On Normal Days

There are some nights, after we’ve signed the nurses out from their shifts, that I like to sit in the room with the kids. We live in a small two bedroom condo, so everyone is pretty cozy in our house. Sitting in that room, listening to the rhythmic whir of the ventilator, and the whoosh of the oxygen concentrator, life is calm.

I can hear Caleb tossing in his bed, with his face firmly planted against his fan (some kids sleep with a special blanket, Caleb sleeps with a special fan). I can hear Charlotte whispering in her sleep, barely audible over her vent. (She’s demanding even in her sleep. Even now and then, she lets out a “Caleb, come here now!” and I fear for her teenage years.)

In those moments, I pause and think about how we’ve gotten here. How CPT treatments and inhalers have become a part of our routine. How planning for a day away from home includes diapers and wipes and feeding pumps and ventilators. How our diaper bag has been replaced by a suction machine, and how it all seems so completely normal to us.

Charlotte adapts to life so quickly. A couple of days of riding the bus, and she’s totally fine with it. She lives by her routines, but adjusts her life easily when things change.

But I don’t.

It’s taken me a long time to feel like this is normal. It’s taken a lot of crying on friends’ shoulders and hashing out my thoughts to come to a place where I can accept my new normal. And accept it, I do. I’d even go as far as saying I’ve embraced our new normal. I don’t think twice about ordering Charlotte’s food from a DME company, and I don’t really worry about her Physical Therapy appointments instead of ballet classes. I love the quirky things Charlotte says, “I no hungry. I a tubie!” and I love watching her move throughout life with reckless abandon.

{I’m not always there, of course. There are days when I watch a two year old do things that Charlotte cannot, or when I hold a newborn baby, or when I attend a baby shower, and everything falls apart. I still mourn.}

But I’m surprised at how often the difficulties of the day, or the added chaos that comes with Charlotte’s medical fragility, don’t cross my mind. I’m surprised at how often I forget that there’s something different going on in our home.

Which is sad, in a way, because there is something different. There’s a little girl who fights everyday to thrive, regardless of the uphill battle. There’s a little boy who loves and accepts his sister, regardless of the personal sacrifice it requires from him. There’s a dad, who tickles his daughter endlessly, and is rightfully wrapped around her tiny pinky finger. He sees her as his daughter, not his patient, which is a hard thing to do when you are a doctor.

This home has seen a lot of different and it’s not all bad.

As the parent of a child with special needs, we often try so hard to tell our children that nothing can define them. Nothing can tell them what they can or cannot do. Nothing about them says they are different from the “typical” kids they see on the playground. But too often,  I think, in our effort to erase differences (a righteous effort, I might add), we forget the mountains we have scaled to get where we are.

Those efforts should never be erased, forgotten or glossed over.

So here’s to “normal” days that celebrate all you have accomplished. Here’s to ignoring the trivial medical diagnoses, and accepting the accomplishments. Here’s a big hug for all the vacations you missed, all the Girls’ Nights Out you couldn’t attend, and all the Man-dates you had to turn down.

Here’s a high-five for the extra years of changing diapers, the long nights of wondering when a milestone will be reached, and the lifetime you’ve wasted in waiting rooms for medical specialists. Here’s to days filled with laugher (even when you are only laughing at yourself!), to friends to lean on when there are tears, and for a never ending supply of your own personal vice.

Here’s a moment of recognition– for doing what every decent parent would do, but has never had to. Here’s to all you do, without even thinking about it.

You deserve it.

A Summary in Photos

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Charlotte starts a new pre-school program in April

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Grandpa comes to visit for a weekend!

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A Sleep Study does not make Charlotte happy, just for the record

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Pneumonia knocked this girl out for a bit. She spent almost two weeks in the PICU in the beginning of April.

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Happy Easter!

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Charlotte hams it up in Vegas during a family weekend get-a-way in March.

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Always the princess, Miss Charlotte shows off her birthday loot from “Dr. Britta”.

WordPress doesn’t want to let me put these pictures in chronological order.

But there you have it.

We’re still around. Much more to come soon!

Happy Birthday

Dear Charlotte,

Today is your day. You are old enough now to know that a birthday is your day. You aren’t quite sure why it’s your day, and you don’t really know what all the fuss is about, but you do know people keep sending you presents, and you are perfectly fine with this situation.

As you get older, this becomes more and more your story. Your story to share and to shape. You have your own moments of frustration and your own moments of triumph. You are realizing the struggles you face to accomplish what should be so easy. But you are also certain of the magnitude of your accomplishments once a skill or task is mastered.

