Thursday, July 6, 2017

A week to forget

And then sometimes life just smashes your face and leaves you dizzy and bloody. 


Me before last weekend: overwhelmed, but still swimming. 


Me after last weekend: a whole lot more overwhelmed, but still swimming. I'd tell you if I weren't. Promise. 


I wrote that last post two days before the Breck Mountain Enduro, another race in the mountain bike series I signed up for so I couldn't back out of biking therapy. I believe I even said, and I quote, "I'll do it if it kills me." 


After I wrote it but before posting it, my friend and I went up and made a few more loops on the short stages so I could get a good feel for the trail, and on race day, I felt really, honestly confident. My downhill and technical skills generally somewhat compensate for my lack of leg strength, and an enduro format meant only the downhill portions were timed. So it was all good, right? 


It was so much fun. I asked Bobby if I could borrow his bike, heavier than mine with better geometry for stability on fast descents, with a longer wheel base and longer suspension, but he was reluctant to let me ride it simply because he didn't want to spend any money to replace anything on it if I broke it. (Remember this little tidbit for later.) So on the morning of the race, I woke up, spent a little time searching for the only pads I own (elbow, purchased after my last big crash that removed a large amount of forearm skin), couldn't find them, so I loaded up my bike and went to the race. 


About halfway through my second stage, I suddenly felt The Switch. The Switch is what I call that moment when something happens mentally that welds me to my bike and nothing else matters. Maybe endorphins and adrenaline kick in. Maybe I finally stop thinking about anything except riding. Maybe I've been on my bike long enough to feel like it is an extension of my body. Whatever it is, when The Switch kicks in, I suddenly look up, relax, let off my brakes, and just watch the trail come, lean into the corners, and feel as if the whole world is smiling. The Switch is the reason I bike. 


Which is how I felt as I started the last downhill portion. I rode around a few features that were too technical for me, took a wooden bridge drop with a fairly gentle dismount, came around the corner feeling strong and confident, and decided in a split second I would ride the last bridge drop, with a steep, short dismount. I had ridden it on preride laps and had frightened myself a little bit because in order to keep from going over the handlebars, I had to be behind my seat enough my butt had to be almost rubbing my back wheel. I had dropped my seat a few inches at the top (I haven't spent $300 on a fancy hydraulic seat post that allows adjustments on the fly like almost every other mountain biker). I rode up on the bridge, dropped my front wheel off the lip, may not have jerked it up enough, may not have thrown my weight far enough back to get it over my rear wheel, and the next thing I knew, I was sliding, face down in the dust and gravel. I slid to a stop, sat up, and felt an odd weight hanging off my face. Reaching up, my hand came away covered in blood and I felt something squishy hanging from my face. I stuck my tongue out and it encountered air, not lip as it was accustomed to. The sickening realization dawned on me that the gummy worm like thing hanging over my bottom lip was, in fact, part of my top lip. I actually looked down to see if the rest of it was lying on the ground, realized my bike was lying in the trail where the next rider would not see it if they came flying over the next feature, forced myself to my feet and drunkenly make my way to it, dragging it out of the trail, then sat down to wait for help from the next rider, feeling bad because they would almost certainly stop to help me and forfeit their race as well. I felt for my phone in my jersey pocket and realized it was gone. 


Sure enough, the next rider rounded the corner, not taking the bridge feature as I had, hit her brakes to ask if I was okay, then sped down to tell medical that I needed help. At the same time, a mystery person appeared. I thought it was the rider, having ditched her bike and walked back to me, but have since pieced together that they were two separate people. She asked if she could help me and I said, as clearly as I could without an upper lip, that I had lost my phone and needed her to call for help. She did, then stayed with me until the medics hiked up the hill to me. In the meantime, I asked if she could see my phone in the trail, she started looking around for it, and I got up and wobbled toward the landing zone as well. I eventually spotted two square dust-colored objects under the dust in the trail, my phone and mini tool kit, grabbed them, and weaved back to my spot under a tree, then wiped off my phone and turned on the camera. The poor mystery angel saw me doing it and gasped a bit. "No! Don't look at yourself!" I switched my camera to front facing because apparently I'm a rebel, gravel and blood falling out of my mouth, and told her, "It's alright. I know I tore my lip off. I already know I've got a lot of reconstructive surgery ahead of me." I looked, and realized the weight hanging off my face wasn't just my lip, but my cheek as well. My bottom lip and chin also hung lower than usual, torn from my gums and jaw. Mystery Angel nervously said something like, "They should be here soon." I stood up again, adrenaline still coursing through me, making sitting still impossible, and announced/mumbled, "Maybe I should start walking down to meet them." At this point, Mystery Angel suddenly grew some authority. "You need to SIT DOWN." Her sudden conviction cut through the other noise, so I obediently plopped back down to wait. 


Medics arrived and I stood up to meet them, grabbing my bike. Someone offered to walk it down for me, but I was reluctant to let go of it. I somehow felt like once I let go of it I would not be a mountain biker again for a really long time, so I said I needed it for stability. They took it anyway, telling me they could provide better stability. I answered all their questions, couldn't remember what day it was, then launched into a long explanation of how this is not unusual for me but it was definitely sometime after June 20. 


And then adrenaline started to ebb and things got blurry. We walked. At one point we had to navigate down an extremely steep, loose portion of trail and the medic supporting me lost her footing and almost landed on her butt, but still managed to keep me upright. And we walked some more. Radios chattered, a meeting place was agreed upon, we walked through some aspen branches I had to duck to avoid them slapping my face, then we emerged into a driveway where an ambulance and firetruck awaited. At this point, all I could think of was lying back on the gurney and sleeping, but once I was lying on it, I tried to close my eyes and realized I was still buzzing and couldn't relax. It was quick, though, we were moving almost immediately. 


As they were loading me up, I kept thinking about them doing the same with my pale, bruised, weak toddler, and how I wanted, more than anything, for it to not be happening. And since it obviously was happening, to have it be me. In some really weird corner of my brain, this happy bell kept going off. "It's me this time! It isn't him! He's fine, and I finally get to be the one the train hits. Thank goodness it's me." It was honestly, and I know this is so far beyond messed up I haven't even tried to process it yet, a weird euphoria. Like this huge relief that finally, finally, I get to pay my dues and this is finally the massive inconvenience we've known was coming and we are so long overdue for. I know. I know. Some day I'll have to face this insane psychotic survivor's guilt and expectation of the other shoe dropping that I feel over Daniel's whole thing and accept that things just are, and are not based entirely on whether or not one deserves them or is due for them. But for my readers not entirely aware of the premium placed on guilt, self recrimination, and the acceptance of less than ideal situations as exactly what one deserves in certain rural, ultra-conservative religious organizations, just know that there is precedent in my childhood and young adulthood for such weirdness to be very deeply rooted. Tossing off a home sewn bonnet doesn't always mean tossing off all the weighty weirdness one has had sewn into ones mind while one was young.


The EMT asked the usual concussion related questions. I told him I honestly didn't think I was concussed, that at no point did I remember my head taking an impact, just my face. I told him my neck hurt, but not vertebrae, it just felt like the muscles at the base of my skull were starting to stiffen up. He told me I was being surprisingly calm, to which I laughed a little and told him this wasn't the first bad thing that had ever happened to me. I then added that my son had been diagnosed with cancer, and after you hear news like that, anything less is just... not a huge deal. He asked about the type, then casually added, "Me, too." Which was how he came to tell me about his own brain tumor and lack of treatment options, while I tried to properly convey, through lipless mumbling, how freaking much life can suck sometimes. 


At which point he shoved a needle into my wrist and gave me morphine to shut me up. As it was kicking in, I realized I had still not called Bobby to tell him his day had just careened off the rails, so I called him to tell him what I had done, carefully choosing my words by their lack of lip-requiring vowels to keep him from freaking out. "So, I crashed my vike and messed uff my face", I told him, then braced for the reaction I knew was coming. Because I know him and his second reaction is generally loving concern, but his first reaction is to disect, disseminate, assign responsibility and pinpoint the point at which things began to go wrong. 


