What I Want You To Know

A couple years ago, I wrote a blog about the things I wanted people to understand about mitochondrial disease. I decided to do an update to that of sorts, but focused on medications. If your kid is basically on, say- a multi-vitamin and an OTC allergy med, with an occasional antibiotic for strep throat,  it may be hard to understand what it's like to need a lot more than that.

I know  drugs and even supplements seem to be a sensitive topic for many people, and one that some can be passionate about. Driven by this passion, some people can be very open about their disapproval about what we do or don't do for Joshua, or they decide to offer help by trying to sell me a vitamin their company sells that is a "miracle." While I realize these sales pitches are generally paved with good intentions, (so I still love you; I promise), please know that first of all- we DO use natural supplements already.  Some are actually considered standard treatment for mitochondrial disease kids. If you like more the natural route for medicines, this should make you happy! But the ones Joshua is on are very specifically chosen for his needs, and our doctors often have specific brands they favor.  In addition, some are done as prescriptions and therefore our insurance covers them. I'm not going to take him off these to try and defy the doctors' ideas and spend additional funds when I don't need to. I also can't imagine losing the groundwork we've gained just because your sister's husband's aunt had good luck with the magical supplement of the hour. If I ever do hear about a  remedy that I feel could truly be a useful addition (not replacement) to what we already are doing, I'll let you know. In other words: don't call me; I'll call you! 

I also want people to comprehend that when we use a conventional medicine for Joshua, it's always researched, justified, and also sometimes a last resort. We have arrived at some drugs that you may have never heard of, or, if you look them up, they describe a different use. That's because almost everything with mitochondrial disease and other diseases with limited treatment options is prescribed off-label. I've learned to be ok with this, although it can still be nerve-wrecking. If we try something and it isn't doing what we hoped, we remove it from the regimen and try again. Please understand that all drugs do have known side effects and yes, I have read about them. You don't need to re-scare me by telling me the horror stories you uncovered on the Internet. If we note that a drug is causing more harm than good, of course we'd remove it from the plan. 

Along those lines, we do frequently comb thought his (admittedly long) med list for ways to shorten it. We recently took him off baclofen (generally used for muscle spasticity but in his case for esophagus motility... See what I mean about off-label?) After several days, he started to have swallowing issues again and asked me to put him back on it. After talking to the prescribing doctor, we decided to put him back on one dose a day versus the previous two he'd been on before, and that is going fine. 

You may now be wondering why we need so many medications in the first place. The answer is that mitochondrial disease affects multiple systems. So Joshua, for example, needs medications for his heart, lungs, brain (nervous system) and GI tract. In addition, there's an energy deficit and that's where the supplements come in, to try and replace what the body may not make enough of, or process efficiently, on its own. 

Deciding to try certain meds, and especially to stay on them long-term has been one of the hardest pieces of this journey for me. I cannot state this enough: I do not take any of this lightly. Does it sometimes keep me up at night, even though other times I'm very at peace with it? Absolutely. 

The other thing I want you to know is that despite knowing these medications are essential to helping Joshua, it is a lot to organize daily and sometimes I really do wish he could wake up in the morning, have some cereal and watch cartoons leisurely  rather than sitting down at the table for a bunch of medications that sometimes don't even taste that great. Likewise, I wish I didn't have to stop his playtime in the afternoon for more meds, or make him do breathing treatments, or put the anti- pain lotion on his legs or check blood pressures, and then do it all again at night before bed when we are already exhausted. 

But of course I'm glad there are some things that help. We don't have the luxury of talking "cure," but we are lucky to have a few tools. And that's what I want you to understand. <3

In Defense of "Sorry"

Lately I seem to come across a lot of blogs from special needs parents regarding what people should not say to them. Honestly, if I was not a special needs parent myself, I think I would be a little scared at this point to say anything, for fear I would get it wrong. While I do agree with many of the points made, here is one in particular that I don't agree with: apparently, upon sharing news that our kids have a certain diagnosis, it is considered uncool for the person to respond, "I am sorry." The reason for this, (according to several blogs I read), is that "I am sorry" implies that your child isn't a source of joy, but a sad case to feel bad about. But if you come to me, even though I am a special needs parent, or maybe BECAUSE I am one, and you share with me that your child has... autism, mitochondrial disease, cerebral palsy, or whatever, I am still very likely to reply, "I am sorry." And this has nothing to do with not understanding that your child is still an amazing light in the world. You will have more joy at times than you know what to do with.

