Lady On Fire and Hot Appendix - an evening at the local Urgent Care

A February Visit to the local Urgent Care

So. Last night I took my 10 year old daughter to the local After Hours Care. After spending 4 hours, on and off, trying to get through to our pediatrician all day, and receiving nothing but busy signals, or the outgoing "do not leave a message" announcement over lunch hour, my kid and her sore throat demanded a trip to the local Health Emporium for America's Healthcare Rejects. This is where people go who a) cannot afford to take off work to go to the doctor, b) have no doctor and rely on clinics and urgent cares, c) have state-funded medical as opposed to purchased health insurance, and d) people like me...moms who have a kid who is sick and just can't wait another day to try to get her into her overworked pediatrician.

We walk into a packed waiting room. Somewhere between 20 and 30 people, many of them miserable, sit in a large circle where they are forced to either stare at their phones, stare at each other, or try to wrangle tired, cranky, often sick children and convince them that they really DO want to sit still.

After waiting 5 minutes for an overworked nurse to appear at the little window and check me in and inform me it was a 2.5 to 3 hour wait, I quickly discover there was nowhere to sit. A kind family had 2 of their school age daughters share a chair so that I would have somewhere to sit. I thanked them and took my seat, and my daughter squatted on the floor next to the coffee table that floated in the middle of the room 5 feet away from the closest chair. (What is that table's purpose? It holds no magazines or books. It's too far away from anything to put a cup of coffee on, or a book....there are no child-sized chairs for the kids to pull up and maybe color....or heaven forbid, work on the homework they are neglecting while they sit for hours and wait to see the one overworked doctor who is on call tonight).

Next to me is the family who kindly provided me with a place to sit. Mom is exhausted looking, trying her best to keep it together while she waits yet another hour to get in to see someone for her abdominal pain and nausea. She assumes she has stomach flu. Her oldest, a10 year old daughter, goes to school with my kid, so they somewhat know each other. The girl is doing her best to help distract her baby brother, about 3 years old and one of THOSE kids - you know the ones. He’s happy in a frantic sort of way; sweet as pie, with a devilish gleam in his eye; bored to TEARS and so ready to DO something, and not afraid to unintelligibly share that with the room at large...and run around the room just out of reach of his traumatized mom in the process. The middle kid seemed almost resigned.

Across the way is the one healthy-looking woman, seemingly the only one there by herself. I can't help wondering at her presence - what could POSSIBLY be bad enough to warrant a trip to this hell-hole? She's well dressed (i.e., not in pajama pants) her hair isn't greasy and matted like she's been subsisting on cold medicine and bed rest for 3 days. She doesn't have a child dripping unidentifiable fluids from every orifice and whining about how BOOOORED they are. When she is the next one called in to see the doctor, I find myself gazing after her with a mixture of jealousy and insane hatred. How DARE she be unfettered and healthy-looking!!!

The manic 3 year old has now discovered my crocheting. Evidently it's Waiting Room Protocol to allow the 3-year-old to paw at my project, yank on my yarn, babble nonsense at me, then run screaming back to his mom after the 200th time she says DYLAN DYLAN GET BACK HERE DYLAN STOP TOUCHING THAT!!!

I guess I'll be washing this baby blanket twice. with disinfectant.

Next to Perfectly Healthy Woman is the Snoring Family: 3 women, all looking approximately alike. The youngest is taking up 2 chairs so that she can sit sideways and keep her iPhone 6 plugged in while she surfs the internet. She’s not the one snoring, but she looks like she might nod off at any time. She's wearing pajama pants. She's not the one who is sick. Grandma is sick. She's snoring.

The 3 year old's aunt and uncle walk in. From forcibly overheard conversations, it's clear Mom has called them to ask them to come help with the kids. I think, YES! They're going to take these poor bored kids away with them, get them some food (they're starving...it's 8 pm by now and they've been here since 5:30), maybe take them home and let them go to sleep. no. they scrunch up together and sit down. They decide to go to their car to see if there are any toys the boy can play with. The mom doesn’t have any toys in her car.

