Monday, August 30, 2010

Preserving Mental Health

Yesterday, Sunday, was a glorious day! We attended church as an entire family! It's amazing how adversity can make the simple things in life so important and precious. William's energy level is up and he seems like a regular 8 year old boy (except at meal time). He gets a bit winded and tired after a while, but I do too! It's a bit like the calm before the storm. Round 5 of chemo starts Thursday.

I have a quote by Thoreau framed and hanging in my family room that says, "Simplify, Simplify, Simplify." In the past several years as I've weathered a home full of 5 little boys, I've often had to simplify. The span from oldest to youngest is just under 5 years with a set of twins tucked in there. So I've spent the past several years assessing my priorities and capacities. I no longer regularly attend such activities as book club, park days, girls night out. My boys don't participate in every available sport at the youngest allowable age, and I've learned that I can get by without a daily shower. And I'm happy. Really happy. Really tired, but still happy. I view the past few years, although exhausting, as a tender mercy from the Lord because of the preparation it afforded me in knowing how to simplify life and accept those changes cheerfully.

I also attribute this attitude to my parents. My mother has always been tied to the home because of my twin sister who has a severe form of cerebral palsy and is as dependent as an infant and the fact that 8 children were spread over 19 years! My parents have never had a social life like many friends and neighbors. Our vacations were never too extravagant, usually wheelchair accessible in nature. But the home was full of joy and sibling squabbles and children complaining of unfair treatment, and curfew negotiations.... The point is, I feel I grew up in a traditional and "simplified" home with parents who never express bitterness or resentment for the challenges they face. And I'm trying to have that same attitude.

I also married into a wonderful, tight-knit family. I have a loving, patient, calm, appreciative, intelligent husband who learned these qualities from the example of his parents. One of the interesting and helpful additions he brought into our marriage is a valued importance of mental health. Thankfully this is not due to former issues or years of instability, but rather his grandmother was a psychologist and his father is a psychiatrist.

I want to preface what I want to share by first sharing some of the purposes to this blog. Some are personal, but include: to have a personal record for our family, to update family and friends, personal therapy, and to help others facing similar challenges.

When we found out William had cancer, we received floods of information and advice from the medical staff. Most of it revolved around William's care and upcoming treatment. But some very important information was for me and Ryan, specifically. We were reminded that our physical and mental health would be equally important in this whole process. We were counseled to make our personal physicians aware of our family situation and make sure we had people in place to monitor our own physical and mental well-being. This also helps to insure the safety and proper care of our children. Our dear friends, Dan and Lisa, have taken on the monitoring roll and we've had some good laughs and some reality and stress checks along the way.

Ryan and I feel enormously stressed at times (and with good cause), but we feel we have solid coping mechanisms to deal with the stress appropriately. We're not perfect. We get upset with each other at times, but when we do, we try to respect the fact that we feel our own highs and lows and different points. We know we each have to be strong for one another, but that sometimes means carrying the other until they can get back up. And that's not easy either. We've had our separate meltdowns and shared a few too. We've also both visited our own doctors, separately.

We didn't sleep much the first two months. Even when we tried to sleep, we'd wake up before 5 AM or toss and turn all night. The anxiety at the beginning was suffocating at times. We still have sleepless nights when we worry. (We're barely 3 months into this journey). And many more await us. Regardless of our efforts, we are exhausted. When asked about our sleeping habits, the doctor explained that although we may think we are sleeping, due to our stress, it is not quality sleep.

We now both have prescription sleep aids we take when needed. For us, our lack of sleep was affecting our ability to maintain focus, process our stresses, stay mentally acute, and have physical strength. I put this out there because I've learned from Ryan's family that mental health is often misunderstood. Medications can do wonders, counseling and therapy are helpful, and no one should be ashamed of admitting they can't do it all on their own.

And that's why it takes villages.

Friday, August 27, 2010

Juggling

Whoops! I've been so exhausted all week, I didn't realize I hadn't posted since Monday. I thought of the blog each night, but always thought I'd get around to it the next day. We are NOT back in the hospital (doing the happy dance)! William is on his "good week" and the mouth sores have finally healed so the only excuse for not eating is a lack of appetite and I'm trying to convince him that that is not a valid excuse right now! Hah! I hope I'm not creating poor eating habits for him later in life, but I guess that should only be a worry if he actually ate more. He's been working on a Jamba Juice all day, but got a bean burrito down at lunch. A whole burrito! (We celebrate the little things!)

Now the pressure is on for weight gain. He is 59 lbs. and had his final I.V. feeding last night. The I.V. nutrition can stress the liver (his liver already has cancer cells in it) and cause other adverse side effects if given for a long period of time so his doctors don't want him on it more than 30 days. So he's getting a break since he'll very likely be back on it during the month we are in S.F. for the stem cell transplant. I bought him a cool K'nex roller coaster if he can get to 60 lbs. and maintain or improve that for a week. So he sits and looks at the box every day and if you stop by, he'll probably show you the box and explain our "deal" (bribe!). He seems motivated and I let him put it on the table while he eats.

