2017: Bounce Back Day!

The brain.  What an amazing, intimate and yet alien mass it is.  Sometimes I find myself thinking about the structures of the brain, the vertical and horizontal weave of networked cells: a microscopic, synaptic forest that makes us who we are.  I think about Jack’s brain, the intense little machine that it has become, and its limitations.  I think about my own memories, represented somewhere within hidden networks of dendrites and axons, some memory pathways so overgrown that they cannot be recovered until they spring to life uninvited through some unrecognized association.  You stumble onto one strand, and find an entire forgotten tapestry.  For me, in February, associations crowd thickly around like little tripwires.  The half-thawed ground, the crackling overhead rivers of starlings on their morning and evening commutes have taken on a dark meaning.  The bare trees seem paused, waiting for the blow.  When the holidays end, when the semester begins, there is a part of me that starts looking over my shoulder.  Sometimes I realize right away that it is getting close to anniversary time.  Sometimes it takes time for me to understand why I feel so strangely off-balance.

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Rituals are powerful, and we have a ritual in our house that is like a spell that wards off some of those swampy, post-traumatic ruminations.  It is time for Bounce Back Day.  Each year on February 27 we talk as a family about Jack’s surgery, with a little more detail each time.  We look at pictures and we talk about the experience.  Then we go do something fun and focus on how glad we are to be together.  This year, I thought Jack could pick what we might do.  He thought about it, and made some suggestions:

  • We can do some Star Wars and Paw Patrol puzzles.
  • We can take all the dirty sheets off the beds and put them in the laundry.
  • We can all go to the forest and throw rocks in the river.

img_1125Ah, the mind of a three year old- both ridiculous and profound.  Just look at that list: he wanted to spend time as a family tackling challenges, keeping the household tidy and running, and playing in the woods.  I think this three year old child just captured my life’s philosophy.

It’s been a while since readers of this blog had some video content, so I’ve curated a few family videos here.  Hope you like them!

As you can see, in the last six months, Jack has become ever more communicative and loves to spin wild stories.  He rarely uses sign language now, preferring instead to use his voice.  He loves to read, often stopping us to ask if we can explain what this or that word means.  He enjoys making up words as well.  For a long time everyone was a silly “baroush”, “hatihot”, or “baroonjay”.  He cracks himself up with these verbal creations.  He can spend a truly impressive amount of time on a puzzle- from 30-piece puzzles with large pieces to mini puzzles of 6 pieces each smaller than a dime.  He remains outgoing and open, and will say hello to anyone.   (The last time we were at AI for a brief check up, he stopped a custodian in the hallway to offer him a high five.  I must say, by the surprised look of delight on the gentleman’s face, I think Jack made his day.)

img_3351Sam remains our happy, sensitive soul.  Right now his great loves are art and playing any game that involves running around with a foam sword.  As you can see in the video, he led me on an adventure under the kitchen table a few weeks ago with his foam sword to fight an annundoolie-flavored dragon (I didn’t know that dragons had flavors!)  I think one of my favorite things about Sam is his dancing.  It’s getting zanier by the day.  He insists on footie pajamas every night and dancing time is apparently right before bed, so the pajamas undoubtedly add to the zany effect of his wild dance moves.

These two bring so much sunlight into our world.  It dances through the tangled bracken of our complicated life, illuminating all the unexpected beauty beneath.  Three years after we sat in surgery wondering what would be left of our son and of our family at the end of it, we are all walking through the forest and throwing rocks in the river together.  It’s awesome.

