
Saturday, February 26, 2011
Hack!

Thursday, February 10, 2011
Of Questions, and Answers
"It occurs to me that we should treat answers like pronouns, connectors that get us to the next question." *
"On a gut level, it is why the surety with which some people navigate complex issues of life feels foreign, even fabricated to me. I am skeptical of people who “have it figured out.” "
"There is an art to, “the next question.” It is mystery that fuels passion. It is awe and wonder at the unknown that draws our gaze heavenward."
Monday, February 07, 2011
It Feels Good to Feel Good
Monday, January 31, 2011
It is Well.
It is Well...
...with Michaela.
She is doing EXCEPTIONAL.
I can see her again. I can see her. Her eyes are bright again. Her face lights up and her smile is genuine. She talks with clarity. Civil clarity.
Her mind is clear.
She is back.
The issues we are currently dealing with, pale in comparison to what we saw in the hospital. It took some time, but she pulled out of that zombie-like state, and now only deals with some very benign handicaps.
Mainly, one of her meds causes a slight-to-pronounced tremor, depending on the time of day. She can be very unsteady. Let’s just say she can quake like the San Andreas. But it’s not all the time, and it’s not always that bad. Sometimes, it’s really not a big deal. She works with it. I don’t feel comfortable with her walking around on her own yet, and we use her wheelchair in all public places, but it could be worse. She could be completely immobile, like she was in the hospital. Also, when we first came home, she would sleep constantly. She would be alert for a brief time each morning until she got her meds, and then she was like jello. I learned the hard way to put her to bed or in her wheelchair before I dosed her--she was that lethargic, almost within minutes. Then she would sleep all day. But now, she appears to have gotten used to it more. If we’re out and about, she stays awake a whole lot longer, and can even move purposefully (as opposed to like jello) after being dosed. The improvement is very obvious.
Surprisingly, she still hallucinates slightly. But thankfully, her voice has gotten markedly quieter since she came home and started talking again. I have to strain to hear her sometimes, which is a HUGE difference from the past....oh, I dunno, year or so? So the slight hallucinating every so often is really no big deal. Definitely nothing I would make an issue of. She was getting too hyper and manic at the beginning of last week, to the point where she even ripped her g-tube out. We quickly upped one of her meds, and all is calm again. I will take calmly talking to invisible people over mania any day. Like the background seizure activity she has lived with for many years, this psychotic stuff might always be just in the background at the least. If so, background is fine. All-encompassing is not. Hopefully, “all-encompassing” will be a thing of the past.
There is also a cough that interrupts her when she eats, and we just started seeing her pupils dilate unevenly (although Chris says he’s seen it before). The cough is a well-known side-effect of the VNS. Unfortunately for Boo, she already deals with aspiration when she eats, which makes her cough. Add the “VNS cough” and it makes for some messy meals. I’m just keeping my eyes on it for now, to make sure the problem isn’t getting worse. So far, it’s only an annoyance. As far as the pupils go, uneven pupils can be a sign of some pretty nasty stuff. Hers only do it intermittently. Some people’s eyes just do it without any problem, however; and we hope that hers is just a by-product of the trauma her brain has been through and not a new development. Chief warned us that if she gets headaches or vomits with it, or if one eye “does it’s own thing,” we should be going to the ER. Thankfully, I don’t think it will be an issue.
Overall, what do I have to complain about? My girl is back from the depths of some pretty miserable stuff. I was on the verge of putting her in an institution. Then for all intents and purposes, it looked like she would exist in a stupor; just an invalid. Neither came to pass.
I know mercy when I see it.
And I’m grateful.
****
It is Well...
...with me.
I get to be full-time Mommy again. A full-time wife.
I get to be home.
Home...It represents so many things.
Everyone who knows how long I was gone, who knows I'm a housewife, who hears that I homeschool, and especially who hears of how many children I have, knows instinctively that I MUST have been anxious to get back to my life.
They were right.
My world revolves around this address. My husband, so diligent to work a full-time job while attending the University as a full-time engineering senior. My 5 other children, ages 4-11, constantly growing, learning, changing--needing a Mama. My little farmhouse, seemingly sagging and moaning under the lack of routine care and maintenance. My church family, temporarily taking my place in many, many ways.