But I am still sorry. I am sorry because I know this is going to be a harder parenting journey than you bargained for. I am sorry because you will spend countless hours at doctors' and therapists' appointments. I am sorry because you will be saddled with endless amounts of paperwork all the time. I am sorry because you will have to fight tooth and nail to get what your child needs in school. I am sorry because you will spend more days as a special needs parent than a typical parent wondering if you are doing all you can for your kid. I am sorry because there are milestones that will never be met. I am sorry because you will be faced with big, scary decisions regarding medications and surgeries. I am sorry because you will often be lonely, even in a crowded room, even with good friends who try to support you. I am sorry because that joy I mentioned earlier? It may end sooner than your parent heart can bear. I am sorry you even have to consider the sobering thought that you may outlive your child.

Now, I do believe an "I am sorry" comment should be followed by something hopeful and sincere. What do myself and other special  needs parents want to hear, then? Probably a simple, "you're doing a great job" can go a long way. If all else fails, invite us out for margaritas and we'll likely forget any verbal blunders you may have made. :)

About That Cat... and other things.

Ooooh boy, it's been a long time!  And this won't be a fancy or eloquent post. I just want to catch up! Let me confess, aside from being busy, one thing holding me back has been my lack of technical skills. I've wanted to change the URL for my blog because I felt it no longer was a good representation of what I wanted to write about. It was "3 times blessed," and while yes, I still feel fortunate to have my family and know we ARE lucky, the word "blessed" has been over-used in social media to the point of nausea for me. And if we are being honest, I felt like maybe it misled people to think this was a religious blog. If you know me, you know I have faith but that sometimes I question that faith and that all of it is expressed in our family quietly at home. I am not and probably never will be a church-goer, and I am ok with that.

So today not only did I finally figure out how to change the URL, but I also realized it was the perfect opportunity to add in the new addition! I might blog about him a lot. No, I haven't had another baby. But we adopted a cat a little over a month ago. His name is Taffy. I frequently call him "Kit Cat," "El Gato" or just "Hey You." But surprisingly, I love him. I mean, really love him! I have had bunnies before but never a cat. I was a very reluctant cat owner, and now, like so many things we choose to take on, I can't imagine my life any other way anymore! The cat was mostly Joshua's idea. Thankfully, he got the affectionate personality he wanted. They've made fast friends.

I no longer keep up with Caring Bridge. I also don't talk much about Joshua's health stuff on Facebook anymore. Just know that while challenges remain, and are sometimes harder than they even were before, we are ok. My life is: medicine dosing, syringe washing, breathing treatments, therapy appointments, doctors, school drop offs and pick ups, baseball, soccer, swimming... And me, sometimes me. I love to get alone time or time to see friends outside the house. My sanity is kept by the escape of books or movies. No matter what though, I am first and foremost a mother. And just doing the best I can every day. (Just like you are). :)

Holding On A Little Bit Longer

Dear Joshua at age 6,

You're the last baby, so you're allowed to come in our bed in the middle of the night, squish in-between us, steal the blankets and force me to sleep halfway off the mattress edge.

You're the last baby, so you're able to bring your bunny to first grade in your backpack (provided he stays tucked away). Maybe some would say you're too old to be allowed this luxury, but I have the wisdom gained from your brothers before you that tells me this won't last forever.

You're the last baby, so I linger for extra bedtime hugs and kisses. I savor the storybooks, bath toys and cute pajamas. The nightly rituals of early childhood are among life's simplest gifts.

You're the last baby,  so I procrastinate weeding out the blankie and sippy cup collections. When those leave my house, I will never have a reason to replace them, and sometimes that makes me sad.

You're the last baby, so I often forget how big you really are. Your height actually rivals that of your 9 year old brother's.

You're the last baby, so I have gratitude for you being the one to truly teach me patience and multi-tasking.

