There are certain things I'm told when someone finds out that my daughter has a chronic illness that drive me up the freakin' walls. I know people are trying to be reassuring/encouraging, but there are some things you just don't say. At least to me. Everyone is different, so I'll speak for myself only here.
Please understand that I'm currently going through the Anger part of the grief cycle. I can even identify now that my 'tone' is much harsher than it normally is. There might be strong language. You have been warned.
"You gotta stay positive."
No, really? You don't think I know that? You don't think I fight to stay positive every day? You try facing this every day, and staying positive. You stupid fuckwit. Why in the world would you say this to someone? What is is going through your head? Think before you speak, dingdong. If you can't say something reasonable, just keep your mouth shut. Ninety-nine percent of the time, if I'm informing you that my daughter has a chronic, incurable, illness, I'm not telling you because I expect you to say something profound, or to say anything at all. I'm telling you because I felt you needed to know for some reason.
"Well, they are coming out with new treatments for stuff all the time."
No shit, Sherlock! Thank you, Captain Obvious. Guess what? I knew that too. Chances are that I know more about the treatments in the pipeline than you do, because its my daughter. Idiot. Sometimes if something is blatantly obvious, you do NOT have to voice it. Trust me.
"Maybe she'll grow out of it."
If its incurable, chances are she's not going to fucking "Grow out of it". Enough said.
What you CAN say:
"Dude, that freaking sucks!"
This is one case where stating the obvious is okay. Its okay because you're not thinking too hard about it. Its okay because it does freaking suck, and sometimes just someone else acknowledging that is all that I need. When someone responds like this, my thoughts are along the lines of 'Thank you for understanding.'
"I'll pray for her."
This one too is perfectly acceptable. That one phrase offers comfort, understanding, and is nice and simple. Again, its one where you're not thinking too hard about it. Do you see a pattern forming here? Your initial responses sometimes are the best.
"Sorry to hear that."
Its simple, honest, and conveys understanding of the situation.
I honestly don't blame people for saying stupid things most of the time. I generally just kind of shrug an acceptance of their response when they say something I think is stupid. I just had to get my thoughts out here.
-------------
A memory:
I'd went to the babysitter's house to pick her up, and was greeted in her usual way. Her voice declaring "MOMMY" as soon as I'd opened the door, and her hands extended straight up over her head with a following demand of "UP". It didn't matter to her that I was still a few feet from her. When I denied her, as I initially do because I'm trying to look through her backpack to see if there's anything I need to share with the babysitter, crocodile tears flowed down her chubby cheeks. As usual, I laughed at her because we go through this almost every day. She knows she's going to get picked up and given loves, but she wants it done on her terms and no one elses.
I chatted with the babysitter, picking Lily up after a minute, and sitting her on my lap. As usual she squirmed and wiggled, wanting to get down. In Lily's world, "UP" at the babysitter really means "up long enough for loves, and then you'll let me down so I can rip and race for a few more minutes". She did eventually get let down, and after a little bit more conversation with the babysitter, I tried to get her coat on her.
Everything was pretty much business as usual until Bob walked in the house. Bob is the babysitter's husband, and Lily has him wrapped around her little fingers. As his lanky figure disappeared into the kitchen, she looked at me with those wide gray eyes, and solemnly asked "Cookie?"
"No."
"Cookie!" More insistent this time. Bob regularly gave her cookies, and she was bound and determined to have her cookie. It didn't matter that we were ready to head out the door, and she was inside a warm house wearing a warm coat.
"No, Lily. We're getting ready to go, and you aren't allowed cookies in your carseat."
"Cookie!" As I started to say no again, the babysitter spoke up.
"She thinks because Bob's in the kitchen, she can get whatever she wants." Her voice was rich with mirth. She knew my little red-headed heathen very, very well. What happened next almost made me bust a gut laughing.
The babysitter had just finished speaking when Lily stared at me with this Duh, Mom expression on her face, and said "Yeah!" What made it even funnier is that Lily doesn't just say "Yes" or "No". She adds tonal emphasis to the words. Basically, she packs that one short word with a ton of attitude. "Yeee-aAAah" She even threw in a decisive nod for emphasis.
Given that she's only 21 months old, I don't generally expect Lily to 'know' what someone is talking about unless it involves the words "bottle" or "diaper change". Sometimes, though, when she responds as she did in that situation, I really think that she does understand, and I don't give her enough credit.
All throughout the day as that memory has randomly popped into my head, I have at least snickered.
Thank you, Lily, for the memory.
The Feisty Lily
Showing posts with label baby. Show all posts
Showing posts with label baby. Show all posts
Thursday, December 9, 2010
Tuesday, November 16, 2010
For all that I know, it still feels like a death sentence...