It's all here, just turning and twisting on an off-kilter axis without me.
I've built my life juggling these balls, and I don't regret setting them in motion. There is something so satisfying about building your life around relationships and investing your happiness in other people. Yes, there are risks involved in that. I understand the consequences.
But I could never have it any other way.
Because see, there is Michaela. The other ball in my act. Slightly un-round, slightly unbalanced, but just as vibrant as the others. I take great care to toss her in the mix with as much strength as every other ball. Even though it takes more effort, more skill...
...more risk.
Someday, she may just fall and break my heart.
But it will have been worth every moment.
I would never have it any other way.
****
It is Well...
...with my soul.
When you go through things that try you, that stretch you, it seems as though people expect your very foundation to be rocked. That you will either dig deep and learn a true lesson of life; turn to God, or you will curse God and move in a different direction.
And, perhaps that happens for a lot of people.
But I can honestly say, that is not my testimony.
On either count.
I don’t think there was one moment when my faith was tried. No, I KNOW there wasn’t one moment. Not one.
Did things end up the way I thought they would? Nope.
That doesn’t bother me.
Did I expect something exciting in Michaela’s condition at the end of it all? Yes. I could see a different outcome. A “good” coming from the “bad.”
But I didn’t pivot anything on it. Not my faith, not my trust, not my foundation.
I decided a long time ago that I would look for the good in situations and focus on that. “Good” is subjective. It varies. It changes. If the good that presented itself yesterday, is not available today, that doesn’t mean it wasn’t good yesterday. It was still the thing to focus on for that day.
But when things weren’t good, and I even felt somewhat in despair, I always knew that it was simply temporary. A door I needed to go through in the journey. And God still fits into all of that.
Even though those types of things cause people to negate God--when things change for the worse. For me, it does nothing more than reiterate His omniscience. From my perspective, life is like a chess game, and God is undefeated. He knows so many moves ahead of the present, that I couldn’t possibly argue with Him on His choice of placement. I can often see the move as it is and see the intelligence in it, even when it turns out to not lead to another move I imagined.
And then sometimes, the move makes no sense at all.
But the fact still remains: my perspective is altogether at a disadvantage. And I don’t question Him.
At all.
People often blame God for the bad, and despise Him for not correcting it. And then some people will criticize medicine, and shout it’s shortcomings from the rooftops. But I see the Divine in the midst of both scenarios, and can hardly say anything demeaning about either one.
Even when I’ve experienced both. It simply doesn’t move me.
Albert Einstein once said, “Science without religion is [crippled]. Religion without science is blind.”
I choose to believe that God has put a lot of time and thought into the science we base our daily existence on. The medicine we practice. The whole of what we know today would not be ours to claim if it weren’t for God’s generous outpouring of knowledge, skill, and tenacity. He’s allowed humankind to know what we know, and to use what we know for our good. Science, medicine, is a gift.
But it is manipulated by imperfect hands. Scientists, or doctors, are not gods. They are at the mercy of their own limitations. Limitations set by God.
So, in this light, I will not allow myself to get bent out of shape at the “grass roots level” when things don’t go the way I had planned. Science has done wonderful things for Michaela. God has allowed it, and I’m grateful. But when science, and even great human minds, can do nothing for Michaela, I refuse to let that rock me.
God can always do something for her.
And if He chooses not to, so be it. That will not rock me either.
I accept the fact that the next move on the board is unclear to me, and I’m perfectly ok with whatever position He takes next. I continue to make my own moves, relying on plays He has pointed out in the past, or holes in the board that seem to open up. Some based on science, and some based on faith.
When it comes down to it, however, I know He will win the game. Yet, I’m enjoying playing with Him anyway.
Because someday, I believe that I will clearly see that He was playing with MY pieces all along.
