Friday, October 10, 2014

Teetering On The Right Side Of The Road

The Right Side Of The Road:
Some of Dad's Life Instructions
By Lori (DeMartin) MacKenzie
written October 2014

Which is the right side of the road?
Is there really a right and a wrong?
Show me Daddy, I don't understand 
Help me to bike along.

What is the right way to ring the register? 
How do I count change back?
I build my confidence by watching you. 
With these things, you have a knack.

What is the right way to turn around?
Why is it called a three point turn? 
What would I do without you Daddy?
How would I ever learn?

What is the right time to check the oil?
How do I change it too?
Thank you for all your help Daddy, Without you I'd have no clue.

What is the right time to move away?
When am I ready to leave?
You never hesitated to encourage my plans   
You even helped me to believe. 

What is the right way to plan my day? 
How do I know what to do when?
I know. I'll make a list like you
I'll get me some paper and a pen 

What is the right major and job for me? 
What should I do for work?
Do your job even when you don't want to
It's a responsibility you cannot shirk

What is the right way to handle
money? 
How do I keep it straight? 
Buy what you can afford and nothing more.
Pay on time and never be late.

Who is the right man for me to marry? 
What if I make a mistake?
There are not many out there like you Dad
I discovered that once a little too late  

What is the right way to deal with loss?
Why did you hate my tears?
You didn't want to see me sad
I didn't know for all of those years

Now I know the right side of the road 
What you've shown me, Daddy, I apply
Work hard and plan, be honest and cautious 
and it turns out, it's ok to cry.  

Sunday, October 5, 2014

Teetering Between Freely Mobile and Fully Comatose - Sleep Paralysis

She lay down to go to sleep for the night, mulling over the day's accomplishments and considering unfinished tasks pushed to tomorrow's to do list.  It happened right away, or at least it felt like it.  Her head hit the pillow, her eyes just closed and she was there, in that place.  "Oh no, not this.  Not tonight" she thought as she braced herself for what would likely be an unpredictable and exhausting night.  "Maybe if I can catch it early, then walk around or watch TV for a while, it won't be so bad.  Ok, here I go.  Should I relax a minute or just start fighting?  I'm so tired. I don't feel like fighting"  She knows that waiting almost always makes it harder to get out, it ends up being more work and more exhausting, "If I'm not careful, I'll go deeper and it'll hurt more"  The hurt is a sort of throbbing, achy all over feeling.  

"If I can get a finger or some toes moving, then maybe I can catch it now"  Although it is very painful and takes a tremendous amount of effort, the slight movement of one digit is a good place to start.  She has come to find that trying to move a digit, try not to go deeper and dealing with what feels like asphyxiation need to be carefully juggled.  If she focuses too much on the breathing, then she may go deeper, if she focuses solely on her moving a finger, then her breathing seems to get worse.  Too deep a breath can be bad.  A shallow breath, then some fight to move, then a brief pause to "rest" has been the best formula.  She has no idea how long it lasts. It likely feels much longer than it actually is. "Am I dying?  It feels like it this time"  She has been through this many times.  In her head, she knows she's not dying, but it always feels like she is.  She manages to move part of her right hand, "There, I can do this. Just keep trying to move, with only a quick breath in between. Try not to rest. You may lose it. Fight. You're almost there"  Philippians 4:13 runs through her mind, "I can do all things through Christ who strengthens me."  Finally, she can move her hand and with immense mental effort, she breaks free.

This is one example of me enduring an episode of sleep paralysis.  My next post will show that this is a milder example of my experiences with sleep paralysis, something which at one time in my life, occurred every night, often multiple times.  You see, when I finally break free, the distress in not over.  Despite how horrible these occurrences are and the past experience of knowing that if I try to go back to sleep right away, it will immediately and automatically reoccur, the urge to do so is stronger than words can convey.  I am compelled to go right back to sleep. These episodes leave me drained, as if every bone muscle cell in my body has been sapped of something essential to go on.  Every part of my body feels depleted of something.  It's as if some of the life in me has been removed.  It is very difficult to explain. 

There is so much more to sleep paralysis than what has been described above.  Along with the sensation of difficulty breathing, there is a feeling of pressure, sometimes milder and other times more intense, on my chest.  The episodes almost always happen when I am lying on my back, which gives the sense that breathing and breaking free are even more difficult. Also involved is an unpleasant tingly feeling in my body, especially my head and chest.  I can compare it a little with the hyper-sensitive "pins and needles" feeling when a body limb falls asleep.  Then, there is the nagging ringing "rushing wind" sensation in my ears.  This is more of a feeling than a sound.  For others, the paralysis can feel like an out of body experience.  I have only experienced that on a few occasions.    
The line between real and unreal is virtually non-existent during an episode of sleep paralysis.  Reality becomes something a sufferer determines through repeated experience and, at least for me, investigating through "trial and error".  For instance, on many paralysis occasions, I had the impression that my eyes were open, but I believed they probably actually were not.  So, I tested it myself one time to determine it.  I strongly recall one particular time when I had my mom's handmade knitted afghan over me.  When I sensed my eyes were open, I looked at and memorized the pattern, folds and layout of the afghan.  When I finally managed to awake myself, I observed the afghan to be exactly as I had observed it to be while immobile. It seems likely that my eyes open and I see while paralyzed, although not knowing for certain, it also crossed my mind that perhaps my subconscious mind could "know" small details that I am not aware.  The opposite end of the spectrum with regard to the question of reality is that of false awakenings.  The belief that I have awoken, broken free and am up and about, only to discover that I am still paralyzed lying on my bed.  Either way, it all is kind of fascinating in a way.  It would be even more so if I didn't have to endure it. 

