Sunday, July 28, 2013

Of Square Pegs and Round Holes




Don’t really know how to start a publishable blog these days. So many subjects, but the colors of my life are just all over the pallet, running into one another and making an awe-inspiring kaleidoscope of life that I can’t even keep up with. The cool part is I’m not even trying to control it anymore…I’ve just been content to sit and watch with utter amazement how the events and circumstances that are running in all directions make the most beautiful fractals and combinations. Some look like abject disasters…and then all of a sudden, a picture emerges, and all the muddiness turns into clarity…the chaos becomes a quirky new order. 

Everything in my life seems to step on the heels of everything else, creating a story that will be cherished long after the final chapter has been written. 
 
But today I am thinking of Philip. I am sitting in my current favorite space and wondering over the direction our life is going. I’ve spent more time in contemplation the past two years than in any other endeavor, I believe, and things have changed. Although changes come slow – one day at a time – there are times when you look around and realize you have made a major shift, and days where the subtle changes suddenly manifest with a vengeance. 



Philip’s health took one of those sudden turns back in December, with the onset of a cough and congestion. When you can’t cough, that just spells trouble. I entered the classroom of “Sudden health changes – 102”, which I believe I detailed in a previous blog. What we learned from that was not so much how to suspend the clock and just do what you gotta do, but to try and troubleshoot the causes. Treat the symptoms…but try to identify the cause and remedy that if you can. Our investigation showed that part of the problem seemed to be the stress of school. While Phil hopes for a social life there, after 8 years it’s just not happening. No fault…no blame…it just is what it is. The school did the best they could, but there is just no denying that Philip is different. For all the attempts to convince him he is the same as everyone else, at the end of the day as he hangs in his Hoyer and I roll it over the bed we have to face it: No…no this is different. Oh, his mind is sharp, as is his wit, but his life is about as different as a dolphins is from a humans. And the current arrangement was just not working. Every time we sent him back to school, his energy level would collapse, and he’d start coughing and choking again. 

So, we – Phil and I – decided that we would home-school for a while to see if that helped. And it did. For a while. We were blessed beyond all reason to have a live-in caregiver during that time. (That’s another blog altogether, but we need more Sammy’s in the world.) We were able to skip the clock like we did when he was sick, but without the sickness. No more rigid schedule…classes that consisted of “Dirty Jobs” marathons on Netflix and a visit to the museum and zoo, late night laughs and starting the garden. A little while into it, though, we decided half-days of school might be a nice switch up, and all was well. 





And then the kids came home! Phil’s best social life is his family. His favorite times in life have been when his brothers and sisters are here. Often, they bring other people home with them and we have hosted some amazingly wonderful people as a result, and Phil now has friends across the USA. They stayed for a month of spring weather, garden-starting, gourmet cooking and fire-spinning at the campfire. And then they had to leave again. It was a short season, and as the crew prepared to depart for their new seasonal destinations, taking his caregiver with, and a brother leaving for Afghanistan, his health once again took a downturn. While driving our last guest to the airport, I was entertaining stopping at Children’s Hospital ER on the way home. His anxiety about hospitals was the only thing that prevented me from doing so. Realistically, what could they do for him there that I could not do for him at home? 

Realization#1: When you share a life with Duchenne, you are pretty much on your own. There are no pat, standard answers, and there is no rule book. You need a medical staff that includes a neurologist, a cardiologist, an orthopedist, a pulmonologist, a dietician, a primary care, an ENT doctor, perhaps a surgeon or two and their attending anesthesiologists, a durable medical goods supplier, a physical therapist, an occupational therapist, and some rehabilitation people who know how to fit crippled people comfortably in their wheelchairs. You may need a few more…but we’re not done yet. Each one of these specialists needs to have a little further specialization in the world of Duchenne Muscular Dystrophy…a disease which is hardly worth their time in terms of money and patients. One in every 3000 boys born just isn’t a huge customer base. And good luck with that. Your best resource is other parents and your own intuition – and even then…they are just reference points. One doctor will prescribe steroids…another won’t. One will prescribe heart meds, another won’t. One will suggest surgery…another won’t. You get to decide what right for you and your son. And you just do.  

