04 March 2011

It may be a looooooong tunnel.

Yesterday, Lim got to use her brain.  She and her math teacher sat down while the rest of the class was at music, and began going over the concepts she has missed.

By both Lim and her teacher's report, the effort lasted about 15 minutes before the lights flickered and died and the teacher called a halt so Lim could put her head down and rest.  He said he may have pushed her too hard (!) and would back off a little bit next time.  I'm not sure how far you can back off from almost-nothing, but bless him for caring enough to try.

She resembled a pale, blond space cadet with deep dark circles under her big blue eyes when I picked her up after school.   She gave me a confusing account of the math and her efforts, and ended by telling me she could try one of the math homework problems IF she felt up to it.  We did try it, and I encountered my first test of my newly installed "poker face system" as our formerly sharp-as-a-tack, quick study, math-whiz daughter struggled mightily to remember/apply basic concepts and focus on one new one.

After 10 minutes of that, the pale blond space cadet turned into a full-blown zombie (aka Zed, aka the british term for zombies, or so my zombie obsessed husband tells me, lol).  She was in bed by 6:15 and asleep by 6:30. 

This is... challenging...


...that's my why, what's yours?

02 March 2011

Proverbial lights and tunnels

So, after 6 weeks of struggling and frustration and complete alteration of our family life and dynamics, we appear to have a plan to progress forward.

Towards what, I really don't know.

Now that the doctors are using words like "adaptation" and "chronic pain" and "retraining" with regard to Lim's ability to become an actively participating member of life, I feel both relief and increased tension.  The former because we actually can start doing something proactive.  The latter because I have no idea how this is going to progress.

Everyone handles pain and challenge differently.  Chronic pain affects demeanor and behavior.  Anyone who has ever had a migraine or any other sort of lasting headache can attest to how disruptive it is to every day concentration, interaction, and enjoyment.

Now have that migraine for months on end, and try to learn math and science and language arts in a noisy classroom with kids who have no idea what you are struggling with and teachers who will do their absolute best to help you but will have to walk a tightrope of pushing enough but not too much.

Never know from moment to moment whether you will be clear headed (relatively speaking) or not.

Be wildly restricted in all your favorite activities because all of your energy needs to go to simply getting through the school day and slowly increasing your actual participation and learning.  Once you do that, add in homework first.  And studying.

THEN, if and when you have anything left over, you can try things you love but that make you feel kind of awful.  Like swimming.  Running.  Reading.  TV.  Music.

And do all that with a positive attitude and without getting frustrated or discouraged, all the while having no idea of when things will get better.  If they do.

And be 11.

Now I, as her Muh THER!! and prime role model, knows all this is coming, and am gearing up as best as I can... (Anyone have any patience pills?  I have a lot at times, but this could tax that supply dramatically)... but it is imperative that I show none of this to her, and just handle it as it comes.  So we, as adults (mostly me, really) will need to ride herd on our OWN frustration and anger/sadness that comes with watching a child struggle and not being able to do a damn thing about it, while simultaneously assuredly bearing the brunt of that child's emotions and struggle.

I'm not sure whether to ask for combat pay or a merit raise.

I am an impatient, want results now, want to know the schedule, want to have control over my life person whose brain spins endlessly over if-then possibilities until it gets answers.  (Sometimes Lim's not the only one with a splitting headache, lol).

But now I need to put a cork in all that and set an example of patience, long term perspective, steady progress towards small goals, and accepting limitations while working to expand them.

I am afraid of letting Lim down.  Of getting impatient.  Of letting my frustration shine through.  Of not being able to walk the fine line of knowing when to push and knowing when to back off and hug.  Of knowing how to offer sympathy and empathy but not coddle.  Of helping Lim take ownership of her progress while still feeling supported and understood.

Maybe being a pillow wasn't the hardest part...?

...that's my why, what's yours?

Touring NE Florida's pediatric neuro specialists...

After struggling to get in to see any sort of specialist we enjoyed a waterfall of appointments this week.  Monday Shands-Jax called to say they could get Lim in to see Dr. Spierre that afternoon (rather than March 21) and we drove to Gainesville for an appointment with UF  Pediatric Neurology yesterday.

I am going to post the summaries I've sent to her teachers and a few friends, rather than recreate the wheel.


    Subject:     Lexi/Mon PM aka "The Plan"
    From:     Sara DiPaolo
    Date:     February 28, 2011 7:09:54 PM EST


Hi --

Today we had an on-very-short notice appointment with UF/Shands Pediatric Neurology rehabilitation specialist Dr. Spierre at 3p.  I am going to keep the UF Gainesville Dept of Neuro appointment, but Dr. Spierre was BY FAR the most useful appointment so far.

As succinctly as I can make it:
We are on the right track with how we are handling her at school.  We should continue to gently seek to expand her presence at and participation in the academics.

More specifically:
1.  No need for neuropsych testing this soon ("all it will show is that she is struggling, which we already know"), so that appt Wed gets changed.
2.  Elavil is fine, but we should add in Tylenol as needed
3. The headache does NOT concern the doctor in so much as it is an annoyance.  Once it crosses over into impairing concentration or is accompanied by dizziness or nausea, cease what she is doing until it subsides.  The doctor said she would only damage her brain more by running into hard objects.  They think.
4. Give her a few more days of being "present" for the entire school day, and then SLOWLY start adding in participation.  I think she was participating some on a very limited and simplistic level in some things today, which seemed to go fine.
5.  The goal is to have her back to full presence AND participation (homework included) with in the next month.  This will probably require both a bit of encouraging Lex to push herself AND knowing when to back off a bit.  You (esteemed teachers) have been around that age child plenty and probably know Lex fairly well; I know her quite well. I trust your judgment and will send feedback if I see anything at home...?
6.  So.... I talked to Lexi and we thought that, if you agree, she'd like to start Thursday to use PE/elec period to try and get up to speed on whatever you want her up to speed on, and start trying to participate in Math especially.  I truly do not think she will (or has) milk things, so hopefully she can provide reliable feedback to help drive the progress.