Remember from my last post that narcolepsy is a disorder of sleep/wake cycle confusion.  So, people with narcolepsy can go into REM sleep immediately when they become drowsy and close their eyes.  Yes, that's right, I wrote IMMEDIATELY!  As many people are aware, normal sleep goes through a series of stages, with roughly similar time frames of each stage.  The first stage of REM sleep usually occurs about 90 minutes into sleep.  At this deeper level, the most restful and rejuvenating sleep occurs.  Our body, when it functions properly, is designed to operate in ways which support solid, deep refreshing sleep.  One way to ensure this is to prevent our bodies for moving.  Temporary but complete paralysis keeps our sleeping bodies from acting out our dreams and at the very least, from repeatedly falling out of our beds.  Simultaneously, our breathing changes to a less conscious type of breathing, again, to support a sufficiently deep enough sleep.  Now, imagine if you will, this process of paralysis and unconscious breathing taking place the moment you begin to enter sleep.  That explains the distressing sensations of narcoleptic sleep paralysis.  

It does not, however, explain the intense fear I have every single time, the fear that someone will find me in this state, try to wake me and not be able to.  I won't be able to tell them I am trying to wake up and can't. Some paralysis sufferers have reported that sleep partners have successfully woken them by simply touching them.  I have never experienced this and when I encounter an episode, I am utterly convinced that another person will NOT be able to help me.  The alternative is some unknown catastrophic fate I am desperate to avoid.  The ultimate fear is that I will not be able to awaken and that my loved one will think I am dead. 

For me, sleep paralysis, with all of it's varied and confusing aspects, can occur without it's common counterpart, hypnogogic (just prior to falling asleep) and hypnopompic (just prior to awakening)  hallucinations.  Although the paralysis can occur without these hallucinations, the hallucinations, at least for me, always occur with the paralysis.  In REM sleep, we not only become paralyzed and breath automatically, we also begin to dream.  Technically still awake, these dreams are actually very lucid hallucinations.  Why they are terrifying experiences and not just benign figments has peaked the interest of psychologists and theologians alike for centuries.  These vivid and terrifying hallucinations add fright to the already existing panic. Personally experienced primarily upon falling asleep, I still have yet to share the most tormenting aspect of immediate onset REM sleep. 

Friday, October 3, 2014

Teetering Between Wakefulness and Sleepiness: Narcolepsy

There she was, sporting that blue and white dated eye-sore of an ensemble and eagerly heading to the break room. "I'm not that hungry" she thought as she entered the stuffy room, littered with dirty plates and overflowing ashtrays positioned in the exact spots from several days before.  "That spot will do" she thought as she made her way into the right hand corner of the room leaving the door only slightly ajar.

She carefully settled herself in, moving the items which lay in front of her a good arms length away.  She made a couple more shifts in the chair and a scratch or two here and there where her skin was irritated by the rough checkered polyester.  "There, ready." With her arms intertwined, she lay her head as comfortably as possible settling in for this shift's brief siesta.  There she was on a beautiful summer day, a full 18 years young, catching a survival nap hunched over a dirty restaurant break room table.

Yup.  That was me nearly thirty years ago.  A teenager needing a nap after only a few hours on shift as a waitress.  The answer to your next question is no, it was not due to partying late the night before.  I was a typical young adult home from college for the summer needing naps in the middle of the day.  It would be another seven confusing years and many more naps later before I would learn of my narcolepsy diagnosis.  I don't think I thought much about it back when I snoozed hanging over the break room table in the back of Friendly's restaurant in Hyannis, on Cape Cod, where I grew up.  Along the way, however, the efforts to get those zzz's became more frantic; the locations, more daring.  Being desperate enough to lock the door to the small counseling office I used at my graduate school internship, about a year before I discovered my condition, and laying on the cold hard floor with my bunched up jacket as a pillow was for me, no pun intended, a wake up call. 

Hey, it's not like they were paying me.  I was an intern.  I would, however, in future positions, come to have my share of paid naps.  I got real good at covering too.  Pretending to be checking charts stored directly behind the door, which I "accidentally" locked, was my reason at the residential program I worked at for seven years post-diagnosis.  If a client knocked, I was checking charts and would be "just a minute".  If they slept late, then, well, I joined them, finding good enough comfort with my feet up on the desk leaning slightly back in the one chair out of window view. 

The ideal scenario came when I did individual counseling in a room with a love seat sofa in it.  I scheduled my own appointments and could schedule my naps and set an alarm.  Being fee-for-service meant my naps were on my time.  No wonder they call it a love seat. My drowsy self had a lot of post meridiem slumber on that sofa. 

Drowsy.  That is the word which I feel best describes the sleepiness of narcolepsy.  At the risk of seeming to embellish, this is not the tired which non-affected people describe when overworked or when experiencing the impact of the occasional poor night's sleep. It is the drowsy you feel when you are trying to stay awake and almost can't.  It is the drowsy a college student feels while in class the day after pulling an "all nighter" to get a procrastinated term paper in on time.  It is the drowsy a Red Sox fan feels when the game goes into extra innings but they finally go to bed because they "just can't keeps their eyes open another minute" (ok, maybe not the diehard fans!).  It is this kind of drowsy every day for a good part or most of the day; usually until it is time to go to sleep.