We had a clinic visit on Thursday and met with the doctor. William's blood counts are good and they canceled our Monday visit since things look to be on the rise. We check in next Thursday for round 5--the very nauseating cocktail we had for round 3. The main things I have to watch for until then are bleeding and bruising since his platelets, although acceptable, aren't super high and may drop, necessitating another transfusion.

The past week has been overwhelming in many ways for me and Ryan. It's sometimes difficult to figure out why we feel so stressed and exhausted when William finally gets out of the hospital and things seem to be on the upswing and we are all together as a family. We are realizing that during the stressful times, we are running on adrenaline and focusing specifically on the bare essentials. Then, just when we think things should be getting better, the toll of finding our place in the middle of the chaotic mess of our lives, feels like we are gasping for air at the surface. No one panic. I think it's a normal, but sometimes unexpected, cycle of life and it just takes some recognizing and constant readjustment of priorities to make sure the family is functioning as well as can be (considering all circumstances).

One of the difficult things about our lives right now is figuring out when we need help and with what we need help and what things we need to just slide off our plate completely. Some days, like any family has, are super busy. Many people offer to help, and I will accept help, but we know that there are even tougher days ahead when help will be more essential. Juggling carpools and soccer schedules feels normal and we don't feel that very often these days. There are going to be many, many days when a friend or neighbor will be doing the carpooling and soccer practices and games. So we want to do them when we can. When William was diagnosed we tried to think through our lives for the next year as best we could and think of what our reality would be like. We've put many things on hold that may be still important to us, but can wait a year or whatever time frame necessary.

Today an army of people showed up to tidy up our yard---people from church, people from school, people from the neighborhood. I was amazed and so touched. I was fully intending on being out there to help, but was still in the midst of trying to still get my twins off to school, clean up the kitchen, and get William to eat and take his medication. I haven't had a chance to look on the helping hands website much and I thought 4-5 people would come. It was incredible as probably over a dozen people filed into the backyard and started working. I don't think I even saw all the faces of those who came. Many tasks were accomplished that I didn't even expect to be done. Thank you! Thank you! for lightening our load today and touching our lives with service. I'm getting all weepy which makes my eyes sting which makes me then have to go to bed early and I have a few things I still need to get done tonight! I felt a great deal of love today and I'm so grateful.

Monday, August 23, 2010

Garden Therapy

Today flew by as I tried to get my feet under me. I tried to catch up on what came home in the school folders on Friday, sort through the papers and mail that stacked up during the hospital stay, ran to Costco, and made 4 pints of pesto with the basil that is flourishing in our garden. I picked 2 huge zucchinis (the garden wasn't checked for a few days!) and 8 cups of beans and a dozen tomatoes and carrots. I wish William had more of his appetite back to help eat all this and I wish I had more time to try all the yummy recipes I collected when I had time to dream of our harvest. The variety of grilling accessories that Ryan got for Father's day in anticipation of many vegetable grilling evenings are still in wrapped in their packaging. At least I now know we can grow something. Our previous record isn't even worth mentioning.

As I was alone with my thoughts while checking the garden, I began to make gardening/life analogies. I thought about how miraculous it seems that our garden has done so well when we've neglected it the past 3 months. We put a great deal of effort into it the first few months of the year. We prepared the ground, built the structures (boxes, trellis', irrigation), researched plants, created a blueprint, planted and then sat back and waited for mother nature to work her magic or wreak her havoc. She did both. But not necessarily all in the garden.

There are many analogies here, but the one that stood out to me is how, like a garden needing to be tended and periodically fertilized, we go through life continually tending our physical and spiritual needs. We never know when the storms may hit or how long the droughts will last, but we hope that our preparation will protect us from complete ruin. Occasionally we need some fertilizer to boost productivity when something unexpected comes, but if the foundation was carefully constructed, then a harvest will still occur.

The harvest is rarely as we expect. Some seasons will yield plenty and some will be meager. Sometimes it will be because of error on the gardener's part and sometimes it will be a result of things beyond the gardener's control. There are so many life lessons in a garden, i.e. faith and patience, but this one stood out to me today. I have a strong foundation physically and spiritually. Some days I may falter and start to wither, but other days I'm well-watered and have an abundance to give. But it's a daily process to keep both aspects of life from complete ruin.

Given this is a blog and not a well organized essay, my thoughts come out a bit like a stream of consciousness exercise. That's where this becomes good therapy. And my garden is good therapy.