"Can you meet me at St. Anthony's ER? They're taking me there by ambulance."


"You did WHAT? Why? What did you do? This is the last thing we need. I cant believe you did that. What the hell? I thought you were more careful than that."


(Feeling like a scolded child) "Well, I went over the handlebars and screwed up my face. I'm sorry." 


"Are you okay?" (Bless him, I love that predictable man so much.)


"Yeah, I'm just mad I did it." 


"Well, I have to go pick up trash and get some work done so I can take some time off. Unless you need me to come right now." 


I wanted him with me more than anything, someone solid and familiar because everything was pain and weirdness, but I lied.


"No, I'm fine. I want you with me, but I'll be fine."


And then I shut up, because morphine, until we got to the hospital and I had to sit up and move, at which point morphine kicked my butt and I was pretty sure I was going to vomit, which wasn't an ideal outcome considering that the only exit route for said vomit was through my mouth. But I held my breath until we got inside, and anti nausea meds fixed it. Somebody manly took my jersey and bra off and put a gown and heart leads on, trying to be deferential until I told him I wasn't shy, and somebody else put a collar on me, which was a special kind of awful because my sternum was skinned and I couldn't breathe through my nose, clogged with dirt and blood, so I had to push my chin down against the collar so I could keep my mouth open to breathe, which pushed the bottom of it into the bloodies on my chest. Surprisingly soon, they announced Bobby was there, so I prepared them that he might pass out because he isn't the greatest with blood, and as his feet appeared under the curtain, I was so relieved to have him with me. 


Except it wasn't him. It was a brother of a girl about my age down the hall. He stopped inside the door, his eyes big and frozen on my face like a deer in the headlights, and I mumbled, "I think you have the wrong room." As soon as it talked, he seemed to definitely realize he wasn't in the right room, and scurried away. Poor guy.


They bumped my transport for a more serious one, so I had to wait for another ambulance, during which time Bobby finally showed up, found his way to the right room, got a peek under the gauze on my face (that the nurse put there when she helped me to the bathroom after the poor random stranger saw me "so you won't scare any children") and didn't faint. I wanted him to never, ever leave me, but common sense won, so I sent him to arrange getting my car home from Breck, pack a suitcase for us and another for the kids, take kids to my friend Ginta's house, and meet me in Denver. I thought it would take about an hour to be transported to Denver. It took three hours with weekend traffic. I spent it in a morphine haze, observing that the morphine didn't do much for the actual pain but it did make me sleepy enough I could temporarily check out in spite of it. 


At St. Anthony's in Lakewood, the trauma surgeon gave me a nerve block in my face and dug some of the gravel out, but soon realized the futility of that endeavor since the nerve block was only effective for part of the injury, and decided to finish in the OR under general anesthetic. Bobby showed up, hung around, then left to get some food or coffee or something, then came back. I got clindamycin and dilaudid at the same time and nausea hit hard, so more zofran as well. Finally we got word the OR had been needed worse by someone else, so my suite on the sixth floor was ready for me. OR was rebooked for 11:40, so we settled in to wait. They pushed me to pre-op, only to hear, around midnight, that the one surgeon and anesthesiologist on staff at night had been, again, needed worse in a different surgery. Several hours later, the same news. And then the lights blinked off, then on again as the generator took over. It's all a bit fuzzy, but I remember shaking and holding my breath for what seemed like hours from the pain during an endless wait while computers rebooted and orders for pain meds were resubmitted, and at the worst possible moment, with all the pain meds worn off, the pre op nurses also delivered the news that as long as the power was provided by generator, there would be no surgery. And then I went ahead and lost my crap. I started to shake and cry uncontrollably, apologizing, saying I understood that I wasn't top priority and that was a good thing, it meant I wasn't dying, but this had happened already at noon and I had been lying with bloody gravel and my lips hanging inside my mouth for sixteen hours already, and I just. wanted. it. to. stop. They had refused to take the gauze off my face, covering the wound, even though I said it felt as though it was starting to stick for hours already. Nobody had actually seen my face since ER intake late that afternoon. They had been just dribbling more saline over it, not believing it was sticking since it was wet with saline, but my meltdown finally convinced them to try, and as I suspected, they peeled back the massive pile of gauze pads, saw the mess underneath, and suddenly got a whole lot more accommodating and less condescending of thirty-three year old female with facial laceration who had been bumped from surgery three times already. 


All night, B sat there. Once he joined me in Lakewood, he didn't leave, and nothing, no pain meds, nothing was as comforting as opening my eyes to see him there, rocking in his chair, trying to doze, jerking awake whoever I moved to make sure I was okay. Solid, present, there. This is why I love him. Once he works through the "why" of a crappy situation, he puts it behind him and he cares, ridiculously deeply. He's difficult until things get difficult, and then he's a rock. He puts his head down and he plows through and no matter how things keep piling on, he takes it on. He's a pretty good person to have on ones side in a crisis. 


About that time, the surgeon stopped back by, obviously agitated, yelled a little about how he was trying his hardest to get to me but now he couldn't because the power was off, and he had a plane to catch, and he was upset too about my having waited all night, told me he thought he'd found someone to replace him, and left. And with him, hope abandoned me. They pushed me back up to my room, pain  and nausea meds finally became available, and I slept. When I woke up, it was because it was day and I was again being wheeled to pre-op. 


And there, a tall, young, angular man said he was the plastic surgeon who had rearranged his day and rescheduled his morning clinic appointments at his swanky Boulder private plastic surgery practice to come suture the facial laceration he had heard about at the end of his shift the day before. So how about we get that cut closed up, he said perkily. Oh, yes, please, I mumbled under the gauze. Alright, he said, let's take a quick look at that. He plucked off the gauze and froze a bit, then immediately swung around and started barking orders and saying things like "don't do that here, let's just do that all in the OR", they pushed a sedative into my IV and the last thing I remember him saying is "you probably won't remember much after this". 


I felt like I jerked awake, confused about where I was, and Bobby stood there with an old friend we used to bike with, back when we lived in Summit County pre-kid. I tried to smile and welcome him, but the strange sensations in my face yanked me back to reality. Bobby took a picture of my face and showed it to me, and I can't even explain the relief of seeing it put back together. My mouth was no longer full of gravel. My lips were enormous, and criss-crossed with stitches, but they were in the correct general location. My cheek was no longer a squishy, dangling flap, and no lip-gummy worm flopped across it. 


Later, when he got a break at his clinic, the surgeon stopped back by and I thanked him for galloping in on his white horse and rescuing me. He shook his head. "I'm not sure about the white horse part. I was here when you got here last night, I could have done it then if I had known they weren't going to get you in. And I could have done it at any point during the night if they had called me. You shouldn't have had to wait so long." 


I like this guy. 


The rest of the stay was boring stuff. I slept a lot. Swelling hit epic levels sometime during the first night, so they called in an ear, nose, and threat specialist, since one of my saliva glands apparently got annihilated and couldn't be located and reattached during surgery, and they thought the fluid accumulation in my jaw and neck might be saliva. But by the time they showed up, I was up and moving around, out of bed and sitting on the couch, and the swelling had gone down, working it's way from my jaw to my chin and neck. I finally got some food, puréed chicken noodle soup, and managed to syringe it into my mouth. 


The kids stayed with Miss Dinta (my friend Ginta) the first night, then my parents dropped everything, jobs, summer projects, yard full of animals, and drove up from Kansas to stay with them. In my absence, my mom mommed my boys and did my laundry and dishes. 


This is probably it for breastfeeding. When I got home, two little boys were completely freaked out by my new face and stared at me with big eyes. I picked them up and they melted into me, heads on my shoulder, and told me how much they had missed me. Little brother was afraid of my face, couldn't quite trust it was me, but when he finally looked up and met my eyes he relaxed, sighed, and snuggled into my arms. It wasn't long before they were asking to nurse, but I stuck band aids on my nipples and told them they had owies too, and they accepted my lie without question. I will admit, I'm both really excited about having my body be my own again, and really freaked out because I have witnessed Daniel bounce back from some pretty major trauma with the help of breastmilk, and I am allowing an extremely valuable and irreplaceable resource to dry up. Painfully, I might add. How long does it take for the pain and hardness to go away, anyway?! 