This is where trying to explain narcolepsy goes from tricky to bizarre. The best general description I have ever read of how to briefly describe narcolepsy is that it is a disorder of sleep/wake cycle "confusion"  How else would it make sense that someone who can barely keep their eyes open during the day lies wide awake and frustrated at bedtime?  That's right, struggling to stay awake during the day then suffering from insomnia, to a greater or lesser degree, at night.  The insomnia is without daytime naps to make sleep at night difficult and the daytime drowsiness of narcolepsy happens with or without the sleeplessness at night.  The brain of the narcoleptic suffers sleep/wake cycle confusion, and it is quite confusing indeed.

This excessive daytime drowsiness (EDD) is the one symptom common to all narcoleptics.  There are other symptoms which are not shared by all sufferers.  This is where bizarre goes to a whole other level.  Among narcoleptic support circles, both on and off-line, we often refer to ourselves as either having narcolepsy with cataplexy (NWC) or narcolepsy without cataplexy (NWOC).  I am a NWOC, so I cannot speak of the dread, inconvenience, embarrassment or fear in experiencing cataplexy.  The sudden complete loss of muscle tone, usually triggered by strong emotions, creates challenges and requires planning of which I cannot even imagine. Depending on how severe it is, this, as well as the extent of one's EDD, can deem an individual disabled and sometimes even not able to drive. 

My EDD has never got in the way of my driving.  I have, however, pulled over for a stretch or even an occasional nap.  There have also been more times than I would have liked when a bad night's sleep meant canceling plans. I spent a number of years taking jobs and planning my entire schedule around my unpredictable sleep needs.  A poor night's sleep could throw me off for a week or more and necessitate some of those desperate attempts to catch some Zzzzs at strange times and risky places. 

Narcolepsy doesn't end there though and despite the gratitude I have for not suffering with cataplexy and never experiencing any indications of needing to relinquish my driver's license, I have yet to describe the horror I endured for most of my young adult years.  Perhaps this was why sleeping nestled on the break room table didn't much stand out in my memory.  Back then, a mysterious tormenter entered my life and threatened my sense of normalcy.  A terrifying affliction, which, like the EDD, was rooted in my then undiscovered neurological condition. This tormenter had me thinking I might be going mad. The reality, though, is more transient and less predictable than madness.  A frightening and seemingly random mingling of air gasping paralysis and a barrage of phantom assaults.  Sound improbable? A bit sensationalized? Stay tuned to discover the very real and bizarre world of sleep paralysis and hypnogogic and hypnopompic hallucinations.


Sunday, June 29, 2014

The Jelly Jar ~

Second Shelf, in back to the right, left of the Mayonnaise 

Either a person is blind or not, right?  Can someone be a “little” blind or wouldn’t that mean they are not blind at all, but a “little” sighted?  “Not blind enough to be blind.  Not sighted enough to be sighted.”  This, a statement made by a friend referring to her spouse, a man whose visual world had been slowly closing in as a result of advanced Retinitis Pigmentosa.  I imagine this statement would make little sense to most people.  Indeed, a few years ago, it would have left me scratching my head. 

Under the right conditions, Mandy appears to be a typical 13-year old.  When well rested and in a familiar, brightly lit area, Mandy is just another kid.  “Does she really need it?” are the thoughts I imagine perplexed onlookers are thinking when they observe her with her cane, often holding it carelessly, while jumping from one floor tile to only other same colored tiles in the supermarket.  That and successfully avoiding “stepping on the cracks” gives the appearance of minimal, if any, affliction.

I can recall more than one instance when a parent of one of Mandy’s peers, already well acquainted with her impairment, looked on in astonishment at Mandy bump into a rearranged or neutral colored chair against a stark background or feel her way through a dimly lit or unfamiliar hall when without her cane.  Even more striking are the gasps of disbelief when, for whatever the reason, the subject of teen driving inevitably crops up, and it becomes known that Mandy will not be getting a driver’s license.  I admit, my initial gut reaction is annoyance, “Do you think she has a cane because she has vision just a little worse than other kids?”  I do conceal the impulse to share these fleeting thoughts, of course, as I am fully aware of the naiveté inherent in well meaning people who have never had to confront these realities.  Of course I am aware, since I used to be one.      

The surprised reactions have gotten easier to deal with over time.  I expect them.  I have found creative ways to avoid tender subjects when I am feeling vulnerable and sensitive or, I am armed and ready with responses and education.  Given Mandy’s usual “typical” appearing behavior in structured/planned settings, people have come to expect, well, the expected from her (this is a double-edged sword; more on this another time).

I have thought a great deal over the years about how to describe to someone just how different and challenging it is to raise and teach a vision-impaired child truly is, despite her still having decent acuity and a good deal of useable vision.  When everyday people don’t seem to get it and some situation arises where I feel I need (or want) to help someone see just how pervasive the impact of deficits in vision are to acquiring basic life skills and the general task of parenting, I have found myself uncharacteristically without words.  