You're the last baby, so I'll never again be the frazzled mama at big kid school pick up with a fussy toddler on my hip, looking for his pacifier. I didn't know I could ever feel sentimental about moments like that, seemingly so stressful at the time.

You're the last baby, so while I want to keep you little, I know there are joys in watching you grow. I hope for your happiness and health and many fun stages to come.

Love,
Mommy

In The Moment... Again

Living in the moment is a popular notion. There are countless blogs, articles and books created to teach us how to incorporate this way of thinking into our daily lives. I've written about it before, too, finding it essential to my happiness. 

It seems to apply so much to the life of a parent who has a child with an uncertain prognosis. How else can we get up, and do all the tasks required for living in a relatively calm manner, unless we take things one step at a time? 

I feel challenged when I am so stressed that I have to remind myself constantly to stay in the moment. The sweet spot for me occurs when I'm living this way effortlessly. Sometimes I can actually go a few weeks at a time without thinking about the future and making guesses what that may look like. 

It is harsh reality that all my maternal love cannot anchor my child with mitochondrial disease to the earth as long as I want. I am not ultimately in control. I can do all the research, take him to all the right doctors, try all the right medicines, and it still may not be enough. 

But here's the thing, and we often forget it. There are no guarantees any child will make it to adulthood. There are accidents every day. There are fluke illnesses that take the life of an otherwise healthy kid. So I've been spending all this time assuming I'm different than other parents, and I am really not. Likewise, us adults are not invincible, either. Even those of us who are relatively young still and healthy have no guarantees on this earth. 

We ALL have to live in the moment. It is truly all we have. We should take that trip, call that old friend, let our sons or daughters stay up just a little longer, and hug a bit tighter. I think those moments make us lucky, whether we get 1000 more of them still or just one.  The fragility of life is best seen as creating our experiences' beauty rather than tainting it. 

What I Want You to Know About Mitochondrial Disease

As we begin Mitochondrial Disease Awareness week, I am finding myself tempted to share statistics or re-post articles that have me nodding my head. I still may do these things. More importantly, I wanted to try and describe my personal experience with mitochondrial disease and how it affects my family.

This is what I wish for you to know, and to understand:

1. Mitochondrial disease can affect anyone at any age. It can be quite obvious, or very subtle. Patients can manage to participate in sports, or can be confined to wheelchairs. In our case, Joshua falls somewhere in the middle. He has exercise intolerance, but he can walk short distances. He uses a wheelchair for longer walks. Sometimes he rides for shorter ventures if he is just having a bad fatigue day. We are thankful to have the wheelchair. We are also grateful he does not, at this time, need it constantly. But it still sometimes makes my heart ache that we even need one at all.

2. Many physicians have been involved in the diagnosis and care of Joshua. We still lack a specific diagnosis for his health problems, (despite all their expertise), therefore, they say he has "unspecified mitochondrial disease." It is common to spend years to even get this generalized diagnosis, much less a specific one. Even the newer, more sophisticated methods of "combing through" all the DNA will not find EVERY type of mito defect out there. We are currently waiting for results of a whole exome sequencing test from TGen that makes us feel hopeful. This has not been an easy road, seeking answers. It makes me upset when someone says that they would stop looking and "relax" if it were their child. You would? You would not want to know what affected your child's daily life in such a dramatic way, or what it meant for their siblings or future generations? Think about this for a minute.

3. There are many issues Joshua has that are considered secondary to his mitochondrial disease, which include: gastroparesis, GERD, hypotonia, autonomic dysfunction, asthma, food allergies, tachycardia, neurogenic bladder, immune deficiencies, dysphagia, heat intolerance, hip dysplagia, cerebral palsy, autism spectrum disorder, visceral hyperalgesia, convergence insufficiency, etc. Even dealing with just ONE of these problems can be hard. So we juggle them all, like a crazy, multi-ring circus! We are constantly adding new issues to the mix, and trying to figure out how to manage them.

