Back in the Saddle

I'll start this post by saying Sis is just fine.

Last Thursday, she had horseback riding as usual, on her beloved pony Murphy ("her" is relative; we partially lease him.)  She was out in the back paddock cantering (faster than a trot) and Murphy spied a wild turkey in the woods.  I guess Murphy doesn't like turkeys because he spooked and jumped sideways, but Sis continued her forward trajectory right over his neck.  She landed on her right side on the ground.  She says she didn't hit her head but did bend back a finger.  

When I showed up after the lesson, knowing none of this, the first thing she said was, "I fell off, but it's not Murphy's fault!"

In fact, she had the presence of mind to immediately grab his reins so he didn't spook again or try to eat grass (horses can choke if they eat with their bridles in place), something that is drilled into them. People came immediately to check on her and she got right back up on him.  So brave!

Of course, we don't blame Murphy.  These things happen--and she wears an expensive helmet because of it.  I teased her, "Did you think I was going to go out and shoot the pony like in Gone with the Wind?"  She was horrified and now doesn't want to see one of my favorite movies of all times.  (And that's not even a big part of the film, but I digress.)

Anyway, she started having headaches that evening and so we consulted with Goo, my brother-in-law who is now a doctor at a hospital nearby, and he said to watch her; nobody wanted us to go to the ER at night if we didn't have to.

But it did happen the day that it was announced that NFL player Aaron Hernandez had advanced brain damage (CTE) at the time of his suicide.  From multiple concussions.  So we were pretty vigilant.

We let her go to school the next day, but by Friday evening we were at the pediatrician's office because her head hurt when she moved too much.  No obvious concussion, but the doctor put her on limited activity for a week--no horses, no skating, no PE in school; we'll go back if it gets worse or doesn't go away (it hasn't completely gone away yet.)  By the way, did you know that cocoon treatments for concussions--no activity, dark rooms, not even much mental stimulation (like music or audiobooks)--is on the way out?  I didn't either.  Apparently it doesn't actually help children. The doctor was even more concerned about the aching middle finger on her right (not writing) hand and sent us for x-rays on Saturday morning.

Not broken!  Just sprained.

WHEW.  

I know missing all of her activities is a hardship, but, considering how awful it could have been, well,  I'd say we are lucky.   And my dad always says that it's better to be lucky than good!

As a horse-loving friend said to her, "Silly Murphy!"

A-Ok

Saw my doctor about my bloodclots today--all good on that front.  Will take the Xarelto for six months instead of four.  Fine.  He reassured me about some of the aches I've been having.  (Some days I feel like I could become quite the hypochondriac!  The days are long; the pangs are sharp sometimes.)  He was amazed at how much better I looked, said I was a totally different person.

My surgeon's appointment has been moved to Tuesday, but I'm not worried about anything.

Feeling pretty good, all things considered.

How To Get Through Abdominal Surgery

A friend recently posted that she has to have laparoscopic abdominal surgery this summer and asked for advice.  I realized we've had some experience with this, from my c-section, to Mama's hysterectomy and complications, and then to my emergency small bowel obstruction and re-section.  Smaller than those procedures, we've also had a few D&Cs and two abdominal hernia repairs.  So, we've had some experience.  Which I thought I'd impart here.  But I will write that in no way does this post constitute medical advice.  You should listen to your doctor.

Beforehand (*if you know, of course!)

• Sleeping Arrangements:  Figure out where you're going to sleep in the days after surgery.  Stairs can be a challenge; couches might not allow real rest.  I have found it easier and better, for me, to climb to my bed and stay on the second floor for a few days.
• Ativan:  if you are at all prone to nerves, ask for a prescription for Ativan or the like for the night before and drive to the hospital.  It just dulls some of the often considerable anxiety.
• Groceries:  Depending on doctor's orders, you might have a special diet.  We always have easy snacks on hand because sometimes your appetite is small and it's easier to eat lots of little things.  Crackers, granola, bananas, peanut butter, white bread for toast.  I also like to have my favorites on hand to tempt me--I like Cream of Wheat when I don't feel well.  And eggs over rice with soy sauce.  And marmalade on toast.  Also, drinks.  I like iced tea, homemade or other, also coconut water.  Kefir and yogurt are also good for the probiotics.  We keep some of these in the bedroom, especially the high-protein ones, to go with medication or late-night snack needs.  See Eileen Behan, Cooking Well for the Unwell, for recipes and ideas about nutrition--protein seems to be very important to healing.
• Prescriptions:  Some doctors give you your pain meds Rx beforehand so no one has to rush out to fill it right after surgery.  Ours never did.  It would have been helpful, though.
• Medical supplies:  
• Because you'll do wound care at home, it's good to have supplies of gauze, paper tape, bandages, whatever, plus an antibiotic cream, if suggested.  Follow your doctor's orders for how to take are of it (mine wants me to use baby soap to shower!)  
• If the surgery is gynecological in nature, you might need extra-absorbent pads.  The ones from the hospital are super bulky and don't stick well.  Have a supply of your favorite brand at the ready.
• The hospital will give you a surgical binder; if not, Amazon sells them.  It helps to have two, for washing.  
• You'll want pillows:  to hold onto when you sit or sleep, to give pressure, especially if you cough or sneeze (oh, awful.)  Also protects you from overly excited pets and little people.   A small stuffed animal would work as well--and be cuter!  (Like the lop-eared bunny ISMITE that my family brought.)
• From my back injury, I love my little bed rail, which helps me turn over at night and get up in the morning.  Probably not necessary for a single surgery, depending.  But I LOVE mine.   
• I also have a temporary suction handrail in the shower, which helps me stay balanced and get in and out.  You can get these at Bed, Bath & Beyond.  It's more for peace of mind.  And again, with my back injury, my healing was long and slow and these things were necessary.  Now that we have them in the house, I find they are doubly helpful post-surgery.  I'm not sure I would have bought them just for surgery.  Well, maybe the shower rail.  
• Clothing:  Check your wardrobe for loose, baggy clothes that won't bind in the days and weeks afterwards.  I wear yoga pants and men's pajama bottoms with ties that can be tightened or loosened.  I also wear layers because my sense of temperature changes.  I also like having pockets.  Wear what is most comfortable to you.  
• "Phone Tree":  Choose someone to be your point of contact to get the word out to loved ones when you're ok.  Cell phones and FB/email really speed this along.
• Other helpful ideas:  
• a tray table:  for eating on the couch or in bed; also very useful to protect your abdomen from pets while you're lying in bed.  The cats so love to sleep on Mama that she slept under the tray table for weeks to keep them from jumping on her tummy.  
• a box or basket:  we both were always losing the telephone, cell phone, tv remotes, pens, etc in the bedcovers.  A little basket or box helped us keep track of things.
• drinking cup with straw:  it helps to have a spill-proof cup with a straw, especially when you're still in bed.