We couldn’t seem to come up with anything quite fitting enough to capture our daily reality.  Our first ideas just weren’t sufficient…....”sneaking” birthday gifts in the house easily undetected (heck, I can do that with my fully sighted husband as long as the television is on), installing an institution style fluorescent light fixture in the living room, needing to “teach” Mandy how to find something she had dropped.    

In an effort to not embellish our experience either, I began trying to think of an example of something ordinary, yet frustrating just the same.  One day it came to me.  A simple, normal, not over-the-top and yet almost daily occurrence in our household and one every reader can identify with: the jelly jar.  You read that right: the jelly jar.  

Do you remember how you learned to make a peanut butter and jelly sandwich (or, ham and mustard or turkey and mayo……..)?  I don’t remember how I learned.   I just did.  I just “knew” what to do once the time came to do it.  Was it that way for you too?  Now, parents, think about this from the perspective of raising your children.  Do you remember how they learned to make their first sandwich?  Did you “teach” or show them how?  I bet some of you are scratching your heads right about now and doing some mental judo to try to remember and/or to try to describe how, in many cases, you did not ever actually go out of your way to demonstrate to your children, step by step, how to make their first sandwich.  They just did.  It was messy, no doubt, but they did it.  Were we all hard-wired with an instinctive knowledge of exactly how to do this simple, yet also highly evolved task? (No, we weren’t)  So, how did we learn?  It’s called: (here comes some of my college psych “theory of learning” knowledge I thought I’d never use again) Incidental Learning.  Also referred to as “informal learning”, incidental learning is learning which takes place without any intent to learn or to teach.   Not surprising, the majority of incidental learning is visual.  At some point parents, you went to make a sandwich (where you needed jelly, mayo or mustard…….work with me here).  One or more of your children were in your vicinity and “noticed” you making the sandwich.   They watched you open the refrigerator and observed you reach to the back right of the second shelf for the jar of jelly.  Guess what mom?  At that moment, you “taught” your child where the jelly is kept.  While engaged in some other activity, presumably, the child then “noticed” you struggle a bit to open the jelly jar, the lid stuck tightly with the residue of gunk from previous rounds of use.  Now, the child has “learned” how, with what degree of force, to open the jelly jar.  You go on to get the bread and peanut butter.  You spread each with a separate knife on two separate slices, scraping if necessary, close the sides together and viola…..a peanut butter and jelly sandwich.  The next time little Jimmy has a hankering for a PB & J; he may be ready to be on his own.   He may want to do it himself or you, up to your ears folding laundry in the other room, may welcome Jimmy’s independence for this safe, simple task. He will go on to make many sandwiches and you and he will likely never talk about how to do it, how you knew how to do it or how he figured out how to do it.  It just happens.

Almost nothing is learned this way for a child with significant vision impairment.  For blind children, there is virtually no incidental learning.  Verbal description and hand over hand instruction is often the bare minimum required to teach even the simplest of tasks for the blind child.  So it is for the vision-impaired child as well.  Despite having a measurable visual advantage from their blind peers, the vision-impaired child’s ability to learn from the natural occurrences in their environment is strangely similar.   

I must’ve pulled the jelly jar out of the refrigerator dozens and dozens of times before Mandy was at an age appropriate for her to attempt making her own sandwich.  When the time came, she had no idea where the jelly was, how to “look” for it or what to do with it when she found it.  We literally had to “teach’ her where it was and what to do.  Even the concept that opening the jelly jar requires more force (and why) than say, the peanut butter jar.  This may not sound like much of a heavy challenge, and indeed, it really was not.  However, this has been how just about everything was taught to, and learned by Mandy.  Add to that her feisty, easily frustrated temperament, and, well, it has not been easy.

I’ve learned quite a lot from being submerged in the world of disability, special education and IEPs.  Like so many other parents and family members of children with additional challenges, I have learned to assume little, and if at all possible, nothing.  This goes for typical children as well.  None of us really knows what any other parent is contending with in raising a little person into a mature, well-adjusted adult ready to exert their independence and make their mark on the world.  Let’s take a tip from our blind and vision-impaired neighbors.  The next time we see a child with a cane who clearly can distinguish the brown from the yellow tiles, or any other special child displaying behavior which is not consistent with what we would expect given our insufficient preconceptions, let’s consider the unseen.

Teetering Between Fully Sighted and Totally Blind: Visually-Impaired

“Not sighted enough to be sighted and not blind enough to be blind.”  A statement made by a friend whose husband’s world has almost literally been closing in on him due to the retinal disease called retinitis pigments (RP).  Does this sentence make sense to you?  It does to me.  It really does to me.   

Many surveys and research studies over the last few decades have identified blindness as one of the top fears of persons in a multitude of different cultures.  It is frequently among the top five fears named.  Deafness, by contrast, doesn’t usually make the list, even if more than twenty-five items or more are indicated.  Interesting to note, if one were to investigate smaller, more specific people groups, specifically the deaf-blind community, a totally different perspective results.  Within deaf-blind groups, when asked which they would choose if they could between being blind or deaf, the great majority chose blindness as preferable to being deaf.  Can you make sense of this?  Once one knows more about each population, it begins to make sense.

