photos.  Lo and behold, I came across several pictures of my children in the NICU.  I was shocked and angry!!

My sister, who was pregnant at the time, had snuck into the NICU and had taken pictures of them.  She defended her actions and told me that she did it because she thought that maybe some day I might change my mind and she wouldn’t want me to regret not having these pictures.  She felt that maybe the children should know how their lives started.  It is a part of who they are.  I still do not agree, but I did save the pictures.

I have a special album set aside with just those NICU pictures.  That album is not viewed very often, but it is there if they ever want to see those pictures.  My children have very typical baby albums, it’s just that they begin when the twins were 2 months old, which is when my son came home from the hospital.

Try as I might to forget those dark days, they have left an indelible mark in me.  I tucked all the pain of watching my children struggle to breathe into the deep recesses of my heart and mind.

I have new heartaches that we contend with on a very regular basis.  I have shifted my energy and focus on my children’s growth and development.  I have been navigating the rough seas of their accumulations of diseases, syndromes and illnesses.  I have been dedicated to following up with each specialist and follow the regimen of medications, supplements and therapies.  I celebrate their milestones and try to not relive the past.  But it does have a funny way of sneaking up on you.

While it was a wonderful opportunity to try to say thank you to very special people, I don’t think that I will be attending anymore NICU reunions.  There are just something things I want to experience once.  NICU stays and NICU reunions are on the top of my list.

 

When You Know More than the Doctor

After my last post, I decided that I needed to finally do something more to take charge of my children’s medical situation.  I had been thinking about doing this for a really long time, but just never to around to making the appointment.

I was able to snag an appointment with a geneticist at a big city hospital in NYC.  I had such high hopes, although I really wasn’t sure what to expect.  I think I was expecting for the geneticist to connect the dots on most, if not all the different diagnoses.  I was looking for that AHA! moment; the smoking gun; the secret that would unlock the reasons why my kid’s medical charts at our pediatrician’s office are the size of the unabridged version of War and Peace.

Alas, the answers remain elusive.

After describing my daughter’s condition, the geneticist flat out told me “You know everything that you need to know about your daughter’s condition.  There is no test that will tell you more than what you already know.”

In the end, it turned out that what I know about Klippel-Trenaunay Syndrome is more than the geneticist knew.  I ended up providing her with more data and current research than she had known about.  So I am waiting for her to review the data and get back to me.

Very recently, there was an amazing “accidental” discovery that begs further investigation.  In short, mice were injected with the PIK3CA gene.  This gene is known to be responsible for causing certain cancers.  I am not sure what they were looking to accomplish, but the accidental finding was that the mice began forming venous malformations*.  The really special part of this research was that once anti-cancer drugs were administered, the malformations were successfully treated.  I am not a doctor, I don’t exactly understand how the malformations were successfully treated, but it sure is an interesting concept.

*Venous malformations are a very large part of what makes up Klippel-Trenaunay Syndrome.

Again, I must put out this disclaimer: I am not a medical professional.  I am a very worried mom who has the capacity to learn and retain too much information, more than what is for my own good.

I am worried because, on the flip side of this gene, I am very concerned that a gene that is known to cause cancer can potentially also be responsible for causing venous malformations.  This information is a bit unsettling to me.  Does this mean that if you have venous malformations, and you test positive for having the PIK3CA gene, should you also be on the lookout for cancer in your future?  In my case, should I be more worried about my daughter’s future?

The geneticist could not answer my questions, nor could she allay my fears.  She did say that she thought that I didn’t have much to worry about.  But I am a mom.  I will always worry.

Much later on, the discussion finally shifted to my son and his newly acquired set of diagnoses.  Now the geneticist was able to flaunt her stuff.  She is very interested in what he has been going through.  So we will make a return visit to her for additional testing.

In a generous way, the geneticist wanted to offer me resources for my daughter’s condition.  She logged into her secret network of medical websites that are locked away from the general public.  She started looking up treatment options for Klippel-Trenaunay Syndrome.  Her first search yielded the name of a highly regarded physician who is on the cutting edge of treating KTS.  I said “Thank you, I am very familiar with this physician, he is my daughter’s surgeon.”  The second search yielded a picture of my daughter’s hematologist.

