Attitude Adjustment

Today I was a grump.  My attitude was crap most of the day.  It was the type of day, where people could instinctively sense coming closer than within a 15 foot radius to me would not be a good idea.  Nothing really  happened to put me in such a lovely mood today, it just didn't start off  with a bang and instead of shaking it off, I just let it settle into my bones for the day.  This is never the right decision to make.  By the end of what turned out to be a very busy, long, non-stop phone ringing day, I was simple exhausted.  Had I chosen to not be a grump today, shake off the Eyeore-esque mood of gloom and doom, it still would have been a long busy day, and I probably still would have wanted to break all the phones in my office, but I would have done with a smile, a lot less curse words, and in a much more positive frame of mind.  I'm determined to make the rest of this week a positive up-beat week. I'm not going to pretend there still won't be curse words here and there (I really do need to work on my sailor language), but they will be flowing out of a smiling face, because in all honesty my life is pretty okay.  In an effort to create a happy mind space (a Yankee win tonight would actually be the best fix for this) a song that always makes me think I can rap and dance.  Enjoy, the one and only, Shoop.

My Visit to the Demon Dentist

I'm aware a large portion of society has an issue with the dentist.  I am one of those people.  My entire life I have feared the dentist.  Not on the same level as I fear getting caught in a swarm of birds and being pecked to death, but fearful all the same.  Nonetheless, I have been going every 6 months for my cleaning, and fluoride treatments for several years, (although I don't get the fluoride each time because my insurance only pays for one treatment a year and it makes my mouth feel really grainy afterward).  Recently, I went for my routine cleaning, and left the dentist office feeling very very angry.  I did not really know just how angry I was until I called the office today to cancel the appointment they forced me to make before I left, and when I got off the phone today I was just as angry as I was three weeks ago when I walked out of the office.  (Boy, I can really hang on to some anger!)  What made me so angry, you say?  Well, I'm glad you asked!

My check and cleaning had just finished and I was busy patting myself on the back for a job well done on my dental hygiene care, when my bubble was quickly burst, when my thoughts of dental health superiority were interrupted by the hygienist stating, she had called the dentist in to look at my front two teeth and address the issue of "that gap".  Excuse me, what?  To make sense of my dismay, here is some history on "that gap".  When I was young I had a gap in between my front two teeth.  It wasn't huge, it wasn't disturbing to look at, but it really bothered me.  A lot.  When you're a pre-teen and a young teenager, you are already struggling with the hormones racing through your body, making all kinds of crazy foreign things happen, and any little perceived flaw can turn into a tailspin of insecurity, and that is what "that gap" did to me.  I begged my parents to let me get if fixed, my teeth were straight, I didn't need braces, so they weren't sure anything could be done to fix it.  I'm sure I harassed them and spilled many tears nagging them to figure something out, so they finally let me go to my dentist and talk to him about it and he told me he could fill it by putting a bond on my teeth closing the gap.  Hallelujah!  I swear the heavens opened and angels sang.  

This is one of the few pictures I could find showing "that gap".  I tried to hide it by smiling with my  mouth closed in a lot of pictures.  You can't really even see it very well, but this is the best I could find.  This was in 1993 I would have been 14, a freshman in high school. 

After that initial bonding I no longer worried about my teeth (I promptly found other things to be insecure about during my high school years!)  Then right before my sister Natalie's wedding in 2005, the bonding chipped, I have no idea how it happened, it's really hard to say, my lack of grace is clearly documented in this blog.  It was a simple fix and I went on my merry way, without a care in the world about "that gap", until that fateful day three weeks ago.  As soon as the hygienist mentioned she was bringing the dentist in to look at it, I became 14 again, and it only got worse from there.  The dentist came in to gawk at the freak (okay, so maybe it just felt like that in my mind) and told me, she would really suggest instead of filling "that gap", which I had not even noticed needed any filling,  I needed to get veneers.  On my six front teeth!  How did this go from a simple fill, which I didn't know I needed, to 6 veneers! Apparently you just can't get two veneers, because then I'd apparently look like a buck-toothed hillbilly, oh no, I need all six teeth done.  Then she said, if I did not go the veneer route (which really would "make me look better") at the very least I need two crowns on my front two teeth, and the kicker in all of this is insurance covers absolutely none of it, because it's all considered cosmetic, and not really necessary.  However it did succeed in making me feel like I have gnarled nasty teeth that should never been seen by the public eye.  As I sat in shock, not being able to form words, because I'm 14 and afraid to talk to adults, they wrote me up an estimate for the two crowns, which of course is their "second choice", and didn't even bother giving me an estimate on veneers. They also made me set up a consult appointment before I left, as they feel it's really important to protect the local children from being frightened by my repulsive smile. 