******

    Subject:     Lexi Tues PM
    From:     Sara DiPaolo
    Date:     March 1, 2011 7:34:54 PM EST

Hi --

We trekked to UF in Gainesville today (withOUT a speeding ticket in Starke, yay me) and met with a pediatric neurologist.   I still think they are making this up as they go...

The good news is, the UF Dr and the Shands Dr from yesterday espoused basically the same philosophy.  The Dr today did a VERY thorough assessment of Lexi physically and cognitively - by far the most thorough yet.  We were in there for close to 90 minutes.  She did some tests that no one has done yet.

She agreed with Dr. Spierre that it is time to start pushing a bit more -- "chronic pain" management and adaptation is how she put it.   She liked the plan we've come up with to reintegrate Lex into functional academia.  She even encouraged Lexi to try some light exercise.  Basically, we seek to expand her tolerance for stimuli.  Something tells me that is going to be just as challenging in its own way as the last 6 weeks have been in theirs.

She believes the headaches "should" end over time.  She also determined that a lot of Lexi's dizziness is associated with altered head position/plane, and we have some actual rehab exercises to start doing for that.  Something about the impact really freaking out the hairs in the ear that contribute to equilibrium (layman's description, lol) and needing to calm them down and retrain them not to spaz out every time she tilts her head. 

This SHOULD conclude our doctor's appointments until after spring break. 

*****

and, my email recommendation to EHS:

    Subject:     Thoughts
    From:     Sara DiPaolo
    Date:     March 1, 2011 7:57:29 PM EST


Hi --

Please feel free to delete this or share it with whomever :-)

I think that there are some things we did right:

I would definitely do the CT scan early, as we did. 
I also would definitely do the lock down for the first two weeks (or until symptoms cleared, whichever came first). 
I think the slow but steady re-integration to being physically present at school is perfect, as is the re-introduction of participation and concentration.

and some things I would do differently:
I would seek to schedule a Pedia Neuro consult immediately and have it set for the end of the second week post-concussion (or beginning of third).  That way, if symptoms resolve, go directly to the re-integration.  If they don't, go to the specialist without a 6 week delay.
I would look into the Elavil and stay on it consistently if headache etc persists past two weeks.
I would also do an MRI towards the end of the 2nd week of symptoms to rule out bleeding or visible brain damage.

I think that we may have been conservative a week or two longer than necessary (because that was what was being drilled into my head by the regular doctors), which is fine, but if we could have avoided two extra weeks of frustration and solitude... 

My overall impression is, be very conservative initially, but at some point the focus turns from healing to rehabilitation and adaptation.  The pedia neuros seem to be best suited to make that decision.  So, I highly recommend obtaining a referral to Shands Gainesville, as they got us in quite quickly compared to the logjam that is Jacksonville's limited pediatric specialists.

For whatever it is worth.


...that's my why, what's yours?

18 February 2011

Everything you never EVER wanted to know about Post-Concussion Syndrome

A lot of people have asked me what the prognosis is for Lim, and what can be done or tested or prescribed etc.  So, I thought I'd put together some of the research I've done on PCS for anyone who is interested.

A few points of note:

1.  Post Concussion Syndrome is a collection of symptoms experienced by SOME people who suffer a concussion.  Not everyone experiences them and what symptoms and how badly people experience them varies from person to person and concussion to concussion.

2.  There is NO proven correlation between severity of initial impact (or the TBI:  Traumatic Brain Injury) and the extent or duration of PCS.

3.  Symptoms of PCS can last for days or months after the initial TBI.

4.  Experts now tend to classify concussions as "simple" or "complex" (the latter meaning symptoms last longer than 10 days).

5.  There is some evidence that people can be genetically predisposed to PCS symptoms.

6. Experts differ on whether PCS is caused by damage to the actual brain, a disruption of neurotransmitters, or whatever it is that causes depression/PTSD etc.  So, one path of "treatment" is to put victims on Elavil or some similar antidepressant for a time.

7.  PCS does not follow a timetable, and it does not trend linearly.  That is, improvement does not tend to be consistent or predictable.  One day may be somewhat better than the last and the next may be worse.  Symptoms can disappear and reappear.  Lim's headache appears to ebb and flow like the tide depending on the amount of stimuli around her and the time of day.

So, what do we know about Lim so far:

1.  She did not black out on impact, but she was immediately dizzy and headachey.

2.  Her CT scan, done two days after the impact, was normal.  Her MRI, done almost 4 weeks after impact, was normal.  So, not visible damage to her brain has occurred.

3.  She has no neck or back pain, ear pain, loss of strength in appendages, or vision issues.

4.  Cognitively she is fairly sharp (counting backwards from 100 by 7s out loud and some other simple tests the Mayo Dr. performed last week) and she has been very inquisitive and communicative.

5. She cannot read without the headache spiking.  She cannot watch TV.  She cannot listen to music for long without the headache spiking.  Artificial lights cause the headache to spike.  Loud voices do the same.

6.  Once the headache spikes, it takes a couple of hours of quiet rest to return to baseline.  At no point has she been headache free since the impact.

7. Her appetite is hit or miss and has been since the impact.

8.  Her sleep is very disrupted.  She is exhausted but she cannot sleep much during the day.

9. Sometimes Lexi is there.  Sometimes Lexi is not.  It is scary and frustrating when she is not.

10.  We have another appointment with Mayo on Tuesday.  Right now we have an appointment with UF Shands on neuro on March 21.  Nemours won't see her until she has had symptoms for TWO months, aka March 22.

11.  I am working on getting Mayo to set up a consult somewhere else, sooner.  Getting such a creature is very difficult, especially from Clearwater in the middle of a swim meet on a holiday weekend.

12. Lim has now missed 4 weeks of school.  She went for a total of TWO classes last week.  It did not go well and she actually seems worse than at the beginning of the week.  This could be because I am weaning her off the Elavil.

13. Our days consist of:

Lim wakes up in a fog.  I make her hot cocoa and maybe some french toast. 

We snuggle on the bed for a bit. 