4. In many moments, on a good day, Joshua can appear pretty typical. What a blessing! However, I am aware that people also do not take into account all that we go through to make this so. Before leaving the house for school, for example, we give him his medical formula, four medications and a supplement. He takes three additional meds in the afternoon, and he needs approximately ten interventions or meds before bed, depending on his status. There is no cure for mitochondrial disease. There are only meds to help the secondary issues mentioned above, and supplements that are believed to aid in mito function. Almost every thing is a shot in the dark, all the time. We give things, often paying out of pocket, in hopes that they provide some benefit.

5. I have encountered a vast support system of other mito parents online, and some in person here in Phoenix. I am thankful for their support, and I hope sometimes I can help them as well. We share advise and experiences. We have each other to vent to when no one else gets it. Some of them have children who are no longer living. But they still come on the Facebook groups to offer support to the others. These are incredible human beings. Never can I express enough my sorrow for their losses, or my appreciation that they still fight for the other mito kids.

6. I am a pretty positive person, but I have tough days. Sometimes I worry a lot about my other children. I worry about my own health issues. I worry about Joshua's future. I enjoy posting on Facebook and texting my friends, or going out, but there are times I feel I cannot be completely honest about the difficulties I am facing, and therefore I withdraw into my own world for a while. I cry more often than I like to admit. On the flipside, there is love. So much love. I do not take much for granted. I am determined to be an advocate for my child. One of the ways I can do this is by allowing myself to open up at times like this and do my part to make mitochondrial disease a household word. If you would like to find out more, please consider checking out www.mitoaction.org

Dear Phoenix (A Love Letter)

Dear Phoenix,

I have been in love with you since I was 10 years old, and I came to visit with my parents. I never wanted to leave. When I was told several months later, (sitting at our kitchen table on a cold Illinois day), that we would be moving here, I cried tears of happiness.

I enjoyed growing up here. I feel like you grew up with me, from a baby city to a sprawling metropolitin area. I only abandoned you when I went to college in Colorado for four years. Colorado is an inarguably pretty state, yet it only left me missing you. I craved returning to your cool winter nights, sitting outside by a fire, and your warm spring days with a desert in bloom. I even missed the summer sun, and the relief that nightswimming or monsoon storms can bring.

I do not think I love you in spite of your imperfections, but because of them. The desert can, at times, be a harsh environment... a little too hot, or a little too dry and plain-looking. That means I have to look harder for your beauty on certain days, but it doesn't take long. It is always there. A brown, seemingly dull landscape, will generally hide an interestingly-shaped cactus, or a desert plant with flowers. You may not have green, rolling hills and forests of tall trees some people have come to associate with beauty, but you radiate all the same.

Some people may connect their home with a traditional smell such as honeysuckle or roses. I desire only the smell of your creosote  after it rains. There is nothing else that can calm me like this, or remind me I am where I belong.

Thank you for your magnificence.

Forever Yours,
Debbie

6th Grade, Autism and Life Wishes

Tomorrow my oldest son starts 6th grade. 6th grade!!! It is his last year of elementary school, in a self-contained twice exceptional program I fought hard for him to be a part of. It has also been six years since his autism diagnosis shook our world and changed everything we thought we knew. (The photo is from right after we found out, though there's nothing in that smile that indicates anything was amiss!) A lot of times I still see the immature aspects of him versus his peers. I have to repeat things a lot. Every night I can tell him to do "xyz" in the morning, and nine times out of ten, it doesn't happen. He has meltdowns comparable to a toddler, and yet more violent in nature. He obsesses about his interests and will talk endlessly about them to anyone who will (even remotely) listen. He struggles with eye contact. He needs an enormous amount of help organizing and being motivated to do any homework. He still attends weekly OT and speech appointments. It's all part of the gig... the autism gig... the one I did not sign up for but took on as a labor of love, the way all parents of kids on the spectrum do. Despite the fact that some things are stagnant and we have rough days often, we have still come so far! No accomplishment is small, in my eyes. Every step forward has been hard won! It is interesting at the start of a school year to see what parents of typical children worry about for their kids compared to special needs parents. (One of my kids IS typical, so I feel I am in a reliable position to make this observation!) There is a lot of chatter about which teacher is best, what test scores a child might have, how the grades will be, how the child might do in sports, etc. I want those things to work well for my autistic child, also. However, it isn't my focus. Those things would be icing on the cake. All I really want is for him to be happy. I don't just mean in school, but even afterwards, in life. I want him to find a job he is comfortable with and that doesn't stress him out too much. I want him to be able to care for himself by shopping, cooking or doing laundry. I want him to have a friend (more than one would be nice, but even just one really good friend would be fabulous). I want him to be a respectful son and brother. I hope he will learn to find joys in little things... the relaxation of a rainy afternoon, the discovery of a new hiking trail, the satisfaction in finishing a good book, the fun of getting lost in a great movie. I want him to realize he is an amazing human being. I am sure there will be some ups and downs in 6th grade, as there will be later in life, too. Experience tells me that we can weather any storms together. Sometimes solutions in autism resemble a complex maze rather than a straight and easy path, but we find our destinations eventually.