At no point in his treatment has Daniel ever been without the dietary supplement of breastmilk. Probiotics are discouraged during treatment due to their very nature of being bacteria- they have a risk of harboring not only good bacteria but also not such good bacteria, I guess? But breastmilk has saved us after so many rounds of antibiotics. Between the ooligosaccharides that feed the few remaining good bacteria in his gut and the good fats and personalized antibodies, he has never seemed to need much nutritional support aside from it. But it has also become increasingly difficult for me to keep doing it, both socially and physiologically. He has been reluctant to let go of it as a source of comfort, even after months of constant redirecting and trying to find other ways to help him emotionally process his world. I have been stuck walking the fine line of letting him have enough to benefit him physically while being sensitive to the social stigma of nursing a preschooler. Public awareness of full term breastfeeding has really not hit the places we've lived yet, and it gets exhausting constantly being an advocate and activist and educating people about why I haven't yet weaned a four year old. (Four is a common age for a healthy, free range child to wean in cultures that accept self-weaning, by the way. I would imagine the fact that my four year old has not yet chosen to do so has something to do with, I dunno, HIS CANCER TREATMENT.) In the last year, however, his latch has changed. It was never great. It has been uncomfortable to breastfeed him from day one. But now his jaw and mouth are maturing and it is getting even more awful, and the nursing aversions are about as powerful as during pregnancy. So I'm conflicted. I feel stupid letting things dry up and losing this invaluable resource, but on the other hand, here is my chance. He has not been able to nurse for ten days now, due to all the meds I've been on. He's starting to work through his stages of grief. If I let him do it again, relactate, no telling when he'll decide to quit on his own. 


Little, I have fewer qualms about. He is still quite enthused about it as well, and quite crushed that they have been unavailable, but he is ridiculously healthy. His latch, which has never been painful like Big's, is still comfortable, and I have no problem with nursing him past two years old, but the problem with tandem nursing is you almost have to wean simultaneously. 


My dad left the day I was discharged to go back home and deal with things there, and my mom stayed until just the other day. It was so great having her here. I mean it really doesn't matter how old you are, and how much of an adult you have everyone fooled into thinking of you as, sometimes you just need an adult. An adultier adult. And your mommy. 


I am still feeling beyond wiped out, for some reason. I don't understand it. Aside from my reassembled face, which has lost 95% of its swelling and is healing amazingly well, my body is fine. So where is my stamina? Why does a flight of stairs suddenly have me sucking wind? 


Except, I guess, I did have a ton of narcotics. I quit cold turkey and embraced the pain when I started to realize that I was starting to feel anxious and shaky whenever they wore off, and was starting to think I needed them without considering my pain level. Also a ton (and a half) of antibiotics. Also general anesthesia. Also not only physical trauma of tearing off part of my face, but the emotional trauma of not being able to deal with it until the next day. Also I abruptly stopped eating and developed a complicated relationship with food, having to decide if the pain of eating was worth it. So I lost ten pounds the unhealthy way, by forcing my suddenly inactive body to cannibalize itself.


I still try to get out and do something at least once a day, if only a trip to the store. I had one mini meltdown, the night after I was discharged we went to a free concert by the lake and several thousand people did double takes when they saw my face, but I'm attributing the resulting blues to my sheer exhaustion that night. I hit a wall and couldn't go much further, but still forced myself to because I desperately wanted things to feel normal, so I dragged everyone to the concert and immediately regretted it when the wind blew painfully on my face, we had to walk fifteen minutes from parking, and the exhaustion hit hard as soon as we sat down. I'm not really self conscious, aside from that night. Mostly I feel like I'm in a weird social experiment, constantly noting the reactions of people around me. They want to stare, but try to pretend they aren't. They start to smile at me, then see my face and short-circuit, then studiously ignore me. It's been interesting. I've been them so many times, I know the feeling well. Why can't we just genuinely not see the ways in which we are different? Why does otherness insist on setting off alarm bells for us in spite of us knowing perfectly well that we are all the same deep down? Not just physical disfigurements, although those are huge, but inherent differences. I was forced into a healthy amount of discomfort this winter during the week Keystone had a massive black ski summit, as hard as little extremely Caucasian me tried to deny it and act totally normal. No, I didn't feel endangered. No, there is no specific bias I carry. It was just being so surrounded by otherness that made my circuits blink a little, and the more ashamed of that fact I felt, the more crummy I felt about myself. I can't help that I was raised around only white and brown people, so anyone darker than Latino automatically seems exotic and other-ish to me. But then my two year old, utterly oblivious to subtext, blew my cover by having a meltdown over having to ride in an elevator full of very large, very black men. His reaction was mine, just on the surface. He knew he was perfectly safe, but the otherness just fried his circuits for a minute and he had to back up, release some emotion, and process. It is a very good experience for me to be on the other side of those sorts of reactions, to be the Other. It is an experience I have missed out on most of my life, unless you count being the only kid in the only openly dysfunctional family in Religious Mr. Roger's neighborhood growing up. 


It will be temporary; once the icky, cheesy grossness sloughs off and reveals the new, pink skin underneath, it will be less noticeable. My mouth and cheek may regrow the nerves and muscles needed to stop the paralyzed droop and my lips may eventually need another surgery to get a semblance of their shape back and be able to close them, but already the scars across my cheek where the shreds of skin were tidied up and sewn together are smoothing out, a testament to the tiny, skillful surface sutures placed there by my new favorite plastic surgeon. My otherness is fading fast. My social experiment in being unenviably extra-ordinary will end soon, as will my opportunity to be bemused by the way people interact with people. 


My surgery was on Monday, June 26. On my birthday, Friday the 30th, B drove me to Denver, I popped my last pain pill and steeled myself for an ordeal, and found my way into the lovely, calm interior of a Boulder private plastic surgeon's office. I won't lie, it was trippy. My only other experience with plastic surgery was through my mom's breast reconstruction after her mastectomy, and that was an office located in a cancer center. The other patients were mostly simply trying to get their lives back, trying to put their horrible experiences behind them by rebuilding their bodies to resemble something they were familiar with. This was a very different experience. The conversation was flowing in the crowded waiting room. Women openly discussing their perceived flaws, the work they needed. In my world, it is impolite to those around you to discuss the things you hate about yourself, because those around you may possess those same features or worse. A mom with two kids on vacation needing Botox, another mom excited about being able to fit in her jeans again in a week, another micro analyzing her own and her daughter's faces for sun damage and areas that needed more "fullness". It was so, so foreign. Talk about otherness. I realized no physical differences will ever separate me from other humans, or make me more uncomfortable around them, than class differences. I was the crude one there, the philistine, with my eight year old purse with the shredded carrying strap, my river sandals, my snagged yoga pants from Old Navy, my sun damage and patchy eyebrows and gross mountain bike injury. The receptionist immediately identified me as "The Mountain Biker" and asked about my crash. I spoke a little louder than needed, knowing I had center stage, as I gushed about how happy I was with my new face. Because the honest truth is, I judged the Botox Belles just as much as they judged me. I realized I carry a lot of judgement toward women who feel their lives will gain meaning when they conform to some arbitrary standard of beauty, and spend so much money to attain those standards. I trust the people I perceive to share my values and interests more than I trust someone I perceive as self absorbed based only on one facet of their lives. I considered what sort of person would wish to provide the services these women seek- one who sees an opportunity to make a lot of money, or one who sees the same flaws these people (I've been saying women, but there were several silent men there as well) see in themselves? 


Once in a chair in his office, the stitch removal hurting like crazy, I told him again how surprised I was that I still recognized myself, how grateful I was he had come in to put me back together, and how I probably had not been giving plastic surgeons enough credit, seeing the tiny, precise sutures and how smoothly the wounds were healing. He nodded. "Yeah, most people think we only do boobs and facelifts, but reconstructive surgery is a huge part of what I do." 