She takes a bath and I try to work out or do chores. 

She lays down on the bed.  I join her. 

At some point we go get a smoothie and maybe sit outside taking pictures or throwing the ball for the dogs. 

We lay on the bed. 

I run to EHS and meet Bim after school for an hour to chat and give her her swim stuff.

I go back home and either snuggle on the bed with Lim or sit outside, depending on how she is feeling. 

M picks up Bim and everyone but Lim eats dinner (Lim usually has no appetite at that point). 

Lim and I go upstairs and snuggle while she starts to fall asleep, and Bim does homework while Matthew does chores.

I leave Lim half or all the way asleep and spend an hour with Bim before she goes to bed. 

Insert doctor's appointments as needed.  On days she tries school, I drop her off and park in the lot and either run or read for the 45 mins she is actually in class.  If she gets to stay any longer I will probably be parked there as well until she demos she can handle a predictable chunk of time.

Occasionally M comes home early and I stay at EHS and run and watch Bim's practice.

Who wishes they were walking in my shoes NOW...?

Here are a few links to info I have found, if you want to read up on it for yourself:

http://www.mayoclinic.com/health/post-concussion-syndrome/DS01020

http://www.training-conditioning.com/2010/08/30/what_happens_next/index.php

http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2011/01/29/multiple-concussions-raise-teen-athletes-health-risks

http://www.examiner.com/sports-in-boston/marc-savard-still-suffering-from-post-concussion-syndrome

Recent interview with Sidney Crosby:

http://www.youtube.com/watch?v=Z3G__Z0WdKM

...that's my why, what's yours?

16 February 2011

The Great Oak

Once again I am reminded of how completely blessed the minis are to be able to attend the school that they do...

From the moment I contacted Lim's teachers to let them know of the concussion, EHS has been phenomenal in their response. Whether it was reassuring phone calls from the guidance counselors, frequent emails from her teachers and coaches (notably, NOT her swimming coaches - they've been pretty much out of contact... Instead, I am referring to her track coaches, who had only met her a couple of times before her injury but who have been wonderful in their support), cards and posters from classmates, or the fantastic post-concussion policy the school has in place, EHS has been a bright light in a fairly dingy month for Team DiPaolo.

As Lim and I sat outside her classroom waiting for her class to return from lunch today (we decided to try again but wait until after lunch, when most of her academic classes were today), we wandered over to the Great Oak that is the centerpiece of the campus. The word "enormous" does not do this tree justice. Stately. Imposing. Aged. Peaceful. Elegant. Stunning. You name it, it IS it.

Lim and I stood looking at the tree and down towards the area where the middle school kids would emerge from lunch. Lim described the post-lunch habits of the average middle schooler. Upper school kids walked past occasionally. The campus resonated with an amazing tranquility, broken only by drifting sounds from the road and the occasional young voice. Squirrels (always squirrels in our world, huh) scampered around fearlessly. We strolled over to check out the newly opened classroom building, replete with a center common area full of flowers and worthy of a college campus.

And once again I thought to myself "self, your children are beyond blessed to be able to attend a school like this on a campus like this...". And all of my "selves" nodded in unison (an unusual occurrence, believe me) in agreement.

Having attended a college planning meeting earlier today for EIGHTH GRADE parents, where they presented us with handouts detailing various academic tracks and the typical school that following that track might lead you to... As well as providing copies of actual transcripts of current students to provide talking points on the various types of course progressions students can follow and how they appear to college admissions counselors... I continue to be amazed at the advantages attending a school like this provide.

As the kids and teachers wandered back to the 6th grade area after lunch, Lim saw one of her track coaches (remember, this injury happened exactly four days into track season) who seemed genuinely excited to see her and took the time to stop and talk to her and offer words of encouragement and support. Each teacher and student greeted her happily. Lim visibly brightened, although I could tell she was already feeling woozier after only a short time on campus.

I've heard people scoff at the price of private school, and question whether the value received is worth the expense...every family makes it's own decisions based on it's own priorities and resources. All I know is, I can't imagine what a nightmare life would be like right now if we had to deal with a public school and all of it's inflexibility, red tape, and anonymity.

In the event that the biofather decides to retaliate against the girls by declining to pay their tuition, M and I will do whatever it takes to ensure the girls finish their high school careers at EHS. As M likes to say, we both grew up poor and we are NOT afraid to go be poor again, lol. Walmart greeters as a retirement plan, here we come.

I'm not sure words can ever express how grateful we have been for the support and understanding coming from the EHS comnunity, or how grateful I am that the minis have the opportunity to attend a school like this....

Lim has now joined me in the truck (my new home away from home will be the teacher's parking lot at EHS until Lim shows she can make it through more than a period at a time) and is resting with her eyes closed while her classmates attend PE. In 20mins or so she will go back in and try to make it through another academic period, although her headache spiked substantially during just one class period. Tomorrow she gets an MRI at noon, and hopefully we will be in to see a neuro doctor at UF Shands soon as well.

Baby steps down a long long road. I wish the Great Oak could talk. Maybe he could impart some patience and wisdom and instill some of his peaceful strength in Lim (and me...). I know that this whole experience is likely to make Lim a VERY centered and mentally strong and resilient person, and it has probably forced me to learn, or at least temporarily accept, a thing or two too... But I still wish the Oak could talk.

...that's my why, what's yours?

15 February 2011

Tick tock tick tock...

Week four.  Lim went to school this morning and made it through homeroom before her headache spiked dramatically.  She toughed it out another half hour or so before we came home.

This scares me.

There, I said it.  I don't understand why she has gotten better to this point and stopped.  Why she can't read.  Why she can't handle noise or lights very well.  Why she seems stuck in this awful limbo.  Nemours childrens' hospital neurologists won't even SEE her until she has had symptoms for TWO MONTHS.  The Mayo doctor we've been dealing with is out of town until Friday.  *I* am out of town Friday.  He's booked Monday (a day off of school, thankfully) so we are going Tuesday at 7a.  (And, I just scheduled an appointment for tomorrow morning with her regular Mayo doctor, if only to reassure me that there isn't something else we could or should be doing).