I learned some interesting things a few years back when a good friend chose the local deaf community to study as part of a human service minority group course requirement.  She shared with me how tight knit the community of deaf people tend to be.  The reason they are so tight knit is related to the reason most deaf blind people would choose to be blind over being deaf:  communication.  As dreaded a thought as it is to us sighted folk, a blind person can learn and manage to get around without eyesight.  However, despite mobility and other sight-related activities being an advantage for deaf people, their ability to communicate with others is extremely limited.  Helen Keller said it like this, “If I could choose, I would rather be blind because if I could hear, I could have conversations with the people around me.  I would feel connected to the world.”  Keller attributed her isolation with not being able to hear.  Interesting food for thought.

There were so many things about blindness and vision-impairment that I was completely ignorant about before being catapulted into the vision disabled world,  such as canes being excellent tools for impaired individuals who have a good deal of sight remaining and how impaired a person with compromised eyesight can actually be.  Also, along the lines of the definition of the “legally-blind”, the idea that blindness comes in degrees.  Actually, sighted comes in degrees as well.

Living in the state between fully sighted and fully blind is a unique, perplexing and often frustration “middle”   No doubt, some sight is better than none.  I doubt anyone would disagree with this.  We are grateful for the eyesight that Mandy has and the prognosis that vision loss will be later and more gradual than most others with her retinal degenerative condition.  Mandy has a condition called Leber’s Congenital Amaurosis (LCA) which is technically a form of RP.  She was diagnosed at age five (THAT story is for another time).  The condition is degenerative, progressive and currently without a treatment or cure.

Let me try to describe the challenge and frustration of this “middle”  Part of it is that her impairment is not a stable one.  We have met other young persons with vision impairments who know that their condition is permanent but static.  For example, those with premature retinopathy or albinism, they know the extent of their impairment and can become adjusted to it.  Even those who are totally blind know what they are facing and can get going with adapting and moving forward.  Although difficult and grievous, there is less “unknown”  This is said in no way to minimize other people’s differing painful experiences.   The point is that for us, this middle is fraught with challenges and frustrations, not least of which is the not knowing.  The not knowing when, how, or if there could be a chance for it to be avoided?  Trust in The Lord does not eradicate fear.    

Other examples of this distressing middle include both keeping up with research and trials on possible future treatments while also planning for Mandy to be ready for a dark world.  This middle involves both participating in fundraising for the search for a treatment or cure while also supporting Mandy in learning Braille, independent cane travel and other compensatory skills.  At times, I find my head spinning trying to make time for both reading and study to keep up on the research, trials and discoveries doctors are making worldwide and the investigation and search for helpful tools, programs and other opportunities to help Mandy prepare for vision loss.  It can involve helping people who think Mandy is more capable/less impaired understand that she needs support, help and compassion.  Other times, sometimes later in the same day, it is helping people who think she is less capable/more impaired understand that she is not without sight and can do things independently which they might not realize.

Sometimes there is a desire, either by Mandy herself or Mandy’s dad and I, to underplay her challenges.  This is when we present it more as, “she has a vision impairment” going on to describe that she needs a lot of light, some additional acclimation to new areas and some occasional support.  These are often things like new programs/camps who are not affiliated with the school system and not connected to IEP services.  They are usually situations when Mandy is able to have social experiences with peers and she does not want to stand out.  There are other times, however, when we really want to drive the point home that Mandy is impaired and has needs which may not seem obvious.  This is when her special needs are presented as that she is “legally-blind”.  Perhaps this sounds like manipulation.  I guess technically it is.  It is, however, with the motive of helping to find a good balance between Mandy feeling comfortable and independent while also making sure she is safe and that her needs are understood.

When people notice Mandy at times when she “sees” particularly well, they don’t realize that a combination of ideal factors, some we can control/influence and some that we can’t, make that possible.  When at her best, blending in with the other kids and not appearing impaired at all, chances are that most of the following are true: she is well rested; she is in a good mood; it is early in the day; she is in a comfortable; familiar or highly motivating environment; she has not had an especially visually challenging day so far; and there is a good deal of natural or fluorescent lighting..  If a few of these factors changed, you’d be looking at a girl feel her way around, bump into things and get frustrated.  If it was bad enough, she would appear completely blind.  So, despite what usually is or seems to be minimal impairment, a good of planning, anticipating and micro-managing has been done over the years, especially when she was younger.

This leads to the last aspect of raising a partially sighted (partially blind) youngster which people may not realize.  Often times, more times than not, teaching Mandy everyday things requires virtually the same strategies, techniques and patience as it would if she were totally blind.  Those of you who have seen her in action may find this hard to believe, but it is true, especially when she was younger.  Vision-impaired people, particularly youngsters, don’t “notice” the things we sighted people do.  Mandy has never been one for details.  She literally sees “the big picture’ and tends not to notice the trees in the forest.  So, despite having a good deal of useable vision, it doesn’t cross her mind to use the effort which would be necessary to watch me fold the laundry or  unpack and put the groceries away.   She doesn’t naturally notice and it is not enticing enough for her to choose to notice.  Therefore, EVERYTHING NEEDS TO BE TAUGHT.  She has to be shown, with a good deal of creativity, effort, patience, and sometimes, repetition, to do everyday things most children pick up naturally.  