She sat back in chair, gave a great big sigh and said, “I am sorry, but as I said at the start of our conversation, you know everything you need to know about your daughter’s condition.  You are already being treated by a leading expert in this field.  I am sorry, but I cannot help you.”

Back to the drawing board!

Reliving the Nightmare

During these last 4 months, the amount of hours I have spent hanging around waiting rooms in hospitals and doctor’s offices is staggering.

Since November 2015, I have taken my children to over 31 doctors appointments.  Thirty One.  31.  So far…I can think of at least 5 more upcoming appointments in the next few weeks.

  • My daughter has endured lying in a MRI machine for 2-3 hours at a stretch on 3 separate occasions so that 6 parts of her body could be imaged.
  • She has undergone 2 surgical procedures since November, and I just scheduled her next surgery for next month.
  • My son has acquired 6 new diagnosis’s since last June. SIX.
    • Sensorineural Hearing Loss
    • Osteochondritis Dissecans of the Knee
    • Fractured Wrist
    • Tinnitus
    • Scoliosis
    • Abnormality of the Retina (still investigating)
  • We have acquired more medical equipment as well.

I have spent countless hours traveling to and from these appointments, anxiously waiting for results and outcomes.  I have met new people in our journey and have revisited old doctors and friends.

As I was running to yet another appointment I bumped into someone I hadn’t seen in a really long time.  She is someone whom I would rather have not run into.  I would be happy if I never saw her ever again.  In this lifetime, or the next.

She is a very sad woman.  She is a woman who is easily overwhelmed; she overthinks and over analyzes everything; she doesn’t laugh very often.  She looks like she doesn’t get enough sleep and doesn’t take time to care about her appearance.

I saw her and tried to avoid her gaze, but it was too late.  I was marveling at how much older she looked.  She now had gray hair sprouting at her temples.  She had more lines on her forehead, I am guessing from furrowing her eyebrows.  She had bags under her eyes, you can tell that she has been crying a lot.

We stared at each other for a long moment and I said “I remember you. And I remember how much I don’t like you.”

In the dark corner of my mind I heard her reply, “It’s not me that you don’t like.  You are back where you started and it’s turning you back into me.”

And then I washed my hands and exited the bathroom.

As I sat in the waiting room waiting for my son’s name to be called, I couldn’t stop thinking about her.  About me.  How can this happen to me again?  I thought they outgrew all this prematurity stuff.

Thirteen years ago, I gave birth to premature twins.  31 week survivors.  And while we have our share of medical setbacks, I knew that we got off relatively easy.  We were ‘lucky’.

We were spared any serious neurological damage or delays.  Milestones were met, maybe a month or two behind at times, but nothing substantial.  Here they are today, standing beautiful and handsome at 13 years old.  Teenagers in 7th grade.  One child is on high honor roll, the other on honor roll.  We are so lucky.

But looking back, the first 2.5 years of their lives, we lived a nightmare. Our days and nights were filled with doctor’s appointments, needles, crying children, a hysterical new mom and with an ever growing list of diagnoses, some of which we had never heard of: Respiratory Syncytial Virus, Kawasaki Disease, venous malformation, lymphatic malformation.

While trying desperately to keep my children healthy and trying to learn about these rare syndromes and diseases, I became that woman whom I detest.  That woman who got lost in trying to keep up with all the medical jargon that the specialists were throwing around, while trying to keep sane, manage working a full-time job while dealing with 2 small babies who were quickly becoming medically complex.  I lost myself in all that.  I became ‘that’ woman.

But over time things began to settle.  It wasn’t perfect, but it became our ‘normal’.  The best way I can describe it is to picture me in a busy diner trying to carefully balance a tray of dishes that are deliberately stacked in tidy little piles.  Everything on that tray is positioned in a very deliberate order so that things make sense and that the tray is not overburden or confusing.

After what seemed like a great stretch of time, it looked like they left all their preemie-ness behind them.  I was able to say goodbye to ‘that’ woman.

We got all our crazy diagnoses in order, along with their treatments neatly packed into our lives so that we could live, laugh, have fun and still be able to deal with the medical issues without throwing our family and schedules into utter chaos.

So now.  Imagine navigating that busy diner, tray balanced on one hand, making our way, and then BOOM!  Here comes a crazed toddler, being chased by a dog who got away from its owner and both the toddler and dog go crashing right into you.

