Visiting History

4 years ago from right now, the skilled surgeons at Mass General and Mass Eye and Ear were drilling into my head and picking apart the inside of my skull.  I am reposting the story of that day.  So much has happened since then, yet it still feels like it was just yesterday.
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September 13, 2006. A day that will always be seared into my memory. The day of my surgery to remove my acoustic neuroma (aka, head booger).

Believe it or not, I had little trouble sleeping the night before my surgery. We did have to get up at 4am to check in at the hospital by 6am, but I slept quite soundly up until then. I didn’t expect to. And when we got up before the crack of dawn, I still wasn’t feeling nervous.

The drive into Boston was eerily quiet. Not much traffic that early. Brett and I didn’t talk much in the car. I think we were both in our own worlds, thinking about this surgery from very different perspectives.

We get to the hospital around 5:45am, and I need a pit stop before going up to surgical admitting. While my mind may not be nervous, my insides are starting to betray me. We soon go upstairs to admitting. The waiting area for outpatient surgery is already pretty full. I am somewhat envious of all those people there for such minor procedures that they can go home the same day. I check in and we head over to the inpatient waiting area. We are the only ones there. Shortly, another older couple joins us, and then by a younger couple with their young child – he couldn’t have even been 2 years old. I was heartbroken, watching the little boy play quietly, wondering what had gone so wrong in his young life that he required surgery. And I was heartbroken for his parents, having to watch their baby go through something so awful. I tried to flip through my magazine, but it wasn’t working. I couldn’t read the letters on the page. Fortunately, there wasn’t a lot of time to fret – I was quickly called back to the pre-op area. The first among the inpatient surgical patients. Brett has to stay in the waiting room for now.

I follow a very nice nurse, Eleanor, back to pre-op. It is a huge bright, white room filled with curtained off stretchers. My first task is to remove all clothing and change into the requisite hospital garb – gown, robe, and slippers. Eleanor then returns to go through her pre-op checklist. I confirm, three times, that I am there to have a left AN removed, and she uses a Sharpie to write the word “YES” behind my left ear. Don’t want those docs attacking the wrong side! After all the requisite vitals (again, my body betrays that maybe I am a little nervous when my blood pressure is much higher than normal), I sign all the papers saying I will consent to the surgery today.

Finally, around 6:15am, Brett is allowed back to wait with me. But we only have about five minutes before the woman from Transport shows up to wheel me off. Brett and I try to say a decent good-bye, but it’s hard with Stern Transport Woman (STW) watching. And then it’s time for me to be off. STW takes my stretcher and pushes me through the Big Silver Doors, down a hallway, and through another set of locked doors. I am now in the surgical wing. I try to look around, but it’s hard with no glasses and I’m starting to feel a bit queasy and shaky (it doesn’t help that I haven’t been allowed to eat or drink anything since the night before). I do notice that both sides of the corridor and lined with surgical suites, and all available hall space is occupied with all sorts of bizarre equipment. STW pushes me, without speaking, for what feels like hours. Finally, we stop at O.R. 27. I’m wheeled around in a small holding area outside the O.R. so my back is to the O.R. doors. STW goes behind me to poke her head into the O.R., announces my presence, and unceremoniously leaves.

A few minutes later, the anesthesiologist (Dr. Kamdar) comes out. She’s young, and quite attractive. It is her job to start some of my IV lines, as well as get my final consent for the anesthesia. At this point, I am starting to freak a little. My stomach is all uptight and I have to remind myself to breathe at times. Dr. Kamdar starts working on the back of my right hand to start an IV (a BIG one), and a nurse comes out to go through everything with me – again. Finally, I sign the last of the paperwork. I guess this is really happening! Now that I’ve signed all the consents, Dr. Kamdar asks if I’d like some medication to help me relax and I agree. It takes effect pretty quickly – I feel kind of tingly all over, like I’ve had a couple glasses of wine. I’m still freaking out, but breathing is a bit easier now.

Dr. Kamdar then shoots my right wrist full of Novocain so she can put in the arterial line. I can’t watch, but try to ask her a few questions (how many people are in the O.R.? What kind of anesthesia do you use?) to distract myself. She’s having trouble with my veins (I’m somewhat dehydrated because I couldn’t eat or drink that morning) so I probably should be letting her concentrate, but I really feel like I need someone to talk to me. She’s been working on my wrist for several minutes when I start to feel very light-headed. I try to ride it out, but finally have to tell Dr. Kamdar that I feel like I’m going to pass out. She quickly pushes a medication into my IV, and a few moments later I’m feeling better. It’s all very unreal at this point. Shortly after, the arterial line is done, and Dr. Kamdar straps my wrist to a soft board so I don’t accidentally move the wrong way and dislodge a large line in a major artery. That could be bad.

