Tag: medically complex

  • Fragility

    Fragility

    Twenty-four years seems too short yet a miracle.

    You were medically fragile but the strongest person I knew.

    Your death was shocking but anticipated.

    You are my son but you are not here.

    I have been looking for answers that may never come. My heart knows healing and alleviation will not be found in the explained. Yet I look.

    I did a deep dive into your deletion yesterday. When the geneticist told me twelve years ago where it was and the genes involved science didn’t know much yet about the specifics of what it meant. “Some proteins” was all they said. Despite advances in DNA mapping, I never did research until the after. I didn’t want to be scared. I didn’t want to mute your life because of that fear and I knew if I knew then I would.

    The simple breakdown is this: you were missing pieces of chromosome 1 which included about 1.8 million base pairs. It is a moderate-sized deletion though classified as micro. Important information was missing imperative for brain and development, body stability and system regulation, immune and infection response, connective tissue and structural support. Within that deletion were 44 known, important genes that have been identified and studied. Ten of those are linked to medical conditions. I dove into the specific genes like ASH1L, SYT11, LAMTOR2 and RNA and how proteins are involved. The information uncovered to me it was a miracle we made it as far as we did, sweet boy.

    I wonder if our DNA is like a symphony. When a deletion occurs, the symphony has missing instruments and incomplete sheet music. Music is still created but other instruments have to play harder and longer to fill in what is missing. Sometimes it doesn’t sound as melodic. Other times it can be quite a cacophony and struggle. Musicians have to improvise and can clash. The stress causes strings to break from the violin playing longer than intended. The cellist fingers begin to hurt. Everyone is playing furiously to compensate for the missing instruments all the while not having all the notes or how long to hold them. It is exhausting and discombobulating to the musicians but it is still music. The process is more exhausting than if they had the complete symphony and all the sheet music. After having to perform that way daily for years, twenty-four of them, and under stress the missing pieces become critical. Daily compensation leads to a tipping point unpredictable and unpreventable until one day the music stops.

    But while the music played it was beautiful nonetheless. From this audience of one I never heard the missing notes or instruments. I just heard your laugh and screams of excitement. I will forever miss the sounds.

    Your body was working harder every single day for twenty-four years than I realized just to make it through the day. Without those important pieces I can’t imagine how much it took just to stay steady. Other genes and systems could compensate for a while. You, my sweet boy, were the king of fortitude and that carried you. That carried us.

    I also saw in the research how over time those systems of compensation become compromised. Hypotonia often becomes worse. GERD and aspiration risk increases. Reserve becomes reduced. Chronic compensation leads to systems becoming fatigued and forces a body to respond more slowly and become overwhelmed more quickly. Everything that can go wrong becomes more likely. And it did.

    Your biology was vulnerable and it was also resilient. Both are true. You died young but lived long. Both are also true. You were fragile but strong. I have to find space to accept those seeming paradoxes.

    Last night I fell asleep wondering if I was in denial about your medical complexity. In reality, my heart and my brain didn’t hold you as medically fragile or high risk or complex. They held and will always hold you as my son who loved pudding and laughing and hugs and music. I normalized what we lived with and we adapted to risks. Others would often say, “I don’t know how you do it,” and that would perplex me. I just did what needed to be done to give you the best life possible. I hope I did, sweet boy.

    High risk was my normal. Fragile stability became baseline. Not living that way would have taken something significant from both of us and replaced our joy with fear. For that I am grateful.

    We lived inside a reality that unfolded slowly, silently, and insidiously until it didn’t. You were labeled medically complex and I did my best to protect your life from being reduced to that. We danced. We shopped. We went to concerts. We hugged strangers. We ate pudding. We swam. We loved and lived without intense fear.

    After you got sick three and a half years ago they told me you wouldn’t make it. Yet you did. Each night after I would kiss you goodnight. I would tell you how you are my whole world and thanked you for fighting so hard to stay with me. I didn’t know, sweet boy, how hard that fight was every day.

    This time when you got sick and we knew the end was near I asked everyone to leave the room. I needed a few moments alone with you. I told you how much I loved you and how proud I was to be your mom. I thanked you for fighting so hard but if it was time to go I would be all right. You didn’t need to fight anymore. I didn’t want you to feel like you somehow failed. I told you how your Dad and Grandpa would be waiting and you would get to meet Jesus. I hoped He would tell you He was proud of me. I already knew, with all my heart, He was so proud of you.