In honor of spreading the word about Pulmonary Hypertension, on the PHA's Blogging day, this post will be all about Pulmonary Hypertension. Some of you may have heard this information before. Some may have not. Feel free to link anyone to this post if they have been diagnosed, or have had a loved one diagnosed with Pulmonary Hypertension....
Lily - not even 2 yeares old - has Primary Pulmonary Hypertension
First off - I'm not a doctor. I'm not going to use a lot of medical words. I'd probably get half of them wrong. So I'm going to break it down as nice and simple as I can.
Q: What is pulmonary hypertension?
A: It is high pressure in your heart and lungs. Specifically, how hard/much pressure the heart has to use to squeeze blood through your pulmonary artery.
Q: So, its like high blood pressure then?
A: Uhm..in the way that a 1 dollar bill is like a 100 dollar bill. Both are printed on the same paper. One is vastly different in terms of effect it has than the other.
Hypertension can be deadly. However, it is manageable, and in some cases if you can negate the circumstances that lead to the hypertension, you can negate the hypertension itself. PULMONARY HYPERTENSION HAS NO CURE. No amount of 'eating right' or anything like that is going to make it go away. A lung transplant might...a heart lung transplant might...but do you really consider something that drastic to be a cure?
Side note: I solidly vow to shove my boot up the next person's rear who makes a comment about how "oh, my (so-in-so) has hypertension" or "Maybe she just needs to exercise more" etc. I have boots with five-inch heels. Don't be stupid. THINK before you speak.
Q: What causes Pulmonary Hypertension?
A: Depends. If Pulmonary Hypertension (Herein called PH) is related to a heart defect, a medication/pill you had once taken such as Phen ..something. I can't remember the name of it. That diet drug... It is called "secondary pulmonary hypertension". The prognosis for Secondary is generally a bit better. GENERALLY. Not always. Now, if the doctors can't figure out why you have PH, its either called Idiopathic (unknown cause) PH, or Primary PH.
Q: Why haven't I heard of PH before?
A: Because its a rare disease. If you don't believe me, look up NORD and Pulmonary Hypertension.
Q: How rare is it?
A: The last estimates I read said 2 in every MILLION people. However, it could be more prevalent than that. There is now some research that indicates a good portion of SIDS deaths are caused by PH.
Q: Babies can have PH?
A: ALL babies have PH in the womb. Then, when they are born, those pressures drop dramatically. However, in some cases, they do not. Unfortunately there is NO standardized newborn testing which would indicate PH. Symptoms generally present as labored breathing, blueish skin, etc. However, the baby could present perfectly fine in the hospital, only to have it develop rapidly a few days later. Rapid on-set. Now, I'm going to say something. I'm going to say it in Bold, Italic, and Underlined. So, just be aware. Because, duh, this is freagin' important.
IF YOU HAVE HAD A BABY, AND YOUR GUT IS TELLING YOU SOMETHING IS WRONG....BUT THE PEDIATRICIAN IS SAYING EVERYTHING IS FINE...DON'T LISTEN TO THE PEDIATRICIAN. PUSH TO HAVE AN ECHOCARDIOGRAM DONE. THIS IS THE ONLY SURE-FIRE WAY OF GETTING A GOOD ESTIMATE OF THE PRESSURES IN THE HEART.
Get it? Got it? Good! Most run-of-the-mill pediatricians/adult doctors have never even heard of Pulmonary Hypertension. So don't fool yourself by thinking 'oh, my doctor would tell me if something was wrong with rugrat/me.' Don't be stupid. Be empowered.
Q: What's the life expectancy for someone with PH?
A: This depends. It depends on how early the person was diagnosed. It depends on how well they respond to medications. It also depends on how well they obey basic tenenaments of self-care like "Take. It. Easy!" In the 90s, someone diagnosed with PH had an expected life span of three years if left untreated. For children? 10 months. Now, with treatments, doctors have managed to extend the expected life-span of someone with PH to 10-12 years. Obviously, there are people out there who have lived longer, and people who have died sooner. It depends on how severe your PH is, and the other things I just mentioned.
Side note: So, yes, I am having to prepare myself for the fact that if Lily does not respond well to medications, my daughter is going to die, and die soon. Even if she does respond well, the prognosis is poor. Will she even live to see 21? After about 10 years old, when a child starts going through puberty, their reactions to vasodilators drops dramatically. So does the survival rate. So, even if Lily does well now, who knows if she'll make it past puberty??
Q: You say in your title "It still feels like a death sentence"??
A: When speaking with an adult who has been diagnosed with PH, I asked if her if she thought that the diagnosis feels like a death sentence, and if she still does. Her answer? "Yes". I, too, feel like its a death sentence. Unless there's some cure that miraculously arrives in a few years, this situation is NOT going to resolve in rainbows and kisses for everyone. My daughter has, effectively, been given an expiration date that will come a lot quicker than it should for anyone.