I demonstrate this in the next post entitled, "The Jelly Jar"

Teetering Between Pregnant and Not Pregnant: Miscarriage #1 ~ IsabelRose

 "Would you know my name if I saw you in Heaven? Would it be the same if I saw you in Heaven? I must be strong and carry on 'cause I know I don't belong here in Heaven" The familiar, baritone voice of Eric Clapton heard and recognized despite playing only faintly in the doctor's office waiting room that day. That dark day. It was a cool, misty September morning with a mix of sun & clouds, as if not able to make up it's mind. The poignant song, written and sung by a grieving father, filled the stagnant air in the stuffy, gloomy place. Overhead music, is provided to create a relaxing waiting room environment, is it not? I was anything but relaxed. The state of calm intended by such efforts was lost on me. Instead, the questions in my head were reverberated by the singer. Strangely, a degree of comfort was sensed in the spirit of commiseration. The music descended from directly above our heads, as if from heaven itself.   

The booming voice of the receptionist abruptly broke my preoccupation. I could hear her speak, but the words weren't registering at all. The soft yet resounding music kept begging for my attention, as if needing to be heard. Thank God Scott was there. He did the listening and most of the talking. I tried, but in the foggy, numb state I was in, it was more like I was watching it all happen. In a dream-like state of nothingness, I dutifully followed my husband into the doctor's large cluttered office. I sat in a stiff brown chair a good distance from the only other seating choice for Scott. I don't remember much. What was going to take place was explained. I allowed myself to zone out and let Scott assume the responsibility of remembering and asking any needed questions, which is not like me. I heard "uh huhs" and "I understands" while feeling like a third person looking in or, like I was watching a movie,  Funny how the shock and impact of sudden grief can transcend time and place.  

We got up out of our chairs and I was instructed to provide a urine sample. "What the heck do they need this for?" I thought, "We know I'm pregnant and we know the baby is not alive" Reluctant to leave the comfort of my husband's side, I became more conscious of my surroundings and of what was going on. Walking down a seemingly never-ending long hall to find the restroom, I observed the old, worn dark brown walls; ugly, depressing wallpaper, chipped paint and nearly no wall hangings. Was my grim perception of this entire office colored that much by my current state of mind? Was this intentional? Were choices fashioned to match the mood of this man's specialty? Why did they pick all of this darkness? I'm not sure if the somber decor made me feel worse, or if matching the tone of my state of mind was in fact validating. I don't suppose bright sunshine and cheery flower designs would have made sense. Sigh....... Oh, what these walls have seen, their darkness screaming out dread and loss.  I entered the narrow dank restroom to provide my sample. The room was beyond dank. It was downright dreary. Dark thoughts passed through my mind, as they had over the last few days. My thinking just wasn't right; wasn't me.  Hormones, unmedicated narcolepsy and devastating heartbreak severely clouded my mind. I recall looking through the hazy narrow window on the restroom down the three floors to the parking lot. "They really shouldn't have an office like this on the third floor." I thought, "I mean, they send someone like me in here with this window? It would be so easy to unlatch this and just jump. They should at least have the windows more tightly secured" I was in no way suicidal, which makes theses thoughts, which seemed perfectly natural and reasonable at the time, all the more haunting.   

I really had no idea what to expect from this appointment, I just knew that we were meet today and tomorrow go for the D & C.  What a strange name.  So many medical procedures have strange names.  Dilation and curettage.  Basically, it is opening the cervix and cleaning out anything inside that is not supposed to be there.  Done for many reasons, it is often associated with miscarriage (miscarriage, another bizarre word) and abortion. A curette is the instrument used to do the cleaning. At first when I heard this word, all I could think of was something cute.  A curette. It sounds like something cute and nice and pleasant. No, it is for scraping, and in the case of miscarriage, this means scraping out and removing your dead child. I say it with striking blunt abrasiveness precisely because this is not in any way shape or form what people want to hear but it's the truth. It's something many women endure and go on to carry daily in silence and isolation. The curettage part is actually the easiest for the recipient. I got to sleep through the ordeal and wake up to the offer of a single Percocet before leaving. Accepted, thank you very much. I was not in much physical pain, but I took it anyway. I see why people turn to substances, particularly narcotics, to not feel.  It works, sort of, for a while. The dilation, by contrast, was no picnic. It is hard to explain. It felt kind of like multiple long thin needles being placed throughout the inner walls of my cervix.  At first, they stung a little, like a cut being cleaned with hydrogen peroxide. Then it stung a lot, then more, then it burned really REALLY bad with simultaneous mild contracting. Scottie held my hand and felt me squeeze harder as each wave of discomfort intensified. I saw how helpless he felt. An involuntary tear streamed down my left cheek, escaping the others I was holding back. The stun of the burn allowed it's release. The stun of the burn melted my defenses and numbness. Our baby is gone but still inside of me. Lots of cramping took place throughout the rest of that day which helped take my mind off of the emotional pain.  This was a sign that my uterus was opening in preparation for the procedure. I already knew what childbirth contractions were like and these were strangely reminiscent.  

The next day at the hospital was a blurr. I only unmistakably remember three moments from that day. The first was when the anesthesiologist dutifully asked me what procedure I was having done, to which I answered bitterly, "fetal demise" echoing my care providers and cynically validating the medical dehumanization of the event. Then, having already received an initial dose of anesthesia, I remember that while being wheeled into surgery I involuntarily muttered, "Bye bye baby.  Bye bye baby" God provided an angel of support and encouragement in the form of a nurse who, having overheard me, tenderly pressed my forehead and said, "You will always have your baby in your head" then shifted to my chest and added "You will always have your baby in your heart". The physical sensation of her gestures felt intense, likely heightened by drugs and emotion. I wish I knew who she was. I would thank her. I wonder if she has any idea what that meant to me. 