In Honor Of...

Early this morning, a little girl named Mylee Grace earned her angel wings at the tender age of five. She suffered complications from chiari and mitochondrial disease. I'd heard about her and seen her lovely smile many times via social media, but I unfortunately never met her. Her mom and I are Facebook friends due to many mutual friends and that shared special needs connection. Unfortunately, this isn't the first death of a child I have heard about in our special needs circles. It won't be the last, but it has made me the saddest. It hit home due to the mito. And it really has made me think. When someone passes away, we try to take a piece of them with us, to honor them, to change our own lives for the better. We say someone touched us or inspired us. How does this work when someone dies who you had never met? I think it's like this: Today I changed fifteen diapers. Fifteen. Fifteen MESSY diapers from my FOUR year old, who should be potty trained, and who is obviously suffering from some sort of intestinal ailment right now. Each time, I wanted to grumble, or be annoyed, or feel sorry for myself. But, I caught myself. Oh sure, I still wasn't jumping up and down about the task at hand, but I thought about how much I would miss every moment, even THOSE moments, if Joshua was no longer with me. I will try harder than ever to take all of it... the diapers, the messy house, the formula spills, the crying, the therapies, the doctor's appointments... in stride. Because if those things were gone, if he was gone, I would miss it all terribly. Mylee, you are pain-free now and I am praying for your family. Thank you for making me more aware of the blessings in my every day tasks. I am wearing my butterfly necklace... and smiling while I change those diapers... because of you.

Reality, Heat and Hope

I love the whole glass half-full concept in life, and I will try to keep up with that as much as I can. I am going to be honest, though, the past couple of weeks have been rough. We've had a change in routine due to school being out for summer, and the heat has been especially hard for Joshua. As much as I want to continue to sugar-coat things, or nod my head with a smile when someone says he is doing "great," I just can't right now. More and more, I see that what we are dealing with is simply NOT normal, and I won't pretend it is. What you see as a good moment can so quickly progress into fatigue and dehydration. Also, a glimpse into our home life would show you what we go through for a chance of him to be even at baseline. Before you see us for a morning playdate at your house, a therapy session or an outing at the movies, a lot of things have already happened. For one, I was likely up til the wee hours with a racing mind, researching, emailing, or (if I am lucky!) reading for fun, just to relax a bit. Joshua has likely crawled into our bed crying and fussing around 3:00 or 4:00 a.m. He may have had leg pains, and stomachache or needed a diaper change. He likely has already had two reflux meds, one supplement, 8 oz of his elemental formula, a motility med and an electrolyte-containing beverage with thickener. He probably has not, however, eaten breakfast, as he usually lacks interest or ability, despite our best efforts. So, the whole time we are out, I am worried about his nutrition and fluid intake as well as how his body is reacting to the heat. I am also observing how he is walking and how tired he seems, to determine if it is a wheelchair day. I am observing any swallowing he does to make sure he isn't aspirating. I am watching his cheeks for signs of redness, his eyes to see if they are swollen, and feeling his skin for cold sweats (hypoglycemia). I am sometimes scared we should not have even left the house, but I try to create as normal a life as I can for him and his two older brothers. I have to carry a huge bag full of stuff just to make an outing safe. I always come home exhausted. On a different note, I am observing listening skills, emotional regulation, speech patterns and socialization, none of which I can claim to be age-appropriate, so that is a whole other avenue to deal with. I realize all parents worry and many parents have so much more on their plates than this. I admire those parents more than I can express. Joshua has done well over time in SO many ways, and for that, we are lucky. I don't want sympathy or- so much worse- pity. I simply want understanding of what families like ours go through on a daily basis, and how that is also amplified by summer heat. Diseases such as Joshua's metabolic/mito dysfunction are similar to lupus or chronic fatigue syndrome in the sense that the patient can look fine in some moments, or even for days at a time. It's both a curse and a blessing to what we refer to as "invisible illnesses." In these cases, a lot of compassion and a desire to learn and spread awareness can go a long way! One of the best things someone said to me recently was, "I don't really understand, but I WANT to!" Thank you for that. I hope many others will follow in your footsteps, with an open mind and heart.