So back home to our arsenal of durable medical equipment: An insufflator/exsufflator or Cough Assist machine, his suction unit and his nebulizer. His feeding tube assembly with constant vitamin C running. And his XBOX, of course. A review of any given day in this mode only serves to remind you that, yes…we are different. No copy of Parents magazine ever contained an article on the pressure setting of a cough assist, or how to best get the coughless child to cough effectively. You end up doing whatever it is you have to do to get that crud out, and that’s that. 

Then one day the Pulmonology people called…our appointment to have his pulmonary function test was up. What timing. When we arrived, I told them they we didn’t need a PFT – (every one has been an epic fail, owing to the fact that he can’t tighten his lips around any of the equipment) – we needed a chest x-ray to check for pneumonia. After lots of what Phil called cripple gymnastics, we got it, and got mostly an all-clear. No pneumonia, just a small spot of atelectasis. (Medical transcription training not-withstanding, you get to learn all these very important sounding medical terms along the way. It’s just a small spot of under-inflated lung.) The doctor gives us a scrip for antibiotics to make sure it doesn’t infect, some settings for the cough assist that seemed ridiculously high, and instructions to use his shaky-vest thing. Now we know something. 

So, home we go. One day’s worth of the dose of antibiotics has us realizing that it’s way too high…unless we plan to spend every day doing the hoyer-commode-bed-hoyer-commode-bed routine. I cut the dose in half and doubled the time he’s on it. Yes…you can do that. Amazingly enough, an entire education on antibiotics and modern allopathic medicine are all available on-line. There is no mystery to it, and if you take any medications at all you really should learn about them. Since we are on our own, here…and since every doctor that is treating my son has a financial interest in his staying a needy-customer, I have set myself up as the final authority – with Phil’s input – regarding all of his medical care. (No judgement on the doctors here…I’m sure most don’t see it that way. Unless, of course, you asked them to treat your kid for free….it just is the way it is.)

The antibiotics are doing their thing, I’m doing mine, and Phil is doing his, and we have nothing but time now to wait and see what happens. As he recuperates, we talk. A lot. About stuff that reminds you once again, that we are square pegs on a game board with nothing but round holes. How many conversations about death, dying, illness, life, living, happiness and sadness have you had with your round-peg 15-year-old lately that were not merely theoretical? You start realizing that your answers had better not be some made-up bullshit from a million years ago, or the latest new-age fancy trend for feeling good about things that hurt. Concepts like heaven and hell suddenly require some serious validation before you pass them on in some type of blind faith. This isn’t you…this is your child. Can you really guarantee them anything? What can you genuinely assure them of? And what are you just hoping they will believe and be okay with? What if you are wrong? They trust you…what are you telling them that you KNOW is true? Wouldn’t it be nice if I had answers for those questions? Unfortunately, no one can answer them but you, in the quiet of your own heart, in the water of your own shower which hides your tears, fears and uncertainties, and in the privacy of your own mind when the world is quiet and dark, and in the moments you stand outside their bedroom door as they sleep, and your heart begins to strain and ache with the love you feel for them. 

And in one of those moments, I made a decision. An epiphany of sorts. I am standing in the hallway listening to his breathing, thankful there is no longer any rasp and rattle. I stare at my son, and a heat begins to well up in my chest, meaning I will either have to walk away and continue about my business, or stay and reckon with the emotions that are sloshing around in there. The room blurs, and the debate is over. Here comes the silent volcano. The denial, the anger, the sadness, the bargaining…where, oh where, is the acceptance this time? 

In the midst of fear, and pain, and sadness and hurt, I realized that what I seek the most is the thing that I am resisting the hardest. That seems incongruous, I know, but at that moment, it made perfect sense to me…and it still does. I have spent a very large chunk of my life resisting what IS my LIFE. 

Let me explain. What is it we all want? How about a life without Duchenne? We want a cure, we want treatments, we want our sons to have better “full quality” lives and to live longer. We don’t want coughs to be fatal, we don’t want wheelchairs and hospital beds. We don’t want spine surgery, and we don’t want to be immobilized by this disease. We want our kids to ride bikes and ATVS and have friends and sleep-overs. We don’t want hoyers and feeding tubes and trach tubes and ventilators. We want an all-expense paid vacation to the Carribbean, not Children’s Hospital. We want our boys to play football and baseball and attend their games, not worry that they play too many video games and that they are socially stunted. And yet…when I stop to look at where the acceptance is that will bring me peace, I realize that with every comparison I draw between what IS and what I think it should be… I push away the very fact of my – our – life and all that it actually is. 