****
I know I can tend to wax philosophical, and definitely allegorical, so here’s the words to a song that just seems to simply sum it all up:
I’m running back to Your promises
One more time
Lord, that’s all I can hold on to
I gotta say this has taken me by surprise
But nothing surprises You
Before a heartache can ever touch my life
It has to go through Your hands
And even though I keep asking why, I keep asking why
No matter what, I’m gonna love You
No matter what, I’m gonna need You
I know that You can find a way to keep me from the pain
But if not, if not, I’ll trust You
No matter what, no matter what
When I’m stuck in this nothingness by myself
I’m just sitting in silence
There’s no way I can make it without Your help
I won’t even try it
I know You have Your reasons for everything
So I will keep believing
Whatever I might be feeling
God You are my hope
And You’ll be my strength
Anything I don’t have You can give it to me
But it’s OK if You don’t
I’m not here for those things
The touch of Your love is enough on it’s own
No matter what I still love You and I’m gonna need You
-Kerrie Roberts, “No Matter What”
Yup. That about says it all.
Wednesday, January 19, 2011
No More Missing Link




Tuesday, January 11, 2011
Some Stories Just Don't Have Happy Endings
Friday, January 07, 2011
Trust
It's been a month since I updated. A long, boring, frustrating month.
As you know from my last note, Michaela has been living in Children's Hospital's psychiatric unit. And if you know me at all, then you know that her being there--away from me--was a challenge.
I could say a lot about that, but I won't go into much detail. Suffice it to say, there was little to no useful communication with me from the psych team, and I don't work that way. I spoke with Dr. Psych ONCE the whole time she was on the floor.
Ummmm...no. Not acceptable.
And this lack of communication just led to problems, which led to distrust on my part.
In the medical field, you have to build trust. I have to have confidence that the doctors are doing their best for my sick child, and they have to believe that I will do my best to understand the concepts they explain (and if I don't, to ask again) and do what they say to do. Chief and I are a classic example. From day one, he proved that he was working to help her, by going obviously out of his way. And I have always given him the respect his training affords, and have followed the protocols he sets up. Even when I didn't originally agree with the treatment.
As far as respect goes, it is mutual. And now, it's built up to the point that it is not easily broken. It would take something awful huge and glaring for Chief to lose my trust and respect. I don't expect it to happen. I don't expect to lose his.
Psych?....well, psych pretty much bombed in the respect and trust department from day 1. It made for an anxiety-filled month. One I don't plan on repeating.
****
Which leads me into the rest of the story, starting January 3rd. Monday.
Ally had another couple of tests scheduled for the 3rd, ever since the end of Nov. One was a neuropysch evaluation, and the other was an extended, continuous video EEG through the 7th. The neuropsych eval was bumped up to the middle of Dec, but there wasn't any significant information gathered from it. We had already had a vEEG at the beginning of Nov, but Dr. E told me back then that she might want to redo this test a few more times.
So that's what we're doing this week. The second vEEG.
Because I have to stay with her for the test, Monday was the first time I had spent more than 4 hours with her since Dec 2nd. And boy, was IT an eye opener. When I had originally put her in the psych unit, she was hallucinating and slightly manic. On Monday, she was more manic, still talking to unseen people, and like back in October, she was talking incessantly half the night.
Needless to say, I was pretty upset.
I had put my child in the psych unit to get better...not worse. And it was pretty obvious to me that she had regressed and wasn't even doing as well as on Dec 3rd. December was such a rough month for me, for Chris, for the kids, that I was intensely disappointed. At 4:30 that morning, while I was awake listening to her babble on and on, I devised my early morning email to Chief:
To: Chief
From: Boss
Subject: Partying Like it's October 2010
That would be Michaela last night. Talking incessantly with outbursts of growls and screams. Not the entire night, mind you, but enough for me to call for Benedryl.
Not to mention the afternoon of angry hollering, pushing things on the floor, and eyes wild like a cat in a cage.
Tell me again why I put her on [the psych unit] for a MONTH???
****
She continued to get worse each day this week. It was especially noticeable when Dr. E decided to cut her seizure meds in half. The whole point of the continuous vEEG is to capture seizure activity on both camera and computer. That info is then evaluated to determine where the seizures start, what kind they may be, how long they're lasting. If she doesn't have a seizure during the monitoring, then it's not getting any helpful information.