And now I wonder even more- how does someone go from reconstructing the aftermaths of horrible accidents in the morning, to liposuction and injecting Botox and butt fat (or something) into faces in the afternoons? How does one switch between perfecting the bodies and faces of Boulder's most vain elite to fishing hamburgerized saliva glands from Summit County's most stupid, and everything in between, without experiencing completely disorienting culture shock?  Our conversation switched to Daniel's chemo appointment that morning, and how resilient people can be, and he told me about a friend who survived cancer to return to pro hockey. I nodded. "Humans are amazing." He shook his head. "Not all of them", he muttered under his breath. So many answers to so many questions I hadn't asked.


So there you have it. Since Friday, I've slept when I can, which hasn't exactly been easy, first because of steroids and itchy antibiotics, then my painful face, kids who are adjusting to not nursing, and for some reason, I suspect the lack of gut flora thanks to the antibiotics, constant heartburn. My biggest issue currently is that I am too easily exhausted and my face is too sensitive to go outside for long, which is beyond frustrating. My kids are getting too much screen time and all I want to do is what we did before last week- live outside. 


In the meantime, we changed Andy the Dog's food and had another diarrheapocalypse. We came home a few weeks ago to poop soup everywhere, soaked into the carpet pad. It was the last straw. The carpet was already smelly and we already didn't trust it to not be growing bacteria harmful to Big's fragile immune system, but after the pooptastrophe, we decided to find whatever cheapest vinyl floor covering we could and yank out the carpet. However, the layout of our house is incredibly stupid and obviously not designed by someone who has ever lived in a house. The enormous kitchen bar crowded into the walkway and living area, leaving about six feet left for living room furniture and a kitchen that was exhausting to cook in, running from one side to the other as one does ones thing. So before we could lay flooring, we demolished the bar, salvaged the cabinetry and reconfigured it, making a much smaller, more sensible kitchen. That part isn't costing much since we're reusing most of it, but it has been massively time consuming and inconvenient. Because the one thing you should always do following trauma and surgery, when you still have a sprained wrist, is a home remodel. I've been far less helpful than I planned on being. Handyman has been far more gracious about that than he would have been in the past. 


I guess all in all, in a messed up way, it has sort of been a vacation. I mean, there were no cocktails on a beach or romantic hot spring soaks, but I did get narcotics and a romantic shower where I sat on a hospital shower bench while the love of my life held the shower head for me while I cautiously washed away all the gross drainage and cheesy layer from my face while we played "count the bruises" on my body. There were no kids or responsibilities for a few days, so we got to just hang out together and talk and reconnect. We needed to do that so badly. B was there for me, with me, the whole time after that first afternoon when he ran around like a maniac trying to finish work and get to me. Amazingly, solidly, comfortingly there. The one person I wanted and needed was right there, translating my mumbling and typed requests for pain meds, helping me up and down, trying to cheer me up. I can't even tell you the difference it makes to go through an ordeal alone, versus going through it with someone who would do anything for you. Even loan you his bike in the future. Even hold your hand and tell you you're pretty when you resemble a zombie from the Walking Dead. I needed to be cared for the way he cared for me, he needed to know how much I appreciate him being in my life. Next time maybe I won't remove my face to get a date. 

Tuesday, July 4, 2017

Concessions, confessions

Hi, and welcome back. I'm currently typing on my phone, lying in bed between two sleeping little boys who are still wearing the clothes, minus shoes, that they wore to the Wave: light, water and sound festival in Breckenridge last night. They are still wearing now-fading glow sticks, and somewhere in the covers are the felt bunnies they decorated with sharpies at the art booth, bunnies they were still clutching when we carried them in to the house from the car last night. In fact, the entire family is still passed out, even the dog, who I'm pretty sure is developing prostate problems or diabetes or something else geriatric and inconvenient, because he generally needs out about every three hours to pee. Of course we moved to a house without the possibility of a doggy door around the same time our dog developed issues with frequent urination. But even he has not yet become conscious enough to wobble his way to the door and whine to be taken out. 


Life has been, well, pretty okay lately. At least for me. Bobby might have a different opinion, since he is the one out exchanging time for money on an erratic schedule every day. This week is the "official" start of summer, school let out two days ago, kids are free, parents are free, and Bobby has agreed to try to take two days off every week. They aren't weekend days, of course, but that's okay. Two days a week without his phone ringing at random, completely inopportune times, two days that we can actually plan things as a family, is an exciting prospect we haven't had in...(mental calculations...carry the two...) a really long time. That isn't to say he hasn't had days off, but he hasn't known they were going to be days off when he woke up on those mornings. 


The weather is warming up at 9,000 feet, finally, and we are taking full advantage. We planted grass in the ill-gotten and guiltily enjoyed fenced area behind our house, so until it sprouts we can't go back there, and there isn't even a remote chance I can keep these two little natives in the house on nice days even with all the YouTube videos in the world, not that I'd want to, so we spend almost every day out exploring the mountains. In those snuggly moments after they wake, I ask them what they want to do that day, and we build our day's plan around their requests to go to certain parks. I generally try to feed them and clean house in the mornings, then we pack some food and sand toys in the bike trailer, and leave for hours. 


Yesterday, we departed from our usual routine, a bike trailer pull to a park. I pulled them up a steep gravel road to a little beach area beside a stream, where we spent hours wading, digging, collecting sticks, building bridges for our matchbox cars and excavating equipment. No cell phone service up there again made me realize how many of their adorable interactions I miss because I use their park playtime to read emails, respond to texts, scroll through Facebook. On our two-day camping trip to Moab a month ago, which we spent in a dead zone in a canyon, I realized this and came home delightfully unhooked. For the next week, I stayed that way and it was nice- I didn't read the news, so it was almost as if it wasn't happening, I didn't see the Facebook memes so I didn't have to experience an emotional response, it was just me in my small world and it was lovely. Of course I also know fully that my privilege afforded me that luxury, that the news and conflict that elicits an exhausting emotional response from me upon reading it is the day in, day out reality for so many others. While I unplug, refugees still die. Bombs still explode. Injustice still wins. Healthcare that we desperately need still gets shoved down the garbage disposal. 


But in Summit County, icy water still flows musically downhill. Aspens sprout tiny leaves, the green tinge on brown hillsides deepening by the day. Sun warmed pine sap inches its way down rough bark, birds and squirrels talk, and as trails dry, mountain bikers and hikers crawl like ants through networks of trails interrupted by melting snow. And we are here to witness it. In our part of the world, it is possible to just be. To sit in the intense mountain sunshine and be surrounded by weightless air, the sounds of water and happy kids, caressed by cool breeze, the scents of pine and sage and wet earth all around as time passes unnoticed, days passing, then months...until summer has turned chilly and one awakes one morning to low, milky cloud cover and realizes winter is here again, with its cabin fever and influenza and seasonal affective disorder.


Daniel's latest chemo appointment was two days ago. It's going to be a fun week; his first dose of steroids yesterday morning was already creating a marked personality change by early afternoon. We don't always experience it so noticeably after only one dose, but when we do, we know we are in for a rough week. It is a really valuable reminder to me of how easily manipulated our personalities, the things we consider so uniquely us, really are. I have experienced this myself, of course, with the hormonal upheaval of five attempts at pregnancy, hormone support through pregnancy, and various attempts to find birth control that does not warp my happiness baseline and turn me into someone even I don't trust to be a nice person. I have witnessed it growing up with parents who walk a fine line, making constant decisions of whether to overcome depression and other mental afflictions by sheer force of will or to medicate, accepting side effects as less disruptive to their lives than not medicating. Mental illness has always been a louder, more complicated conversation in my life than physical illness, and I say that as someone who has been support staff (in varying degrees) in three different cancer battles. But watching someone who has only been alive for 53 months, still fairly emotionally unmarred and beautifully innocent, someone incapable of wearing the masks we adults do, take a few small, bitter, powdery pills and turn into a completely different person as a result of slightly increased production of stress hormones, that is powerful. That is a lesson in mental health and tolerance we all need to take note of. We are all the sum of the interactions and synapses and chemicals that make up our physical states, and changing just one thing reveals just how fluid this thing we call "self" really is. That fresh realization always blows my mind and quiets the festering judgements I build up against those in my life I have been measuring with the same yardstick I apply to myself. It also reveals the full weight of those "for better or worse, in sickness and in health" commitments we make to each other. We so rarely take into consideration how easily people change. 