But I don't know what he can tell us, other than "it takes time".  I suppose we could kick back up the dosage on the Elavil (and I may try that on my own anyway) but that creates some potential issues on the back end when we wean her off of it.

I've been reading about the injury suffered by the Penguins phenom, Sidney Crosby.  He has now missed 15+ games off of a mild concussion from being clocked in the same exact spot as Lim took her hit.  There is no timetable for his return, but there IS a lot of discussion about his toughness, and whether he is justified in waiting to come back.  After all, he IS the leading scorer on his team, so isn't he letting his teammates down by not coming back and risking his entire future?  (insert rolling eyes here).

------------------

Writus interuptus, first cousin to trainus interuptus... It is now Tuesday afternoon. Lim awoke feeling a bit worse today, and off we went to Mayo. Our regular Mayo doctor wants to set an MRI and get a neuropsychology/neurology consult for her, either with Mayo or at Nemours. Lim spent much of today dozing on the bed with the mutts.

Back to Sidney Crosby and the NHL. In researching what happened to him I also found a number of other players who have been flattened by PCS, both this year and in the past. I've read of the possible predisposition to more severe symptoms and of its possible relationship to PTSD and depression (hence the dosage of Elavil Lim is on right now), and I've seen that there is no timetable... and that some people continue having symptoms for years after their last concussion.  In other words, Lim has good company.

None of this eases the concern and frustration I feel for Lim. She is now coming up on an entire month out of school. Her flag football playing days are over.   So too her soccer playing days, brief as they were and talented as she appeared to be.   Some glitch in her system led to this complex reaction to the original brain trauma and we have no interest in experimenting with future impacts and repercussions (reconcussions?).  She is on the verge of missing her first high school track season, which had started off so promising.  Lord only knows when she might be able to handle the exertion and flip turns of a swim practice...

At this point I'd just be ecstatic for her to be able to read again comfortably.

This entire trip has been a very lonely journey for both Lim and me. Matthew and Bim have been helpful and flexible and supportive (Matthew a bit more so, of course) in spite of the serious disruption to the family routine.  Bim has done her best to understand why things are different and to not be too resentful, but it is still difficult on her.  The radio and tv are generally off and Bim has to keep a good governor on her normal boisterous exuberance, as loud noises still greatly bother Lim's head.   My attention has been divided differently, and, even though Matthew and I have worked together in a concerted effort to get me some time with Bim and him some with Lim, she has definitely gotten the short end of the stick.

But, in the end, Lim and I have been united in our isolation. While Lim expresses her feelings pretty clearly to me (sometimes in conversational form and sometimes in the form of "Mom taking the brunt of the 11yo frustration storm"), I'm actually struggling to find a way to express mine - time and opportunity are in short supply, and writing is hit or miss as well.   When I actually get 5 minutes in a car by myself I debate whether to call a human or crank up the music I seldom hear anymore.  Working out feels more like disloyalty to Lim than an outlet.  Besides, I'm not even sure I can describe what I feel anyway.

The gamut of emotions this past month encompasses empathy for Lim's own feelings and a witches brew of my own. The crazily full calendar we look forward to every spring and summer is starting to loom large on the horizon, and all the events we anticipated are now clouded with question marks. And when those question marks will be answered is ALSO a question mark... And, as anyone who knows me knows, I hate unknowns. The blinking question mark exists even within the 24hours of any given day, as whether Lim can go to school, when she goes, and how long she stays is all TBD on a rapidly changing basis.

As with anything, Lim and I do much better when we take the future in hourly or daily increments and refrain from looking too much at the big picture. Doing that helps diffuse the impact of how quickly time is racing by, and how much she is missing out on right now (and for the foreseeable future). It helps us avoid dealing with questions no one can answer, like, when will she be able to read again, when will she be pain free, when will she be able to actually last through a day of school, when will she be able to start actually participating in school, when will she be able to get caught up academically, when will she be able to swim or run or watch tv or listen to music....

And what if the answer is.... Never?

Now THAT is scary.

 ...that's my why, what's yours?

31 January 2011

Things I've learned during my life as a pillow

As you may know, I've spent the better part of the past 8 days channeling my inner vampire (irrational fear of sunlight) while doing a spot-on imitation of a pillow pet (let's call it a "pillow-mom" - it's a pillow, it's a mom, it's a pillow-mom!) for human and canine alike.





So, given the sheer quantity if time spent in reflective silence, I've learned a few things about myself and the world. For what it is worth, in no particular order:

1. Snuggling with a quietly weeping 11yo and knowing you cannot make it better is a sickeningly frustrating feeling.

2. Seeing my daughter smile and giggle for the first time in a week makes me cry.

3. Apparently the reason I became an ironman athlete was to prepare me mentally for 8 days (and counting) of silent immobility.

4. German Shepherds make wonderful nurses EXCEPT when the doorbell rings or the dog next door comes outside, at which point they return to being completely brainless and clutzy.




5. Head injuries follow no timeline for recovery, which means uber-planners like me are immediately forced to find some inner-equilibrium and flexibility we didn't know we possessed.

6. The simple kindness of people both friend and acquaintance can brighten the day dramatically, even when that person has no idea she/he has done so. Unexpected kindness is a powerful thing that takes minimal effort.

7. Spending the majority of their time at our house has worked miracles for the minis' relationship with each other, and Bim has really stepped up since Lim's injury.

7a. Seeing Bim hug Lim and tell her "I love you" without prompting makes me cry.

7b. Seeing Lim's big smile after 7a makes me cry harder.

8. When the doctors say kids with PCS can have wildly vivid dreams, they are not kidding. Apparently Bim and I were shot in the head and a kitten drowned in the first two nights, and each morning we play that "want to hear about my dream last night" game.

9. Lim has an amazing mind, and the best part of this whole thing has been getting to observe its' fascinating workings. I will never understand why people don't really talk with their children; few things entrance me like glimpsing the development of my kids' personalities and thought processes.