I have my own story, intertwined with yours. My own feelings of elation, my own experiences with setbacks. I don’t know that it will ever be a story you desire to read, or understand. You have a lot going on in your own life, my dear, and it’s an important life, to be sure.

But should you ever stumble upon it, I hope you sense one ever true arc within the story: that of my admiration and respect for you.

It may not be something you understand, ever. It may be something you inherently know for all of your life.

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But regardless of understanding, I hope you can believe me. Believe me when I say you have strength untold. Believe me when I say regardless of strength, you should always take the time to rest. Believe me when I tell you that you are more than a list of diagnoses. You are more than any one person’s evaluation. You are more than an age range of abilities, more than a list of delays.

You are the inspiration you give to others. You are the strength you summon each day. You are the joy found in your smile, the twinkle in your crystal blue eye. You have the security of a mother’s hug, the guarantee of a father’s admiration. You have the blessing of a brother who loves you so much, even he does not understand the extent of it.

I hope when the time comes for you to understand this journey you know that you get to take from it whatever you want.

Choose wisely, my dearest Charlotte Amalie.

Happiest of birthdays

Mama

Giving Our All

For a month I have written and deleted paragraphs and paragraphs of thoughts. I’ve lamented about the difficulty of premature birth, I’ve cried over the pain of pregnancy loss, I’ve laughed at the beauty of life, and I’ve typed out prayers upon prayers, begging for understanding, peace and…. yeah. You all know.

Nothing has felt quite right. Nothing captures the emotions the days and weeks and month before Charlotte’s birthday seem to bring for me.

The pain? How do you adequately express the sorrow over the pain and suffering of a child? How do you encapsulate the inadequacy, the loneliness, the outright depression and anxiety?

The joy? How do you share the intimacy of a survival story like Charlotte’s? How can I possibly use words to define the awe my daughter inspires in me? How can I accurately portray the ecstasy each breath she takes is for me?

So, my dear friends, I’ve struggled. Struggled to give you insight into what this is like for me. Struggled to find words that wouldn’t discredit the success Charlotte has each and every day. Struggled to do right by her own, individual efforts to write her own story. Because, in the end, this is her story.

And so, at the end of the day, at the end of this month of silence, I offer this:

I love my daughter. Love her with all the love a mother can hold. Every particle of my being, from my intangible soul, to my calloused hands, to my wrinkled brow, exists to love her. My love and respect for Charlotte has shaped me, molded me, and defined me.

With that love comes vulnerability and unease. No parent escapes it, no parents is free from the worry of what-is-to-come. But somewhere between making funeral plans for our unborn daughter and witnessing her live, that vulnerability has been intensified.

Despite that vulnerability, we love. Despite the delays. Despite the fear. Despite the sorrow and the illnesses and the pain.

We love. We honor. We cherish. We respect.

The evening of Charlotte’s birth, my father, father in law, and Peter were able to visit her in the NICU, to give her a name and a blessing. This is routinely done in our church, usually when the baby is a couple of months old. However, because we were not certain she would survive the night, we wanted her to have a blessing. To have some record of living.

Instead of placing their hands on her head, these men placed their hands on a plastic isolette. Instead of being in a church building, they were in the middle of the NICU. Instead of being surrounded by friends and family, heads bowed in prayer, they were surrounded by nurses, busy placing lines and administering medications.

When the blessing was given, one of the nurses told my father in law, “It’s up to her now. She’ll give it her all. That’s all we can ask of her.”

Charlotte gave her all.

I love her because, despite the fear, I can do nothing, but give mine as well.

——————

{I have to say here, that I cannot imagine the pain and sorrow and vulnerability felt by those parents who have not only planned a funeral, but acted out on those plans as well. I think part of the reason I have felt so hesitant to write over the past month, is that I do not want to oversell our perspective as one of ultimate pain. I have but glimpsed the reality that all too many parents live with on a daily basis, and I know that many of them would gladly live with the challenges Charlotte faces each and every day, if it meant they could hold their babies again. May we remember them always.}

A Good, Old Fashioned Charlotte Update

That’s right folks, a Charlotte Amalie update!

(Lungs/Neuro) Charlotte’s still having apneas while sleeping (forgetting to breathe for a period of 20 seconds or longer). The past few months have been marked by a nice little fight between the Pulmonologist and the Pediatric Intensive Care doctors about this situation. Pulmonology wants Charlotte off of the ventilator, with the thought that we are just teaching her brain to be lazy by breathing for her. The PICU team feels that it is irresponsible to take Charlotte off of the ventilator, particularly when she is still having events. To be fair (we agree with the PICU, but wanted to give Pulmology our best effort of compliance), we tried taking Charlotte off the vent for six weeks. She was still having events, and after a readmission for a GI bleed, the PICU refused to discharge her without an order for a home vent.