 "Beyond the door there's peace I'm sure; and I know there'll be no more tears in Heaven"  

Monday, June 16, 2014

Teetering Between Married and Single: Divorce

Ugh, divorce. It was a long time before I could comfortably say, "I'm divorced".  My divorce took place back in the mid-90s, nearly eighteen years ago now. It was undoubtedly the defining experience to burst the illusionary bubble I had unknowingly carried all of my life up until that time. There was a life I was certain that I would have and it definitely included "'til death due us part". The end of my brief three year marriage to my college sweetheart, my first love who I had been with just shy of ten years, was without a doubt, the decisive, sudden, pure gut-wrenching and heartrending blow to my naive belief in "happily ever after" 
"You have the sweetest boyfriend" I heard repeatedly through our years of dating.  Showered with attention, affection, cards and flowers, this man beamed and could not contain tears on our wedding day.  The known "nice guy" left our marriage in a way many had difficulty believing.  I accepted the lack of closure a long time ago, but it is still hard to believe.

After months of devastating "just get through the day" grief and blaming anger, I came to a crossroads: either I become bitter, untrusting and cynical or, I choose to release the pain, surrender the "need" for closure, forgive and open my heart again.

I chose the latter.  The Lord forgives me, so I must forgive others.  An unexpected and pleasant byproduct of forgiveness, God's gift, I am certain, had been a significant fading of the bad memories and a stronger preserving of the good ones. 

I had the desire to write a poem about the rise, life and fall of my relationship with Andy, from dating through marriage and on to separation and divorce.  When I finished the poem, I knew for sure that I had arrived at a good place of healing with this part of my past.  The entire poem flowed out of me with almost complete ease.  

Seventeen stanzas to represent nearly ten years of friendship, love, loss and abandonment.  My ex, Andy, my first love, my former best friend who will always hold a place in my heart.  Like the death of a loved one, the grief is never completely gone.  This poem did, however, show me that the majority of my grief was in the past and that most of my healing was done. 

Raggedy Andy
(Written late 2010)
Raggedy Andy,
All tattered and torn
Hand-me-down clothing
Looked shabby and worn

He didn’t have much,
They didn’t look twice
Modest belongings
Would have to suffice

He didn’t complain,
Had no need for more
Humble and kind,
And sweet to the core

She tried to resist him
Her heart feeling fear
Sensitive and gentle
He grew very dear

Raggedy Andy
Did catch her eye
She liked his simple demeanor
So rare in a guy​

She made him feel wanted
Like never before​
He sensed her approval
Admired for sure

A first love…
A wonderful romance…
A beautiful friendship…
A magnificent dance

Yet Raggedy Andy
One day discovered
Something was missing
But what, he wondered

He wanted more status ​
He wanted more stuff
Being her husband
Just wasn’t enough

Greedy, insatiable,
Excessive and vain
She finally saw
He would never be the same

Raggedy Andy
Was ragged no more
Being with her
Became such a bore

Now Andy was
Snazzy, haughty and stunning
He also thought
He was really quite cunning

Settled down
He did not want at all
A cheatin’ scoundrel
Will eventually fall

Raggedy outside
With the inside so real
Was what had once won her
Her heart did he steal

Now raggedy inside
The outside looks striking
His heart has grown hard
It’s not to her liking
​ 
He no longer wants her
He has to move on
She’s better without him
It’s best that he’s gone

Raggedy Andy
Took a new bride
Maybe she'll find
More than stuffing inside.


I am happily remarried and have been for sixteen years now.  I do not regret marrying Andy.  I loved him deeply and intended to keep the vows I made.  When we give someone our heart, we give them the opportunity and power to break it.  The only foolproof way to avoid this is to withhold giving our heart.  I considered it for a short time.  It took meeting someone whose heart went through more breaking and aching than mine to open me to take that risk again.



Sunday, June 15, 2014

Blessed Disillusionment

No silver spoon, no picket fence.
A humble home; it just made sense.
To have and to hold. they pledged one day.
For better or worse, they both would stay.

A mom and dad; two kids (no dogs) 
Dad worked hard, had two jobs.
Mom kept house; worked part-time
Clipped coupons; watched every   dime.

School, chores; homework too; then we'd play outside.
Extracurricular activities; the mall, if we could get a ride.

Mom and Dad hardly ever fought but surely they had their woes. 
If they had a lot of stress, they fooled me, I didn't know.

Never expected a lot of things like big vacations and fancy stuff. 
Did just fine with what we had
Enough was just enough.

Life would surely have struggles and problems, of this I was well aware.
But the ones I had when I flew solo, for them I was not prepared.
I thought I'd have what my parents had, of this I wrongly believed.
I thought vows were unbreakable, on this I was deceived.

From that moment when my wedded groom picked up and walked away.
I learned that every man was not my dad, some men just do not stay.
Life would not go as I had planned; this lesson hit real hard.
Maybe I just trust too much; must be on my guard.

I went forward from this heartbreak to never be the same. 
I decided somewhere along the way no point in assigning blame.

The illusion of life like I had known, now broken and shattered and burned.
The life that I was going to have would be built on all that I had learned.