Medically, we have had an easy year free of hospitalizations.  Our first!  Jack’s had illnesses on and off but no seizures, no reemerging hydrocephalus or such sudden pitfalls.  We have even had some positive developments.  First, Jack had a sleep study this fall that he passed with flying colors.  The study showed that his brain is functioning normally in sleep and there is no central apnea as a result of his brain injury that would require a ventilator for life.  Second, we had our definitive, final MRI showing that his brain continues to grow normally, and his tumor is very much gone.  We are now well past the period for re-growth, so we can say that it’s not going to come back.  We will only be followed with MRIs every 2 years rather than every 6 months to check on the status of his hydrocephalus.  Such a blessing… those words don’t even come close to expressing how incredible it feels to be releived of that burden.  Third, we are weaning him off of his ventilator, (first by removing the forced breaths, and then removing the positive pressure that the vent provided, and now he is on another machine (the Airvo) at night.  This is a very simple machine which gently blows heated, moist air to an area just in front of his trach.   (You can see it in the picture below.) When he is healthy, the work of breathing is all his, and he does well.  When he’s got a cold (which is still somewhat frequent) or a fever (also still quite frequent), his 02 levels drop and he does require the vent.  Amusingly, he doesn’t like to have the Airvo on as he falls asleep- preferring the ventilator.  Some kids like teddy bears, some kids like hard plastic tubing, I guess…?

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We’ve faced continual trouble finding nursing coverage, so lately we’ve had to cover 1-2 night shifts per week ourselves.  As I was writing this post, I learned of another nurse leaving the agency, which will mean that we no longer have Sunday, Monday, Wednesday, and some Friday coverage. Even on nights when Jack is healthy, covering the night shift ourselves is a trial.  We either must sleep on his floor in short spurts while waking to check the Airvo, his food pump or his oxygen monitor, or stay awake.  Each month that Jack does a little better off of the ventilator gives us hope that someday we can let go of constant nursing coverage, but we still desperately need it right now.  Jack is fortunate to have a great team of nurses at his side.  The little man has developed quite a temper, and our nurses do a great job of not taking too much of his nonsense, while giving him real affection and great care.

This May, we expect to have a great visit with pulmonology.  We hope to get him off the vent and discuss what further diagnostics might be needed to reassess his swallow in light of the fact that he has had so few pneumonias this past year (and is now participating in all meals- tasting everything but also clearly ingesting some of what he tastes.)  I think the future for this little boy is very bright indeed.

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Thanks as always for keeping Jack and Sam in your thoughts!

September: Back to School Thoughts

It was a hot day, so we started our outside play early. With the aid of a cracked plastic bucket of chalk, our driveway transformed into a dusty pastel town- the town of Cucumber Sauce.  Baby blue for the police station, dull khaki green for the bank.  A grocery store, a library, and a park with a bright red swing set and multicolored grass.  We had a balloon parade all the way from the firehouse to the outskirts of town, our hands clutching our imaginary strings while the bright invisible orbs bobbed above us in our favorite colors. The boys ran or rode their tricycles to the different places in town.  They were serious in their errands.  Head to the bank to withdraw funds. Go to the grocery store to buy supplies for our park picnic.  When the errands were done, we sat cross-legged and savored the cloud-soft icing and delicate crumb of imagination, while our sandals and pant legs smeared the dusty hues of our chalk park into a strange summer haze.  A few minutes later we were sitting in the yellow Cucumber Sauce Public Library, while Sam, his hands cupped in the universal book position, told the tale of “The Person Who Was Afraid of Fish”.  Jack sat on my lap and relentlessly interrupted his brother with his own ideas about the story.  I rested my head on Jack’s, sleepily listening to Sam struggle through his half-baked narrative, his voice almost drowned out by the riotous snap-crackle-pop of late summer bugs, and I breathed in the smell of Jack’s sun-warmed hair, pleased to have just one more week before the start of the semester.

 

Maybe it was the imaginary play that had primed the recollection. Maybe it was the reedy, insectile language that surrounded us- the whirring cicadas, the jackhammer of locusts.  Perhaps it was the sweaty scent of his hair, that not-quite-permissible musk of the outdoor child which tugged the memory intrusively into my consciousness.