Sunday, August 22, 2010

Boosts

Saturday:
  • Said goodbye to my sister, Angela. Thanks for the help!
  • William got a platelet and a blood transfusion (larger dose this time).
Sunday:
  • Farmed the kids out during church so I could lead the music without distraction, but still cried through the meeting. The talk on patience and enduring was comforting and hard at the same time. One of these Sundays I'll make it through with dry eyes.
  • William was released from the hospital, and came home full of energy. Thanks, blood! His blood counts still show his immune system down, but beginning to recover.
  • Ryan and I are exhausted, but grateful we got out a couple times together in the evenings while Angela was here and before we landed back in the hospital. We're trying to remember that our marriage can't be ignored. I'm glad I married a wonderful man who can handle a lot of neglect!

Friday, August 20, 2010

Almost Made It!

If William was going to follow trend, he should have landed back in the hospital yesterday afternoon (Thurs). I took his temperature often throughout the day. No fevers! Yay! He made it past his trend. He seemed good and perky and although the mouth sores have begun their cycle, he managed to eat a little food. After dinner, he announced he was really tired and wanted to go to bed early! Music to my ears! But not from William. I was worried, but chalked it up to having made it through 4 rounds of chemo and the exhausting toll of it all on his little body. He was sound asleep by 6:45 PM.

I checked his temperature at midnight and he had a fever of 100.8. I'm supposed to call at 100.3 or higher. I suspected that he was neutropenic by now and that would mean automatic hospital admittance. Our room was warm, windows closed, and William had on 2 blankets. We opened windows, ran the AC and removed his blankets. His fever disappeared. (I think that may have been cheating, but that's how bad I didn't want to go to the hospital.) I couldn't sleep out of worry and woke up every hour throughout the night to take his temperature. If he had a fever, I would take it again and wait a few more minutes and take it again until I felt justified in going back to sleep. I sound like an awful, selfish mother, but I must add that we had a clinic visit to see the doctor and have blood drawn in the morning. I really wasn't that negligent. It's kind of like waiting for the contractions to really get going.

We showed up to the clinic visit fully packed to be admitted. I was honest about my night's activities with the thermometer so they drew blood for blood cultures (infection). His ANC was 0 (no immune system) and because he had a fever during the night, we are now sitting on the sixth floor of the hospital for at least the next 48 hours. The tender mercy here is that we finally have a private room. I really needed that for my own sanity. (see the stress post that Lisa trumped!) :)

Thankfully, my sister, Angela, is here so I had the kids covered without any effort. The main logic and purpose of her visit this week was to help with unexpected hospital stays. Do I say I'm glad we didn't disappoint? She's been fantastic with the school drop offs and pick ups and bedtimes and meals and endless entertainment. I am truly blessed to have such an amazing, supportive family. And having 7 siblings has it perks in times like these!

Wednesday, August 18, 2010

Help is on the Way!

Friend Lisa here. I am finally putting out the call for help. So many have done so much already and now we will try to organize the troops.

As you can gather from Julie's last post, it's time to lighten her load (and Ryan's load! although I do transportation not water, sorry Ryan). Here is a clip from a letter I sent out to friends at school:

William will have more difficult chemotherapy next month followed by major surgery followed by a stem cell transplant. So I think it is time to get down to business and start a better coordinated effort of helping. If you are interested and willing to help with gardening, errands, grocery shopping and meals, meals, and meals, please follow the link and register your email and name. I think there is also a way to add notes (or you can send me a message) if you have any ideas of ways to help (like you LOVE to work on sprinklers). If you can bring 1 meal- that is a huge help.

Here's the link:
https://www.lotsahelpinghands.com/c/627356/

Thanks everyone!

And a note to my friend- Your "fight" was in the wrong place for today, perhaps; but your heart was in the right place, as always.

Stress cycles

The past few days are on my list of days I am glad I won't have to repeat. Nothing specifically awful happened, but it feels more like the combination of many stresses and emotions all piling up on each other. I'm waiting for that big cry that finally bursts out and makes everything feel okay, more or less. I have moments when the tears start to surface, but the timing isn't quite right, so I hold them back and move on.

Yesterday I bought William a new DS carrying case to hold all his games because I was tired of them being in a plastic bag and having to carry them in my purse. With a new case, he would be in charge of storing and transporting. William was thrilled until he realized it was a case for a DSi and he has a DS lite. The two charging mechanism are not compatible. Who knew? Not me. Why, Nintendo? Why? So I returned it last night to Target. However, when I got home, I saw his games on the counter and many were missing. William had started to put them in the case and I had just returned the case with 6-8 games inside. They were not cheap games! I panicked. I called the store. They were closed. I showed up this morning and waited outside for them to open. I entered and asked at the service desk and checked on the floor with no luck. I asked an employee for help without giving any details, just that I had returned it with games. It turned out that one of the women helping me was the mother of one of William's friends and knew I was William's mother. She was amazing and sent many people on high alert looking all over the store for the case. A HUGE THANK YOU to Bea for helping to find the games!!