And I'm back from the rabbit trail. Daniel's lumbar puncture was uneventful, although he was very slow to wake up and it took about six hours for him to be able to walk in a straight line and not stumble over the floor and his own feet. His first few steps upon waking were a disaster that ended with him on the floor. He recovered quickly, scrambled back up, but a nurse hurried for a wagon so he wouldn't have to walk out of the hospital on his own feet, since they weren't really working yet. 


Our last year of treatment starts in August. It is now I am realizing how his being a boy is making his treatment longer. I mean, we were told from the beginning that boys have longer treatments than girls due to the risk of testicular relapse, but that was not something we thought about until now, when some of the girls who were close to us in frontline treatment are nearing the end of Maintenance already, and we still have over a year to go. Our nurse told us we will probably be shocked at how much better he feels almost immediately after he stops treatment, how much he will probably start growing, how his energy levels will soar and his attitude will improve. I am cautious about believing it, having heard other moms also talk about nightmare detox rashes and sickness and immune systems that are slow to recover on their own after so many years of being suppressed, not to mention things like central lines being calcified into arteries after having been in there for over three years. But that stuff is temporary in the big picture, and he has the rest of his life, aside from the next 14 months, to live chemo-free. That is exciting. I won't even go into how 30% (ish) of kids can develop potentially life-threatening long term effects from childhood chemo, and around 90% have at least one chronic effect. He isn't likely to walk away from this completely unscathed, and if the effects he has are mental, we will most likely never know for sure if it came from over three years of relentless chemo in his spinal fluid, bypassing his blood/brain barrier to roar through his developing brain and personality, or the murky gene pool he sprung from. 


******************


So that was three weeks ago. This has sat on my phone (because I blog on my phone, thumb-tapping, these days, because once I sit down and commit to writing, I immediately have two kids in my lap, pulling my hair, fighting, accidentally scratching me as they fight to get inside my shirt, that's a whole other thing) while I've been too busy to write. 


The weather hasn't been great the last week or so, we've had some rain and wind, so I haven't been out as much on the bike, which means I've been doing the thing that had me so pent up and beside myself all winter- staying home with them. The thing that had me in therapy this winter, crying in frustration because while I'm still breastfeeding a kid whose body is already a toxic waste dump, I can't take meds for the ADHD that makes me a fun and exciting and exhausting and irritable and unreasonable person, meds that would pass into my breastmilk and possibly alter Daniel's already at-risk brain. I will be honest, even a week at home, inside four walls, forcing myself into a housemommy mold instead of just momming on the fly under a big, blue sky in a beautifully uncontrolled environment has had me uptight and more than a little resentful of Bobby, out there working, problem solving, having adult conversations, doing varied and financially profitable things. 


I decided, this spring, to just put a lid on my mommy guilt and do something strictly for me this summer, something on a schedule that was unaffected by me, so I couldn't just cancel when it was inconvenient. So I decided to do the local mountain bike race series. Because 

nothing is quite like the sheer therapy of flying over a narrow trail under the sky, pushing oneself, challenging oneself, going fast, balanced on a moving bit of aluminum, carbon fiber, and rubber, with nothing but physical exhaustion and survival to think about. With all that high intensity resistance training of pulling a hundred pounds of kids and gear eighty miles a week, I should be in good enough shape to race, right? Turns out, no. My winter of inactivity, skiing for two hours a dozen times, a few walks with the dog, a few randonee climbs up and powder turns back down the hills behind our house was not enough to kick off my summer with the endurance competition legs needed to be in the top 50% in my race category. I'm struggling to keep up. That part is okay, exactly what I need to stay motivated, but it turns out committing to something when one is a mother and stay at home wife of a person with an extremely erratic work schedule is harder than anticipated. If it weren't for my friend Ginta, who has her own crazy life and busy schedule and two kids, I'd have probably dropped out already. She's been my rock. When she was in my position, with little kids, I did not yet have kids so it didn't occur to me she needed a rock. I really regret not being there for her, ten years ago when we met, me looking for girlfriends in an outdoor community that is like 90% dudes, she newly pregnant but still fooling herself that she could have kids and maintain a crazy outdoor life, like she has been for me. 


It has turned out to be unexpectedly hard because each race requires not only to show up on race night, but to preride the course so one is not grinding up a hill with no idea of where the top is, then bombing down a course one is unfamiliar with at a speed faster than one should be riding a trail for the first time. And because my fitness is not there and I am constantly sore from riding, I try to do the preride enough in advance I can take a day off before race day. This means I have to preride on a day Bobby has the maintenance line (Sundays and Mondays) and is on call, so it isn't smart to leave him with kids, lest he suddenly have to go out on a call. Which happens a lot. All that to say, I now realize I probably have no business doing it, as much as I'm loving it. But I'm committed, a local bike shop paid for my season pass and gave me a jersey to represent them out there, so I'll do it if it kills me.


So yesterday, on his one day off this week (because he's already caved on his commitment to take two days off due to pressure to finish projects in the gaps between bookings) Bobby went for a quick mountain bike ride in the morning, then took the kids, me, and my bike to Breck to preride all three of the stages of the enduro race happening there tomorrow. I had a mechanical failure that rendered me unable to ride, so I had to buy new parts at full Breckenridge price, work on my bike, then Daniel fell apart because he wanted to ride with me, which turned into an endless exercise in patience getting him down a long hill, about ten steep, loose switchbacks that didn't recognize his feet as brakes on his Strider bike. I watched helplessly as his speed got away from him, he couldn't stop, and had a big, dusty crash in the trail, then dusted him off and coaxed him back on his bike. By the time I was actually ready to preride, everyone was already tired, hungry, and hot. I did the two short loops, which only revealed that I really needed to ride them more, because they are quite technical, then the eight mile loop of the big stage, and seven hours later, we returned home, my guilt over having subjected them to such an exhausting day overwhelming. 


Therein lies the basis of all my conflicted feelings about motherhood, having a sick kid, wifing, housekeeping, and still trying to maintain some level of self and identity apart from them. The guilt. I have guilt when I resent my kids for getting in the way of my plans for escaping the house. I have guilt for escaping and leaving them with Bobby after he has had a long, exhausting day at work. I have guilt for snapping at them when I am pushed beyond the limits of my patience, when we are at home and I am feeling guilty for not having a clean house and everything I do, they follow me around undoing, and I just want one thing to go as planned. I feel guilt for envying Bobby's job some days. I feel guilt for listing these things without the accompanying disclaimer that I love them more than life, and even if I were drowning, they are the reason I would fight to swim. I feel guilt because I only have two of them. I feel guilt because even with only two of them, I still miss some of their moments, still don't give each the one on one attention they deserve. I feel guilt because they sometimes request peanut butter on a spoon, nothing else, for lunch, and I give it to them. I feel guilt because I can't get the house clean without giving them screen time, and I also feel guilty because the house stays permanently trashed when I don't give them screen time. 


And then, God forbid, my husband mentions a particular shortcoming, hears me snap at them, chastises me for dropping an errant f-bomb in a frustrated moment, notices the pathetic nature of my attempts at cooking, observes that the bathroom is starting to smell like an outhouse, that one cannot walk through the house without a lego-related injury, that breakfast should include protein, and that big tray of guilt, balanced so precariously on my head, breaks. The guilt cascades down over me, sticky and messy, all jumbled together, each piece so indiscernible from another I have no idea what to even point to as the cause of my current mess. All I know is that he has just confirmed as unjustifiable all the things I have been trying so hard to justify. So we have a fight, because my lifeline consists of removing myself from the guilt, to constantly tell it to stay away from me, that I don't deserve it, so hearing it noted that even one piece of it is, in fact, deserved, means it all sticks to me. And feeling it all stick is just too much, too yucky, so I fight to get it off me and back on the tray as fast as I can. Which, of course, leads to more guilt. Not only have we torn each other down, we've done it in front of the kids. 