 

I was nine.  It was my first year at summer camp.  There was homesickness, but mostly I was in love with this newfound land of songs, cedar trunks, jangling mess halls, crackling taps on the loudspeaker at night and damp morning flagpole assemblies.  I loved archery, swimming, crafts, but especially a session dubbed “farm”.  I suppose farm must have been supervised by someone, but what I remember is long periods of just watching things happen- holding, touching and listening.  There was a cow and a calf, a chicken coop, goats and a few sheep.  There were barn swallows and mice in the rafters, blue flies and dust motes in the hot air, and the sweet-sour olfactory cocktail of a barn in summer.

 

There were perhaps a dozen chicks- though calling them chicks is being generous.  They weren’t the yellow fluff balls of Easter fame, seemingly created to rest in a child’s hands.  These were bigger, ganglier and somewhat mangy looking- their adult feathers not quite in.  They were the middle schoolers of the chicken world.  We would eagerly scoop them with two hands, their legs hanging down beneath our fingers in an odd knock-kneed pose, their long, almost naked necks arcing like ships’ prows.

 

I don’t remember seeing it happen or hearing the crack of the wooden door as it came down like judgement on the neck of the bird.  I do remember crowding around the cage with my peers, watching it struggle and claw the dirt.  “What happened?”  “Is it’s neck broken?”  “What’s wrong with it?” “It looks funny.” “Can we help him?” “Yes! Make him a little bed!”

 

The next day, the counselor gave us the broad strokes- our little patient didn’t make it.  But a friend who’d been at the farm just after our class soon told us the manner of it- the wounded bird had been pecked to death.  As I lay in my hot, narrow cot that night listening to the summer bugs, I thought of it.  The struggling bird lying there, panting, one flat, black eye fixed upwards like a beached fish, powerless as the flock  gathered as one and descended.

 

The fear.  I sit in summer sunshine with my sons in the midst of one of the best mornings of my adult life, and there it is before me like a shimmering mirage obscuring the horizon.  This is one of the swampy places, where the terror finds you even in your joy- perhaps because of it.  For me, although we have come so far, this is one of the great fears against which we have yet to be tested: the flock.
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I want my sons to venture out into the world.  I want them to stand at the rocky edge of what they know and welcome what is to come.  I want the acceptance of this unknown world to swell beneath them, the benevolent laughter of their peers cresting to patter gently about them- a welcoming.  I want Sam’s ridiculous dance moves and insane vocabulary to be a cause for celebration, not ridicule.  I want his steadfast love of the color purple to endure until he leaves it behind, untarnished.  I want the visible marks of Jack’s victories to be as unremarkable as the color of his hair- and not a signal that he is unfit to take his place among the flock, that he should be sacrificed.  After all that has been done for our family, all the kind, skilled, adult hands that have borne Jack and Sam up, will it be their peers who take them down?

 

I drove through campus during move-in weekend last week.  The faces of the parents I saw reminded me that this is not a fear that is unique to those who parent a child who is disabled, different, or medically complex, nor is it one that only afflicts the parents of young children.  First day of preschool, first day of college… is there really anything we fear more than the brute power of the flock?

 

Jack will be heading back to DSD today, his first day of preschool.  There are only a few children in his class, all with differing levels of hearing.  This year at least, we have found him a supportive educational community, and we can put aside the fear for a little while longer.  And yet, even after working so hard to make DSD a reality for Jack this year, I struggle with the decision.  Jack and Sam spent a fantastic August together at Sam’s daycare center.  Though shadowed by a nurse, Jack has been able to enjoy all of the ups and downsides of spending his days with peers.  It’s the first time he has been in a non-special education / non-medical facility.  He seems to have been able to fully participate despite the noisy rooms, despite his communication challenges.

 

Are we choosing a small environment devoid of “typical” children for Jack because we are afraid?  Or are we choosing it for all of the right reasons- for the qualifications of the teachers, the amazing facilities, the opportunity for a bilingual education?  And what about Sam, who went off to school today feeling alone and missing his brother. Am I making the right choice for him?