On Eating Out With Special Needs Kids: Why We Still Try

Saturday was Cinco de Mayo, and so I decided I "had" to have some chips and salsa (ok, and a margarita, too). The way the restaurant experience went was pretty typical for us. It wasn't one of our better outings with the kids, but it certainly wasn't the worst, either. We went to a local Mexican restaurant, which took about 15 minutes to drive to. During this time, my 7 and 4 year olds hit each other with a toy drum stick, which of course my husband took away, which then caused more screaming. When we finally arrived, there was a 10 to 15 minute wait for a table. My 4 year old fussed and moaned so much that I finally picked him up, hoping some cuddles would calm him down. Once we got seated, we realized the booth was pretty tight for our family of 5, but we didn't want to wait for another spot to free up, so we decided to make the best of it. Now on to the next challenge... Two of my children and myself have food allergies. This was a restaurant we had been to before, so I knew what I could eat, but it had been a while since the kids went to this particular place with us. I was racking my brain trying to remember what things were ok from the menu. Once I got that figured out and the order was placed, I remained busy trying to keep everyone hydrated and happy. My 4 year old requires thickener in his water, so I luckily had remembered to bring that. Usually when we go out, I also bring some extra snacks such as cereal or fruit chews, plus some baby food and his medical formula. This provides a "safe guard" in case he doesn't feel like eating much from the restaurant (which is often), or, in case the food allergies are too hard to figure out at an establishment. If I am lucky, I also have remembered to pack some form of entertainment, although on this day I really didn't have anything with me that excited anyone! Once the meals came to the table, we checked carefully to make sure they had been prepared to the specifications we need, and then we got busy eating. Well, some of us did. My 4 year old pushed food around on his plate. I think he finally ate one french fry. My older kids did fine. However, they are not immune to table time issues, either. Sometimes they get restless and try to act too silly at the table. Other times, an allergen winds up in my 7 year old's food. (He can't have dairy). Sometimes my 11 year old suffers from swallowing difficulties. Even my husband can struggle with this at times, thanks to a disorder referred to as "EE" or "EoE." We have been in restaurants before when one of my kids had a tantrum, cried about reflux, or worse, vomited at the table. With all of this on board, you might wonder why on earth we don't just stay home all the time. Here is why: I like going out to eat. My kids also, generally, enjoy this change of scenery from our normal life. We have a small house and an even smaller kitchen. It's fun to spread our wings now and again. Aside from that, eating is social! I have two children on the autism spectrum. That, or the food allergies and other digestive issues could scare us off from eating in public, but I think of all the opportunities they would miss if I simply isolated them from meals out, picnics, school carnivals or birthday parties. Almost everything social involves food! I would hate for them to grow up believing it is too hard for them to join in these activities. When they become adults, I want them to feel confident that they can handle a noisy restaurant, and that they can navigate a menu. I want them to accept the invitation to a friend's birthday party, wedding or baby shower. At the very least, they can eat ahead of time and simply go for the sake of supporting friends and mingling. This is what it is really about. If I keep instilling in my kids that they CAN do this, then it will positively impact their future. Until then, though... I might be needing an extra margarita!

Sweetest Valentine

This past week was Valentine's Day, a holiday that I think is fun at my kids' schools, but that I have no major emotional attachment to, or so I thought. That was before I received the most beautiful valentine ever.