What to Expect in the Hospital
Depending on the doctor and hospital procedures, your experience might be very different.  Of course, do what your doctor and hospital staff say.  In planned surgeries, there is usually a pre-admission appointment, with blood tests, maybe heart checks.  Often, you're assigned a day but not a time; you often get the time the day or two before . . . and even then there will almost always be delays.  You go, check in, and eventually they take you back.  Sometimes your partner can go with you; sometimes they have the partner wait until you are enrobed and on your gurney.  In the ER, Mama and I were only separated during my x-rays and my CT-scan.  There is always a lot of waiting and time moves so oddly in the hospital.  Eventually, they'll start an IV and then you're off.  For my recent surgery, I was unconscious before the gurney left my room to go down the hall (or at least that's how I remember it; Mama says I'm missing parts of my timeline.)  And then at some point, you'll wake up in recovery.  Often they don't have your partner with you until after you wake up.  I think I woke up and fell back asleep a few times in recovery--I don't even remember being transferred to my room.  But eventually you'll be transferred to your room.

Depending, you'll be on a catheter for a day or so, with an IV.  I wasn't allowed anything by mouth, but Mama was allowed liquids almost right away.  Liquids includes jello, broth, juice, etc.  You'll then progress to regular food.  Best. Meals. Ever.  Order whatever you like from the menu.  I always seem to crave the roast turkey with mashed potatoes and gravy, green beans or corn, and a roll, with chocolate pudding or rice or tapioca, and hot tea and gingerale.  That's two hospital stays now . . . but then, it's hard to mess that up.  Mama herself had a dozen or so meals of baked potatoes!!

They'll wake you up in the night to check blood pressure and temperature.  This is when people complain about not getting any rest at the hospital.  I didn't mind the visits, maybe because I always fell back asleep.

TV in the hospital is an odd thing.  I kept it on all the time, day and night, as did Mama (though, not when we had the babies.)  It is distracting background noise so you can't hear other people and all the beeping machines.  It's company when you're alone.  It keeps your mind off pain and worry.  I think it even helped me keep track of time--I could mark that an hour had gone by.  I always seem to watch the stupidest stuff that I'd never watch at home (and I definitely can't watch cooking shows in the hospital.)  Mama watched "Deadliest Catch," "World's Most Dangerous Roads," "Ice Road Truckers," something about Arctic gold, pawn shop stars, was there storage locker wars?  I watched "Ancient Aliens," "Swamp People," and others.  And there's always the Weather Channel!

I was shocked at how quickly they got Mama up and about after her robotic hysterectomy--that night, even (but only once the catheter is out.) Anyway, don't be surprised if they are constantly encouraging you to get up and walk, sit in the chair, even shower, pretty soon afterwards.  And the walking, while slow and painful at first, even with the binder, is so important, especially to getting your bowels working again and also to help break up gas pain, which can be very uncomfortable.  You'll need to either pass gas or have a bowel movement for them to discharge you--apparently, the colon is the last part of the body to wake up, so it's function proves that you are healing relatively normally.  No doubt they'll be giving you a stool softener and fiber in the hospital, with instructions for more at home.  Suffice it to say, the first few bowel movements are difficult, regardless.  But you'll get through them.

A note about nurses:  BE NICE.  I'm always confused about the hierarchy (tech, RN, APN, nurse manager, charge nurse, and others) of nursing staff in hospitals and the shift changes, even who is in charge of me; it's all made harder by narcotics!  Recently, our hospital has put up these great white boards where your tech and nurse sign in so you know their names.  Use their names.  They are people, taking care of you at one of your darker hours; they have to stick you and wake you up, even stick an NG tube down your throat, not because they want to but because you need it and it's their job to do it.  They have amazing resources--compassion and knowledge--that most will willingly demonstrate.  But if you are mean, rude, or even indifferent--trust me, because I see it weekly in nursing homes--your care will be less . . . careful.  I don't accuse nurses of hurting or punishing people who aren't nice--they're professionals after all--just that, well, trust me, you'll feel better if you're nice.