 

The rain came a day after our games, washing away our little town.  Cucumber Sauce- population of three humans plus an infinite number of figments- was gone before we heard the water in the gutters.  The little chalk town where the bakery is run by a pink seahorse who bakes sausage cake for turtles (but not for horses, because horses don’t eat sausage), isn’t a place where anyone can live forever.  We’d be fools, and very bad parents indeed, if we tried.

 

May Update and Mother’s Day Thoughts

The Grotti family had a really fantastic Mother’s Day celebration last weekend, which included a hike, ice cream, and planting new lilacs in the yard.  Since I had been away at a conference for a few days prior, the kids were much more lovey than usual, and I think we all had a pretty tremendous time.

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Following Mother’s Day, we had numerous visits to the hospital for a combination of sick visits with Pulmonology, (Jack is fighting another virus and has been getting fevers pretty constantly for over a week) and follow ups.  Medically, there’s some positive news to share on several fronts.  Some time ago, Dr. Chidekel (Pulmonology) had given us the green light to place Jack on CPAP at nights rather than continuing with a breath rate on his vent.  With the exception of his most recent bout of respiratory illness, it’s been going very well for nearly 2 months.  This continued weaning from ventilator support is a great sign.  We’d love to say good bye to the incessant night-time beeping of that machine!  Our next visit is June 6th, and at that time we’ll schedule a sleep study to learn what’s really happening with Jack’s Co2 levels and with his brain at night.  This is likely to happen this summer.  There will also be another swallow study this summer to help us learn how much progress Jack has made with his eStim therapies.

Jack also had follow up visits with Dr. Piatt and Dr. Walter, who have continued to monitor Jack for any signs of tumor reemergence.  They indicated that we should have an MRI in November.  If that comes back clear, Dr. Piatt said he feels that “we can declare victory over that tumor”.  Another amazing piece of great news!

Jack wowed Dr. Walter with his spoken English skills–particularly when he stuck his finger in his ear and held it up to Dr. Walter, saying, “I got some potatoes in there!”  (I’m sure oncologists could use a good laugh every now and again, but I was a bit mortified by that one…)

I was struck during my recent visits to the hospital at how comfortable –happy, even– I felt when I was there.  I tried to puzzle through this very strange feeling, and a talk I attended by Dr. Kimberly Griffin, who studies the identities of transfer students through the lens of intersectionality helped me to make some sense of this.  For any working mom, identities are always in conflict.  When you explain to the crying child that you have to go to work, when you explain to the supervisor who was expecting something from you that you have to go fetch the sick child, there is an uncomfortable clash of very important identities.  I’m a woman, a mother, a wife, a daughter, a professional, a scholar, an artist, a writer, an advocate, and an educator (and these are just the identities that spring readily to mind).  As this intersectionality theory points out- we are all complex, and these identities wax and wane in primacy throughout the day, the week, the lifetime.

Lately, following some pretty wild shifts at my workplace, I have found my professional identity to be much like a hot, brittle planet orbiting a bit too close to the core of the system for its own good.  Navigating the context in which that identity exists has recently forced me to aknowledge the gravity that I have (unwisely) given to this particular aspect of my self.  Being at the hospital takes all of those questions and those unrelenting self-judgments, and silences them.  That planet is knocked into a completely different orbit when I’m back in those hallways, looking at all that could have been, and all that we have accomplished.  I can have just a single, comfortable “me” when I am there, and no one faults me for that– least of all myself.

I find myself mulling over this lately.  Is there a way to meld my professional life with this other identity?  Is there a way to take all of this theoretical and practical knowledge of information literacy specifically, and education and learning more broadly, and apply it to help other parents of a medically complex children? Is there a way that I can give back?

… I have some ideas.  But that will have to wait until the next blog post!