That is what happen to us last June.  We were back at different doctor’s offices looking for answers. We now have an even better understanding of the human body.  It has been one-on-one training from skilled professionals.  My children are beginning to think that they will eventually become healthcare professionals when they grow up.  At this point, they would probably be able to teach a class or two.

I am trying to remind myself that as uncertain as everything is, I will learn from this the way I did last time.  I will be a stronger and better advocate for my children.  Now they are old enough to understand and help us make decisions about their ailments and treatment together.  But at the same time, I am back to feeling overwhelmed and exhausted because my children started becoming medically complex again.  I am back to being anxious as I dread taking time off of work, pulling the kids out of school for more appointments and hanging on every word out of each medical professionals mouths.

I know this road I am traveling.  I know this woman.  I needed to avoid turning into ‘her’ again.  But here we go again.

 

 

Denial Is an Ugly Word

I sat in the parking lot of my pediatrician’s office considering what I had just been told.  I silently started counting off the number of medical devices that have been prescribed to my children:

  1. The dreaded c-pap machine for my son’s sleep apnea.
  2. The nebulizer to treat the twins (and myself) for asthma.
  3. A stethoscope that I acquired after my son’s bout with Respiratory Syncytial Virus (RSV).
  4. An ophthalmoscope – don’t ask how I ended up with one of those.
  5. 3 sets of crutches.
  6. A wheelchair.
  7. A hearing aid to combat my son’s tinnitus.
  8. A blood pressure monitor to keep an eye on my blood pressure.

What is wrong with me?  Why am I not willing to look at the situation for what it is?  I own enough medical equipment to start my own small pediatric practice.  I have medically complex children.  Not one, but two!  And one who has serious mobility issues at times.

I sat there blotting my tears away, and trying to convince myself that marking the box “Permanent Disability” didn’t mean that I was giving something up.  Marking that box would mean accepting a truth that everyone can see, but that I was unwilling to admit to.

After much self-talk, coaxing and cajoling, I eventually resolved myself to checking off that dreaded box.

I unfolded the application for the handicapped parking permit and saw that the pediatrician had already checked off that box.  I silently thanked her and drove to get our new permanent handicapped parking permit.

Who me? In Denial? Nah

Several weeks ago I needed to renew the temporary handicapped parking permit I acquired for my daughter.  Because it is a temporary permit, we have to get it renewed every  six months.

I have been renewing the permit, every six months for the past 4 years.

The day after her 11th surgical procedure on her leg, she was back to using her wheelchair.  I knew her wheelchair use would be temporary and transient.  She would be using it for about a week or two, until she could bear weight on it again.  I reached for the handicapped parking permit only to realize that it had expired two months earlier.  We seldom use it, only when she is in too much pain to walk.  So there it sat in my glove box, expired, for over two months.

Trying to be helpful, I presented the partially completed application to renew the permit to my daughter’s pediatrician.  I easily provided the basic stuff, name, address, patient information.

While reviewing Part 2 of the form “Medical Certification” the pediatrician asks me to spell out her diagnosis – Klippel-Trenaunay Syndrome.  The pediatrician asks me if we should be checking off TEMPORARY DISABILITY or PERMANENT DISABILITY.  Without hesitation I blurt “Temporary! Like always.”

The pediatrician asks, “Why do you keep torturing yourself like this?”

“Hmmm? What?”

“Well, every 6 months for the past 4 years you keep renewing the permit.  I thought your daughter’s condition is a lifelong condition.”

“Yes, it is, but she doesn’t need to use the permit everyday, just occasionally, on the days it’s too painful for her to walk far.”

“I understand, but if you mark off permanent the permit will be good for 5 years and you won’t need another medical certification when it’s time to renew.”

While tears burning my eyes, I fight back the tears and with a very tight voice firmly state “Yes, well, what you do not understand is that if you check off permanent, then…then…the truth is…I physically cannot bring myself to out a check mark in that box that says permanent.  My brain, heart and hand will not allow me to check off that box.  Because that would mean that I would be making an permanent admission, on a legal state form, something about my daughter needing handicapped parking privileges.  I will be saying it aloud.  And that is something that I cannot do.”

And then I couldn’t hold back the tears.

My pediatrician signed the document and handed it back to me.  Both boxes unchecked.  I was given one instruction.  To please photocopy it and return a copy to them for record keeping after I checked off the “appropriate” box.