Wait. What? Who has 3 kids, one of them a 3 year old boy, and doesn't have a SINGLE toy in their own car?

The 10 year old offers to go look. She comes back with a ...

toy xylophone.

CLANG CLANG BANG CLACK CLANG GIGGLE!!!!

oh. my. god.

The temperature in here is by now approximately that of molten lava. Too many people, most of them running fevers and sniffling, 2 or 3 of us suffering the periodic joy of hot flashes.....

They take the toy away. They find a matchbox car. VROOOOOM

Meanwhile....two other things are happening all this time. In the middle of the room, kneeling at the little table, my daughter is playing Pokemon Go on my cell phone. The 7 or 8 year old son of another family is watching. and helping. He leeeaaannns in closer....she leans a little away. He reeaacchhhes over her shoulder to touch the screen....she scoots over a little more. Every time I look up, she's moved down a little further along the table. Eventually she's gone about 3/4 of a full circuit of the table, and he's still limpeted to her side. She's handling it well, and I don't interfere. If she wanted help she'd ask me. His parents appear to see nothing wrong with this either, since they also do nothing.

But I suspect one reason they say nothing is because the kid's dad is too busy being brain sucked into his own cell phone. He has 2 little girls limpeted to HIS sides, so maybe this is their normal personal space parameter. Who am I to judge? Their mom is....

Ok. Their mom. She is That Woman. The Loud Talker. The Loud Talker On Her Cellphone. In a crowded waiting room. A waiting room with signs plastered everywhere saying "Please turn off your cell phones. Thank You!" She is having a conversation. We are all part of her conversation. I think the doctor in the back is part of her conversation.

She's here because she has a UTI. "A UTI!!! you know, a Urinary Tract Infection! They keep givin' me dose antee-bye-ot-ics and dat jus' gimme a yeast infection.  I keep TELLIN’ dem dey don't work none, but dey keep givin' dem ta me!!! I itch SO BAD! I went ta da circle K up on state? yeah I went ta get me some benadryl? for da Itchin'? - the bottles is too 'spensive so I went ta get me one of dem single packs? yeah! Dey was $4.49!!! I said LLAAWWWDY I ain't payin' dat! so I just gonna itch. It's like a FIRE down dere!! mmm hhmm!!"

shoot. me. now.

THE NURSE COMES OUT AND SAYS A NAME!! YAY!!! there's a visable stir!! it's Mom to Manic 3 yr old!! She heads back.

The lady On Fire is now discussing That Time With The Bed Bugs.

Demon Boy is now bored, and no longer happy. He's mad. He wants to GO!!!

The lady On Fire is now googling silver fish "cuz you 'member dat time dey sayz we gots silverfish?? what ARE silverfish anyway? I'm'a gonna google it. hang on. oh. OH MAH GAWD DEY IS NAAASTY!!! GROSSS!! WHY I DO DAT TO MAHSELF!!"

Lady On Fire's battery is dying. "i gots 2%!!" phone dies. blessed. wonderful. silence.

Then she starts talking to her kids. <sigh> OH HALLELUIA SHE'S CALLED IN NEXT!!!

silence. oh, except for the 20 other people sniffling, coughing, wheezing, and Antiques Roadshow on the television.

The nurse is back at the door asking for the family of the Mom to the Demon Boy. They take the aunt back.

Hmm....this doesn't look good.

A few minutes later the aunt comes back. Enforced intimacy of proximity - tells her husband to go out to the sister's car and get the car seat and move it to their car. Don’t know where the keys are. Why do we have to do this? What are we gonna do with him? What about the girls? And, right there, in front of the 3 year old demon child (not paying attention) and 7-year old not-quite-there girl, and 10-year-old way too grown up girl...she says "they're calling an ambulance to take her to the hospital. they think her appendix is about to burst."