Summer 2015 Ups and Downs

It’s been several eventful weeks for the boys since the last update.

Jack continues to work on his spoken and signed language.  He’s recently picked up the sign for “sunshine”, “chicken,” “song/sing” and “again”.   He is learning his signed alphabet and can very clearly make the hand-shapes for A, D, E, K, L, O, S, T, V, and W.  He’s also using his spoken voice a bit more intentionally these days.  He can now say (though it is not very intelligible) “ball”, “bye bye”, “hi”, “daddy”, and “boy”.

He had the opportunity to attend summer school for about six weeks in June/July, which just wrapped up this week.  He just loves school- loves his teachers and friends, and especially the many opportunities for constructive play.  Here are a few pictures that one of the nurses who accompanies him at school took for us, to document this wonderfully rich environment.

Heading off to school on the bus, like a big boy:

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The sunny courtyard, complete with bubbles, water play, and a vegetable garden that the kids can tend:

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Jack at song time, with his “twinkle twinkle little star” prop:

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We are so sad to say goodbye to school for a little while, until classes resume on September 8th.  During the hiatus, John and I are working on getting nursing coverage for an additional school day covered by Medicaid.  I truly hope it will work out!

Sadly, Jack missed some school recently due to another hospitalization.  Thankfully, this one was not nearly as dramatic as previous, recent hospitalizations, with no emergency surgeries required… though it did start with our first, panicky midnight ambulance ride.  Our night nurse called us out of sleep concerned that Jack was having another seizure.  We grabbed a phone and recorded the event so that a neurologist could see it.  Jack was trembling hard, but I noticed very pronounced goosebumps, and he was responsive to us, so I wasn’t sure he was seizing.  We didn’t want to chance it, so we rushed via ambulance to the emergency room.  As soon as Jack got to the ER, a 103-degree fever spiked up, and an abnormal chest x-ray showed us the cause of the fevers- a minor pneumonia.

Ugh!

IMG_1895Though it was minor, 103-degree fevers sure are awful, and Jack was pretty sick there for a few days.  He spent about three days recovering with lots of TLC from some of his old friends from his rehab phase.  Lots of his new signs emerged during this period, while he didn’t have much else to do but practice.  We also discovered a good way to beat the terror of a hospital stay… get a stuffed animal, and make it suffer through all the same procedures that the patient must suffer.  Inhalers, stethoscopes, blood pressure readings, probes… any time someone came in to tend to Jack, we tended to his doggie immediately thereafter.  A good strategy, I’d say!  (At least it kept us busy.)

We’ve been out of the hospital now a little less than a week, and Jack is doing well. His current favorite activity is trying to hop, which he can’t do, as one side is much weaker and less coordinated than the other.  So instead of hopping, he tends to look like superman going from a crouch to tip-toes- just barely lifting one foot off the ground to take off into the sky, one fist raised up high.  We love it.  It’s just such a Jack pose.

Sam is always at risk for missing out on lots of things because of the logistics that surround his brother’s care.  So, this summer, I wanted to make a commitment to getting him on at least one trip to New Hampshire, where my parents have now moved.  I spent weeks dreading a 9-hour journey with a toddler.  But my little blond trooper did not disappoint!  Here he is at the rest area enjoying a treat for his amazing behavior during the first leg of the journey.

IMG_1903We talked a lot about cars, diggers, trucks and big bridges during the drive, and we sang many hours of Sesame Street songs.  He napped a little bit, but only really fussed during the last 15 minutes of the trip.  It was great.

Once there, Sam got to go in a canoe, swim in a lake, eat chocolate cake, and just enjoy himself.  He was able to have a long visit with my grandparents as well as with my folks.  He’s still talking about the trip, and it’s easy to see why!

Here’s Sam on his first day of the trip, just after scaling a pretty intimidating “mountain” for a little guy:

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And here’s Sam enjoying the lake.  I especially love this picture as it gives a sense of what the world must look like to a two-year-old.  A forest of big people!