I walked out of there angry, and the more I thought about it, and the more I realized they made me feel like that insecure 14 year old again, the more furious I became.  Today I called to cancel the consultation appointment, stating I had thought about it and would not be needing a consultation on crowns or veneers because I'm perfectly okay with the way current teeth look.  I was asked three times in the three minute phone conversation if I was "certain", "sure", or "do you need more time to think about it" before they would accept my cancellation.  Yes I'm sure.  Yes I've thought about it.  Yes I will be finding a new dentist!

If There Was a Problem, Yo I'll Solve It

Recently I have been loudly pondering the loss of critical thinking and problem solving skills I have witnessed the last few weeks. Educated, professional, adults who seemingly are unwilling to try, or rather want, to think it out before asking someone else for the answer, an answer which they can just as easily access.  An answer with an ounce, a millisecond of self pondering would be in their grasp, it would take but a moment of stopping and evaluating the situation to conclude, "Hmm.  Better not."  And then I stopped and pondered myself and was reminded of the multiple questionable decisions I have made in my life. Seriously, really dumb ass decisions; to include dating the wrong guys for way way way too long, wearing a bell sleeved shirt while shoving food down a running garbage disposal (RIP sheer maroon blouse), consuming way too many adult beverages when I have important things to do the next morning, trying to prove I can sit crossed legged on top of my stability exercise ball and balance when it's well documented I am an enormous klutz (that one left a bruise, or three).  So I concluded I will try to make it the rest of week without being such an irritated judgmental jerk. Good thing tomorrow is already Thursday.

Labor Day Lessons

This was Labor Day weekend 2012.  Labor Day, a day originally created to recognize the dedication and work ethic of the American worker, reflect on the workers of the nation, but seems now to mostly be regarded as the end of summer, filled with pool parties, barbecues, trips to the beach, and an excuse to over indulge in consumption of adult beverages.  I did none of those things.  However I did learn a few things this Labor Day weekend.

1.  Peach salsa from the farmer's market is delightful on fish tacos.

2.  Playing the harmonica and pillow fighting with my 3 year old niece may be one of the most fun things to do, ever.

3.  When you are 3 and get told to pick up your toys, you can fake a headache and get out of it.  That doesn't work when you're in your 30s.

4.  I have a vastly different definition of "pulse-pounding thriller" than the person who wrote the review on the back of the Winter's Bone movie case.

5.  No slip head wraps do not exist.  The packaging is a lie.

6.  Finally, "You save big money when you shop Menard's".  This lesson was taught to me once again by the littlest person full of wisdom, my niece, who decided to break out into this song while shopping in Target.

Hope everyone has their own small moments of laughter, relaxation, and happiness on this Labor Day weekend.  Now prepare to get back to work tomorrow!

And They Lived Happily Ever After

I have worked with many children in my career in child welfare, all of whom hold a special place in my heart, but in the summer of 2008 I held a 3 month old baby, who impacted my life in ways I never imagined.  That summer I was appointed as the CASA for a 3 month old (who will be referred to as "Baby" throughout the rest of this story) who was in the system due to Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT).  I had previously worked with infants, but did not have a history working with SBS/AHT, and since we knew from the beginning it would be a very involved and difficult case, as the supervisor I took it on myself.  At the onset of the case, the infant was life flighted to the closest major hospital with diffuse cerebral edema (swelling of the brain), sub-arachnoid hemorrhages (bleeding on the brain), pre-retinal hemorrhaging in both of eyes, experiencing seizure activity, was placed on a ventilator in a vegetative state upon arrival at the hospital, given a critical/unstable condition, with hospital staff stating his condition was not likely to change.   Baby was hospitalized for approximately three weeks. Upon discharge Baby was breathing unassisted, but was considered to be blind, deaf, had muscle rigidity on the right side of the body, a severe seizure disorder, and had a g-tube for feeding.  All of these things continue to be true for Baby.