The two little girls are staring at her in horror. The aunt is paying NO attention. She's arguing with her husband about car seats, and trips to school, and the kids' dad who refuses to come get them cuz they're HER kids to deal with, and work schedules, and a broken down car, and I can't miss work....and the two little girls start silently crying.  No one says "it's going to be ok. your mom is sick, but they know just what to do, and they're going to make her better."  They say, abruptly, "your mom's going to be fine." and go back to arguing.

My daughter is looking over at them, with pain on her face. She doesn't know what to say or do.

I finally tapped the middle daughter on the shoulder and motioned her over.

"Do you know what an appendix is?" says I.

Shakes her head. Looks at me only glancingly.

"It's this little piece of organ, right here in your belly" <I touch her lightly on the abdomen with one fingertip>. "Our body doesn't use it for anything, and sometimes it gets angry and makes us sick. but the doctors know how to take care of it. They will take her to the hospital and give her special medicine. Then they will probably have to give her a very simple operation. After it's all done, she will have this wicked cool little scar right about here" <touch her lightly again on her abdomen> "that she can show off."

out of the corner of my eye I can see her sister, sitting on her uncle's lap, sitting straight-backed and silent. I can tell she's listening too.

"Don't worry. It's very easy to fix. Your mom will be all right. ok?"

she nodded at me again, and walked back to her sister and leaned in to her. They whispered back and forth to each other for a few minutes, and then they both calmed down.

Eventually we got to see the doctor. we were the next to last people in the waiting room, at 10:00pm.

I hope the lady with the hot appendix is ok. I hope her daughters are ok. I hope everyone is ok. even the Lady On Fire.

The Owl

Written on June 9, 2002

In the end of August 2000, I had just returned from a disastrous field season at our archaeological dig in Turkey.  I’d been forced to leave in disgrace due to a long sequence of stupid mistakes on my part, and on the part of others around me.  Although the following year I was brought back and completely forgiven, at that moment I was devastated, fearing the reputation I had built in the field had been destroyed.

I returned to my home in downtown Buffalo, the two bedroom apartment I’d lived in for more than 3 years.  I returned to my landscaping job, and the strength-leeching, pointless relationship I’d been trying to wrench my way out of for months.  Although I’d kick him out some months before, I was still tied to him, and it was me he called when he was in trouble.  And I went.  He still had a key to my apartment, and he would come and turn up in my living room in the middle of the night when he’d been out all night on a binge. 

I wanted out.  Out of the relationship, out of that apartment, out of the city.  Within a week I had found a new apartment (the first I looked at) and discussed moving immediately with my landlord. 

The first of September I moved from my roomy downtown apartment to a small 2-bedroom apartment over a 2-car garage.  The place was perfect – still within the confines of the urban area, but surrounded by woods, with lots of space and lots of quiet.  A garage in which my car could huddle during the blasts of Buffalo snow, and a yard.

A yard.  Trees.  And the place to put in a garden of my own.  It had been a burning desire for me for some time.  I’d taken stabs at growing things at the apartment – some bulbs in the beds in the courtyard.  These were promptly killed the following spring when my landlord decided to put in a rock garden.  Some window-boxes on the roof-top terrace, with geraniums and wave petunias, vinca vines, impatiens….whatever I thought might look good.  They thrived, but I was gone during the height of the summer and had to leave others to tend them, to enjoy them. 

I settled in quickly to the new place, although my finances were severely strained.  The next few months were in some ways a nightmare, in some ways beautiful.  I started my gardens, planted out more than 200 bulbs, many of them gifts from my mom’s gardens.  And I sat back to await spring.

In October I finally broke away from the pointless relationship, with a sudden realization that I just didn’t want to be in it anymore. 

I spent a financially strapped winter, teaching a High School Latin class part time, working for a local company as a consultant, and awaiting spring – my garden, landscaping, a new start.

I changed phone numbers 3 times.   The ex kept calling, kept managing to get my number, kept showing up at my door.  Then, on New Year’s Day, he called me and threatened.  I’d never felt he was an actual physical threat before.  For the first time, he scared me.