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Fall promises to be very busy for me at work, so I’m hopeful that the eventful spring and summer that we’ve had will mellow into a pretty peaceful fall.  We’ll see!

Sorry It’s Been Awhile!

Today was Jack’s follow up MRI.  We are again hoping for a clean scan and no more signs of either hydrocephalus or the tumor.  Jack seems to have forgotten all of his hospital manners– he fought like heck today and didn’t want any of those scary nurses and doctors doing anything to him!

Since my last update, much has been going on for Jack and for the rest of us, too!

image Jack was recently evaluated for language skills as part of the follow up to his hearing loss diagnosis.  His receptive language skills were judged to be “age appropriate”. This feels like a stunning victory to us!  Jack listens, responds to his name, finds humor in things, plays and seeks to engage with others.  He responds to commands such as “give Sam a hug,” or “show me the doggie”. He clicks his tongue or makes gurgly coos to get our attention when he needs help, and he points at pictures and then to the corresponding real-life object in order to label and categorize.  He spontaneously waves “bye bye” to people.

Jack now has six signs under his belt:  Please, Wash, Kitty, Daddy, Doggie, More, and Phone.  He’s made up a sign for “swing” (he points and then rocks back and forth in pantomime).  He’s working hard on the signs for “mommy”, “baby”, and “open” and “close”, but hasn’t quite mastered them yet.  I really enjoy learning sign language and challenging myself to incorporate as many signs into my reading aloud or singing songs with the kids as possible.  It’s fun to learn something new in the same way and at the same time as the kids.

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Jack isn’t walking yet- progress in this area is slow.  However, he is now able to wobble-walk for considerable distances with just one hand being held for support.  I’ve also caught him standing independently for a few seconds once or twice.  I don’t think that walking is far away, now, though he will have to really work on his balance before he is able to get there.

The most exciting thing to watch now is the emerging relationship between Jack and Sam.  They are begining to play together more and seem to find their game of under-the-dining-room-table peekaboo to be the most hillarious pasttime of all.  They can also be found pushing one another on a little toy plane through the house.  When Sam is being pushed by Jack, who uses the toy as a walker, you can hear Sam chiming “Thank you Jack” as they go.  (Though it sounds more like “gank goo Gack”.)  They occasionally steal from one another, grab each others’ things and get angry when one gets his way and the other doesn’t, of course.  But Sam says hello and goodbye to Jack every morning, and Jack (who doesn’t quite understand that one has to use one’s arms to give a proper hug) lays his head on Sam’s chest affectionately when he sees his brother.  When one of the boys takes a tumble, the other is often there with a hug, a gentle head-pat or a toy to offer.  I’m really proud that they seem so empathetic toward each other- at least for now!

Sam’s language capabilities continue to explode.  He asks simple questions like “Mommy go?” parrots every language-esque sound he encounters, and his word count is currently somewhere over eighty.  Some of our favorite words and phrases that Sam uses right now include Octopus (“ah-boo-dis”), Bicycle (“Bi-tic-oh”), Noodles (“Nu-nulls”), and probably our ultimate favorite:  Cold (pronounced “CoOoOo” with full, shivery vibrato).

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Sam has also picked up some new names:  Tucker (“Tah-coo”) and Rachel (“Ba-tcho”), which of course refers to John’s brother and his wife, who have recently relocated to Delaware!  It feels great to have family in the area.  Right now, as they get settled into new jobs, etc., they are staying with us which has been a great help.  Jack has an enormous crush on Rachel, and plays a shy game of hide-and-seek which is really cool.

We have some further check ups with Oncology later this week to learn the results of our MRI, and on Monday of next week a full meeting with all of Jack’s therapists to learn how he is faring.  I promise I will try my very best to get back to you, my dear friends and readers, with an update as soon as possible  As always, thank you for holding Jack in your hearts!