10. Squirrels are hilarious. No wonder dogs sit and watch them all day.

11. When your right shoulder is used extensively as a pillow for a week, it does not particularly enjoy swimming.

12. It is important to fight the guilty feelings and take a few minutes out of each day for myself while serving as universal pillow. It helps make the patient a bit more independent and reinforces my tenuous grasp on sanity.

13. Anger is counter-productive, but we found ourselves struggling mightily with it as we hunkered down with Lim while the biofather galavanted off on a cruise (neglecting to contact me even once in five days to check on Lim).

14. When my daughter does not want anything sweet, she is really not feeling well.

15. I can survive having a completely disrupted and up in the air, fly by the seat of my pants training schedule... But it takes effort and occasionally talking myself down off the cliff and back into perspective-ville.

16. There is something very peaceful about falling asleep with a shepherd draped over my stomach, one smushed up against my legs, and a little blondie smelling sweetly of Angel perfume snuggled into my shoulder.

17. Sara's rule of pillowhood: the odds of your child falling asleep for the first time all day are directly proportionally to the amount of pressure her skull is putting on various nerves in your shoulder.



18. Dog fur should be a food group.

19. There are one heck of a lot of hawks in the preserve behind our house, and they have opinions on EVERYTHING.

20. EHS has the most progressive concussion policy and the most thoughtful teachers and coaches. 20a. Seeing all the cards and posters Lim's teachers had her classmates make for her made me want to hug them all. It also made me cry.

21. For someone who doesn't usually cry unless I am REALLY REALLY angry or completely at wits end, I've teared up a lot this week.

22. It is fascinating seeing the responses of people to what's going on with Lim. Some people have amazed me with their concern; some have stunned me with their indifference.

23. Choosing to lie about going on the cruise and completely ignoring the adversity Lim is dealing with, while still sending glowing messages about how great the cruise is and how the girls should go with him on one soon, may prove to be a nonproductive relationship building tactic. That sound you heard may well have been the final nail in that particular coffin.

24. Even after all this time and all the lies and boneheaded choices, we still have (or had) the capacity to be amazed at the sheer gall. Unfortunately, that gall hurt an already reeling little girl, and. That's. Just. Wrong.

25. While this is not how I would have picked to deliver the lesson, this has provided us with a means of discussing and learning about patience, and long term views.

26. Squirrels turn to stone when hawks are nearby. Even their tails.

27. Just because you are spending your time as a pillow does NOT mean you actually get any rest.

28. After 9 days of lock down, hanging with Lim is like hanging with a mexican jumping bean with a concussion.

29. Eye covers, like the kind you use on airplanes to sleep, are god's gift to pillow moms, because I can at least see out the window and have some light to read by while Lim is in darkness.



30. Telling a child who lives to read that, not only can't she read for herself, but she also can't listen to books on tape, is like telling me I can look at, but not actually eat, chocolate.

That's it for now... back to the dark side we go.

...that's my why, what's yours?

26 January 2011

Expect the unexpected...

After talking myself into, and then back out of, going for IMKY again this year, I spent the better part of last week thinking it through AGAIN, this time from a different perspective.  And, I even had the registration page open and ready to go.

Then Lim and a teammate cracked skulls diving from different directions for an interception on Saturday.  I didn't see the actual hit (as always, I view the game through a camera lens) but I saw her drop the ball and roll onto her back holding her head.  Later I found out his forehead had hit her behind the left ear (he came out of the game in tears as well, but his injury was fine right up until he fell out of his bunkbed that night and split his skull open).

Lim immediately burst into tears, which is not necessarily a signal of mortal wounding with her.  Many a soccer or flag football game has seen her clutch a body part, limping heavily and crying but waving off assistance and sniffling back to the ref that she is fine (calling to mind the Jeff Foxworthy piece where he is talking about the man who chopped off his lower leg and, not wanting to look wimpy to his buddies, hops around on one leg repeating "I'm fine, it's ok, no problems here" etc).

But, when we got her up and she said "Mommy I'm really dizzy" and she KEPT crying, came out of the game, held an ice pack to her head, and kept repeating how awful she felt without any concern for the game itself, I knew we had a problem.

A trip to Mayo ER confirmed a concussion, but the ER doctor seemed to think she should be ok to go to school Monday. 

Then the Post Concussion Syndrome kicked in, and Lim has spent the last three days on the couch, snuggling with her stuffed bear and shepherds.  She can't read, watch TV, look at a computer, look at any moving objects, ride in moving objects, listen to the radio for long, or even play with any toys.  Each makes her dizzy and her head hurt even worse.  (try drying the hair of a child whose head you cannot touch on one side...not an easy task).  She got some appetite back yesterday, which was nice.  Most telling, she is not blinking AT ALL at the idea she might not be allowed to play flag football again.  Ever.



I've read a lot about concussions, but it's always been in the abstract.  Watching the severity of Lim's PCS after a fairly minor concussion (no loss of consciousness, no puking) and knowing there is no blueprint or timetable for recovery has been eye opening, and fairly scary.

Her first concern, of course, was making up school work.  Thank GOD for Episcopal's forward thinking concussion protocol policy.  I contacted her teachers and coaches by email and before the weekend was over the middle school guidance counselor was aware of the situation and each of them had responded kindly and with re-assurance.

Being able to tell Lim that there were procedures in place that would ensure she would not get hammered with make-up work the second she walked back in the door, and actually encouraged caution on the timing of her return to school, helped alleviate some of her stress about "getting behind" and making all of her work up.  Knowing that her coaches and teachers were all on the same page about slowly returning her to the land of the living helped MY anxiety about her anxiety, lol.

While Lim can't read or listen to music, she can, apparently, think.  As I've been sitting on the couch under a pile of Lim, dogs, bears, and blankets, I've been asked to discourse on the brain -- it's structure, function, healing and injury, and role in everything we think, feel and do.  Lim has developed quite an interest in learning about this previously taken for granted part of her existence... so much so that I searched online for a book appropriate for her age that provides a good overview of the brain and neuropsychology.

Lim's comment: "Not that it's good I got a concussion, but at least I know I am interested in learning about the brain now."