Now Dr. deBros, the senior anesthesiologist, comes out. We chit-chat a few minutes, and then he starts discussing the anesthesia protocols with Dr. Kamdar. I listen, amazed that he has a specific protocol he likes to use for AN patients. What really gets my attention, though, is when he describes the dosage of a specific med to push when the surgeon is about to start drilling the skull to put me under a bit deeper – otherwise, he says, the patient can reflexively startle and move a bit from the noise. (I later find out that Dr. deBros specializes in anesthesia for neurosurgery cases.) I actually find myself reassured that this team is so experienced with ANs that even the anesthesiologist has developed a specialized protocol. At this point, Dr. Kamdar has given up on starting the other IVs she needs, saying my veins are too collapsed from dehydration and she’ll finish up after I’m under to minimize my discomfort. Then she and Dr. deBros disappear into the O.R., leaving me alone in the waiting area.

I have no idea how much time passes, but I don’t think it’s too long. A nurse finally comes out, and says it’s time to go in. And just like that, I’m wheeled into the O.R. I wanted to remember to look around and really take it all in and remember it, but I think the meds are starting to play with my brain. I note that the O.R. is very large, and there are lots of large, white, shiny pieces of equipment all over. And enormous lights over the operating table. My stretcher is wheeled over so that it’s right next to the operating table. I hear someone say out loud “In the room at 7:45am.” Then a couple nurses appear right next to me. One asks if I can slide myself over to the table, or if I need them to do it for me. I reply that I can do it, and proceed to (somewhat awkwardly) move myself over. The nurse remarks how strong I am, and quickly covers me with warm blankets and puts towels under my elbows on the little armrest jutting out from the table. To my right, I see someone I think is one of the surgeons pacing back and forth and muttering to himself. In a very disconnected way, it again hits me that this is actually real.

Dr. Kamdar is back, near my head. She places a mask over my nose and mouth, telling me they’re starting to give me some oxygen. I’m grateful that she just holds the mask a bit away from my face – I somehow know that I’d freak with claustrophobia (though I’m not usually claustrophobic) if the thing were strapped down tight. The air in the mask suddenly starts to smell different and I wonder if Dr. Kamdar is starting to put me under, hoping that she’d tell me if first if she was.

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There’s a hive of activity around me. I can hear it. I will myself to open my eyes and they do for a brief second. I see a woman standing to my right, writing on a clipboard, before my eyes decide they really don’t want to be open. I lose sense of the activity. Then it comes back, though I have no idea how much time has passed. I hear people talking about what I think are medication doses. My head hurts, A LOT, and I say so. But I don’t know if I actually say the words, or if it’s just in my head. Somewhere back in the deep recesses of my brain, I finally realize I must be in Post-Op Recovery. And I’m convinced it’s 5pm, which is good – it means the surgery went faster than expected. And then I pass out again. Suddenly, I’ve got the dry heaves, which is exceptionally miserable and kills my head, and them I’m out again. (Looking back, that’s probably when they took out my breathing tube.)

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My stretcher starts moving. It’s not a good feeling. I really don’t want the world around me to be moving. I feel like I’m spinning. I close my eyes and try to pass out again, but it’s not working. After what feels like a three-hour trip through hell, I stop moving. I’m in a room – ICU. My brain is working enough again to realize what’s going on. The room is buzzing with nurses, doctors, and other people. I look around a bit and see the clock on the wall – it says 9:00. For a minute I’m very confused. Is it 9pm or 9am? I thought I was only supposed to spend an hour in Recovery. Did something go wrong?

The doctors notice I’m alert and start talking to me and asking me questions. I’m actually pain-free – good meds! I pass the initial neurological assessment, which is great. I can actually feel both sides of my face moving – is it possible my facial nerve wasn’t damaged? That would be amazing. But my left hand is numb. I tell this to the doctor, and he looks concerned. He examines my hand and arm and finds that I have a pressure bruise on my elbow that is causing problems with the nerve going down to my hand. He seems disappointed, but not concerned.

I ask to see Brett. But, again, I’m not sure if I say the words out loud or just in my head. I think I’ve been given IV morphine, and it’s starting to make me very sleepy again. I start to doze off, and then Brett’s suddenly standing at the foot of the bed, talking to the ICU nurse. Everyone else has left. Brett and I talk for a few minutes (about what, I have no idea) and then I’m dozing off again. By the time I can get my eyes open again, Brett has gone and I’m left in the ICU, with a wonderful nurse, to recover.

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Day by day by day… I feel a little better every day. And I never did figure out why I thought it was 5pm when I was in recovery. Trick of the meds, I guess.

The Stuff of Memories

The beach.  There's something indescribably primal about being at the beach - the rhythm of the waves, the infinite cycle of the tides, the call of the birds, the salt on the breeze, the isolation of realizing how minuscule any one individual against the vastness of the water.