While they'll have so much of what you need at the hospital, including toothbrush and paste, soap, shampoo, and towels, you might be more comfortable with some of your own things.  When Mama was in surgery, I had her overnight bag in the car and I fetched it before I could go see her, after she was in recovery.  When I had surgery, she rushed home in the wee hours of the morning to throw some things in a bag, though I didn't need them until much later.  Some things we liked to have:

• robe, for walking the corridors in comfort
• slippers or shoes, also for walking the corridors.  Slip-on Merrills were great--supportive and non-slip, also easy to get on without bending over.
• extra pillow (see above) for coughing and support, etc.  
• cellphone and charger (longer cords that reach the bed are great, at hospital or at home!)
• a set of clothes to wear home, plus extra underwear and socks
• deodorant--there are always your own bodily smells in hospitals (earthy, sick, unfamiliar, distressing smells) and I like to lessen some of it
• hand lotion and lip cream--it can get so dry in hospitals and I like the scents of my own products sometimes (funny, I didn't need my own soap and shampoo, though.)
• if you have long hair, consider a scrunchy or hair band to hold it back.  

Miscellaneous

• Mama was wonderful to bring me pens and notecards so that the kids had something to do while they visited.  Then we decorated my wall with them.  Goo also brought me a notebook to write in when I couldn't comfortable talk with the NG tube in.
• I usually leave behind whatever flowers I receive with reception on my ward, a small thank you.  The kids also brought a big plate of Italian cookies as a thank you to the staff (I think I brought cookies to Mama's ward, too.)  And we had filled out numerous positive comment cards.  
• There is just no predicting when doctors make rounds, though it can be really early.  I missed them on many of Mama's days and vice versa.  But they often answered our pages quickly, when we had questions.  It's amazing what the staff can do with email these days.  

Afterwards at Home

• Discharge instructions:  Discharge always takes longer than you think it will, to get the doctor's sign off that you can leave and then have the right person come and give you instructions.  I was surprised that I could walk out of the hospital if I wanted to, but since it was a long walk, I opted for the wheelchair.  It reminded me of being wheeled out with the twins--I told them how two people handed me money for them ($20 and $50, I think it was) and wished us luck.  Mama took down my bag and fetched the car, while the kids walked beside me in the wheelchair (which they thought was odd.)
• Walking (or that uncomfortable discussion of bowels!):  If you're home, your bowels have returned somewhat to normal.  But it doesn't really feel normal, especially after bowel surgery.  I'm sticking to a bland diet, no raw stuff (to avoid food poisoning and excess gas, which is awful), no gassy stuff even well cooked (cabbage, broccoli, beans), no oily or fried things which also cause gas, and food only from people or places I trust--I can't even bear the thought of food poisoning.   I have also found that several small meals are better than three regular ones, if only because a full stomach presses in odd places.  I also try to have yogurt or probiotics everyday, to repopulate my gut well.  But when I chose poorly or ate too much and didn't feel well, walking was my lifesaver.  Walk, walk, walk.  It moves things along, keeps me from being too sedentary, keeps a few muscles going, gets me outside in the sunshine, even helps me be social with neighbors.  Walking has been really really helpful.  Yes, I started slowly--just around my room, then once around the hall, until I could do 3-4 circuits of our ward.  Now I do 15-30 minutes up and down the driveway or sidewalk near the house (so I don't get too far from home) at least three to five times a day.  Not fast--I call it my "surgical shuffle"--just one foot in front of the other (I always carry my cellphone in my pocket, outside or even in the house, just in case . . . . )  I didn't do it enough after my c-section and Mama didn't do it enough after her surgery, but oh, it is such a help.   Both the nurses on my ward and even my surgeon commented how well I was doing with walking. Not just for bowels, but for everything.  I would say it's my number one recovery advice.  
• Reflux:  speaking of food, it's good to have some kind of treatment for indigestion, especially in the beginning where I'd be napping or lying down after eating, which contributes to reflux.  Now I try to sit up for an hour or so after eating and not eat too close to my afternoon nap or bedtime.  
• Pain meds:  I'm a firm believer in pain meds, in staying on top of the pain.  I don't worry about addiction, but then that's never been one of my challenges (my addictions are digital and edible, separately of course.)  I've been told that if you really need the pain meds, you can't become addicted, but I don't know.  I find it's best to keep a list of the times I take pills; otherwise, day in and day out, I forget when and what I took (I also sometimes just email Mama so that we're both keeping track.)  In the beginning, I took them as often as I could.  Then, I got the heavy dosage of Percocet down and switched to something less powerful, Vicodin (which I didn't know was less potent than Perc.)  Right now I'm on one a day, midday, when I'm tired and achy, to get me through the evening hours with the family so I don't hibernate upstairs in pain.  When the Vicodin is too much, I'll move to Tramodol or Tylenol with codeine.  Interestingly, I don't always recognize that I am hurting; I do notice that I get grumpy or snippy or sad or anxious, and THEN I notice that I've been hurting.  I try to take the minimal number of painkillers I need to stay comfortable, but sometimes I figure incorrectly (take too few) and hurt anyway.  It takes a lot of awareness.  I find I move more and do more when I'm properly medicated so it really is a major part of my recovery.  (When I was under-medicated for my back pain, I didn't/couldn't move much at all and that was a disaster.)
• Meditative Tools:  To supplement painkillers, utilize your own familiar, personal technique for relaxing, being mindful, etc., be it a "happy place," meditation, or the like.  I found Toni Bernhard's How to Be Sick to be the most helpful thing I've ever read regarding pain management and mindfulness.  (See also here.)  Counting my breaths, acknowledging that all things change, focusing on the present and not worrying about the future, have gotten me through so much pain and, I truly believe, actually lessened my experience of the pain because I've minimized the suffering.  (Pain being the physical sensations, suffering being the mental thoughts about pain.  But others explain it better than I do.)  When I am not mindful, my mind goes to my deepest fears and anxieties about loss, illness, and death.  It is best to stay in the present.  But it takes practice and you will have days where it is hard to stay present (I'm having one of those days today, hence posting on my blog!)
• Meals and errands:  Some people find it very hard to ask for help.  I've gotten better at it over the years and realize how much it really does make a difference.  I cannot begin to tell you how helpful it is to have people bring meals.  We have been on the receiving end of meals now maybe six times, beginning with the birth of the babies, and it is amazing.  Not only is it physically nurturing, it is emotionally uplifting to be embraced and enveloped by generous friends.  Even if you get a lot of pasta!  Besides, pasta is versatile, easy to reheat, and almost everyone eats it.  I've organized meals for others several dozen times, first using clumsy old email lists and now beautifully streamlined with my favorite site, Food Tidings.  There are other sites, some that even do errands and such, but I like this one, probably mostly because of my familiarity with it over dozens of uses.  But I have already written about organizing meals.  Being on the receiving end just helps immensely.   
• Distractions:  Books might be too heavy or require too much concentration, though the heft  problem can be fixed with an e-reader or magazines.  I had fun going to the store to choose magazines for Mama before her surgery--lots of different titles she would otherwise never have read--civil war history, photography, cats, British travel, etc.   I also opt for constant internet contact--I can lose myself in Facebook and Pinterest for hours--as well as television.  Nothing like bingeing on Netflix.
• Visitors:  Long recoveries reveal some uncomfortable truths:  some people just are not comfortable with illness or injury.  I won't say I've lost a friend over my back injuries or surgery; I've just noticed which ones aren't bothered by it and which ones are.  I like to have visitors and am thrilled that I can sit downstairs and receive friends.  It helps when I can be honest with them, if I need to keep it short or need to lie down in the middle or run to the restroom.  I'm usually tired afterwards, but with spirits lifted, it is worth it.  Friends make getting better so much easier.