Yes, we are a bizarre family.

What does any of this have to do with IM training or deciding to do an IM?  Wellllllllll... part of the analysis I've been going through is whether I am capable, mentally and physically, of doing the juggling, re-routing, altering, skipping of workouts, and complete overhauling sometimes (frequently?!) necessitated by my version of parenting.  Not only CAN I do it, but WILL I do it and will I do it with some degree of pleasantness.

Am I capable of giving myself enough rest days, and permission to back off if necessary, or miss outright.  Am I strong enough to push through the cobwebs of exhaustion or stress.  Can I train properly under these circumstances (properly being -- not "just" to finish this time) and can I do so without being miserable and stressed and dragging everyone down into that hole with me?

Training with a concussed, miserable kid is not easy, at least for me.  It is impossible for me to say "ok, you sit there, alone, in silence, staring into space, while I go for a 10 mile run".  And, I just did not have it in me to get up at 4:45 to swim at 5:15 and get back here in time to make lunches and get Bim off to school and be here when Lim stumbled awake.  So, I've grabbed a bike video here and there, taken an extra day off on Monday when we went to Mayo, and am doing my best to just roll with the tide and not get stressed out about being exhausted and not training the way I had planned to this week. 

Of course, now the girls are not going on the cruise, either, which further throws a monkey wrench into the weeks plans (not that I am complaining).

And Lim's recovery could literally take weeks, or longer, which means the chaotic routine we all know is going to be altered for the foreseeable future.  Fitting training in amongst the normal chaos got challenging at times, so who knows what the next few weeks will be like.

I come from the mindset of "if nothing changes, can you handle it the way it is RIGHT NOW" (this is a good philosophy for relationships too, lol), so my thoughts about this season have to assume that the trainus-interuptus currently in existence represents the new norm.  And, if it does, can I adjust to, adapt, or accept the new norm and still pursue certain goals WITH a somewhat pleasant personality and outlook on life.

If I were just thinking about doing another IM for "fun" or for the experience, the answer would be "yes"... but I am not.  

So, I am going to go sit on the couch, in the silent dark, and talk brains and philosophy with Lim, and maybe get in a workout later.  Or not.  And wait for the answer to come to me (knowing full well that no answer can BE an answer in an of itself).  And be thankful that I can even debate the issue while I wait impatiently and anxiously for the fog to lift from my little one.


...that's my why, what's yours?

17 January 2011

All that glitters...

I've been thinking a lot about happiness, and fulfillment, and personal challenges/obstacles - mine, and people I know.

This topic comes up frequently in one form or another because of the difficult circumstances some friends of mine find themselves in thanks to various factors in their lives - financial, familial, etc.

Many people look at other people's lives and circumstances and think how much happier their own life would be if they had the other person's __________.  In the blank goes some attribute - time, money, job, freedom, etc - that describes something about the other person's ostensible world that makes it more attractive, we think, than our own.

In reality, though, whose life would you REALLY swap for, in toto?  Can you think of anyone?  I couldn't, and that is not because my life is perfect.  It's because my life is MINE, and I've come to realize that, while I wish I could cherry pick characteristics from other lives, I'd never trade in full.

I think there are a number of areas that combine to create our satisfaction and fulfillment in our "world" and that each of us prioritizes them according to our own standards and values.  One way we get into trouble and find ourselves sad, disappointed, unfulfilled etc is when we allow other people's choices and priorities to reflect our own back poorly.   When we don't accept ourselves and our choices, or we regret those choices and the place they've brought us to over time.

The areas I came up with include: family, friends, career, spirituality, interests/passions, finances, health, and spouse/significant other.  These are the things that engender great emotion in most people.

It is easy to look at another person who seems to enjoy success in an area of our own lives where we feel stress or unfulfilled and think that that person "has it easy" or is in an enviable position.... And sometimes they do (the best example I can think of is the person who inherits his money - he didn't have to work for it and he is not in a pressure filled job earning that money.  It just kind of fell into his lap with no effort on his part)... But more often than not, a quick look beneath the surface reveals that whatever you are envying comes with strings you may not want in your life even IF it meant having what you are envying.

Every step of our life, both forward and back, involves a free choice on our own part.  Who to marry.  Whether to unmarry.  Whether to have kids, or adopt kids if unable to have them ourselves.  What job to take.  Whether to look for another job.  What time to delegate to ourselves, to our family, to our work.  What behavior from others to accept or not.  How we react to the events in our world.  What/who to put effort into and what/who to write off.  How hard we work.  What personal goals we set.  What order our priorities fall.  How we raise our kids and how much responsibility we assume for our extended families.  Etc.

Each choice and decision is based on whatever value we assign various things and what we decide the options are worth or will cost.   I think a lot of our personal angst grows from a dislike of the available options and an ensuing unwillingness to make a choice or a change.  Not choosing is still choosing, whether we like it or not.

If you think about what your perfect life would look like, what would it be?  How realistic is it?  Is attaining that perfection within your control or not? My guess is, it is neither realistic NOR within your control. 

Off the top of my head, my perfect life would involve an endless supply of income with little or no effort or time commitment; the time to train full-time, parent full-time, and pursue a career full-time; a close and fulfilling relationship with my husband, my children, my extended family, and some friends; and stellar health for myself and the people I care about.

Of that I actually HAVE the close and fulfilling relationship with my husband and the girls and some wonderful friends.  The rest I either do not have through my own choices or cannot control and thus do not have, or some combo of the two.

So,  life becomes a series of barters and trade-offs and concessions.  It becomes a constant assessment of priorities and endless cost-benefit analyses. And how happy I am depends entirely on whether I have accepted the limitations my choices have created and whether I embrace without regret the priority based choices I make each day.

It is easy to look at a wealthy man and think how easy he has it and how happy we would be in his shoes.  Seldom do we look past that single facet of his life to examine whether we would ever make the choices and assume the same priorities he has made and set to reach the point we envy.  Is his personal life a shambles?  Does he work long hours and travel often?  Are the job pressures even ones we would EVER want to have on our own shoulders?