We're exploring the beaches of Cape Cod, up near the end where there are fewer people and more conservation areas and wilderness marshes.  It's very minimalist here.  And it couldn't be more lovely.  We can walk to the marsh and low tide and marvel at the sheer distance the water travels between the tides.

The boys loved walking over the sand dunes.  This part of the Cape is just one big sand dune covered with sea grasses.  And tiny holes in the sand providing homes to tiny hermit crabs.

We arrived late in the afternoon, so we were only supposed to be scoping beaches to see where we wanted to come back to set up camp for the day.  But when you put kids near the water, the lure is just too strong and they must go in.

And what is it about boys and the wet sand of a beach?  If their feet are touching sand, they must drop everything and dig in it.  Now.  Don't get between a boy and his sand.

There is Hope

A conversation in the car this morning.  ("T." is J's preschool teacher, who got engaged last weekend.)

me: So, T. is getting married! That's exciting!

J: Yes, it is!  She shared her celebration cake with us at snack today.

me: That was nice of her to share.

*pause*

me: Do you remember going to the wedding in New Jersey in January?

J: Yes.

me: Well, now T. is planning for her wedding so she can do that next year.

J: I've never met who she's marrying.

me: True.  I've never met him either.

J: It could be a her.  I don't know because I've never met them.

me: You're right.  But I heard T. say "him" today, so I'm pretty sure she's marrying a boy.

It struck me that J. has no pre-conceived ideas about weddings and marriage.  Over the winter, we spent time explaining what a wedding is and what it means to make that pledge in front of family and friends in preparation for the wedding we went to in January.  But as far as he's concerned, any two people can get married.  And I'm happy to keep the politics of that away from him as long as possible.  Because, at least where we live, he's absolutely right.

And that makes me happy.  It gives me hope that we can raise a generation that thinks the gender of the people getting married is irrelevant.

A Bucket of Tears

It's so hard to understand post-partum depression.  I certainly didn't.  Not until it happened to me.  And even after it happened to me, I find myself at a loss for how to describe it.

It happened again this week.  My third baby is 1 year old and I had almost no issues with PPD after she was born.  It was the easiest, happiest recovery of all three of my births.  But a few days ago I was hit hard.  

It was late afternoon and I was helping the boys clean up their rooms and vacuum upstairs while Brett finished up outside.  I was in a bit of rush because the downstairs was still a disaster and my in-laws were coming over with dinner to stay with the kids while Brett and I were going to a play.  I left the boys to finish and went to start on the downstairs.  

A few minutes later, I went back upstairs to check on the boys.  They had finished up, and then proceeded to pull stuff back off the shelves to play.  And I broke down in tears.  I did the best I could to choke out the words admonishing the boys and directing them to pick up again.   They knew something was very wrong and jumped right on board.  And that's when I heard Brett and his parents downstairs.

I lost it.  Utterly and completely.  I locked myself in my bathroom, sat on the floor, and sobbed.  And sobbed.  And sobbed.  For no real reason.  (Because the boys did what I asked them to and then started playing?  Not a real reason.)  It was beyond any control I had over myself.  The tears would not stop coming.  And I knew with absolute certainty that I would NEVER be able to go downstairs for dinner (ever again!) and that I was NOT going out of the house that night, and that I would NEVER stop crying and that I would NEVER feel happy ever again.  Everything was a shambles.

So I cried nonstop for a good 40 minutes.  Every time I even thought about trying to pull myself together and interact with other people, even my children, the tears came stronger.  And after I was cried out, I crawled into bed and fell asleep for 30 minutes.  When I woke up, it suddenly seemed like it might actually possible to see another person and not break down into tears.  I might not be happy, but I could function.  An hour before, I didn't think that would ever be possible again in my lifetime.

So I survived dinner.  Brett and I went out to the play (which was phenomenal, though I probably would have enjoyed it even more on a different night).  And when we got home I went straight to bed.  By the next morning, life seemed to be returning to normal.  And by the end of the next day, I was left wondering if I imagined the whole thing.

I felt it for a few hours this time.  I try to imagine what it must be like for the women who live with those feelings for days and weeks and months on end.  I remember it a bit from after my first was born.  I still can't talk about some of the thoughts that lived in my head during those dark days.

May this give you just a touch of insight.  It's not a fun place to be.

Audrey at 1 year

Audrey's first birthday was last week.  We had a very enjoyable family party on Easter Sunday, where we also celebrated the birthdays of her brother, her cousin, and her uncle.

She's now 19lbs 7oz, and 29 1/2".  That means she's grown 10 3/4 lbs and 9" over her first year (8lb 10oz, 20 1/2" at birth).  