We need a vacation. Too bad we feel too guilty to leave our kids with anyone else to actually enjoy one. I thought putting my foot down and demanding some me-time this summer would be the answer, but it isn't. Bobby doesn't get to have him-time if I get me-time, and that isn't fair. There are only so many hours in a day, not enough for us both to recharge and be ready for the next day. 


I guess I am coming to the realization (again) that people don't just change because their situations change. Bobby's overdeveloped sense of responsibility is again causing him to withdraw, to silently put his head down and plod through the insane amount of work and drama at work, making him emotionally unavailable and impatient with me and my constant need for reassurance. The few reserves he has at the end of the day goes to his kids, as it should. My insecurities and inability to calm myself, focus, and actually finish a task if there is the slightest interruption has us constantly washing around in a state of inconsistency. Repetitive, moving outdoor exercise is the only thing that orders my thoughts and calms my jittery brain, and being out and on the move on my bike is the only time I feel truly calm and happy, which is exactly the sort of thing that is so hard with small kids. In the meantime, because he knows this about me, Bobby sacrifices his own workouts to allow me a little time to escape from my own head, and he gets less healthy, has less energy, while I build muscle, gain energy, feel like, upon returning to the house after a ride, that life cannot possibly get me down anymore.


Lest you think I'm complaining, I'm not. I'm pretty sure if we all stopped trying to wear our masks, we'd all say similar things. I think we all need to take off our masks. I'll go first. 


I'm not a natural at this whole parenting/wifing/adulting thing. I envy people who are. But if you aren't, I guess I keep a confessional sort of blog so you can know that you might fail too, but you are far from alone. 


Memory harvest

Hello, and welcome to the memory harvest. 

Every bad thing we witness has an effect on us. Mostly, it makes us feel insignificant and out of control. These things happen to people no more or less deserving than us, and nothing can be done to stop our collective, inevitable march toward the end. There but for chance and fortune go I, we say when tragedy strikes somewhere else. I used to say there but for the grace of God, but lately, maybe because we have been on the receiving end of some crap and have put more thought into the "why" than it takes to repeat a cliché, I no longer say things like that, or things like "we are blessed". Not because we aren't, but because of the unfinished edges of the implications such a statement makes toward those less fortunate, less blessed, more touched by tragedy. When one states that a blessing has been given, one leaves a glaring negative space in the implication that blessings have been withheld from others whose stories took more tragic turns than ones own. I must say, I'm still struggling with the question of why things happen. Oh, I know the canned answers. The world is imperfect. Imperfection and consequences of mistakes cause bad things to happen. But they leave something missing, yet, for me. The world would be such a neat and tidy place, all speculation of cause and effect could be fair game, if it weren't for the suffering of small, innocent children. 

Yes, I'm going somewhere with that. I'm searching for a good segueway into talking about the feelings of impotence, of smallness, of the loss of control over the things that befall us, and the mounting urge to do something, anything, to take the reins of ones own life and make that one life mean something. 

Time keeps approaching, brushing past, then retreating into nothing more than memories of past experiences. It is enough to make one we realize only one thing can be controlled, and that one thing is the beauty and quality of the memories one has stored.

We are in full blown memory harvest. We are hoarding memories, frantic lest we lose one. We weren't like this before we realized pediatric cancer could rip our future memories away, before we had the chance to make them. But now, with two little humans growing up all around us, we realize so keenly the importance of remembering that we don't get a do-over for even a single wasted moment. My phone has so many pictures on it, and these aren't posed or edited or polished pictures, they are candid snapshots that, when viewed in the future, I hope will provide a route to access the memory of the moment it was taken. I fear losing my memories more than losing my ability to control my body, more than death. Now we say things like, "I'm going to be so sad when I no longer have my little boys", and we aren't being morbid, we are simply acknowledging that they will leave us some day. Whether budding adulthood or tragedy takes them, they will be gone. 

So we create, then harvest the memories and emotions each day brings, and try to savor each moment, and we just can't. It is too much. They come too fast, they bring too many emotions, and it is just too overwhelming, and too much pressure, and so much simply gets lost. 

It is summer in the mountains. Sunlight is too intense. Breeze feels too gently cool. Grass is too green, mountaintops too white, rivers too musically rushing, lakes too deeply blue-green to be properly processed. It's too beautiful. It hurts to be surrounded by it. And then, the sweet intensity of two innocent, beautiful towheaded boys tugging on me, asking endless streams of questions, begging for me, for my approval, my knowlege, my authority, my love. Their eyes are too blue, their lashes too long and dark, their dirty bare feet and suntanned toes too busy. It's too much. I want to experience it all properly because it is all so fleeting, and I just can't. 

So I do what I can. Almost every day I ignore growing piles of laundry and an increasingly messy house, pack a lunch, hook the bike trailer to my trusty, prized blue classic steel road bike, and we ride over the twisty, hilly bikepath, flying through deep pine shadows, past wildflower covered hillsides, along the roaring Snake River, swollen with snowmelt, to our favorite places. One day it might be a calm, shallow portion of a tributary to the Snake, up a steep gravel road. We might be found splashing, jars of fruit smoothies submerged in the icy water for when we get hungry. We might spend hours constructing bridges, dams and roads for the toy cars we brought along, and when the shadows grow long, three exhausted humans, one big and two little, will make our way back home to see daddy and tell him all about our day. Another day it might be Keystone Lake, with pockets full of carefully hoarded quarters to put in the fish food dispenser in exchange for a handful of pellets, which we toss into the water and jump in delight at the feeding frenzy in which the trout engage. We might hang on the jungle gym, dig in the sand, send toy trucks rocketing down the slipper slide. Another day we might ride around the lake to the campgrounds and day use areas located on the other side and spend long, sundrenched afternoons throwing sticks into the water, trying to skip rocks, exploring trails, collecting pinecones. And yet another day, we might use a key to gain entry to a pool in a condo building and pretend we are on vacation, swimming, splashing and shrieking, eating lunch at a real table with an umbrella. 

You would think I would lose a few pounds with all the biking. This has been an easy week, lots of trips to Keystone, and I've still pedaled more than 110 miles this week, most of them with 80-100 lbs of kid and trailer behind me. But no. I feel myself hardening, toughening, but weight loss has not been my priority and it hasn't been a result, and for the first time in my life, I am calm about this. This sort of effort requires fuel. Im not going to deny myself those wonderful picnics. I am a nearly 34 year old mother of two little boys. My priority is not to take up less space. It is to experience all the things. 

As steady as the heartbeat in my chest is the thudding dread that drives our manic search for joy and beauty and the best, most unspoiled memories. We don't know if this is even more temporary than we assume. With each blood test, with each lumbar puncture, abnormal blood cells could be spotted, and overnight, it would all end. We would be inpatient immediately. More chemo. Harsher chemo. Another nightmare month of high dose steroids, followed by hard decisions like trying to get into trials for CAR-T or go the more conventional route of bone marrow transplant, or maybe there would be no decisions, simply being told this is the only treatment option available to us. We could be in a honeymoon right now. Or it could be permanent. We don't know. But it's enough to make two parents cling fiercely to every perfect moment, just in the rare event it could be the last one.

Each night, after a glorious day, Daniel snuggles into the covers between us, and we make no effort to remove him. We plant kisses on each of his cheeks, and we ask him if he knows how much we love him. He says he does, of course. He stretches his arms out and says, "This much!" We then repeat how much: "To the moon and back. Deeper than the ocean. Higher than the clouds. More than all the stars, and wider than the whole, wide world." He sighs and falls asleep, and we watch him sleep and talk about how smart and handsome he is becoming. Not to discount little brother, who is usually snoring by this point half in his bed, pushed up against ours, half in mine, arms flung out and little fist grasping whatever part of me he still has a hold of after we have snuggled to sleep. He is usually muttering in his sleep, because not even slumber can shut him up, bless his expressive little heart. 

Through all the happy, Bobby is working. Sometimes he gets days off that he didn't realize were going to be days off; the phone never rings. Sometimes he takes days off that turn into twelve hour work days. Sometimes he dares to go on a bike ride only to have me come pick him up on the bike path somewhere because something fell apart at work and he is needed immediately. It is frustrating, but still, he has to admit, well suited to his personality. He doesn't enjoy life doing the same thing day in and day out. Better for him if every day has a new and unique emergency. 