For every moment I have spent fighting, hating, cursing, and anthropomorphizing Duchenne, I have lost an opportunity to grow, to be and to experience this life. Because every moment is all that we have…and how we look at it, react to it and experience it is the writing of our life’s book. It’s how we choose to look at anything that determines our reaction to it. And I realized the truth of “When you change the way you look at things, the things you look at change.” 
 
I challenge any person of faith to deny the teaching that everything happens for a reason. If you believe this – as opposed to just saying you believe it, then you have to know that the presence of Duchenne in your life is a gift. It is packaged in some very unseemly packaging, with all the aforementioned accoutrements, and certainly emotional and physical challenges. But this is just the wrapping paper! Don’t get caught up in it. If we spend our life tangled in the wrappings, we may never get to the center of this tootsie pop…and the intangible, miraculous and wonderful gift that is the reason it showed up to begin with. If we say we believe it, then we need to act on it. 

But what about Phil? What does he think about all this? He hates this shit just as much – no…probably way more than - I do. Easy for me, from a philosophical view, to proclaim Duchenne a gift for my own spiritual betterment…at whose expense? Who am I to put my son in that position just for the sake of my peace of mind and sanity? 

I think the better question is, Who am I to take away his hopes, dreams, and his very health with the nocebo effect, telling him what his body can’t and never will do? How many of us refer to our kids as frail, or sickly, or ill, or diseased? Even healthy kids will live down to a poor medical billing. We use our son’s condition for far less noble things if we are honest about it. But in our defense, we have bought the package. We are told our kid has Duchenne, given the standard outline of what to expect in graphic terms, and sent home to deal with that information. The only hope offered us in this corporately sponsored package is the unrealistic hope for a pharmaceutical cure, which won’t help anyone born today. Even if it did, are you ready for the world of hurt your son would have to endure in physical therapy just to regain the movement in his buckled under feet? To keep us busy, we are asked to prostitute our kids disease for the monetary causes of big pharma, and then to feel good about it. No judgment if that’s your thing…it just isn’t mine for these reasons, and I can’t pretend it’s helping my son.

How does Philip feel – about being the bearer of Duchenne and all its “gifts”? The better question to ask him, however, would be how does it feel to be the bearer of Duchenne and all that sucks about it? Because that’s how we’ve been seeing it. This was perhaps best illustrated one day when he was at the respiratory bottom. There is no greater hardship to holding it all together than to watch your kid struggle for air. So I’m looking at him, waiting for him to come up for another hit off the cough assist, and he said to me, “Mom, when you look at me that way and feel sorry for me, it doesn’t help.”  

 He doesn’t want to be the object of anyone’s pity. When on the XBOX, he doesn’t pull out what he calls “The Cripple Card” when playing with friends who wonder why he’s calling his mom for this or that. 

But I realized that’s the only perspective I ever gave him. It was handed to me, so I handed it to him. This sucks. Your disease sucks. The things your disease brings into my life suck. I hate it. This hurts. Oh, yes….love, love, love, love all over you…but the disease…ugh. I suddenly had a “shame on me” moment. 

I suddenly found myself into a different world. I moved into a world where when children are born who are in some way NOT like the “ordinary, normal” child, the community comes to attention! “A special one has been born!” the murmur goes out through the community. “To who? Who are the lucky parents?
Who was deemed worthy to receive such a tremendous honor?” For everyone in this community I find myself in knows and understands that these children are the blessed ones…the ones through whom the purest LOVE of the universe flows into humanity! Miracles surround them! Healing surrounds them! Some say nothing, and do nothing tangible, but the aura about them is a spiritual force to be reckoned with. The caregivers are akin to the attendants of the King…so sacred is their job. The families of these special children lack nothing, for it is an honor to assist them in seeing that the lives of the blessing-bringers are comfortable and happy. The parents are honored, assisted, up-lifted and blessed by the community for sacrificing their independent lives to parent these gifts to humanity.