Q: What treatments are there?
A: Flolan, Remodulin, Sildenafil, Tracleer, Lasix, Letairis (sp?), Oxygen. Those are the ones I know about.
Let me break that down a bit more: Sildenafil (also known as Viagra) and Lasix are two common, low-risk treatments. Lily has been on those for longer than I care to remember. The Lasix gets the extra fluid out of her body, making it easier on her heart and lungs. The Sildenafil is a 'vaso-dilator' (vessel-expander). You know how a man takes that little blue pill, and gets a happy? Its because it opens up the blood-vessels more, and allows his 'little head' to get more blood-flow/oxygen, etc. Well, same thing with Lily, except she doesn't get a visible salute going when it starts working because 1. she doesn't have boy parts and 2. its working on her heart.
Tracleer - the only medication for PH that (as far as I know) comes in Pill form. Tracleer has some SERIOUS side-effect possibilities. Like, you know, if you get pregnant, your baby might have no head...or two heads. That type of thing. There is also a serious risk of liver damage. To the point you have to have a blood-test for liver functioning every month before you can continue to take the medication. This is what Lily is going to be on. Tracleer is 5,000 dollars a month.
Oxygen - I shouldn't HAVE to explain this...but just in case. Oxygen is a medicine. Yes. A medicine. Putting Lily on oxygen at night has ensured she gets a healthier sleep, has increased her energy levels, and helped her heart and lungs a little bit. Lily is lucky to be on it only at night. Some patients with PH have to be on it constantly.
Flolan, Remodulin, and Letairis are out of my realm right now. I just know that one of them is an inhaler. One is administered via a catheter leading straight into the heart. One is administered subcutaneously. I think Flolan is the one straight to the heart. I do know with that medication that you are required to be hooked up to a continuous infusion to help keeps things level. If for some reason your pump would stop working? You have 5-7 MINUTES to fix it, and get the medicine going again. If not, well...lets just say you should always keep an updated will around. The consequences can be that serious. All of the medications I just talked about in this paragraph also have serious side-effect possibilities.
Ok, so, now that I've written everything I can think to write without your eyes glazing over...
This is what I'm dealing with. So, pardon me if, over the course of the next several months, I get a little grouchy and depressed.
Also, let me list a site for you.... http://www.phassociation.org/
Wonderful website.
If you have any questions, you can ask me and I'll try to answer them.
Regular bloggy-update on Lily coming later.
Lily - not even 2 yeares old - has Primary Pulmonary Hypertension
First off - I'm not a doctor. I'm not going to use a lot of medical words. I'd probably get half of them wrong. So I'm going to break it down as nice and simple as I can.
Q: What is pulmonary hypertension?
A: It is high pressure in your heart and lungs. Specifically, how hard/much pressure the heart has to use to squeeze blood through your pulmonary artery.
Q: So, its like high blood pressure then?
A: Uhm..in the way that a 1 dollar bill is like a 100 dollar bill. Both are printed on the same paper. One is vastly different in terms of effect it has than the other.
Hypertension can be deadly. However, it is manageable, and in some cases if you can negate the circumstances that lead to the hypertension, you can negate the hypertension itself. PULMONARY HYPERTENSION HAS NO CURE. No amount of 'eating right' or anything like that is going to make it go away. A lung transplant might...a heart lung transplant might...but do you really consider something that drastic to be a cure?
Side note: I solidly vow to shove my boot up the next person's rear who makes a comment about how "oh, my (so-in-so) has hypertension" or "Maybe she just needs to exercise more" etc. I have boots with five-inch heels. Don't be stupid. THINK before you speak.
Q: What causes Pulmonary Hypertension?
A: Depends. If Pulmonary Hypertension (Herein called PH) is related to a heart defect, a medication/pill you had once taken such as Phen ..something. I can't remember the name of it. That diet drug... It is called "secondary pulmonary hypertension". The prognosis for Secondary is generally a bit better. GENERALLY. Not always. Now, if the doctors can't figure out why you have PH, its either called Idiopathic (unknown cause) PH, or Primary PH.
Q: Why haven't I heard of PH before?
A: Because its a rare disease. If you don't believe me, look up NORD and Pulmonary Hypertension.
Q: How rare is it?
A: The last estimates I read said 2 in every MILLION people. However, it could be more prevalent than that. There is now some research that indicates a good portion of SIDS deaths are caused by PH.
Q: Babies can have PH?
A: ALL babies have PH in the womb. Then, when they are born, those pressures drop dramatically. However, in some cases, they do not. Unfortunately there is NO standardized newborn testing which would indicate PH. Symptoms generally present as labored breathing, blueish skin, etc. However, the baby could present perfectly fine in the hospital, only to have it develop rapidly a few days later. Rapid on-set. Now, I'm going to say something. I'm going to say it in Bold, Italic, and Underlined. So, just be aware. Because, duh, this is freagin' important.