Life is good, it is summer both at the moment in Summit County and in this time in our lives, the memories are ripe, and we are doing all we can to preserve them.

Thursday, April 20, 2017

The moving life

Hello and welcome back! It's been far too long, I know. Life hasn't stopped, but I haven't been stopping to record it lately. It's been coming at me just a little too fast, like I'm perpetually running up a Lego-strewn "down" escalator. Last time I checked, it was sometime in February, and now it is past mid-April. That's a lot of water, I mean Legos, under the bri- I mean feet.

I am haunted by a refrain, ricocheting through my thoughts as I ricochet through my world. "Am I enjoying this enough? Will I remember this? Will this stay with me?" 

Little brother is just ridiculous lately. Two is such a ridiculously beautiful, golden age, he talks a mile a minute and is so innocently sweet with big wet kisses, tight hugs, and proclamations of his devotion- "you aw my best friend, mommy. I wuv you sooo much." Of course, the next moment he melts down over something terribly important like the color of his sippy cup. And the next he is demonstrating his best songs and dances for me. And the next, inconsolable because Big took his toy. And the next, stranded on the kitchen countertop. And the next, dumping his orange juice on the floor so he can drive toy cars in the mess. My life is basically a whirlwind of adoration and exhaustion and laughter and the need to take just one moment to poop by myself. And maybe, occasionally, taking the dog for a walk while Bobby experiences the small humans alone.

Big brother is developing a much larger emotional landscape and paints a new picture of it every day. He's violently angry. No, resentful. No, feeling the need to tightly control his surroundings. No, floundering in despair. No, confrontational. No, remorseful. No, excited. No, demandingly impatient. My happy, tranquil boy, the boy who took everything in stride and walked to the beat of everyone else's drums without fighting for two years now, is suddenly, finally beating his own drum and demanding we all dance feverishly to it. He cries easily when challenged, and it takes so much time, time I have to remind myself that I have, that nothing is more important, to sit with him, talk about things with him, calm him, and love him through a hundred upheavals a day. He is losing the sweetness and compliance he used to have, shedding his happy toddler enthusiasm along with his baby fat. I struggle with questions of whether his emotional instability is because he has had chemo breaching his blood/brain barrier and roaring through his fragile developing brain for two years now, or if he is just four. At night, when he has fought himself into deep, exhausted sleep, I curl my body around his and whisper to him how much I love him, and how he could never get so difficult I will stop fighting for him. This isn't to say he doesn't have his moments, moments of sweetness and caring and empathy that surprises me. But as he becomes a person, he becomes complicated, and he challenges me in the most genius ways. Not to mention the questions. He is making up for having been non-verbal for so long with probably a thousand questions a day. When we finally throw up our hands and ask, "Why are you asking so many questions?!" He responds with, "Hmmmm...that's a good question!" Or sometimes, "I don't know...Why do I?"

Intensity. That's why I haven't stopped to write. Every emotion is so intense and must be addressed immediately. Every need is imperative. Every thought must be heard and responded to promptly and appropriately. 

And joy. Joy has permeated our house, the sort of joy that comes from being surrounded by innocence. 



How can I hold on to it? These two are changing in front of my eyes, every day, reminding me of the transience of building an identity around and finding joy primarily in them. I suppose this is the emotional process that prompts some to keep having more children, but the notion does not seem attractive to me. It isn't the mere fact that they are children that lights me up, it is the fact that they are my Big and my Little. The thought of adding more intensity does not appeal to me when I realize how many of the beautiful, simple moments I have missed, have not borne witness to, because the intensity clouds my view. How many moments have had something amazing happen in them while I was too busy to notice? I want to store it all, every giggle, every squeal, every mangled sentence and awkward tower of blocks they construct. As they mature, I am so excited about traveling their roads with them- we have so many trails, literal and not, to explore together. Their bodies are growing strong, legs are stretching out, and soon we will be having amazing outdoor adventures together, where I will share with them all my favorite things; the damp, sun-warmed dirt and pine scented breeze on my favorite trails, the brief feeling of weightlessness underfoot when cresting a hill on bike or skis. I want so badly to share the world with them in their most formative years before I am replaced by peers and budding individuality. For four years now, I have been more or less housebound, watching my body soften, my face grow pale, dark circles form under my eyes, while I have changed inside as well- my heart has also softened, my interests have also paled, and my circles of friends have grown smaller. 

It isn't that I want my old self back, it's that I long to take my new self with its little tow headed satellites out into the great, wide world with me and show them all the beautiful things. So no. For me, another child is not the answer. To keep repeating and extending this time of hopeful toddler innocence is not the answer. But because time moves in a linear path, we are always leaving something behind, always choosing between staying put and moving forward, always losing one thing to gain another. 




In my case, Little's head full of flaxen curls represents it all. I press kisses into them, run my fingers through them, and my heart develops a thousand cracks when I realize I will lose him. Because I will. That sweet little head pressed into my shoulder, it will someday lift from my shoulder for the last time. I could have a dozen more babies turn into toddlers with silken curls, but those curls will soon stop tickling my cheek just the same, and while I am frozen in time as a progression of curly heads rest on my shoulder, I will miss the intricacies and patterns of sunlight and shadows on the trails preschoolers and preteens and teenagers must walk, trails I can't wait to watch them travel, to walk just a little behind them, the better to observe their reactions to the hard and painful and beautiful things.

I know some who read this will think it sounds like I intend to hover. But this is why I am struggling with questions of identity lately. I am not solely a mother. It feels like it, but I know, and the knowledge is so sweetly excruciating, that I am raising them for the express purpose of achieving an end goal, and that end goal is them finding healthy independence apart from me. When they happily, confidently walk away from me, I will know I have succeeded as a mother. This knowledge is why, between now and then, I know how imperative it is that I am first a mother, but close second, an adult person who walks my own path, that path chosen while my own mother stood tearful, her own primary identity, by necessity, shattered by her child's independence.

More than ever, with only a little over a year left in Daniel's treatment, I live in two worlds. The happy one is the one in which his cancer does not exist. We are already striding away from this experience, leaving it behind us even while we are still in it, with long steps, our heads high, with no thought of any remote possibility that cancer can take any more from us than it already has. 

But the underworld is still there, the shadows and dread seeping from the earth when we least expect it. Sometimes I am skipping along in the sunshine and without warning, a crack opens and I tumble in, and until I can climb back out, I cower in the shadows, down there in the foul air, breathing the toxic, creeping fumes. It happens when I hear of a friend or acquaintance parenting a child through a relapse and I'm reminded that just as we were once parents who didn't even consider the possibility of our child having cancer, we are now parents who don't even consider the possibility of a relapse. While I'm down there, I let the fears roll over me and am choked by the suffocating imagination of what it would be like. In that moment, there is nothing. It is then I realize our joy also comes from something beyond, and far more dangerous, than hope. It comes from belief. It comes from being not merely hopeful, but rather sure cancer is strictly in our past. It is then I realize we have no safety net. We would fall just as hard, if not harder, the second time. 

Our strength is in choosing to be oblivious, and that is a perilous source.

I am on a worldwide forum of parents also dealing with this disease, and a few themes of discussion are recurrent. Is this symptom/that rash/this pain normal, they ask again and again. How do you walk the line between having a life and keeping your child healthy? How do you stay calm when everything sends you back to the moment you most thought you would lose your child? How do you manage family stress when you cannot be an adequate parent to your other kids, or an adequate mate to your spouse, because your first responsibility is to support your child fighting cancer? And every once in a while someone will start a thread that quickly devolves into "things you shouldn't say to someone with cancer", and "horrible things people have said to me". 