Throughout it all, I reveled in my new home.  It was small and cramped, but it was away from the constant sirens, the revving engines, the motorcycles screaming down Delaware Ave., the thump-thump of a pimped-out car’s stereo.  I fell further and further behind in the rent, the utility companies threatened to turn off the heat and electric. I would lie in bed at night, waiting to fall asleep, dreading the next day of working a teaching job I hated, and listened to an owl outside my window.

Across the driveway from my house is an old willow tree.  In winter it resembled a broken and arthritic body, hunched over the snowy ground, an ancient woman standing guard over my life.  And in its branches, every night as I lie in my bedroom under my grandmother’s feather comforter, the owl would whoo-whoo into the night.

It was such a joy to me.  I’ve always loved owls.  We had a few on the farm when I was young, barn owls that made their nests in the oak rafters of our 100-year old barn.  However, in all that time, I’d never had the simple pleasure of listening to one call out in the night.  In Greece I saw them once in a while, even startled one out of an olive tree one day during survey work.  It flashed over my head with a nearly-silent WHOOSH, and careened off into the heavy air laden with the  drone of the cicadas.

My owl was like clockwork.  Every night, after slogging through grading, writing worksheets, brainstorming new ideas to get my uninspired students involved, and searching for the money to pay the bills, I’d finally crawl into bed disheartened and alone.  I rarely answered the phone, because it very likely was the ex, still bothering me.  And lying there, the owl would call, around 11:30 each night.

Whooo hooo! 

Such a soothing sound.  My mind would clear, and I’d drift off to sleep.  More than once I tried to spy out the bird itself, wanting to see what brought me such simply joy.  I never did, and it was bitterly cold out, so I didn’t go out to find it.  I feared the opening of the door would scare it off, anyway.  I wanted it to stay.

Winter slowly turned, and spring eventually took it’s reluctant hold of the Niagara region.  My garden began to sprout – daffodils, tulips, crocuses.  I was seeing a man named Gus, but that didn’t last long.  Wrong man.  At the end of May, I was fired from the teaching job.    Trumped up charges of fraud allowed the principal who had hated me to force me to resign.  The fact that I actually wanted to teach and hold my students accountable never sat well with him or his coddling relationship with the parents.  Latin is evidently a fluff class, which was news to me.  I continued to struggle with my finances.  Landscaping restarted and I worked that in addition to the consulting job for some weeks until they let me go too.  All the while, my owl continued to wish me goodnight with it’s eerie call.  I lived, I healed, I struggled to redefine myself after a long, trying time.

Then in late spring, perhaps around the first of June, work crews began ripping out all the trees which surrounded the properties where myself and a half dozen other people lived.  Forty years ago the area had been a dump, and our time had come for the superfund to clean up the mess.

Within 2 weeks, all the trees were gone except those immediately on our property.  I was told the pines behind my willow would go soon too, as well as the pole-building behind them.  When I left for Turkey in early July, I could see the bustle and lights of Transit road, a half-mile away over what used to be thick woods.

It ripped me apart.  My quiet haven was being ripped out of the ground. 

I spent my field season in Turkey, worked hard, had an extremely successful season, and returned to a home totally changed. 

My willow remained, but it was the only tree between me and Transit road.  Everything else was barren earth.  The backhoes and bulldozers were still hard at work.  They were digging down up to 40 feet, removing the tainted soil, and trucking in new dirt.  The plan was that nothing could ever be planted there.  Once it was clean, the area would be capped with clay, another layer of soil, and guarded indefinitely to be sure no one tampered with it, and nothing more substantial than low brush would grow. 

And my owl was gone.  I would lie in bed and listen for him, or sit outside at night, straining for some sign he was still there.  I mourned, and got on with rebuilding my life.

I’d gotten a new job, and only worked landscaping while the drug test for the new job was being processed and the paperwork was finalized.  A permanent job, something I’d not committed to before.  Always before I’d avoided permanent positions, because I wanted the freedom to finish my PhD, to travel to Turkey for field work every year.  I realized I had to fix my financial situation before I could do anything else.