    Until your last heart beat I savored every moment with you. Every single time, no matter what I was doing, when you asked for a hug I gave you one. You were such a stinker and would ask for one sitting in your shower chair, soaking wet. I would hug you and you would laugh so hard. I will have that picture in my heart until my last beat.

    I sit with the paradoxes that create a push and pull in my soul. I acknowledge both can exist and both are true. I despair it was only twenty-four years. You are irreplaceable. I am grateful it was twenty-four years. You were a miracle. The instruments that will connect those two diametrically opposing movements of my muted symphony, my sweet boy, is found as I grieve your loss and celebrate your life. Those notes are the quality of those twenty-four years. The time we did get we created by giving one another joy, loving lavishly, savoring every shaky hug, laughing at the littlest things, eating wonderful food, and caring for one another in a way even death cannot unentangle. It will be with me always, my sweet boy. As will you.

    Missing chromosomes and base pairs, incomplete information – none of that matters as I sob on the couch on this dreary day. You were created exactly as He intended. You were His masterpiece. You were the most beautiful symphony I will ever hear. And being your mom is my highest honor.

    I praise you because I am fearfully and wonderfully made;
    your works are wonderful,
    I know that full well. Psalm 139:14

  • Books

    Books

    Grandma has been cleaning out my closet to make space for your things, sweet boy. I can’t bring myself to let anything of yours go other than your bed. I will sort through your toys and clothes once I am stronger.

    She found books in a dusty box. Titles like, “Even This”, “Just Enough Light for the Step I’m On”, “It’s Okay Not to Be Okay”, and “The Broken Way.”

    The books must have been in there stored away for almost fifteen years. I received them as gifts the first time my entire world collapsed and grief stole my soul for a little while. You were nine when your father committed suicide. On February 10, 2011 you and Emerson went to school not knowing everything would be different when you walked back through the door into a home shocked and cracked to the very foundation.

    While you were at school I found your father in the woods. Not even ten minutes had passed from the time I last saw him to the time I last saw him. I still don’t know why I ran into the woods that day, just my spirit knew I would find him there. The police put me in the ambulance I had initially called for your dad. I was going into shock. Grandpa knelt beside me.


    “Stay with me, focus on me,” he urged. “Look at me. Stay here.”

    At times he had to shout to get my attention. When I looked at Grandpa I had clarity and the full force of my grief was held at bay. As soon as my eyes diverted from him everything became chaotic and uncertain. The world was literally spinning. Gravity was failing. I was disconnecting from reality. Dissociation led me to the cusp of oblivion. If I only let go I could float to an unknown place. Anywhere would have been better than where I was. I somehow knew if I did though I might not know how to get back. As if an enormous vacuum was trying to suck my soul away my altered mind knew I had to try to stay. I was scared. I did not want to go there yet did not want to be in reality equally as strongly. What was transpiring was much too much for me to handle. My world was being ripped apart both figuratively and literally as I lay in the ambulance looking at my father’s loving, pleading eyes.


    “Stay here, the boys need you to stay here,” my father begged.

    That was it. One sentence changed everything. It was the exact switch that needed to be flipped and the fear and uncertainty vanquished. I knew I needed to stay. From the moment of conception I loved you more than my own self. When I was pregnant with you, I would care for myself. I would eat well and drink plenty of water. I quit smoking. I could not or would not do any of those things for just me but when my body became a vessel for you I did anything to ensure you would safely arrive into the world. I needed to do anything to ensure you would stay safe in our now rapidly changing world.


    I fought back with all my might against the lure of being in the other world where, I believed, I could be numb but where you would not be able to find me. You did not even yet know you lost a parent; I was determined you would not lose both.

    The following weeks after your dad died felt similar to where I sit now yet altogether different. Both losses were traumatic and unexpected. Both left me uncertain of what the future holds. Both were excruciating and piercing. Both resulted in a significant loss of my own identity. Both necessitated rebuilding from less than ashes. Both required more than I thought I had.

    And during both I praised God through it all.

    Burying a spouse has stark differences from burying a child. When your dad died and each moment before and after, every decision I ever made was always keeping in mind your wellbeing before all else. I was strong for you and for Emerson. Grandpa’s words, “your boys need you,” was enough to bring me back to reality and to fight just a little more.