That's all I can think of now, but I will add to it as more comes to me.  If you face similar circumstances, I wish you the best of luck, with quick and gentle healing.  Get well soon!

Monday

Gommie and I are watching tv--lots of BBC like "Mr. Selfridge" and now "Sherlock," alas I didn't set our new cable/DVR system right to tape "Wolf Hall," but I got it for tonight--and resting after a wonderful Easter and several days of intensive activity.  Well, as intense as two wounded folks can do.  Mom's stenosis needs a break and I'm, well, still recuperating.

Especially because there were signs of infection this weekend and the surgeon on call saw me Saturday afternoon.  Instead of treating the minor surface infection with meds, he removed my 20 staples and packed, ugh, the bit that was oozing.  I've got butterfly tape across the whole thing, plus dressing, and my binder to hold me altogether.  It was exhausting.  Plus, he really questions the cardiologist's diagnosis of the blood clot--he thinks it's a vein infection, phlebitis--and so said to call Monday to schedule new tests.

I go for an ultrasound on my leg at 3.  In retrospect, I realize the cardiologist was less than thorough and I would rather not be on the heavy-hitting Xarelto, so I'm glad for the test.  Well, as glad as I can be about another little tick in my recovery timeline.  Still, ultrasounds are easy.

So, that's where we are today.  Lots of rest.

I'll tell you all about Easter in another post.

Well, Just *&$%#

I awoke with a painful, tender spot in my thigh today, clearly red and swelling.  I'd been having pain in my calf, which I thought was a muscle pull.

Cardiologist confirms this afternoon that it's a blood clot, or DVT.

Of course, the only thing I know about DVTs is that they kill you.  But apparently that is quite rare.  Very rare.  Let's just keep going.

Anyway, new treatment is at home, medically, with pill Xarelto.  For 4 months.

No exercise, lots of rest, going to ER if I have trouble breathing or chest pain (pulmonary embolism, that would kill you, rare, though, remember?), calling cardiologist and surgeon if there is any bleeding--it is an anti-coagulant, after all.  Apparently, the heparin and leg cuffs I was on didn't stop the clot.

Typical post-surgery.

But I've had enough.

Thursday's Update

It's just so good to be home.  Yes, I hurt and am very tired, and, yes, it's going to be a long slow road--it is a 10" incision with 20 staples, but a few laparocopic holes for good measure.  But other than that, I feel pretty good.

Of course, we're surrounded by love and support--meals, calls, emails, FB posts, cards, prayers, etc etc.  It means so much, helps so much.  Tomorrow, Gommie arrives to help keep things flowing smoothly.  And to celebrate Easter.  Sure, she's the walking wounded too, with her knee (torn meniscus) and back (spinal stenosis) issues, but any little bit helps, and the kids will bask in the attention.  So will I.

For now, I get my staples out next Friday and will start PT sometime in the next month or so.  My physical issues are complicated at the best of times.  And now I'm back to not having a core, since they sliced right through it.  I'll need to build that up again, best I can, and keep strengthening.  I expect hiccups--maybe even big ones with my back, which relies on my core such as it is--progress is never a straight line, but a series of loop-de-loops.