What did I learn? Well you know what.  Just ask Gilda and Lennon fans.
Life means not knowing and about what's happening while you're making other plans.

So faith in God and those I love and finding joy wherever I can. 
Doing my best, showing His Love and leaving the details in His Hands.

Try not to sweat the small stuff 
Expect what can't be planned.
Pain will still be painful
But joy will be more grand.


Sunday, June 8, 2014

The Middle

       The middle.  For me, thinking about it or feeling to be in it have largely become commonplace.  In my job as a professional mental health counselor, I often attempt to help guide people from less functional and more problematic extremes (e.g. aggression or passivity in communication) to healthier, more adaptable attitudes and behaviors somewhere closer to the middle between those two extremes (e.g. assertiveness).  In my personal life, however, the concept of "the middle" is, and has been, much more complex and elusive.  On the one hand, the middle is good, adequate or at least preferable to the alternatives.  For example, being in the middle class, somewhere in the median American family income means we are not homeless and do not go hungry.  Having more might be nice, but the middle is more than sufficient.  In other situations, however, being in the middle is quite undesirable.  Whether it is being in the middle of two warring family members or trying to make a decision between two equally disagreeable options, some middles are uncomfortable and even downright painful.
       I often feel that I am attempting to escape a middle where, by involuntary inclusion, I feel stuck.  Or, that I am hanging in the balance in a limbo-like state of "maybe, maybe not" or "wait"  I am referring here not so much to typical, natural  transitions (e.g. kids moving out, aging parents) or the state we often find ourselves in when we are attempting to make a change in our life (e.g. getting married, apply for a new job).  Those are tough and stressful enough, indeed.  The events and circumstances I am speaking of here, nevertheless, are ones which are not by our own creation and, without a doubt, not expected.  They keep me landing in this wearisome middle when a definitive "yea" or a "nay" would be preferable.  There is a unique agony in limbo.  What starts out as a potent sense of hanging on for dear life hoping for the desired outcome gradually, insidiously morphs into the need to know born out of desperation and often, exhaustion.  A point comes when the loathsome final blow is preferred to ongoing, seemingly never ending  indefinite suspension.  Relentless hope turns to weary surrender.  The relief can come as a surprise, such as when I finally accepted that my brief marriage to my ex-husband, my college sweetheart of nearly ten years, was truly over.  The simultaneous experience of devastation and relief.  An end and a beginning.  It is nearly impossible to explain. 
       I didn't really start consciously thinking in terms of 'the middle' until my now dear husband of 16 years, Scott, labeled our seemingly frequent unwelcome, emotionally draining and usually painful circumstances as such. The "almost but not quites", the "maybes but not yets" and the "hurry up and waits".  "Once again, we are in the middle", he would say.  This is especially bothersome and heartbreaking when a potential blessing we weren't even seeking gets dangled in front of us, like the proverbial carrot, only to seemingly be snagged away just as we go to excitedly reach for the unexpected treat. A tease of sorts. 
       A spirit of gratitude does help.  My family and I, husband Scott and 13-year old daughter Mandy, are committed Christians.  I believe in a loving God who has His Hand on me and is aware of my sufferings.  He allows them and sustains me.  I trust Him.  Still, as a therapist, I am not inclined to spiritualize away the reality of my difficulties and subsequent feelings.   Many a frustrated Christian has sought out counseling simply because platitudes and bible passages were not what they needed.  Although true and ultimately helpful, what they needed was someone to acknowledge their pain and be able to sit with them in it.  
     So, I praise and thank God for all of the mercy, grace and favor he has granted me.  As for my own challenges, losses and disappointments, in addition to loving support and time spent periodically seeing my own therapist, one thing that really helps me is writing.  Sometimes I write about what took place as the situation unfolded but I more often write in other forms, such as a poem, or in a third person narration.  I enjoy writing and have found it not only assists in my grieving, healing or decision-making process, it also frequently cues me to important details I might not otherwise be aware.  For instance, when I have significant difficulty writing regarding something I truly want to write about, it usually means there is something crucial getting in the way, unforgiveness, unspoken words, misunderstanding or that it is either too soon to write or that I need to approach it from a different angle.  On the flip side of that, sometimes the words pour out of me, the rhymes flow easily and I feel tremendous peace at the end.  This usually indicates to me a sense of closure.  Any work that was needed is likely done  and I have found peace and acceptance with the situation. This is a marvelous and liberating feeling. This happened when I wrote a poem about the rise, life and demise of my first marriage.  It was a surprise and really moved me along in my healing process. 
     The middle.  The uncomfortable, uncertain, sometimes grievous, sometimes disappointing, always annoying middle.  Regarding our legally-blind, vision-impaired daughter, it's that she's not blind enough to be blind, but not sighted enough to be sighted.  She is not impaired enough to get treatment, not well enough to not need it.  Two lost pregnancies meant being pregnant enough to have created new human beings, not pregnant enough to meet those human beings.  The upcoming posts are poems, stories, thoughts and humor from the vantage point of life in the middle.  My life in the middle. Healing, humor, frustration, loss and faith will all be embraced, These will not necessarily be shared in a chronological order, or any order at all.  I believe whim and The Holy Spirit will be my guide. 
    These are my experiences.  Moments.  Weeks.  Sometimes  years, teetering on the brink of the middle.