She's now standing on her own as long as she wants and taking a few steps at a time.  Though her funny scoot-crawl is too efficient to make walking very appealing yet.  She talks a blue streak - we just can't yet understand most of what she says.  But when she really needs to, she makes clear what it is she wants.

And she very much enjoyed her cake!

A Rant about Breastfeeding

OK, I'm pretty sure I'm going to piss some people off with this.  I'm going to make someone feel guilty, even though that's the last thing I want to do and is not my intention.  But there's been a lot of talk flying around the Internets the last few days because of the study published online last week in Pediatrics (the official journal published by the American Academy of Pediatrics).

I hear a lot of moms defending their use of formula instead of breastfeeding using a lot of different reasons.  But they mostly boil down to an inability to produce enough milk and/or returning to work making it too difficult.  I will never, ever, ever judge the decision that an individual mom has to make for herself and her baby.  They have to live in the here-and-now.  No mom should ever be made to feel guilty about the use of formula vs. breastmilk.  Formula is NOT a bad word.

But we, as an entire society - women and men, parents and childless, singles and couples - don't support breastfeeding like we could.  And that's on all of us.  The idea that women have the legal "right" to breastfeed anywhere they are is just a tiny drop in the proverbial bucket.  It's so much bigger than that. 

Why aren't women given a year of paid leave after having a baby?  Why aren't lactation consultants readily available at every pediatrician's office the same way nurses are?  Why aren't workplaces set up for moms to have access to their nursing babies instead of relying on pumps (which don't work well for many, many women - myself included)?  Moms should be able to bring their babies with them to work or be given onsite care where they can go to their baby to breastfeed every few hours.  If we, as a society, were willing to make the investment this could be done in just about any type of workplace.  Yet companies are still complaining that having to provide a non-bathroom private room for their employees for pumping is too costly and too much of a burden.  What a supportive culture we have here.

Why is breastfeeding seen as an all-or-nothing proposition?  Why do we not talk more about using a combination - nursing when you can, and using formula when you can't? 

And, why is formula the only alternative to a mother's own breastmilk?  Why do we not have easily accessible milk banks available to all women?  I personally have many, many, many bags of breastmilk in my freezer that my now-1-year-old baby won't use (she only wants it straight from the tap) - why am I thought to be deviant for wishing I could give that to another mom and baby that could use it?  Wet nurses were the norm until not very long ago (if a mom didn't have enough milk, you found another nursing mom who could also feed the baby), yet our society now thinks that's disgusting.  Despite a few stories over recent years about groups of nursing mothers banding together to provide breastmilk to dads who tragically lost their wives in childbirth and are left to care for a newborn on their own.  Why is formula considered better than breastmilk from someone other than the baby's own mother?  Why is formula the only option other than a mother's own milk?

Of course, the formula companies will say that they're pouring all that money into research to make their products more like breastmilk to make life easier for moms.  What would happen if all that money went to finding ways to pasteurize breastmilk without affecting its nutrition?  But there's no profit in that...

These are the kinds of large-scale societal shifts that would have to happen to change the percentage of mothers still nursing at 6 months.  It's not just about giving us the freedom of "choice" - most of us aren't even thinking about the choices we don't yet even have the option of making.

http://www.cnn.com/2010/HEALTH/04/05/breastfeeding.costs/?hpt=T2 

http://www.cnn.com/2010/HEALTH/04/09/breast.feeding.society/index.html?hpt=C2 

http://thefeministbreeder.com/when-it-comes-to-breastfeeding-we-cant-handle-the-truth/ 

http://www.huffingtonpost.com/melissa-bartick/ipeaceful-revolutioni-why_b_208697.html

Original published study in Pediatrics (the official journal of the American Academy of Pediatrics)

Over the Past 10 Years

This is inspired by a post my sister wrote in her blog.

Over the past 10 years, I have (in no particular order):

• made three incredible children
• lived through most of the 4th decade of my lifetime
• felt time stop when the Towers crumpled and stood in shock as the hospitals rose as one to help the victims, but no one came
• said good-bye to my adventurous grandmother, my feisty great-aunt, and my beloved father
• been diagnosed with a brain tumor
  
• sailed through brain surgery with the unwavering support of my husband, family, friends, and AN community
• completely lost the hearing in one ear
• adopted feline furbabies - first Guinevere and then Arthur a couple years later
  
• visited London and Scotland
• bought two new cars
  
• watched my husband transform into a father, and fell in love at a whole new level as it happened
• graduated with a Master's degree in Training & Development
  
• created a career in technical training
  
• gave up my career in technical training to be a stay-at-home mom, with no regrets
• found a new career working with other remarkable, supportive women with young families
• discovered the joy of volunteering in ways that help families
• made some amazing friends who have enriched my life and changed me for the better

Happy New Year!