We have made some hard decisions, though, in deference to my surgery and recovery:

• the biggest:  I'm putting off applying for seminary for a year.  It's too much to think of applying now and being ready to go in August for full-time school and volunteer internship.  It's not a cancellation, just a postponement.
• We have canceled lots of minor activities--tickets to see Helen Mirren on Broadway, our last-minute free getaway Easter in Vermont (found out we could go on the day of the surgery, oh well), spring break visit to Block Island, maybe my piano recital at the end of April.  Bigger trips to Texas this summer and our fantasy of going to London for Christmas are also off the books as well.
• I'm stepping back from all of my usual activities--hospice, Girl Scouts, historic house.  I can help behind-the-scenes some but can't attend those weekly as I have.  I'll go back to them.  But physically, it's just too much right now.  

It's all good, one day at a time, staying home with my family, connecting with my friends. 

I'm very fortunate and I know it.  

And in the coming days and weeks, I'll tell you more of my insights from the hospital, especially with regards to chaplaincy.  

For now, I'm eating lunch and watching a movie with Mama and the cats.

Home

I just woke up in my own bed!!  So good to be home.

Updates

Here we go, a short recitation of my life since last Wednesday, I'm using google voice recognition because there is still an IV needle Medlock in my right hand.

Wed:  the pain started around 2 though I hadn't felt well while grocery shopping at 130. but at some point I looked at my belly button and noticed the petechiae and bruising and realized that the sharp pains and nausea are not good. I called my doctor and Mama and we got to the ER around 3:45. I had probably six injections of morphine before the evening was over so bad was the abdominal pain and cramping. The doctors were concerned about the bruising around my belly button / hernia scar and so they were talking surgery.

Thur:  surgery was first thing in the morning I think, but only after the painful introduction of the nasogastric intestinal tube.  I don't want to talk about it. I don't remember most of the rest of the day I think the surgery took a few hours and I didn't learn until a few days later that they removed a 6 to 8 inch portion of my small intestine which had become wrapped up and even infiltrated by the mesh from my old hernia scar.  Apparently they were really worried.  They started the surgery laparoscopically but had to move to a full abdominal incision from my breast bone almost to my c-section scar. I'm told I still have my belly button but I have refused to look.  I am think there are dozens of staples.

Friday:  I think I slept most of the day Friday in a darkened room on lots of morphine and other things. All I remember is the Tube. Though at one time I also had the Foley, oxygen, and the two IVs.    I remember the ancient aliens guy with the fluffy hair. at some point I also watched dangerous weather shows and something about quicksand.  I know I was on some heavy morphine because I have weird memories of feeling like I was floating or flying between the puffing and deflating of the special bed mattress and the leg cuffs for clots.  I didn't feel like I had a regular body, the leg cuffs especially were like a special massage, the part of me that felt the very best. It was trippy.

My beloved Mama was with me the whole time, also juggling dear Babysitter and miss K and daughter babysitter who were lifesavers.  I got some beautiful red roses from Gommie and Pop which brighten the room and a sweet little purple vaze of flowers from

Saturday:  I got up to walk around the ward much more on Saturday and in doing so met both of the chaplain and the therapy dog which were really important encounters for me.  Chaplain I talked a little bit about her training and her experiences at the hospital and then we prayed for patience for me because by then the NG tube consumed most of my thoughts. It caused me to feel like I was choking, hindered any speaking, and in general hurt. Even medical professionals who talked to me felt bad about that tube.  Goo visited on his way to spend the day with the kids and relieve mama, which was very nice. He makes a good doctor and sympathetic friend. The kids loved having him to play with. I think this was the day there was snow my days are getting a little confused but it is snowing as I record this and I think it's lovely. I'm in the minority of one on this though. I think that was the night that Aunt Banana and I texted each other and she even ended up talking to my nurses; they found this very sweet and entertaining.  Aunt Banana, these experiences always give me a new appreciation for the amazing and challenging work that you do.  Thank you.

Sunday:  This was a banner day. The Tube came out!  Mama had come for a visit but was down getting lunch when they ripped the 60 millimeter tube out of my nose and throat and stomach. It was the best feeling ever to breathe and swallow and talk again hallelujah! Rejoice!  Swallowing that first sip of cold water was the best thing ever followed by cranberry juice and for dinner jello and putting in sherbert and broth.

But the very best part of Sunday was it the kids came for a visit after their trampoline birthday party with a friend. think they were nervous to come visit which is totally understandable so we sent them a picture of me smiling with the stuffed bunny they'd given me so I looked normal and of course we wouldn't have let them come if the tube had still been in place.  We spent two hours walking in the ward, eating my dinner, meeting my nurses, using the art supplies Mama gotten me-- mama is a hospital genius--hugging and chatting and cuddling and playing on the bed.  The perfect end to a good day.  They'll come back this Monday afternoon and everyday after school that I am not dismissed.  I'm guessing it'll be Tuesday at the earliest.  So I'm doing a ton of walking, drinking, and breathing exercises to be ready.

Some final notes: I am very aware of my privilege with regard to immediate quality emergency healthcare probably very well coveredby our generous insurance supplied by Mama's employer.  I am in the minority even in our rich land and this saddens me even as I benefit from it.

At the same time that I'm going through this, my dear friend, teacher had knee surgery and is at home recovering I was supposed to be her escort and mail provider during this and have not been able to but I hear she is recovering well.  Yay!!!  Also the daughter of a person of my acquaintance has been diagnosed with a heart issue and is in the hospital as well this weekend though not I think the one I'm in. I am grateful that it was me not my children who required emergency surgery last week and I pray for good recovery and prognosis for the little girl.