I started my new job on September 4, 2001.  On September 10^th I met a man, and shortly thereafter fell in love.  On September 11^th, everyone’s world was shattered by terror.  I lived, I worked, I began to dig my way out of my financial hole. 

By January I was able to start saving money, to pay off old debts.  I loved a good man who wanted to take care of me.  My life felt like it was finally coming under control again.

Then, in mid-march of 2002, I lie in bed one early morning, awake before my alarm, and heard a quiet sound from outside.

Whooo-hooo!

For a split second, my heart stopped.  I lie and waited, hoping I hadn’t mistaken a pre-dawn morning-dove for something else. 

Then it came again…

Whoo hoo!

A grin split my face from ear to ear, and I wanted to get up and dance with joy.  He was back, if only for a moment, and I lie and listen to him until I had to get up for work.  I glided through the morning, happier than I’d remembered being in a long time.

I’ve not heard him since.  I don’t really mind.  I know he’s still around, and I listen for him.  But he’s still alive, still out there stalking the night.  He brought me a small moment of joy when my life was in tatters around me.  I almost felt like he came back to check on me, to see if I was well, and when he saw I was, he felt he could move on.  He is now probably in the woods on the far side of the road, too far away from my house for me to hear him.  There he will find game, and the shadows in which he can hide.

I wish him well.

Having A Type 1 Diabetic Child - The First Year

Photo credit: Rosie Kew/Clique

When your child is diagnosed Type 1 Diabetic, if you’re anything like me, you think you have a pretty decent idea that your life is about to change completely.  I was aware enough of the disease and how it is managed to know that it meant finger-sticks and shots, and to know that my heart was breaking because I knew and she didn’t – she had no idea that I was about to allow her to be poked and prodded and examined and that she would have to keep doing it for the rest. of. her. life.

What you don’t know, and what no one can explain, is how completely it will change in other ways. 

I didn’t know that sleeping through the night would become the exception rather than the rule.  Or that you both love and hate technology, because it has improved so much that it allows your child to live a mostly normal full life…but it is still so new that it fails often, and that little bit of uncertainty is hell on earth.  I didn’t know that I’d be struggling not only with the results of the disease, but with the emotional impact on a child I love.  I didn’t know that some people will scoff at the seriousness of the illness, and will treat my child as if she is overreacting when she’s upset about it, and scoff at my statements of stress and exhaustion. 

I never would have guessed that an appliance that makes delivering insulin so much easier would become hated in a way that no one can imagine unless they’ve relied on it day to day for their very life. 

I wouldn’t have believed it possible that a child’s personality could change so much, so quickly.  Or that the failure of some to empathize and understand could hurt so much. 

I had NO IDEA how much work I would miss.  I am thankful every single day that I co-own my company, so I can’t be punished for missed work. I have no idea how those who hold normal 9 to 5 jobs or otherwise work for others can keep from getting fired:  The routine doctor’s appointments an hour away which require at minimum a half day away from work, and for my child away from school;  Your child's missed days of school due to unexpected illnesses, abdominal pain, complications.; The struggle to figure out what your child has missed, and how to make it up, and realizing that your child no longer cares and is blowing ALL of it off; The meetings with teachers, counselors, social workers;  The missed work due to utter physical and emotional exhaustion when you just can. not. do. It.

Field Trips.  Oh yeah, did I mention field trips?  Unless there is an RN or LPN included in the chaperones…you’re going too.

Birthday parties?  Those too.  You get to go to every single one.  You get incredibly good at googling menu items for their carb content, and eventually create a mental cheat-sheet of routine items that you see over and over again.

You buy a highly accurate scale, and carry it around with you on trips because sometimes it’s just easier to weigh food than estimate otherwise.

You dread trips to certain restaurants, because you KNOW the child will ask for that slushy that contains 140 carbs…and you know you have to say no because it causes her blood sugars to skyrocket and you spend days trying to get her back to normal.