I always read through these with bemusement. Some are truly horrifying, like, "when is your child expected to die?" and "your child wouldn't have cancer if you hadn't (given them sugar, vaccinated them, drank water from copper pipes, lived where you did, fed them red food coloring, treated them with vitamins instead of chemo, etc, etc, blah, blah, blah)." Some are more benign, like "thoughts and prayers" and no further contact. Some are well intentioned but tiresome, like the many suggestions a cancer parent receives to try essential oils, cannabis, and elimination diets in addition to chemo, which is far more complicated than someone unfamiliar with their treatment protocols might expect, or to try those things instead of chemo, which puts a parent in a terrible position. And some are just mildly discomforting. I find it interesting how many people fighting huge battles take issue with the compliments meant to lift them up. 

"You're so strong. If I were in your shoes, I'd just die."

It doesn't seem like this would be a hard one to hear. But oddly, it is. Many similar threads on said forum got me to thinking about why it is that nobody wants to be called strong. After all, it is a positive trait. So why does the word make someone fighting big battles want to fall apart? 

The way I see it, we all have people in our lives who have a harder road than we do, and we admire the hell out of them for traveling it with grace, while at the same time experiencing a rush of gratitude every time we are reminded of their circumstances, thankful that so much sacrifice and pain has not yet been, and may never be required of us. I feel the way about parents who have lost their tiny warriors that "normal" moms feel about me when they catch a glimpse of what childhood cancer is like- a mix of awe, admiration, discomfort, pity (yes), and sadness. I tell them the ways their situation reminds me to live and love in this moment, the moment I have with my kids, that this joy we now intentionally find in each moment together is a beautiful legacy their child has given to mine, and it comes full circle when other moms tell me how our very existence in their lives makes them realize how fortunate they are for their kids' health that would otherwise have been taken for granted. 

I think it is just hard to be told we are "strong" by someone who dismisses the trait as inherent instead of something we have chosen to fight the biggest battles of our life to become, have clawed our way into, and fight to hang on to every single day. I'd much rather hear, "You and your kid are badasses who make me realize how much crap humans are capable of surviving, and also, here's some chocolate because there is no way you are as okay as you seem. I hope if I ever have to be as badass as you are being right now I can make it look as easy as you do." Which is essentially what people are saying when they say "you're so strong" and I recognize the sentiment. But not everybody fighting a big battle does, especially when it is stated in a manner made even more awkward by the fear of being improper and the discomfort of imagining ones self in suckier shoes than ones own.

At any rate, things are good. Daniel is exhausted, but he has also shot up almost an inch in the last two months. His weight has not gone up, so he is looking more lanky by the day. The layer of little boy padding over his port is gone, and for the first time I am starting to see not only the outline of the reservoir bubble under his skin, but the outline of the tube under his skin traveling from his port up toward his left clavicle. His hair seems thinner, as well, which can happen during maintenance chemo, although hair loss after frontline treatment is fairly uncommon. He is pretty rashy at the moment, especially his face, but again, not uncommon. The sun, sunblock, and his chemo work together to really inflame his skin. We went to Kansas over the weekend and he may have brought back a tummy bug, because he spent the night vomiting. It breaks my heart that he is so used to vomiting that he requires no supervision. Just a bowl and a quiet corner to watch a movie, so he can puke in peace when he needs to. He is challenging and tough and amazing and unlike the adults in his life, hasn't learned to lie- when he seems okay, he really is okay. 

'Til next time, dear ones. Hopefully it won't be so long next time.

Thursday, March 9, 2017

Let's talk about healthcare some more

A grand adventure is never complete without a financial analysis, and it has been awhile since we've had one of those. I always hesitate because I don't want to sound needy. We aren't needy. We are quite resourceful, actually, and doing okay, thanks to certain programs we've been able to take advantage of. I also don't want to sound like we are doing too well, because, well, accurate representation. So here is a bit of where we are at, no extra polishing, no making it worse than it is, just an honest account of our experience in Crazy Cancer Land. 

Our biggest issue right now is finding insurance once we inevitably exceed the cutoff for the Medicaid coverage that has kept us solvent since June.

So let's break this down. Realistically, shopping for insurance on the open market, the cheapest plan we can find will cost us $29,500/year. This is taking into account premiums, deductibles, copays, etc., because when you are saddled with a cancer diagnosis (or anything else chronic or life threatening) you WILL squeeze every penny from your insurance. Yes. We're what's wrong with healthcare. We get it.

So. Stay with me here as I wax hypothetical... In order to afford almost $30,000 a year in medical expenses in a family of four with two young kids, instead of staying home with them, mom (or the non-primary breadwinner, who in our case is mom) has to get a job. Guess what? Now you have to add daycare to that. Let's say $20,000/year to leave the kids with someone else five days a week. I don't know if that's realistic, but that's about what I found two years ago looking at commercial licensed daycare. While they raise your kids, you now have to make $50,000. This, of course, doubles or even triples your income. Now you are in a higher tax bracket, so let's add around $10,000 for that. (I don't actually know, just stabbing in the dark on that one, but in our non-hypothetical case, we're self employed so our tax bracket is pretty high.) So now mom has to make $60,000/year. And for that $60,000, she sees zero net rise in her family's well being. In fact, not a penny of that is available to be saved or spent.

Let's be honest. What possible motivation would a family living just under the qualifying cutoff for Medicaid ($32,000/year) have to go over that cutoff? The primary breadwinner could much more easily cut back on his or her hours to fall below the cutoff, have time to spend with their family, mom (or non primary breadwinner) can stay with the kids and raise them at home, and their quality of life is higher than if they worked hard and made an extra $60,000 (still with me? That's $92,000 for the family- the original $32,000 cutoff that, when they exceeded, bounced them off Medicaid, plus the $60,000 needed as a consequence.) 

So now let's say, in 2020, there is a freeze on new Medicaid enrollees. This means that even if a family decided to do the "right" thing and make a stab at working hard enough to make that extra $60,000, they pay for their own health insurance... But in a few years, they realize they can't swing it. Maybe they have another kid, or a health crisis, or a vehicle breaks down, or literally any unforeseen expense. Now they don't have the option to go back to one income and Medicaid. Guess what this means? Thousands if not millions of people right now are doing the math. "If we try to be self-sufficient and we can't, in four years we will lose our safety net. Well, it was a nice thought, but we can't risk it. Guess we'd better move the recliner to the front porch because we're gonna be spending a lot of time there, now that we've decided to make even less money for the foreseeable future". 

Of course, the American Dream being what it is, a more likely scenario is that they will still work hard, just not hard enough to make up the difference, exceed the cutoff, shop for insurance, realize they cannot afford it, and become uninsured. 

So about that: 1 in every 285 kids will be diagnosed with cancer in the next year. 

In our experience, an overnight stay at a U.S. children's hospital costs about $7,000/night.

Certain chemotherapies (used to replace more common ones if the patient has an allergic reaction as happened with us) cost over $200,000/infusion.

At home oral prescriptions can cost from $300-$700/month (or more, that was just our experience before we had prescription insurance.) 

We and our insurance have paid over $1.5 million to keep our child alive. We never thought it would happen to us. There's a 1 in 285 chance it will be you next, and that's only childhood cancer, it doesn't even account for adult cancers or other health issues. I don't say this to freak you out about cancer. I say it because I want everyone out there to understand how imperative it is that Americans have access to healthcare, and how hard it actually is to chase the American Dream, that belief that you only have to work hard to achieve your financial goals. 

We're happy. Like most Americans who have never had to choose between food and heat, we naively assume it'll all work out for us. We live well, if minimalistic, which is exactly how we like it. But if anyone wonders why they shouldn't judge someone as a "welfare queen" because they intentionally make less money than they could, well... it's complicated.

What isn't complicated is living where I can walk outside my back door, climb from my driveway, up three feet onto the snow, and find myself in a silent, white world, just me and a happy dog and the mountains sliding under my skis. It's free. It makes happiness. We don't need a lot here. Our big expense is a ski pass, which means we can go on vacation three miles from our house whenever we can get away. Our house is small, which I love aside from storage issues, which wouldn't be an issue if we weren't running a home repair business out of it. Two alive kids are, when you think of it, especially through a lens of how it could be, the most amazing thing we could ask for. The future might get harder for us, looking forward in light of certain proposed healthcare changes, but the only bridges we can cross are the ones we are standing in front of.