Lastly there are ever so many people to be thankful for today from the hospital staff doctors nurses and techs to those people closer to us who have helped take care of the kids and those who are surrounding us in love and organizing meals, with sending emails and Facebook updates, too many to mention.  I feel the blessing of their love and care and am grateful for our sacred community.

Emergency Surgery

This is Mama posting for Jamie.

Jamie had severe abdominal pain yesterday and had surgery this morning to clear an obstruction (likely related to the umbilical hernia when she was pregnant).

The doctors successfully cleared the obstruction and she is rest comfortably and will be in the hospital a day or so more.

Flip Side

For a few years now, I've noticed that sometimes I can hear and understand everything someone says to me, and sometimes I can't.  I've been to two ENTs about it--one said it was my advancing age, another said it was a vacuum caused by my little nose, teeth, and little ears.  Neither had any real suggestions.  And even with two hearing tests, neither said my hearing was anything but average.  Maybe not as good as it had been, but still regular.

Well, I finally did less than average on a hearing test!

Yay?

Average is to about 15 or so, and I'm closer to 25, if I understand the explanation correctly.

I went to a new ENT, recommended by a friend, last week.  He ran tests--audiology and x-ray.  And I have a bit of a hearing loss in each ear, more on the left, particularly in the high frequencies--all of which means I don't hear all consonants, especially if it's noisy or if the person's voice is higher.  It's not ear wax or build up, not sinuses or infections, not TMJ or jaw pain and inflammation.  Probably the very common sensorineural loss.

Yay?

And the only treatment is hearing aids.  Which can run expensive.  And aren't covered by insurance. So, they were asking me if it affected my life?  Well, several times a day I have to ask somebody to repeat something, usually Sis, who gets tired of it and says, "Never mind."  So yeah, it affects me.

Still, we're checking into some things.  Trying a nasal spray just in case it helps, though he didn't see fluid or pressure (my ear drum functions normally.)  And I'm practicing trying to always look right at people to hear them better.

But in the end, it'll probably be hearing aids.
Sis said, it's a good thing I'm taking sign language.

Ouch.

But I guess at least I heard her.

Spontaneous Healing, or TMS TMI

Maybe I should call this blog "Mommy Healthy" these days, since I'm posting more on that than the kids.  Well, this never was "just" a mommy blog . . . .

I've been thinking a lot about the American medical complex and big pharma recently.  Very little of it positive.  In my grumpiest, most cynical mood, I see doctors as shills to the drug companies who don't know enough about actual health and healing beyond which brand-name drug to prescribe for which problem or who are too scared of lawsuits or death of a patient (or who don't have the time or the interest) to prescribe anything besides the most invasive tests and treatments.  For example, my previous GP loved tests--ultrasounds and ECGs--and medication; my current GP loves referrals to specialists for anything  from athlete's foot to reflux.  For that, my ENT prescribed Prilosec--at a dose 4 times the OTC dosage--and believes I'll be on it the rest of my life (he's been taking it for 10 years!  And when I questioned effects, he laughed and said he'd die before I did from it).  There was some talk of dietary changes (no tomatoes, no coffee/tea, no citrus, no full-fat diary, no greasy foods), but that didn't seem to really matter to him as long as I took the meds, even though the main problem with reflux is my discomfort without any real damage to my system (there my be vocal nodules eventually but that's about it).  Lucky for the drug company that will profit, especially because insurance won't pay.  Except I went to my naturopath/acupuncturist with the diagnosis and was given deglycerinated (I think that's it) licorice (DGL).  And immediately, it's made a difference; much better than the Prilosec.  I'm even off all of the Prilosec (mainly because I couldn't take it before tomorrow's injection because of its effects on platelets, according to the pharmacist).  And I won't be going back. Of course, there are many doctors who won't even mention diet and lifestyle changes to patients, much less herbal treatments (do you think my ENT had even heard of DGLicorice?) before prescribing anti-inflammatories, antibiotics, pain killers, antihistamines, cholesterol drugs, blood pressure medication, and other meds.  And I know that many doctors don't have any knowledge of alternative treatments, though an article in the NYTimes recently indicates that many GPs are also starting to believe that their patients are overtreated (see also an article on how vinegar can identify cervical cancer, an alternative way to identify it which is often much more reliable than pap smears!) I know that some of those doctor-patient conversations would not be easy, or even usually effective (and it's obviously taken a long time for certain conversations to sink in with me), but I believe as patients we have the right and responsibility to know what else we can or should do.  (Proud of you, Vegan Pop!)

I've been exploring some of the alternatives to our American medical-pharmaceutical complex, investigating traditional Chinese medicine (TCM) and other techniques in an attempt to find anything to help (like the computer game SuperBetter that I posted about yesterday!).  I've got references to cranio-sacral therapists, hypnotherapists, a reiki practitioner, among others.  And I must say, there are some  . . . unusual  . . . ideas out there.  I stumbled onto something called EFT, or Emotional Freedom Technique.  It's energy healing.  Accomplished through tapping your fingers on your face and body while repeating phrases about your pain.  As I understand it, it's based on TCM's theories of meridiens and qi upon which acupuncture is based, but the non-medical founder of the technique has said that tapping yourself pretty much anywhere will work because there are meridiens everywhere. The tapping clears the emotional-electrical-energy blockages that cause pain (though EFT people will repeatedly point out that they don't claim to heal medical problems, just the emotions surrounding them).  It's like acupuncture-lite, without the historical background and clinical trials.  Skeptical yet?  I'm learning all sorts of scientific terms--like the importance of falsifiability (mainly, that to be able to test something, it has to be able to be proven wrong; if any meridien spot works, you can't ever prove EFT wrong), the idea of regression to the mean (or that many people, with pain, anyway, will return to health without too much intervention), and the placebo effect. The Skeptical Inquirer tore EFT to bits on these and other grounds.