The next several months following Baby's initial discharge from the hospital, were filled with appointments with specialists, a lot of time spent in hospitals and doctor's offices.  I met neurosurgeons, pediatric neurosurgeons, retina specialists, g-tube specialists (I'm sure there's a different name for that, but I don't know what it is); if it had anything to do with the brain I met that doctor.  On a side note, during this time, out of all the neurologists I met, which was about 3, I determined they are such brilliant doctors it doesn't leave a lot of room for a fantastic personality, (sorry if I offended any neurosurgeons who may be reading this!).  I also need to note, I was not doing this on my own, far from it.  At the time Baby came into foster care, I had a good friend who was the supervisor of our local foster care agency at the time, and she worked the case for their agency.  We were lucky to be able to do this together in the beginning, when everything seemed to still be so unknown and undeniably scary.   We went into every appointment with our brave faces on, but for me at least, inside I was in knots wondering what new dismal outcome we would be told today.  There is one appointment that will never leave me.  We were seeing another neurologist, this time a follow-up appointment.  The doctor came in, examined Baby, and told us it was a miracle Baby was still alive, most children with this amount of trauma would have already died.  The doctor described Baby's brain injury to us as “the brain is falling away". Due to the damage suffered, Baby was left with 1/4 of a brain. The doctor then went on to tell us Baby's life expectancy could not be determined, he had seen children only last a few months or on the flip side a case where the child lived 10 plus years with this type of trauma, but his best guess for Baby would be 3 to 5 years, with no progression from the current state.  Before this appointment, no doctor we had seen had ever put a "number" on Baby. That moment, holding that child and hearing a time frame on life, will never leave me.  I felt like I couldn't breathe, but had to continue to be the professional skilled at handling this type of news.  I left that appointment, got in the car, and cried.  Cried for the child who had been born completely normal and had life altered and shortened due to abuse, cried for the child I had already grown so attached to, who may not be with us for too long, and cried out of sheer exhaustion of hearing bad news on top of bad news at every appointment we attended.

 As the case continued there were more hospitalizations, surgeries, more doctor appointments with specialists, more in-home care professionals (Baby qualified for daily in-home nursing care), and more medications added on to an already lengthy list, at one point I believe the daily medication list was over a dozen different medications a day.  Along with in-home nursing care, Baby also received Infant Child Development Services which consisted of occupational therapy, physical therapy, early childhood development, speech therapy, and vision therapy.  I would be lying if I said I wasn't skeptical of what vision services would be able to do for a child who has been found to be blind, or what speech therapy would do for a child who will always be non-verbal, or what physical therapy could do for a child with a seizure disorder, feeding tube, and 1/4 of a brain.  It's not that I did not want those things for Baby, I just believed what the doctors were saying, and progression was not likely.  I also need to say when all these services started, Baby had recently been placed in a third foster home, an amazing family, allowing me to come and observe these services while they were taking place in their home so I could get a better understanding of what they would be working on with Baby.

As the months stretched into years I became more and more captivated and amazed by this sweet fighter of a child.  Baby continued to amaze us all by beating the odds.  As Baby continued to receive services from all agencies involved, we began to see progress.  I can't even begin to list all of the exercises and equipment used to help Baby.  In the beginning it was a struggle to watch because the services seemed to bring so much physical pain, especially during physical therapy, but the end results were Baby being able to sit unassisted, which was a major feat when it first happened.  The next big accomplishment was being able to bear weight when held in a standing position, with assistance, but the biggest accomplishment was when Baby took some steps while in the walker (Baby does not have a normal walker, the walker comes with a harness to strap in for safety because Baby does not have enough body control otherwise).   After someone physically picked up and made a step with Baby's feet a few times, Baby was able to mimic the behavior with a couple steps.  Baby cannot walk or stand unassisted, is wheelchair bound, but the fact Baby has even progressed to taking steps while in the walker is not anything I ever thought would be possible.  