So too the age old dichotomy of stay-at-home moms and career moms.  Each tends to look with disdain at the other, yet often that disdain is fueled by jealousy and a sense of loss on both side.  Again, we are where we are by choice and we choose where we go from where we are now.

So too athletes of different competitive levels.  The middle of the pack racer looks at the pros and elites with envy.  How wonderful to be able to just focus on training all day and year!   But the average athlete has no idea of the pressure and personal sacrifices and strain experienced by the higher level racer (we all fear injury or illness- imagine if your very livelihood and reputation hinged on the strength and resilience of your body and mind...) Just as the higher level racer probably cannot imagine the lengths to which the rest of the world must go to participate in a demanding sport while juggling jobs, kids, families, and finances.

I could go on (more than I already have, lol) but the point is simple.  The old adage that the grass is always greener remains apropo.    Scoffing at how easy someone else has it or how happy WE'D be in their shoes etc seems merely an escape from dealing with the hard stuff in our own lives - what do I really want, and what am I willing to do to get it or make it happen?  Change comes in small increments, and we can either change our circumstances by making new choices or change how we view our circumstances by finding peace with the choices we've already made and where they have led us.

There is no escaping the fact that life will continue to happen, and the only thing you can truly control is what you choose and how you choose to look at it.  One of the hardest lessons to learn, and one that requires constant vigilance to remember is, it does no good to spend time and emotion regretting the choices you've made that have brought you to where you are -- all you can do is figure out how to get where you want to be FROM where you are, one small step at a time.  This has always been an achilles heel of mine, as I can wallow quite contentedly in self-recrimination and regret.  The sooner one learns not to, the happier one becomes.

I guess the way I try to look at it is, the grass is always greener, but it may be because it's planted in cow sh*t and it rains a lot.  Try fertilizing and mowing your own before you assume jumping that fence will make you happier.

...that's my why, what's yours?

10 January 2011

Music I move to...

A friend of mine suggested I write about some of the music I use for inspiration while working out, and what makes it inspriring.... So, here it goes (you'll notice an angry theme running through a lot of these, lol)


Monsters, Matchbook Romance -- This song originally got me through ten days in the hospital for a stubborn collapsed lung and the ensuing surgery. I jammed out to it while waiting for them to wheel me down to the operating room and again while waiting for my doctor to stop by to take out the chest tube and send me home.

Sound of Madness, Shinedown -- This song taps into my inner bitch who gets REALLY angry at self-styled victims.

Down with the Sickness, Disturbed -- Not only does it have a great beat, but I also "get" the lyrics.... Although the one section makes me cringe and usually gets cut out when I listen to it.

Change, Candlebox-- This is a little mellow in places, but I love the lyrics.

The Catalyst, Linkin Park. -- Just a great beat with simple words.

Bleed it Out, Linkin Park -- The lyrics ("i bleed it out, digging deeper just to throw it away") and the heavy drum beat make this song one I can listen to repeatedly during a bike or run.

Bawitdaba, Kid Rock -- The live version. Just a great "f@@@ you" song, which is my favorite kind to work out to...

Feel Good Drag, Anberlin

Kryptonite, 3 doors down -- "I took a walk around the world to ease my troubled mind..." ... "If I go crazy will you still call me superman..."

Something In Your Mouth, Nickelback. -- I cannot listen to this song without grinning for some reason, and the beat is great to cycle hard to too.

If Today Was Your Last Day, Nickelback -- I've always loved this song, but then they played it right before the pro start at IMFL 70.3 last May, and I love it even more. "My best friend gave me the best advice, he said 'each day's a gift and not a given right', leave no stone unturned, leave your fears behind, and try to take the path less traveled by..."

How Far We've Come, Matchbox Twenty -- "but, I believe the world is burning to the ground"...

Amazing Grace (both versions), Dropkick Murphys -- There is an instrumental version and a version with words. I don't remember which version was on an episode of The Shield, but it was a very intense episode and the music fit the moment perfectly. Ever since the two songs have been on the intense workout playlist.

Paradise City, Guns and Roses -- My all-time favorite part of a song starts at the 4:30 mark or so.... And just great jamming to run or bike to too.

I also have a playlist of what I consider "mood intensifying" music (for lack of a better description) that includes songs such as:

Past the Point of Rescue, Hal Ketchum

Remember the Name, Fort Minor and Styles of Beyond. - "10% luck, 20% skill, 15% concentrated power of will, 5% pleasure, 50% pain and 100% reason to remember the name"


Till I collapse, Eminem -- my Ironman Louisville song

Waiting, Watching, Wishing - Antigone Rising -- a band composed of Bucknellians and a folksy song about getting out.

Wonderful, Everclear -- My childhood, lol. You either get this one, or you don't.

Copperhead Road, Steve Earle -- I actually loved dancing to this "couples dance" song, as long as it wasn't with the asshole I was dating at the time.

Funeral for a Friend/Love Lies Bleeding, Elton John -- My favoritist instrumental part of a song ever.

God love her, Toby Keith -- something about his voice and the beat of this song

Paralyzer, Finger Eleven

Welcone To The Black Parade, My Chemical Romance -- "will you defeat them, the demons, and all the nonbelievers..."


...that's (some of my musical) why... What's yours?

06 January 2011

unfinished business

I've been debating back and forth on the merits of signing up for IM Louisville 2011.  Yes, I know I've said, fairly emphatically, that I want to and should focus on some shorter things this year, and avoid any BIG commitments (such as an IM).  And part of me (my knees, for example) still feels that way.

BUT... I've been dogged by this feeling of unfinished business.  I've done two IM races now... Florida '09 and Louisville '10... I've finished 10th and 7th in my age group, respectively.  I was VERY happy with my Florida performance.  I was disappointed with myself -- both personally and athletically -- at Lou, and that disappointment only grows stronger with time.

Matthew asked if I thought I could go fast on the course at Louisville.  The simple answer is: Yes.  Of course, IM training and racing is never quite that simple, so the more complex answer is:  Yes, IF the IM training and racing Gods sign off on my prep and performance.