It's actually not that far off from another theory that has a few more medical credentials, that of Dr. John Sarno of NYU, who identified (invented?) TMS, or tension myotitis syndrome, and is supported by alternative medicine gurus Dr. Andrew Weil and Dr. Mehmet Oz.  TMS is basically muscle inflammation caused by stress; in other words, it's all in your head.  And the "all" is a lot:  pain from herniated discs, plantar fascitis, scoiliosis (yes, I mention "my" three up front for a reason), fibromyalgia, TMJ, carpal-tunnel syndrome, pretty much any pain that has a musco-skeletal origin is TMS even if there is an injury!  The cure?  Listening to his lectures and doing his emotional work.  Yep, you can clear back pain by processing, or just even acknowledging, your repressed emotions (mind you, you have to pay for the lectures and books).  Because again, emotions (this time not electrical blockages but the brain reducing blood and thus oxygen flow to muscles, tendons, etc) cause pain.  (In the 20/20 video Sarno disingenuously states that nothing has changed about the American back in the last 20 years that the nation has seen an uptick in back pain, which he correlates to people's brains choosing back pain instead of the less-trendy ulcers now--except he forgets that we're more obese and sedentary.  One big change in the American back in 20 years?  How about more sitting at the computer??  Interestingly he also admits that all of his patients--with whom he is successful in the 90% range!--are pre-screened.).  There's a psychoanalytic twist to this one:  the emotional work delves into your relationships with your parents, childhood trauma, and the like.   It's received a lot of press because several stars have been cured by Sarno--it's the Scientology of back pain theories.  Though, even Sarno (proudly) acknowledges that 99.9% of medical doctors reject TMS.

That's not to say I don't believe there is a mind-body connection or that alternative theories aren't useful or helpful.  I just don't think it's as simple as just saying that my back pain is only from my emotions.  In fact, our ideal doctor would combine both Western and alternative medical theories . . . and we've found her.  She's our pediatrician!  (Is it coincidence or causality that she's Russian, with a background in both folk medicine and medical school?)  She prescribes arnica and garlic mullen and humidifiers and cold air along with cortisone cream and amoxycilin.  We even ask her for advice on our problems (she pointed me to acupuncture).  Otherwise, I've long seen the value in breath work--I used to be able to lower my blood pressure and heart rate through breathing during numerous prenatal checks (I'd be hooked up to a monitor for 30 minutes and I'd work on my breathing to see the numbers change; yes, it was boring).  I have also seen the value of Jon Kaba-Zinn's Mindfulness-Based Stress Reductions for the acceptance and reduction of pain. In fact, I just read Dr. Weil's Spontaneous Healing and loved his support of less traditional (or, actually, more traditional!) treatment--many of which my naturopath had already given me--and his wariness of invasive American medical treatments (which, again, can be very valuable for certain conditions and issues).  I'm going to try his 8 Weeks to Optimum Health, with its suggestions for supplements, dietary changes, spiritual work, etc.

But I will add this:  I did some of the tapping last night, as part of a free "world pain relief summit" and also thought on Sarno's psychoanalytic approach, reiterating that I know that stress makes my back pain worse.

And I sat for a whole minute last night and this morning.  That's about 56 seconds longer than I can usually tolerate.

Was it EFT or TMS?  Or the cortisone shot I had last week?  Or my continued use of supplements?  Or weight loss?  Or my hour of exercise everyday?  Or regression to the mean after almost exactly 6 months from the second disc injury?   Or even some early placebo effect from tomorrow's injection? Or even the dream I just had about being healed by my favorite physical therapists?

I don't know what it was (or how I can continue it).  It was, in many ways, "spontaneous."

I just hope the healing continues.

Doctor Restored

A few days ago, I really questioned the the knowledge of my OB/Gyn. I've come to revise my opinions somewhat because she called me the next day and we spoke for 25 minutes about the situation. Her latest reference book didn't mention the progestin-gestational diabetes research, but she was open to the research I'd found online and totally agreed that I shouldn't take the medication because of the tripled Type 2 diabetes risk. She said she follow my research leads and get back to me with anything else she uncovered. While I could say again that I'm not impressed that she was not up to date, I was impressed with her willingness to listen, her talking to me at length, and her to desire to get to the bottom of the most current state of research. Still, I'm glad I double checked.

Terrific Tuesday

Snow

Okay, normally, I count snow as pretty terrific, but regular readers of this blog will note my waning enthusiasm. It reached an all-time low yesterday as we drove through it to get to NYC. Much more than a dusting, we probably got 2-3". And we sat in traffic for more than 2 1/2 hours to get to town. I hadn't thought of it much before, but I think I might be scared of snow. Or specifically, being out in it. I like watching it from inside, playing in it later, but I don't drive in it while it's falling nor walk around outside too much before we're shoveled. You know what they say, "If God had wanted Texans in snow, he would've made bullshit white." I knew I'd gone round the bend when I actually turned to Mama and said, "Well, at least it's unlikely that we'll get into a fatal car accident going this slow." To her credit, she just patted me and kept driving. And we did get there safely with no problems.