And in the nanosecond that I lived there, I looked at Philip sleeping in his bed, and realized that I have perhaps done him the worst disservice, by not living up the high calling that is mine. And then I am plummeted back into this world I live in now, and realize that I have bought into and perpetuate the lie that is our social paradigm: That he is diseased, he is less than. The things that he cannot now, nor ever will do without a “normal” body are the highest and best things…the coveted Round Holes...and he will have to find what second best thing he would like to engage his Square Peg energies in. We are reduced to begging for everything, and apologizing for our existence.  I am daily consumed with all that is not; all that I don’t want, all that I despise, all that saddens me, all that hurts, all that I  hate, and all that I fear. And I realized…I don’t have to live here. And neither does Phil. 

But it will take me to lead the way, as I have done his whole life. I tell him he is a gift. Over the course of time, we have talked at length now about our lives, and who we are, what we are doing, why we are doing it, and what we want to do now. 

We have Duchenne. We need to decide whether we will see it as a blessing, or a curse. It cannot be ignored…it must be one or the other, and that is nothing more than our choice. We need to stop being mindless about this life process, and quit pining for things that are not, (with all the attendant poor-pitiful-me jargon), and start looking for (and finding!) the doors that are opening to us because of Duchenne. We need to stop – and help our kids stop – hating on their bodies because they are not like what we have defined as “normal”. While their bodies may be in decline, there can be no doubt that a body that is loved on will perform better than a body that is hated on. Can we make our way into a world where physical activity and financial productivity are not the measure of person’s worth? A world where we redefine our valuation system altogether? 

I believe we can – and we are. We no longer have to understand “why”…we know why: For a Very Good Reason. That is our FAITH. I have a life than carries testimony after testimony to the fact that the shittiest, most horrible things that passed through have been the catalysts for the best, most beautiful and profound positive changes. Every time. Why would this be different? Do I live in a world where there is a force that is out to “get” me? Or do I live in a world where it’s all working FOR ME, if only I stop complaining long enough to see it that way? If I only believe that it’s for our GOOD, and leave it at that?

Does this new “acceptance” of Duchenne make it less painful? In some ways, but it does not negate it all. Each layer of the gift that surfaces is a different pattern: some nice, some horrifying and unfamiliar. We Duchenne students get an up close and personal look at things few ever see – and perhaps ever want to see – but we carry the backstage passes. If this be a gift, we hold our noses, cry our tears, feel our feelings, pocket the change when we are ready, and carry on with the next lesson – thankful for the experience. If this be a curse, we wallow for years on end, crying for why, and what and who and how, seeking blame and relief from the wrapping paper that is suffocating us. We forget that it’s a gift. 

I realize not everyone can see this…this kind of revelation doesn’t come all at once, and the application is a daily thing. It’s a day at a time growth – and like the progress of Duchenne, it’s a little here, a little there, and a few sudden roller-coaster drops that throw you off balance. Knowing it’s a gift brings you back to center a lot faster than wondering who threw the curve ball at your head and why. 

It’s taking Phil more time to see it this way, but he’s beginning to make more and more progress toward it. 

He asks me, “I’m not dying, am I?”
I say, “Not on my shift.”
“But am I going to die?” he still wants to know.
“Yup. So am I, and everyone you know, sooner or later. Same as being born.”
“Am I okay?” he questions. 
“I don’t know…do you feel okay?”
“Yeah…”
“Well, there you go. You’re okay!”
“I think my mind is telling me I’m here for a reason. It’s not my time,” he concludes, and then asks, “Right?”  
“Dude, I KNOW you are here for a reason…so, yeah!” I concur.
“Maybe I’m supposed to change the world. Do you think someone like me can change the world?” he wants to know.
“You already have, kid…in more ways than you know. And you’re right…you’re not done yet.” 

Welcome to the world of the Square Pegs. We are not less than - we are different. We are not victims of a disease...we are the students of a single-gene disorder, which is the boot-camp we have been signed up for - and which is designed to make us the  best and most fulfilled human beings we were meant to be. Duchenne Strong. But we need to see that Duchenne is not our enemy. It is, in fact, our ally, and if it's not, we need to make it one. Plenty of organizations have capitalized on it and made it THEIR ally...why don't we? Perhaps they've made it about the money...but I'm making it about LIFE. How much MORE life will this teacher afford us if we stop seeing our square peg status as a liability, and begin to see it as an asset...a window to a whole new world view?