    One month ago today you left. Each day I dig deep to empty reservoirs and find my “fight just a little more”. Grandpa is where you are and I don’t have his pleading eyes to remind me that your brothers still need me. And so, I keep my eyes on my Father especially during those moments I am not sure how to live this life without you. You were my whole world. I told you such every single night before I kissed you once more before sleep. My heart is happy I never once forgot to tell you and, more importantly, show you. And you knew.

    The full force of grief, however, is not held at bay. It is crushing. It is relentless. It is suffocating. But I am not alone in it.

    The books are back on the shelf. Grief settles in our home. She will be staying for a while as she did before. Sometimes she sits quietly next to me on the couch but I can still see her in the corner of my eye. I make no sudden moves. Other times she ambushes me and delivers blows consecutively until I am begging for mercy. She is the albatross that hangs around my neck as I walk through the day trying to be “normal.” I am certain she will accompany me for the rest of my days. From my time with her before I know she can become gentler and maybe even a little kinder. Someday, but not soon enough, perhaps just a nudge to remind me she is by my side still.

    Sweet boy, she will not rule me but for a while. I do not know how, I only know God will not let me languish here. I am crawling through the valley of the shadow. I have been here before. It isn’t the same but I see similarities enough to make it a less foreign land. The valley is longer, deeper, darker, and seemingly impossible but my God is still as strong and my dependency on Him even greater.

    He lifted me out of the pit of despair, out of the mud and the mire. He set my feet on solid ground and steadied me as I walked along. Psalm 40:2

    He has not lifted me yet but He has not left me. I will keep my arms raised knowing He can and He will.

    They say the deeper the love the deeper the grief. I would add the more treacherous the valley. It is a price I willingly pay one thousand times again to have loved you, my sweet boy. For it was and always shall be my highest honor.

  • Hugs

    I picked up Nathan by myself yesterday. It was the first time I have since you left. Every day around ten a.m. you would start signing “Pick up baby” and you would get so mad when I told you it would be several hours more. Finally, at 2:50 pm Monday through Friday you would squeal with delight to get in the car to finally get him. We would listen to music on the way. Every time I had to go over those aggressive speed bumps at Nathan’s school I would say, “Ready bump?” and you would laugh as your chair bounced.

    Yesterday it was quieter. I listened to Christian music and prayed. I miss you every moment of every day and sometimes, even more. I still said, “ready bump” and perhaps I will until he graduates.

    I am trying to sit in my office a little more. Each time, though, I look at the couch and cry. I see where you sat with your legs crossed asking for coffee. It still doesn’t feel real sometimes and other times all too real. It is a cruelty I cannot escape.

    I thought it would be good to get a checkup and wanted to see if some medication might help me, so I had a doctor’s appointment today. We have known Dr. Campbell for over twenty years. He already knew you passed away. He was great friends with your dad and helped me then as he is helping me now.

    His nurse entered the room. “You’re here for depression?” she asked.

    “I am not sure. My son died,” I responded.

    Each time I say those three words the knife twists a little deeper. As if saying it makes it truer but the truth is absolute. I am not delusional. Still, saying those three words slays my soul a little more each and every time.

    “Can I hug you?” she asked.

    She gave me a hug and told me she has an eight-year-old son. I suspect he will be hugged a little tighter when she gets off work.

    Bruce came in shortly after and sat in the chair with sympathetic eyes.

    “Burying your child defies the natural order of things. You won’t get over this. But you will learn to live with it,” he said.

    Tears formed in my eyes. I knew that truth. There was no way around it. A loss as significant as you will necessarily change who I was and who I was going to be. It changes everything.

    “You buried a husband. And it was traumatic and shocking. I know this is different,” he said.

    “This is so much worse,” I cried.

    Nodding in agreement he patted my back. “You have to remember who you are,” he said gently, “You are a survivor.”

    I drove home sobbing once again. I was alone in the car and let out the most guttural desperate scream. It felt so good as if twenty-five days of nightmare dissonance released all at once.

    Grandma started clearing out your room. We are saving all your t-shirts hoping to have a quilt made. Many of your toys will be saved for baby Chloe. You were always so good at sharing with her except your wheelchair. That was off limits. We will tell her stories of “Uncle Wesley.” Your Santa still hangs on the door. She likes us to push the button to hear him sing. I don’t foresee Santa coming down despite the season.

    Boxing up your things is the hardest, most painful task we have ever had to do other than holding you at your last heartbeat. Your medical supplies remain in the bathroom. My heart just hasn’t been able to clear them though I know they will be donated through All Blessings Flow once I bring them. God works all things, even Tegaderm and catheters, for good.