So we’re still on the ventilator, with the hopes of having a sleep study arranged sometime soon. She’s still on a Cystic Fibrosis style regimen for her lungs, with a twice daily routine of Flovent, CPT, hypertonic saline neb, and Atrovent. Being a preemie is rough on the lungs. In case you didn’t know.

(GI) As far as that GI bleed mentioned above, Charlotte needed to have surgery to completely replace her g-tube in December. We were at church when we noticed there was blood in her extension tubing, and after attempting to ignore it and hope it would just go away, the bleeding got worse. We took her into the pediatrician’s office and the poor weekend doctor (who always sees Charlotte in a moment of crisis and never quite knows what to do with her) admitted her. We had high hopes of staying out of the PICU this time, but her labs kept coming back worse and worse and it looked like she might be headed for a transfusion, so we transferred over to the PICU. Once we were settled there, Charlotte felt much more at home and her levels improved. Impressed with her improvement, Peter and I felt that he would be fine to leave on a short underway with his ship. (He’s working on a ship for the Navy). She was scheduled for an endoscopy, and Peter left for the week, confident that she would be home in a day.

During the endoscopy, I get a call asking if I can return to the floor (I was grabbing lunch) because the surgery team needed to talk to me. We found out that the gtube had essentially eroded the lining of her stomach, to the point that there was nothing left for the tube to anchor against inside her stomach. They couldn’t even find the tube in her stomach, it had retracted into the tract, and her stomach was trying to grow back over the tube site. They had to completely re-do her gtube and close her original site. It was a blast, and a week later, we finally went home.

Lesson learned: Never assume anything about Charlotte.

In other GI news, she is scheduled to attend a feeding tube weaning program at CHOC in April. Keep her in your thoughts and prayers that she will be healthy and able to fully participate in this program!

(Immunology/Infectious Disease) CA has been battling c.diff for several months now. We’re on our fourth treatment course, and praying with every bone in our body that this is it. {C.diff provides nothing but terribly nasty diapers. Not.fun.} We should know more in about a week. Please let us kick this!

We recently had some test results come back that indicate Charlotte’s immune system isn’t up to snuff. It’s pretty complicated medicine, but the gist of it is that CA isn’t remembering how to fight an illness, even if she’s battled that illness previously. There are still more tests to run, but currently she’s not showing any immunity to several of her vaccines, and generally low immune levels. The doctor is unsure at this point if her immune system is just severely premature (lagging more than the rest of her development) or if is a case of Common Variable Immunodeficiency. If it is the first, then there’s not much we can do about it. If it’s CVID, then she would be a candidate for IVIG, a blood product administered every three weeks in the hospital. It’s really expensive, and not the most pleasant process, but it would essentially give her an immune system, and it would be a lifelong battle.

We’ll give her several new vaccines, and then test her response to those vaccines in eight weeks. That’s the plan, at least.

(Eyes) CA saw the ophthalmologist in December and he said she was good to go. He continues to explain that while whatever vision Charlotte does have is essentially perfect, she does have significant scarring in her eyes from the laser surgeries, and her range of vision is severely limited. {Guess we can’t blame her running into walls solely on her lack of a cerebellum.} We’re so impressed with how well she manages with such a limited sight. Most of the time, we totally forget it’s an issue for her.

(Therapy) Still receiving Speech, Occupational and Physical therapy. Each twice a week. She’s a busy girl!

(Interests) Princesses, barbies, Curious George, Elmo, Minnie and Mickey Mouse, dressing up, anything Caleb is doing, comparing items {BIG ball, little ball– with the most amount of enthusiasm you can imagine}, coloring, “writing”, books, talking to “Nana” (refers to all grandparents) on the computer, and dancing.

(People she routinely asks for) Daddy, Uncle, Joey (cousin), Maeli (cousin), Isaac (family friend), Alan (family friend), Britta (family friend), Dean (cousin), Sunshine (friend from school), Aurora (friend from school), Beth (Physical Therapist), Nikki (Speech Therapist), Anne (nurse), Lauren (nurse), Bala and Papa (my grandparents) and Colby (one of Caleb’s friends from school. She’s never met Colby, but Caleb talks about her all the time).

If you have read this far, you win an original work of art from Charlotte. E-mail me your address.

And a picture of Charlotte. Of course.

Courtesy of blackbirdinkphotography.com

Courtesy of Blackbird Ink Photography November 2012