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I’ve been home for nearly two weeks now. Recovery has been slow and has sapped me of most of my excess energy so many apologies. Because there’s so much to cover – and I’m having difficulties organizing my thoughts – we’re going to go about this bullet-style.

  • I’m home. I was discharged with a four-week course of IV Vancomycin (a very powerful antibiotic) at a very high dose. Because we never got those sensitivities back (i.e. what bug we’re fighting and what antibiotic is best to fight it) and my reaction to the infection scared them (though I assure you, it did not scare nor surprise me or Keith), the doctors are playing it safe. I guess that’s what they do best. I was also on Cipro (another antibiotic), but I have finished that course.

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Today you are You, that is truer than true. There is no one alive who is Youer than You.
-Dr. Seuss

Sometimes it surprises me how happy I am. How comfortable I am in my own skin. A year ago, I’m not sure if I could’ve seen myself this happy despite all that has changed (my zip code, my health, my occupation, my income, my aspirations, etc.). But I’m honestly, truly happy.

Keith and I deal with a ton of stressors with our daily life that shock many people. For instance, every day this week, I’ve had at least one medical appointment, over half of which were in Boston. (This is not out of the ordinary.) In addition, we’re watching my niece and nephew while my sister recovers from surgery. (This is something that Keith likes to call “birth control.”) We also deal with daily medical regiments including IV nutrition, stoma care, catheterizations, sterile procedures, and medical interventions. (This is in addition to Keith’s full-time student status and my work tutoring, researching, and volunteering.)

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April is Autism Awareness Month. Although Autism has been getting good press, many still don’t realize it’s a spectrum. Language skills, social skills, and development can vary. And autism can strike anywhere, regardless of ethnicity, gender, and socio-economic status.

So I have a treat for you. One of my favorite mommies and bloggers agreed to write a “guest blog” about her experience with her daughter. You can follow her story more closely at Living Life with a Side of Autism. Thank you, Jen!

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She sat in the hallway. Alone. In a blue, plastic chair. She was told she wasn’t welcome. She couldn’t behave like that.

She was 3. Non-verbal. At school.

This was life for my daughter before we got her Autism diagnosis. She was treated like the bad kid in class, and every day I received what amounted to a verbal lashing from her teacher. There were exasperated sighs and advice on how to better discipline. I felt like a failure. I had messed up my kid. I was reminded of that each day at 11:30am, when I trudged into the school to drag out my screaming first born. Or maybe at 11:45 after she had stopped having a tantrum in the classroom because she couldn’t put on her jacket, yet had no words to ask for help. Not that it mattered. She was still the bad kid, words or not.

A lot of children are diagnosed with Autism around 2 1/2 or 3. Katie, however, wasn’t diagnosed until the month she turned 6. We went through years of evaluations and diagnosis after diagnosis, none of which really fit. First, we were told Katie had low self esteem. Then we were told it was ADHD. Then, that she was probably bi-polar. None of this explained her extreme language delay or social deficits, however. We were told everything from she just was choosing not to speak, to she just had a strong personality. No one took all of her symptoms and put them together. We were just given a different explanation for each concern we had.

Over the years, I have moved from being the mother who just sat there and nodded her head in agreement, to the mother who does her own research and fights for her child. When Katie went from preschool to Kindergarten, things really went downhill. Fast. She was having a lot of meltdowns at school, and eventually began hitting other students. I was tired of being told my child was just a discipline problem with a speech delay. I lived with her and knew there was more to it than that. I saw her rigid behavior. I saw her inability to transition and inflexibility when it came to change. I saw her not making any friends, not knowing how to play with her toys, and becoming more and more physically aggressive at home. I saw her unable to participate in childhood activities, such as dance, and soccer, and gymnastics. She would either meltdown or be off on her own. I saw how overwhelmed she became around large groups. How going to the busy store guaranteed us a meltdown. How she had severe anxiety over the smallest thing. How she had irrational fears. No, my daughter wasn’t spinning in circle or flapping her arms, but were those the only things that defined Autism?