Well, she didn't have a seizure that first night, so in order to induce seizures, Dr. E went ahead and changed the meds to half their normal dose. But she didn't have one the second night either (Michaela usually has her seizures at night). So by Wednesday night, Dr. E decided to take away one of the drugs completely. But it did nothing---same story, no seizures. By Thursday morning, I was asking Dr. E myself if she would completely cut out all the seizures meds. She agreed. I knew we were supposed to be discharged from the Epilepsy Monitoring Unit (EMU) on Friday, and I really didn't want to go through the entire week-long test with no recorded seizures.
In the meantime, her mental state got worse and worse. She was combative, screaming, hollering, speaking unintelligently, angry with me to the point of tears. Kicking, hitting, throwing. Telling me "Noooo!". She couldn't even eat, she was talking or hollering so much. The only thing that seemed to calm her for any amount of time was the occasional Sprite the nurses would bring her.
Thursday night was the climax. She carried on like this to the point where she just collapsed. A true meltdown. I've never seen her that angry; her face that contorted in screams and tears. I got one of the nurses to sit with her so I could get some "fresh air" (ie: a walk through the abandoned sections of the hospital). By the time I got back, she was about asleep. Conked out in the same position she flung herself into--in order to get away from me.
That night, after such a horrific day, her brain exploded into grand mal seizures.
****
This morning, discharge day, she is back to her normal self.
The calm, polite, sweet child that we all know, was back. The turnaround was dramatic.
And pivotal.
****
But back on Thursday, I got my first visit from Chief.
He knew as soon as he walked in, that I wasn't happy. I couldn't fake the smile this time. It was weak, at best. I tried to act nonchalant, all business at first, but we both knew that I was not a happy camper. We had stopped acting "all business" years ago; he had become a family friend, and I couldn't hide my feelings when I knew he already could see right through my facade.
And once again, his kindness and compassion won the day. He just calmly stood there, gave me his full attention, while I asked questions he couldn't answer, and cried tears he couldn't make better. Honestly, quietly, telling me, "I don't know, Boss. I wish I did..."
We both knew I wouldn't consider putting her back on the psych unit on Friday afternoon. They weren't helping her. But what could I do? She wasn't well enough to come home, and there was nothing else he knew to do to stop the craziness. The only viable option was a residential home for mentally ill children.
And it broke my heart right there in that room...
...to even be seriously discussing it.
I promise you, it feels like death.
****
He left without any answers, and no promise of any. Not that I was expecting them. I knew his limitations. He's just a man. A very smart, very kind, person; but still only human. He came back that evening to check in on us. Yet again, with no answers.
His only idea was for me to talk to Dr. Psych. I hemmed and hawed over that suggestion. Why? What good will it do? They wouldn't listen to me before...why would they start now? The ward won't change it's policies for my sake--one person! I mean nothing to them! They have their way of doing things, and I have mine...we don't mix. What's the sense?
And he nodded.
And we stared at each other, while my face was flustered with betrayal and disappointment. My eyes wide and red with anguish over the decisions I was being forced to make for my child. Because the psych ward didn't help her. Wouldn't help her. And now she would have to be away from me permanently.
I was appalled at the suggestion. As far as I was concerned, Dr. Psych was fired. No confrontation, no blame, no anger to be shown. A simple, "We don't need your services anymore." and it would be over with. I didn't have to worry about getting emotional in front of a doctor who I didn't trust enough to care about my pain, my feelings, my hurt.
But Chief was still staring at me. And I knew that if I said "absolutely not" he wouldn't push the issue. Yet I also knew that he had asked me to do it for a reason. That he was considering my anguish, and still made the request. And even though I was not interested in having the meeting, it came down to trust.
"Chief. I trust you. If you want me to talk to that doctor, I will do it. But I'm doing it for your sake, not mine or Michaela's."
"I think you should."
Trust is a very strong thing. I truly wrestled with this request in my mind, and everything in me was unwilling to honor it.
But again, trust is a very strong thing...
"Ok. I will do it."
****
In between meetings with Chief, Ally was very present, and showed true concern for my frustration as well. She let me vent, offered advice, made phone calls, shook trees, did research. In some ways, I know it's her job, but in other ways, you can't fake kindness. Not really. You can't fake caring. Not completely.