Baby can also take some food by mouth now.  While the majority of nutrition comes from the feeding tube, Baby can eat foods that are the consistency honey, anything of a thinner consistency, there is a great risk of aspirating.  I previously mentioned the muscle rigidity on the right side, this is due to the left side of the brain being gone, the right side does not move much, and Baby's hand is almost always in a fist.  In order to help loosen this side up, Baby now receives Botox injections every few months (not just for Orange County housewives anymore!) which helps loosen the muscles giving more consistent movement.

With every ounce of progress made, one major medical concern remained, and that was the amount of seizure activity.  Baby suffers from a seizure disorder and it seemed with each passing month the seizures became more and more frequent and more and more painful.  At one point Baby began having seizures that presented as long fits of crying, and it was not just regular crying, it's the type of crying where you know there is pain behind those wails and tears, and with a child who is non-verbal, there is nothing you can do to soothe them but try to remain calm yourself and keep them comfortable.  Another moment in this case that will never leave me is when I was holding Baby at one of my visits and one of the "crying seizures" took place.  I managed to keep it together while it was occurring, the seizure lasted for several minutes, but when I left that day and got in my car, I just cried.  It was obvious to all of who had witnessed these seizures they brought severe pain.  In order to help with the seizure activity Baby went to see another new pediatric neurologist, who the foster family really respects, who prescribed new medications to help with the frequency and aggressiveness of the seizures.  While the downside of the increased medications are Baby sleeps a lot, the flip side is the seizure activity has decreased significantly and I choose to believe this means Baby is in much less pain on a daily basis.

As the years went on, Baby continued to grow, and although Baby's health still remains fragile, the progress made is nothing short of remarkable.  I feel incredibly blessed to have been a part of this child's life; the resilience is something to be witnessed.  Baby doesn't know the odds were supposedly insurmountable. Baby was never supposed to be able to sit, or bear weight, or take food by mouth, or connect with caregivers. Baby doesn't know the odds of survival, so Baby learned, and grew, and continues to live.  

I was fortunate enough to work Baby's case as the CASA for the duration of time in the court system, which was 4 years.  I previously mentioned when Baby began receiving all intensive services a move had just been made to a third foster home.  Baby has remained there since that time and in the summer of 2012 there was an adoption finalization hearing, and they became Baby's forever family.  There is no doubt in my mind if it were not for the adoptive family, who took Baby in as their own, from day one, and provided consistency, advocacy, and love every day, Baby would not have made such remarkable progress.  They are amazing people, I could not be happier they are the forever family.

I wanted to write this story because it's a story that needs to be heard.  SBS/AHT is the leading cause of child abuse deaths in the United States, infants from birth to 4 months are the most vulnerable, and crying is the greatest risk factor (http://www.cdc.gov/concussion/HeadsUp/sbs.html).  Unfortunately, we don't know for sure what exactly happened that set off either of Baby's biological parents causing the trauma, and we will never know, that's something they have to live with, but we do know the trauma occurred at two months, which falls into the statistics.  The other very important point that needs to made here, is SBS/AHT is 100 % preventable.  Preventable.  Having a newborn is trying, it's frustrating, it's exhausting, and it's normal for your baby to cry, for no reason, and there are perfectly acceptable things for you to do to take a break from your inconsolable baby.  Programs like the Period of PURPLE Crying exist as preventative programs to give parents resources and safe options to prevent the tragedy of SBS/AHT.

In working with Baby, I changed as a worker and became a better person.  I became set on helping to prevent future children from suffering the same trauma.  SBS prevention efforts in our community became a big focus to me, and we were able, with a lot of work from collaborating agencies, to bring the Period of PURPLE Crying program to our local hospital and community agencies.  Any time one of my friends or friend of a friend, or anyone I was remotely aware of had a baby, I badgered them with information about the normalcy of crying, the PURPLE program, checked up to see how they were doing being new parents, to the point of utter annoyance I'm sure. Honestly I'm surprised people still answered my phone calls!  Also being a person, with little patience, (I heard the saying, "Patience is a virtue" a lot in my life), Baby taught me with patience great things come to you, and to never doubt what may be possible.  Watching Baby grow and bonding with this child, this child who has never seen my face or heard my voice, but does know my touch, is one of the greatest experiences I have had in my tenure as a social worker in child welfare, and not one I will ever forget.  Baby inspired me, taught me to be a more positive person, to be a more loving person, a more hopeful person, and I will be forever grateful.