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Note: I wrote this blog nearly a month ago and am just now getting around to posting it because a good friend has been asking for it for ages and I thought she could use a small pick-me-up. This one’s for you, Liz…

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Little darling, it’s been a long cold lonely winter
Little darling, it feels like years since it’s been here

This winter has been one full of challenges, stresses, adaptation, loss, learning, sickness, and love. Yes, love. Without it, I’m not sure I would’ve come out as relatively unscathed on this end.

This winter, New England received more snow than it had in years. It was blizzard after blizzard. It was cold and unrelenting. Even worse, my body appeared to be taking lessons.

One thing that I’ve always prided myself on is being able to rise from just about anything and everything stronger and smiling. After December, I was petering on the edge, still smiling, but straining and struggling not to lose myself. But after the second month of medical hell, I wasn’t sure that I wasn’t going to rise.

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Once you choose hope, anything’s possible. -Christopher Reeve

Four months ago I got my muscle biopsy results. It showed severe deficiencies and came with the official diagnosis of Mitochondrial Disease. Although I had lived over a year with a “clinical diagnosis,” it had suddenly become real. Really real. I found myself at a crossroad: I could breakdown and cry; or, I could do something about it.

That night I spoke with my best friend and expressed how I felt. Less than a year earlier, she had had the same conversation with her physicians. She heard those same words: “You have mitochondrial disease.” She felt the reality come over herself. And she chose to fight back.

We spoke for a long time about what we could do. How we could change the future. How we could keep this horrible disease from consuming our every wish and dream. Our every hope.

It was on that night that the Show of Hope was first conceived.

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I’d like to introduce my good friend Matthew. Matthew is a happy 6-1/2-year-old who loves singing, dancing, and drawing. For my birthday, he drew me a beautiful card:

Matthew's Card

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After over two glorious months of freedom, I’m back at the Chateau de MGH. I was hoping it’d be a quick stay and I’d be out by now so I put off an update until I could include the good news of discharge, but that doesn’t look like it’s happening too soon. So here’s a quick recap of the last few days and the current plan for the future.

As many of you know, I struggle with chronic intestinal pseudo-obstruction (CIP or CIPO). Because of the CIPO, my intestines (both the small bowel and the colon) act as if there’s a physical block that keeps me from passing stool or gas. The result is abdominal distension, vomiting, nausea, and abdominal pain. This condition is complicated by any sort of illness or trauma. Two weeks ago, I had a GI bug that resulted in ileus (no or very diminished movement in the bowels).

Prior to going to the ER on Wednesday night, Keith and I had tried our entire home arsenal to get my bowels moving: 3 bottles of Magnesium Citrate, a GoLytely bowel prep, and 2 Fleet enemas. Nothing produced anything. And all of this is in addition to my usual maintenance treatment of 4 doses of Miralax and 1/2 a bottle of MagCitrate each day. We were at a loss as this was triggering severe nausea and pain. Because we didn’t want to cause an electrolyte imbalance with all the continued strong laxatives, we headed to the Lowell General ER. At this point, I thought it’d be a simple overnight stay at our local hospital (LGH) and it’d be resolved in the morning. Keith, on the other hand, predicted a stay through – at least – the weekend and that they’d transport me to MGH in fear of breaking me. Keith won that bet.

The nurses hooked me up to fluids (in addition to my own) and some IV Zofran and set me up for an abdominal x-ray. The x-ray didn’t look good, apparently. After telling the ER doc what was going on and that I had primary mitochondrial disease, he immediately called MGH to have them prep a bed for me. With in a few hours, I was in the ambulance with my favorite medic (yes, it’s sad that I have a favorite…) and off to MGH in Boston. They hooked me up with more Mag Citrate and a soap suds enema. Still no luck. I had officially earned myself an overnight stay in the Emergency Department Observation Unit.