You didn’t know that puberty was your enemy in this battle.  Hormones cause crazy things to happen to blood sugars.  As if the mood swings weren’t bad enough, now you have to contend with sudden fluctuations in highs and lows, in correction rates, in basal requirements.  And they Change. Constantly.

On the up side, you are instantly part of a club - Parents of kids with T1D:  other parents you can contact to commiserate, get suggestions, or just hang out with when you need that break.  You share stories of diagnosis, treatment, favorite foods.  You know these people will understand when you've just had it, and your body and mind are protesting the strain, and you just need to let it out.

Because here's the thing - you have no idea what the stress of being responsible for your child's well-being day by day, hour by hour, will do to you.  You think you know - after all, you are a parent!  You held this tiny infant in your arms, you were 100%, completely, independently responsible for keeping him or her alive through those first few terrifying days, weeks months of life.  You think, "No problem!  I got this!"

And, if you're lucky, you do got it.  You can learn to handle the needles, the blood glucose meter, the calculations of total carbs based on serving size, the conversions of grams to ounces, or vice versa, the correction factor tables, the dosage guides, the difference between basal and bolus, and fast-acting versus long-acting insulin.  What about insulin pumps?  Doctors and other diabetics sing their praises!  So, which one?  is this one better than that?  what do they do?  how do they work?  once you pick one, how do you program it?  how do you convince a scared child that yes, it will hurt, but it will make things SO MUCH BETTER!  what happens when your blood glucose reads HI and it won't allow you to bolus for that?  How do know when the cannula fails and your child isn't receiving ANY insulin when you think they are?  how to do you know when that happens?  What about checking for ketones?  Did your child stick that little test strip into her urine stream to make sure her body isn't building up poisons in her blood stream that can kill her?  If she didn't, how do you get her to understand she HAS to do this?  You want her to stick this WHERE?  EW!  When do you call the doctor?  when is it time to pack up and head to the ER?

Will tonight be the night when you wake up at 2:38am, for no apparent reason, and test her blood sugar...and have it read 12, and you cannot wake the child up.  Will this be the night you have to administer the emergency glucagone shot, and call an ambulance?  

Will this be the day you kill her......

No Problem!  I got this!

and you do...until you don't.  Until the stress and the sleeplessness and the worry finally take their toll, and your body says, no more.  You need rest.  You cannot do this alone.  

<deep. breath>

This is the life of a parent of a T1D child.  We don't want sympathy.  We do want understanding.  We don't want pity, or statements of "oh my heart breaks...that poor girl!"  We want better research.  better funding.  Fewer battles for insurance coverage for the medicines and supplies and equipment that is required to keep their child alive.     we want a cure.

and we want sleep.  uninterrupted, stress-free, sleep.  

On behalf of all of the T1D parents out there, I want to apologize for those times when we just don't have enough left to care about your  topic of interest.  It's not because we don't value you, or your interests, or your well-being.  It's because we only have so much, and sometimes we're just tapped out.  And we hate ourselves for it.  Please don't think I'm joking.  You think...no you KNOW...that you are a failure as a friend, a wife, a lover, a boss...whatever it is.  Because you just don't have anything left.

But you have to find it, because in a few days, hours, minutes, another crisis will appear and you will have to make that judgement call.  You will have to make another decision that directly affects your child's well-being.  You will have to approve having your child restrained in order to get the IV in, give the 10th injection of the day, the 2nd blood draw....

Most of us aren't nurses, or doctors, or otherwise medically trained.  We're just moms and dads.  We were never taught how to do this.  We were never trained in how to make these decisions without investing our whole hearts into the process...to learn to accept that we are human and humans make mistakes, and we are just doing our best...this is our CHILD.  One of those people put on this earth that is our responsibility to keep healthy and whole.  

So, the next time you see that friend, or sister, or acquaintance,  whose kid is T1D....give him or her a hug.  Hold on to her, and say, you got this, but you can let it go just a little right now.  You are human, you are doing an amazing job, and you can just. let. go.  

And hold on for the storm is there, just under the surface, and it just might break over you.  

But that's ok...because, you got this.

Holly