Thanks for all the comments and emails regarding the school situation. I had a good reality check with Lisa this morning (after my over stressed DS search) and today I have realized that William's schedule is so unpredictable right now that it's not even worth my time trying to fight as hard as I thought I should yesterday. He has two chemo cycles and surgery in September and 2 clinic visits each week and several appts. for a new round of tests and scans to prepare for surgery. Then he'll be in S. F. for a month. So for now I'm going to fight the fights that matter today and worry about tomorrow tomorrow. And when he's finally back home with only radiation to deal with, we'll move forward on the school route. We'll take any slots that fit with our schedule for now and worry about how many hours we are receiving later.

It's wonderful having all the boys back, but it's hard at the same time to suddenly toss 4 lives into my already precarious juggling act. When William was admitted for chemo last week, as is standard protocol, I was asked the date of his last bowel movement. I usually can rattle off exactly when it was and all the necessary descriptions of it. When I was asked this time, I thought, "Hmmm, I know I've seen a lot the past few day, but whose was it?"

I feel like I've been thrown in the boiling pot with all the new schedules. I have two different school schedules at the elementary school, one school schedule at home, another school schedule to start in September, 2 soccer schedules (thank goodness twins consolidate some things), clinic visit schedules, medicine schedules, chemo schedules, and any of those that involve William mean that the schedules have very little consistency from day to day or week to week. And somewhere in those daily schedules I must fit in meals, laundry, cleaning, bathing (although daily is extremely optional!), errands, a husband, bills.... And I blog. And I'm only getting to it right now because I have 5 hours to sit in this hospital room while William gets a blood transfusion as I type.

I've mentioned before that I love Sundays. I really do. I get a spiritual boost and strengthen my perspective on life and my purpose in it, but it doesn't mean that I don't think Sundays are stressful and sometimes full of unpleasant moments.

The past Sunday. Ryan and William stayed home since we worry about his susceptibility to infection. I got the boys piled in the car, to church, and filing in the chapel just as the meeting was supposed to start. The only catch was that we had to file up to the front of the room and up onto the podium and make our way into the choir seats because I am the music chorister for the month of August. We sat down, I gave a quick, unproductive, and ignored speech about reverence and then hurried to find the page of the first hymn and stood up to lead the first song. It was good. One of my favorites, "Count Your Many Blessings." It's upbeat and it's message is always a good one. But it's not good when four of my little blessings are wrestling and whistling and giggling to the point that I have to reach back and grab an arm while still waving my other hand for the music. I tried to remain calm, but the sweat had started. After the hymn, I had a brief rest between songs to restore peace and order. Then I had to lead the sacrament hymn which is of a reverent nature to help prepare to partake of the bread and water. The boys were still very disruptive and just as the hymn ended and the prayer was about to start, Clark hit his head on an arm rest and burst into tears. I grabbed his arm to hurry him out, but he held on to the chair thinking I was yanking him to take him out to be disciplined. So I quickly sat back down, whipped him onto my lap, and tried to stifle his cries in my shoulder. And I wasn't wearing a skirt appropriate to have boys climbing all over my lap! Disaster averted. I was able to redo the seating arrangement to reduce mayhem.

The speakers began their talks. The theme of all the talks: trial and adversity. Seemingly appropriate, right? I wanted to listen and glean some words of wisdom and counsel, but Cameron's ball point pen exploded all over his hand and pants. So we hurried out. And evidently the other boys followed a few minutes later because I found them in the boys bathroom playing around when I exited the girls bathroom with Cameron. All 5 of us made our way back up the podium to wait for the closing song. Soren passed the last few minutes running back and forth across the width of the last row of choir seats. I gave up. At least he was doing it quietly. Then came the closing song, a beautiful hymn and another favorite, but I wasn't prepared for the power of the words, "Where Can I Turn for Peace?". I lost it. I coudn't sing. My eyes filled with tears and I couldn't even mouth the words. I had to hold back the sobs and keep waving my arm. The words were touching and perhaps what I really needed to hear that day. And today too!

Here's a clip of The Mormon Tabernacle Choir singing it.

Where can I turn for peace?
Where is my solace
When other sources cease
to make me whole?

When with a wounded heart,
anger, or malice,
I draw myself a part,
searching my soul?

Where, when my aching grows,
Where, when I languish,
Where, in my need to know,
where can I run?

Where is the quiet hand
to calm my anguish?
Who, who can understand?
He, only One.

He answers privately,
Reaches my reaching
In my Gethsemane
Savior and Friend.

Gentle the peace he finds
for my beseeching.
Constant he is and kind,
Love without end.
---Emma Lou Thayne

So I'm going to count my blessings, take deep breaths, attempt to reduce some stress, restore some eternal perspective and find a little happy pill! (That'll be a post for tomorrow!)