And I could tell by her face, her eyes, that she was right there with me. She was pulling for me and Michaela. She was invested on a deeper level than just "doing my job."
And as I've gotten to know her, I believe she does that for all her patients. Giving them a little piece of her to hold on to during the difficult and painstaking process that is pre-surgical testing.
I totally underestimated this woman. She IS a fireball. A no-nonsense kinda gal. But she's not inflexible. And she uses her bluntness and fire for all the right reasons.
She's been a true gift to me these past two months I've known her. And she's become a welcome sight, no matter the news.
That's priceless.
That's trust.
****
Before Chief left Thursday evening, for the second time that day, I made this statement:
"You know what I want more than anything right now?"
"What?"
"I want Dr E to tell me that all this mess, all these hallucinations, this screaming, this psychosis...I want her to just tell me that it's all seizure activity. So I don't have to deal with psychiatry anymore. So maybe,maybe it will go away if they do surgery."
"Yeah....that would be awesome."
(pause)
"What are the odds of that, Chief?"
(pause)
"Winning the lottery."
(pause)
"Yeah. That's what I thought."
****
This morning, I was up early. I slept like a rock after yesterday's craziness, but once I was up, my stomach was churning. Today was the day Dr. Psych and I were supposed to meet. He was bringing Michaela's therapist from the ward, and Ally insisted on being here as well. At 10 o'clock, he would be in my room.
I prayed a lot about this meeting. I just knew that I was upset. I knew that I was justifiably upset. But I also knew that there are two sides to every story, and he was allowed his. I didn't want to come across all irritable, when he may have very good explanations for what I perceived as cracks in the system. I wanted to be fair. I wanted to keep my integrity, at all cost.
But my feelings were very raw.
And every time I thought about the issues that led to this meeting, the tears were still very hot on my face.
So, once again, I asked God to come through for me. To make the journey easier. This time, I asked for something particularly special....I wasn't specific, just wanted Him to arrange things in such a way that I knew everything would pan out alright.
I just needed God to work it out. Work it ALL out. Make the decisions for me. Decide if she would go to a home. Which home. Decide if she would have surgery. How much of the seizures it would help. When she would go home. When she would get better. When I would be better.
And I just wanted to see something that told me, "this is not the end."
I wanted some hope. Because it was very dim at this point.
Partially because, to be honest, I was too guarded to allow myself any.
It's been a long 3 months.
****
At 9:30 this morning, Dr E came in for morning rounds. She remarked about the seizures and how she was glad we finally caught some. But what was even more obvious, was how incredibly normal and sane Michaela was. The change was like night and day.
Even Dr. E was amazed. She ran Michaela through a series of questions to see how she would answer them, and she did awesome. She could barely focus the other day when Dr. E tried to ask. And when she did focus, she couldn't even recall the correct words to say. Today, all the answers were right. Even her eyes looked different, better.
She then turned to me and smiled. In this scholarly way she does, when she's about to drop a bomb's worth of insight...
"So, I'm going to tell you, that this just proves that all this hallucinating, all this psychosis is directly related to the epileptic encephalopathy."
My brain didn't absorb the statement at first, although true to form, there WAS a bomb in there. I have heard "epileptic encephalopathy" for years. It simply means a disease process in the brain, caused by epilepsy, i.e. seizures. We used the term a lot more when she was younger, when she always seemed to be in a stupor of some magnitude. Epileptic encephalopathy was the big, bad reason for it.
And here she was referring to it again.
"Dr. E, could you rephrase that? Are you saying that the psychosis is actually seizures?"
"Yes, it is seizure activity."
"So she doesn't have a separate brain disorder. She's not psychotic, she's having seizures."
"Exactly."
In other words..
...I had just Won the Lottery.
!!!
****
I was visably celebrating after she told me that. Personally, I had always felt like it was the case, but I could never get any positive vibes out of anyone else to confirm my feelings. I had actually been told that it was all a part of becoming a teenager; that teens just get moody and difficult.
Ok, I could accept a little of that, but this was way overboard.