*It should be noted there are multiple agencies, social workers, teachers, attorneys, doctors, judges, who played a major role in Baby's case and subsequent permanency.  It is not my intention to leave any of those individuals out of this story, there are just too many to name.  A huge thank you goes out to all of those who worked on Baby's case, you know who you are.

**It should also be known I was given permission by Baby's adoptive family, to tell this story.  I hope I did it justice.

Morning Musings

Recently I had a discussion with my sisters about seeing the good vs. seeing the bad in people.  It wasn't a deep long philosophical discussion, it was basically me saying, not everyone is a bad person or out to get you, and them saying, but there are a lot of bad people and gently chastising me for not being more aware and questioning of people.  I would like to state, I am aware there are bad people in the world, I just don't believe it's more likely than not, someone is going to want to kidnap me and stuff me in their trunk and drive me across state lines.  I understand the importance of safety and being aware, but I just don't think I have to live my life being vigilant every minute of every day.  I had basically dismissed this conversation, because as I said, it wasn't a lengthy thought-provoking conversation, but then I woke up yesterday to the headlines of the senseless tragedy in Aurora, CO.

Unfortunately this is not the first of this sort of tragedy we have seen in the last 10-15 years.  Columbine, Jonesboro, Virginia Tech, and the list goes on.  Obviously we all, as a society, mourn the loss of the innocent people and the grief of their families and loved ones in all of these violent crimes; but then it becomes almost automatic to get caught up in who these perpetrators were, what kind of person commits such senseless violence, what made them do it, what finally pushed them over the edge. I don't know if those questions can ever fully be answered.  People who commit such acts of violence are simply maladjusted individuals, who for whatever reason could no longer take the reality of their lives.  I am not so naive to know there are not bigger problems looming in our society, given tragedies of this proportion continue to plague our world, but I don't think we can shut down and shy away from people either.  Do I think we have a gun problem in the United States?  Absolutely.  I have never been a fan of guns and refuse to ever have one in my home.  I don't believe more guns in the hands of civilians is the answer.  Do I think Batman had anything to do with the shooting in Aurora?  No.  I think James Holmes would have found a message of violence in an episode of Sesame Street if he so chose.

 I know there are many of you, some of who may stumble across this blog post by mistake, who will vehemently disagree with my thoughts. You are as entitled to your opinions as I am to my own.  I write this not to offend, but simply to get my own thoughts out, make sense of what's been a running dialogue in my head for the last day.  As I said previously, I am aware there are bad people in this world, who do intend to do harm, and I am not free of knowing that first hand.  I have lost people I love to violent acts of crime.  However, I will continue to choose to look for the positive in people, see the good, because I believe the majority of the time it's always there.  If that makes me a bleeding heart liberal, so be it, that's a title I feel pretty comfortable owning.

Daddy's Girl

This picture was taken in September of 1980.  I was 15 months old, and a Daddy's girl.  32 years later, nothing has changed, well except the fact I no longer sit on Dad's knee on a regular basis. I have always been a bit of a Daddy's girl.  I think we all were really. My dad coming from a family of 10 children, where there was an equal split between boys and girls, was blessed in fatherhood with three very lovely, well-mannered, do as we were told, soft-spoken girls.  (If anyone believes everything in that last statement you've clearly never been around my sisters and I, especially on a day after Christmas shopping trip).  I have amazing memories of being with my dad.  I used to love watching him work in the garage building projects.  He used to give me a scrap piece of wood to practice hammering or sanding.  I know how to drive a nail, the difference between a flat head and Phillips head screwdriver, and how to check the air in my tires all because of my dad.  Dad spent many years coaching me on and off the field, in sports and in life.  As much sawdust and dirt I remember being in my memories with Dad, there are also the times I remember as a little girl him braiding my hair, or laying in my bed telling me bedtime stories he would make up, or singing me songs until I fell asleep.  I loved listening to him, and I honestly still do.  We haven't always agreed, and frankly the older we both get, the more things in life we seem to have very differing opinions on, but we can always have a conversation.   I treasure those times.  I know how lucky I am at 33 to still have both of my parents, and to still have them together, when so many of my friends have already lost a parent or have to split time between the two.   I can't begin to express all the gratitude and respect I have for my dad, I love him dearly, and will forever be a Daddy's girl.