IF YOU HAVE HAD A BABY, AND YOUR GUT IS TELLING YOU SOMETHING IS WRONG....BUT THE PEDIATRICIAN IS SAYING EVERYTHING IS FINE...DON'T LISTEN TO THE PEDIATRICIAN. PUSH TO HAVE AN ECHOCARDIOGRAM DONE. THIS IS THE ONLY SURE-FIRE WAY OF GETTING A GOOD ESTIMATE OF THE PRESSURES IN THE HEART.
Get it? Got it? Good! Most run-of-the-mill pediatricians/adult doctors have never even heard of Pulmonary Hypertension. So don't fool yourself by thinking 'oh, my doctor would tell me if something was wrong with rugrat/me.' Don't be stupid. Be empowered.
Q: What's the life expectancy for someone with PH?
A: This depends. It depends on how early the person was diagnosed. It depends on how well they respond to medications. It also depends on how well they obey basic tenenaments of self-care like "Take. It. Easy!" In the 90s, someone diagnosed with PH had an expected life span of three years if left untreated. For children? 10 months. Now, with treatments, doctors have managed to extend the expected life-span of someone with PH to 10-12 years. Obviously, there are people out there who have lived longer, and people who have died sooner. It depends on how severe your PH is, and the other things I just mentioned.
Side note: So, yes, I am having to prepare myself for the fact that if Lily does not respond well to medications, my daughter is going to die, and die soon. Even if she does respond well, the prognosis is poor. Will she even live to see 21? After about 10 years old, when a child starts going through puberty, their reactions to vasodilators drops dramatically. So does the survival rate. So, even if Lily does well now, who knows if she'll make it past puberty??
Q: You say in your title "It still feels like a death sentence"??
A: When speaking with an adult who has been diagnosed with PH, I asked if her if she thought that the diagnosis feels like a death sentence, and if she still does. Her answer? "Yes". I, too, feel like its a death sentence. Unless there's some cure that miraculously arrives in a few years, this situation is NOT going to resolve in rainbows and kisses for everyone. My daughter has, effectively, been given an expiration date that will come a lot quicker than it should for anyone.
Q: What treatments are there?
A: Flolan, Remodulin, Sildenafil, Tracleer, Lasix, Letairis (sp?), Oxygen. Those are the ones I know about.
Let me break that down a bit more: Sildenafil (also known as Viagra) and Lasix are two common, low-risk treatments. Lily has been on those for longer than I care to remember. The Lasix gets the extra fluid out of her body, making it easier on her heart and lungs. The Sildenafil is a 'vaso-dilator' (vessel-expander). You know how a man takes that little blue pill, and gets a happy? Its because it opens up the blood-vessels more, and allows his 'little head' to get more blood-flow/oxygen, etc. Well, same thing with Lily, except she doesn't get a visible salute going when it starts working because 1. she doesn't have boy parts and 2. its working on her heart.
Tracleer - the only medication for PH that (as far as I know) comes in Pill form. Tracleer has some SERIOUS side-effect possibilities. Like, you know, if you get pregnant, your baby might have no head...or two heads. That type of thing. There is also a serious risk of liver damage. To the point you have to have a blood-test for liver functioning every month before you can continue to take the medication. This is what Lily is going to be on. Tracleer is 5,000 dollars a month.
Oxygen - I shouldn't HAVE to explain this...but just in case. Oxygen is a medicine. Yes. A medicine. Putting Lily on oxygen at night has ensured she gets a healthier sleep, has increased her energy levels, and helped her heart and lungs a little bit. Lily is lucky to be on it only at night. Some patients with PH have to be on it constantly.
Flolan, Remodulin, and Letairis are out of my realm right now. I just know that one of them is an inhaler. One is administered via a catheter leading straight into the heart. One is administered subcutaneously. I think Flolan is the one straight to the heart. I do know with that medication that you are required to be hooked up to a continuous infusion to help keeps things level. If for some reason your pump would stop working? You have 5-7 MINUTES to fix it, and get the medicine going again. If not, well...lets just say you should always keep an updated will around. The consequences can be that serious. All of the medications I just talked about in this paragraph also have serious side-effect possibilities.
Ok, so, now that I've written everything I can think to write without your eyes glazing over...
This is what I'm dealing with. So, pardon me if, over the course of the next several months, I get a little grouchy and depressed.
Also, let me list a site for you.... http://www.phassociation.org/
Wonderful website.
If you have any questions, you can ask me and I'll try to answer them.
Regular bloggy-update on Lily coming later.
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