And then when Chief tested the WHAZOO out of her in the middle of Nov, trying to find some underlying condition, with no success at all, we were even more discouraged. It looked to everyone as though Michaela's brain had just given up trying to function properly. That she was in brain failure. It seemed the most likely cause to me once I heard it, because I knew how much she had been through over all these years. Why wouldn't her brain just decide to call it quits?
Who wouldn't go loopy after 10 years of harsh drugs and endless, destructive seizures?
We had already seen her throat do the same thing 5 years ago. It just up and decided that it wouldn't work right anymore. This is why she has the G-Tube. Because even though she can swallow most days, if the seizures get bad, her throat just up and quits working. Totally goes on strike.
So I could accept the concept of her entire brain pulling the same stunt.
But I truly wished it weren't true. I just wanted it to be another type of seizure. Even if it was one they hadn't seen often, or ever. I am used to seizures. I can handle that explanation.
Later on in the day, Chief came in to see us. I had emailed him about my future meeting with Dr. Psych, and a possible solution that I felt would be better than putting Michaela in a mental facility. But I needed his approval for the plan.
Yet now that I had this news from Dr. E, my game plan totally took a backseat in the conversation.
I lit up when I saw him, "Chief! Did you hear our good news!?"
He looks around the room for an obvious answer, "Uhh nooo. What's up?"
"We won the lottery!"
"You did?!? Are you buying a bigger house???"
"Chieeeeeeef! Not the real lottery...! Dr E figured out that the psychosis IS seizure activity!"
(pause)
"Are you serious?"
"Yes!"
He raised his arms in victory, "Alright, Michaela!"
****
After all this good news, my pending discussion with Dr. Psych just didn't seem that big of a deal anymore. Sure, the situation was still very much the same: I still had a child who had not been controlled well enough to come home. However, just the fact that she wasn't a true psychiatric patient, took a huge load off my shoulders. She is strictly a neurology patient, and psych only gets involved so we can add different meds (beside seizure meds) to help control her. And I knew that she wouldn't need to be in the psych ward or in a home to do that. That we could just go back to a Cube or whatever, and tweak the meds there. Even do some tweaking at home if we found a good combination.
That even though it might take some time to do it, she wouldn't have to be away from me.
And from what the psych doc said, these drugs SHOULDN'T take a long time to show if they work (that's anti-depressants, not anti-psychotics). We had already proven that out in Nov when we changed them, and she would switch within hours or days. Unfortunately, she always seemed to go back to psychotic stuff after a week.
BUT....we had really only tried ONE med.
And that was a point I stood on. Since when do we give up after only one med? We've tweaked the fire out of that med: dosing times, dosing amounts, switch switch switch. It never helped bring her home.
SO CHANGE THE MED.
Duh. This is so simple.
But we tweaked that irritating med for 9 weeks. And I was DONE with it.
So, out of the various things Dr. Psych and I talked about, the only thing that really mattered to me was this:
Will you allow us to use you as a consult, if neurology admits her for psychosis? Will you help us tweak the meds on a regular floor under neurology's service? Will you stand behind us trying another drug or two until we make this work?
I got a yes on all three counts.
The rest of my frustrations and anger and irritation melted away.
Because really, when it comes down to it, Dr. Psych was no longer a major player. No need to even "fire" him. We were back in Chief's care.
And I was back on my home turf, physically and mentally.
****
Before Dr. E left after rounding this morning, she decided that Michaela would stay through Monday morning. She was just starting to get the good information, and she didn't want to stop yet.
So between Dr. E extending the test, Dr. Psych (or some psych resident) agreeing to work with us off the psych floor, and Chief agreeing to admit her under neurology, we have a new game plan.
If she starts to ramp back up into psychotic seizures by Monday, then we will readmit her as a neurology patient, and keep messing with the drugs. Now that we know what we're dealing with...what the problem is, we will feel more comfortable playing with the meds and getting the job done.
To get her stable.
To bring her home.
If she stays stable enough to be dischargeed on Monday, then she and I will stay at the RMH for a few days--just to be sure. And if stability continues, we will be coming home. Even if we have to readmit with Chief, it may not take as long as we used to think it should. We could be home very soon.
Home!
It seems too good to be true!
Thank God for special answers to prayer!
For working it "all out!"
Like He always does...
...Preserving my trust.