    I still wake up every morning with my first thought being I don’t want to live in a world where you are not. But the last couple of days just after that thought I have asked God to show me the full measure of His mercy and His Grace. I have asked to know His Presence in powerful ways. I have asked God to fill my heart with warm memories and smiles of you. I know some day the memories will be accompanied with a few tears and more smiles. It will not be the deluge it is now. May it come soon, sweet boy. May it come oh so soon.

    They say grief is just love with no place to go. I disagree. It has some place to go. It does not dissipate. It still exists even though you, my sweet boy, are on the other side of eternity. My faith insists I can still actively love you. It victoriously claims death does not diminish love. The very foundation of my faith asserts love can reach eternity and back home again. So, sweet boy, I will love you as fiercely, boldly, and unconditionally as if you are sitting there in the foyer, furiously searching your iPad or asking for a hug or laughing at a silly noise. The love still has somewhere to go and I will continue to release it. Perhaps when the grief subsides enough to where I can function easier, the releasing will lead me to help others the way strong women I know have done before me.

    For now, sweet boy, I miss your hugs. My entire body physically craves one. I close my eyes and can feel them still. You would hug so tightly it made you shake – a whole soul hug.

    Spring is just around the corner. You would sit on the porch swing with your feet going back and forth. You would vigorously point to the empty spot next to you and ask me to sit and hold your iPad. After only a few minutes we would hug and bask in each other’s presence.

    I imagine where you are it is always spring. The weather is always perfect, flowers are always blooming, the green is young and the hugs endless. The only other one who could love you more than I, sweet boy, is our God. And I am quite sure He gives the best hugs.

    I am not sure I would label myself a survivor. I have survived terrible trauma. I have survived burying a husband and now a child. If I am a survivor, it is only because I have been strengthened. I have been sustained. And I have been saved.

    I can do all things through Christ who strengthens me. Philippians 4:13

  • Cola

    Cola

    I am not at all steady today, sweet boy. The tears won’t stop. My eyes are swollen. The world does not spin as it should. The fog descended again and everything seems slow motion. It has been twenty-two days.

    Today I am simply hoping to hope.

    Years ago I wrote a blog about Kintsugi, the Japanese art of repairing broken pottery with gold. The pieces are put back together with gold leaving familiarity but a new creation reinforced and more valuable than before the breaking.

    I wrote it after your dad died. I tried so hard this morning while watching the morning sun come to hope perhaps I would be put back together once again . This time, sweet boy, my soul is not broken. It is pulverized.

    I began looking for some sort of hopeful imagery about pulverized material being created into something new.

    Glass Blowing

    It begins with molten glass. The process requires purified sand (the structure), ash (lowers the melting temperature), limestone (stabilizes and strengthens), and recycled glass (makes the mixture melt faster and conserves energy). The mixture is heated to about 3100 degrees Fahrenheit for melting, chemical reactions, and impurities rise out. The molten glass is kept hot for the refining process. The heat forces trapped bubbles to escape, the mixture becomes uniform, and impurities separate.

    The artist will then blow air through a special instrument to form the shape. The new creation is shaped by the artist’s hands, gravity, and breath of life.

    Perhaps glass blowing will be another writing for another day. A day when I can see the forming shape that has been created by God’s hand and the breath of His Spirit.

    Today is not that day. Today I have not been able to stop crying. Today your baby brother held me on the couch as I sobbed and told me it was normal to be sad, that I should cry it out so it doesn’t come out in a bad way. I don’t know when he got so wise. The coin flipped and instead of me telling him it was going to be all right and kissing away the sadness, he did that for me.

    I told him about a sermon I watched today about Nathaneal, his name sake. In the Book of John, Philip tells Nathaneal about Jesus.

    Can anything good come out of Nazareth? John 1:46

    Before Nathaneal knew Jesus he couldn’t imagine what good may come. Immediately upon being found by Him he said “Rabbi, you are the son of God; you are the King of Israel.” (John 1:49)

    It didn’t take long for Nathaneal to realize what good could come from unexpected places. I told Nathan for us, it may take a little longer not because we don’t believe but because our grief is so deep. But we do believe. And it is coming.

    Your sweet brother got me the last coke in the house with a bunch of ice. He even made it fancy to try to make me smile. And it worked.