Every hour in the EDOU, I took Lactulose (another powerful laxative). I had no movement and the distension and pain just increased. Around 2am, I was brought in for another x-ray. It looked worse and suggested that I had an obstruction. So they started decompressing and draining my stomach through the G-tube and I was rushed into a CT scan about an hour later. I took a two hour nap back in my bed and was awoken by the attending doc. There was no physical obstruction, but severe air accumulation throughout and packed stool in the cecum and ascending colon. I had earned myself another night, but now I was up in my usual hospital home, Phillips House. (For anyone who doesn’t know, Phillips is like the hospital suites. These private rooms have mahogany accents, a couch, a desk, a mini-fridge, and room for a guest to stay. Also, we have satellite TV and a DVD player.) The team in Phillips knows me quite well and busily got to work when I reached my room around 7pm on Friday evening.

After my GI doctors were contacted, we started another course of GoLytely, hooked up to D10, and increased the pain and nausea medications. Unfortunately, all this drama had meant that I only slept for 5 hours out of the past 55 or so. This lack of sleep set off a bad dystonic storm (the explanation of a “dystonic storm” is halfway down the page) and caused my autonomic system to go wacky until I was able to fall asleep. I slept straight through 16 glorious hours. This morning – or should I say afternoon? – was much improved on the neurological end, but just as bad for my GI system.

My hospitalist decided that it was time to consult the surgical team to see if they had any other ideas that would (hopefully) keep me from the operating room. First, they felt that I had something called “Ogilvie’s syndrome,” which is just a severe acute episode of pseudo-obstruction of the colon. Apparently, it can be pretty dangerous so we’re trying to treat it as aggressively as possible without disrupting my delicate metabolic stability. One solution they came up with isn’t too pleasant so if you feel as if you already know me well and don’t want to know me THAT well, I’d advise skipping the following paragraph. Seriously.

The first idea was to add gastrografin to the regiment. Gastrografin is a common prep for CT scans; it just happens to have the side effect of producing diarrhea. We figured that’d be welcome, even if not too likely. Additionally, a rectal tube was inserted to help decompress my colon and hopefully that will get things moving once again. The tube isn’t exactly comfortable, but I’d do anything to help. Anything.

(For those who skipped, you can start re-reading here.) The other solution, if the above doesn’t work, is a drug called Neostigmine. It’s commonly used for myasthenia gravis and is effective at stimulating contractions in the colon (read: pushing out poop!). The downside is that it causes bradyarrhythmia (significant slowing of the heart rate) so it requires me to be moved to the MICU (medical intensive care unit) to be administered so I can be very closely monitored. Because this sounds likely, we’ve decided that it’s very lucky that I usually have moderate to severe tachycardia (abnormally fast heart rate) to begin with so hopefully it won’t lower as dangerously for me.

Luckily, we have so many people who love and care about us and make the hospital a much easier place to be. Stefani and Linda (“Nana”) stopped in on Friday afternoon so that Keith could get our car inspected and pick up some supplies from home. A few of our awesome friends from Brandeis stopped by Friday night to distract us with fun games. My tubie sister, Sarah, who is also currently in patient at the Chateau, came up for a quick visit as well. Thank you to everyone who has called and sent their love and prayers our way. I don’t know if I could ever tell you how much it means to us to have so many people by our side through this ugly war.

Keith is now hooked up with his favorite free hospital meal (Gardenburger with Tapioca pudding) and True’s loving the attention from the oodles of nurses that find excuses to come in to visit with her. And me? I’m still waiting for poop.

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And now my requisite giggle that accompanies the posts filled with the icky…

This time on “You Can’t Make this Sh*t Up”:

Would you believe that my neighbor in the Lowell General Emergency Department (prior to being transferred to MGH) brought her dead husband with her in an urn? Yep. She also cried and screamed about how he used to beat her incessantly. I think this is an odd case Stockholm Syndrome being inflicted post-mortem…

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