Why am I disappointed in myself and at my performance?  Because I don't think I gave myself the best possible chance to do well.  Was that all my own fault?  No, but, ultimately, yes, because I am the one responsible for how I react to things.  Let's examine the evidence:

1.  While definitely in great "shape" I was NOT in great "Ironman shape" (and yes, there is a huge difference). 

My swimming preparation was fine (actually improved over IMFL), and my biking preparation was more than adequate for a flat course... alas, Lousville is NOT a flat course (call it rollers, call it hills, call it whatever you like...it ain't flat) and I did almost zero preparing for a "not flat" course.

And then there was my run prep.  Or lack there-of.  My prep leading up to IMFL was sketchy enough, with my top distance being a couple of 13 milers and my weekly mileage consistently falling in the 15 mile range.  (Go ahead, laugh, I do...)  But, I was at least running consistent, albeit limited, mileage.

My IM Lou prep, on the other hand, was abysmal.  Whether because of the freakishly hot weather, achy knees, or flagging energy levels, I barely ran at all in the month to six weeks prior to the actual race, and I never ran longer than 10 miles in training (I DID do a half Ironman in May, so ran 13.1 there...count that as my top run, a mere 3 months prior to IM Lou).  Whether it was being unprepared or the awful weather, or a combo of the two, I was disappointed in my marathon at IM Lou.

2.  My mental focus was fuzzy.  I've talked about this before, but suffice it to say I was distracted and allowed those distractions to affect my training.

3. My physical energy level was flagging.  Whether from my viral buddy, or low B12 levels, or mental exhaustion, or who knows what, I seriously considered withdrawing on almost a daily basis from June through the race in late August.

So, in my mind, there is quite a bit of room for improvement in my preparation.

Reasons to try and recoup my pride at IM Lou 2011:

1.  A commitment to doing the proper bike training, as much as practicable.  If that means weekly trips to the Palm Valley Bridge to ride 2 hours of BOOOOORRRRRRIIIIIIIIINNNNNNNG bridge repeats, so be it.  If that means hauling the bike trainer around in my truck so I can take advantage of the girls' 2 hour swim practices and/or lengthy swim meets, so be it.  And, if that means getting my butt out on the Baldwin trail more than once or twice to do a 80+ mile ride, so be it.

2. An acknowledgement that, while I can complete a marathon in 100' weather with minimal run training, I have not demonstrated I can complete it at the speed I WANT to do it.  This suggests a higher motivation to run train, even if it is just 15-20 miles a week consistently with one or two 13-15mile runs thrown in for fun.

3. I liked the course.  The bike was challenging, but I loved going through La Grange twice and I have a much clearer idea of what is involved.  The run course was pleasant, and the half-way turn around and finish were phenomenal and VERY motivational.  The swim, while not as fun as IMFL because of the staggered start, is definitely conducive to a fast time for me, and I would line up even closer to the front than I did last year (besides, the sooner I get on the bike and run course the less likely they will run out of water when I am out there, right?).

4. I fully expect my exhusband to create some sort of drama involving the girls during the course of my training (this is also in the "are you NUTS?!" section, below) and knowing it is coming allows me, theoretically, to insulate myself from the disruptive impact.

5. The girls are, currently, spending all but two weekends a month with us.  (This is ALSO in the "nuts?!" section)  This allows a sense of greater freedom on my part, as I don't feel nearly as much pressure to maximize every second with the girls to make up for missing every other week.  So, while I will still endeavor to schedule the majority of my training while they are asleep or at swim practice, I theoretically will be able to periodically disappear for a few hours to finish a long ride, if necessary.

6. The time of year is ok -- barely the beginning of school and HS swim season.

7. The heat favors us Floridians, especially the ones smart enough to stay hydrated and adjust their race plan to acknowledge said heat.

8.  I respond well to goals and challenges, and I use perceived slights and anger as a prime motivator.  I find myself harboring a simmering anger at myself for allowing things to slide during training last year and at certain other people/things for their BS shenanigans that I then allowed to disrupt my training.

9. My husband will support me no matter what I decide, and thinks I can do anything I set my mind to (I can't, but I appreciate the faith).

10. Heather is racing, and I want to go to Louisville ANYWAY to watch, so why not participate?  Misery loves company, right?

11.  I actually LIKE training for Ironman distance.  I can eat a lot, and I like seeing those little muscles over your hip bones that are so hard to get normally.


And then there are the reasons NOT to sign up:

1. Ironman training SUCKs and is very time consuming.  It will require a lot of juggling on my part, primarily because of my pathological refusal to allow it to interfere with my time with the girls and family time.    I will need to find the discipline to get up early and/or break my workouts up according to swim practice times and other activities, and also find the energy and flexibility to adjust my workout schedule on the fly, according to everyone else's schedules.  If I don't have that discipline or buckle from exhaustion, I'll be in the same position as last year.

2. My exhusband is liable to freak out, yet again, if the girls do not resume the schedule he wants (alternating weeks at each house) but which they abhor.  This freak out could involve attorneys and/or court action, which, while insane (does anyone actually think the judge will give him full custody, order the girls to want to go see him more, or throw the girls in jail if they don't want to go to his house for a week at a time!?), would still be expensive, disruptive, and stressful.

3.  The girls are with us all except two weekends a month now.  In the past I have engrossed myself in training to dull the pain of the girls being gone.  Now... see #1, above.

4. Expenses.

5. Concern that the underlying issue causing me to fluctuate from exhausted to ok to, occasionally, energized, will continue or even get worse, thus making the training a death march and causing me to be perpetually energy-less around the girls and Matthew.

6. The ever present worry that my knees will give out once and for all.

7. Logistics -- school is in, swimming has started, it's a 12 hour drive, gotta find a dog sitter...

8.  It would be my 3rd IM in 24 months.  For someone who never thought she'd even do ONE (and who only believes she's actually done two because there is photographic evidence and the medals had to come from SOMEWHERE) that is a lot.

Stay tuned.   :-)

...that's my why, what's yours?