Doctor's Appointment

We'd left early because the kids had a school delay and we decided to go to the museum before my appointment. The weather didn't cooperate. We found ourselves in town too early to go the doctor but too late to really go anywhere. So I called the office and they said he'd see me early, special exceptions for out-of-town patients, though there might be a wait. Now, when there's a "wait" at most doctor's offices, it can be a long time. I bet we didn't wait, from entering the office to seeing him, more than 10 minutes. Bless him. He thinks I'm still doing well, gave me three trigger shots to my lumbar area to help with pain, prescribed a muscle relaxer in addition to my other meds, applauded the treadmill purchase (talked bad about ellipticals as unnatural again . . . if only we'd found him before we bought it), bemoaned hormones and the weather, and was all-around encouraging and friendly, especially to the kids who jumped when I squealed at the shots (he didn't let that alcohol dry! And, well, my lumbar spine is very sensitive). Another great visit.

"Dinosaur Museum"

The kids had voted for the American Museum of Natural History since we'd been to the Met the last two times (and the exhibition on the Forbidden City hadn't opened yet), so we headed there next, across the park covered in snow. We always go on Saturdays, so it was nice to have the museum to ourselves, well, relatively, for one of the top tourist attractions in the city. Sis chose to see the bunny diorama and Bud the dinosaurs, so we went to those first. And just happened across the monks, who we hadn't known were going to be there.

Tibetan Buddhist monks. And they were creating a traditional Tibetan medicinal mandala out of colored sand (that's the sand up above). It was fascinating to watch them work, beautiful to see, as they applied minute amounts of brilliant sand layer upon layer in synchronized silence, one monk on each side of the mandala table, no instructions, no model, all from memory and study and teamwork. The kids, at least conversant with Buddhism from their talks with Ma and Gong and visits to temple in Queens, were still surprised to see the red-robed men. And, because Ma and Gong follow a different tradition, curious about the Dalai Lama, whose picture was on the altar next to the mandala.

We watched for a long time, purchased a few children's books on Buddhism and a new set of flags to hang outside, and then headed to the cultural anthropology dioramas of Asian peoples. Where we happened upon a children's activity about to begin. They would be able to make their own sand picture, over the brain logo of a current exhibition, using Tibetan techniques with the help of a monk. Sis and Bud were the only kids there when it started, taking the chakpur, long, tapering, hollow metal tubes and tapping them, with the monks' help, to distribute colored sand on the outline. They concentrated very hard, were very careful and serious, and then became shy when they looked up to see about a dozen curious adults watching them. It didn't deter them long and they went back several times to add different colors, as other kids and adults took turns too. We spent quite awhile traversing between the two stations, the monks working on their mandala and the visitors working on their picture. It was such a special experience.

(Actually, it always seems to be at AMNH, from our wandering through polar tents during an Arctic global weekend, to watching traditional Chinese performers during another, from the Silk Road exhibition to this. While I'm usually biased in favor of art museums, AMNH has done a better job of capturing our attention and delighting (and educating) us with new experiences. )

Fondue

We stayed much later at the museum than expected or intended. And so we decided to stop for dinner on the way home, realizing we'd get home too late to eat, especially because they'd probably fall asleep. And so we stopped for fondue. The kids were cautiously optimistic, since we promised shrimp and chocolate (no, not together) and told them it was "Swiss night." And we all had a great time. They both tried the traditional cheese fondue but then just ate the bread and apple bits, leaving all the cheese to Mama and I, which was fine by us. Then they had chicken, steak, and shrimp in a boiling vegetable broth. Because they've had Korean BBQ, they've had some experience with cook-your-own-at-the-table, though not quite in a soup pot (and Bud wanted to drink the boiling soup, like you would for sukiyaki, so we'll have to do that with Ma and Gong), but we still had some cross-contamination with eating forks touching raw food and impatience for food to be cooked before it was. Bud loved the shrimp, Sis the chicken. I ate all their vegetables. Mama ate surf-n-turf. And then we had room for chocolate! The highlight for both kids because there were strawberries too. It was late, but they revived when they saw dessert and our server was nice to bring extras.

After such a day, you won't be surprised that they slept all the way home. A good sleep after a great day.

My New GP

I went to a new doctor this morning and love her! As you've heard, I'd been less than pleased with the single-mindedness and lack of listening of my previous GP. And after a particularly frustrating conversation in which she refused to hear my concerns about my back because she was too fixated on my sugars (for the record, yes, I had gestational diabetes but I've been clear since then, with some occasional pre-diabetic fasting numbers probably related to my extra weight, but everything else normal, but I'm very aware that 40% of women with gestational diabetes go on to develop Type 2 so I'm working on it. But even the 3-month blood test came back fine). I decided to find a new doctor. Breaking up is hard to do.

But not as hard as I thought. The new doctor is approximately my age, with a young child--someone who can relate! And she took all of her notes in a laptop! And does all sorts of e-prescriptions and online medical stuff. I had been concerned that perhaps a younger doctor wouldn't have valuable experience, but I had overlooked the possibility of greater enthusiasm and interest in new technologies and procedures (thanks, Miss J--that would be nurse J because there seem to be a lot of Js in my circle--for helping me see the light). I was really impressed. And she was so encouraging, had kind and supportive things to say about all the PT work I've done to shrink my diastasis, my continued efforts to lose weight, my hopes to walk a 5K this summer, my vegetarianism. Never had my old doctor muttered so much as a positive word about any of my efforts--yep, you guessed it, she just had to express concerns about those sugars. So, I've turned off that broken old record.

And updated to an MP3 player!!