My husband took the kids to school that morning and collected paperwork from the teacher, and so it was not until later in the day, when we switched cars back, that I saw a red and purple correspondence lying on the floor of my van. There was some sparkly paper folded up with a heart sticker in the middle. In retrospect, I wish in some ways that I had waited to be with the card-maker (my 3 year old, as it turned out), before opening. But in other ways, I am glad he missed my emotional reaction. I carefully peeled back the sticker, and inside was a small, red construction paper heart with a photo in the middle. The picture was cut jaggedly into a heart-shape also (obviously done by my preschooler with love). The photo showed him sitting in the sand of the playground, looking down contently at a bucket. It summed up the innocence of the age he is at now.

As any mother would, I then thought about how he would not always be this little and sweet, and how time was moving too fast. But then, something else hit me unexpectedly. I got a rush of emotion about his diseases, and it slapped me in the face, more than it ever has before, that I might outlive him. Yes, I have thought of that before, and I have even blogged about it. But this time, in a way that is tough for me to explain in words, it was different. It was the most I have ever faced the enormity of it all. And I realized I don't know how I could ever be on this earth without my son. My heart hurt and I couldn't breathe. His lack of exact lab findings on mitochondrial disease have left me the ability to ignore reality many days, or to assume the best (maybe he doesn't have it!) But the fact of the matter is, he has something metabolic for sure, and also, we know that he has gastroparesis. His stomach has slowed down a lot lately to the point where we are having to search for more and more medicines to get things going, as well as get second and third opinions and consider drastic measures like gastric pacemakers. We now also give him several supplements believed to increase energy. Take a minute to think about that oddity, as I did. He is in preschool. He will be 4 next month. Usually at this age, mothers are chasing their children, and saying they cannot keep up with them! It is common to hear things like, "I sure wish I could bottle that energy!" And here I am, giving my child a "cocktail" of remedies just so he can (sometimes) get off the couch. I have to encourage him to try and play, as do his teachers, where as normally you'd be telling a child this age to slow down or relax!

So, how to take these sad feelings and reality and make them positive? I think the answer is the same as it has always been for me. Don't dwell on the future. Appreciate every day. And, when grief does want to take over, let it come for a while. It's acceptable to grieve normalcy. It's ok to think about how much you will miss someone when they are gone. And then... hug. Cuddle. Say "I love you"- a hundred times. Don't stop believing in the possibility of a cure.

The precious heart card is now in a frame in my family room. I knew I needed to keep it close and make sure it was preserved. It doesn't make me sad to look at now, as it reminds me of all that is good in my life, of all I have to be thankful for, and of love, in it's purest form. Nothing could be better than that.

From The Darkness: On Seeking Help

Recently I have read quite a few blogs in which people have opened up about their struggles with feeling overwhelmed or depressed.

I think about this a lot, as I experience the same feelings sometimes. It's optimal to say we are happy, and to stay as positive as possible, but it is also ok to be sad! I am not a huge advocate of saying I am "fine" if I am not, or posting inspirational quotes when I feel like my world is actually caving in. Sometimes in attempting to look at the bright side, we can, in fact, make our mood better. Still, for the most part, if I am having a hard time, I am going to tell you. I don't really think it benefits anyone for me to be dishonest. If you know me well, you have seen that I feel profoundly hopeless and alone on a down day,and yet luckily this doesn't happen too often anymore. I feel genuinely happy more often than not.

One of the darkest hours I remember, though, was when I was at the end of my pregnancy with my third baby. We were already navigating a new autism diagnosis for my oldest child and a food allergy issue for my other son. The baby I was carrying was not moving much at all, and I was horribly sick with a cough that would not go away. My mothering instinct felt that this third baby had special needs, too (and I was right). When I look back on that period, I remember everything being black. That's how depressed I was. Literally, my images are in black and not color, when I reflect upon that time. I think I very much felt like I was standing on the edge of a dark cliff and that life wanted to push me past the edge.

Despite not feeling social at that time plus being busy, I somehow still became interested in a local high functioning autism support group I had heard about. I remember when I spoke to the woman who started the group, she was in awe of me wanting to get involved right before having another baby. In fact, the first meeting we attended was right after he was born. It was one of the best things I ever did, though. Five minutes in the door, and I knew I had found others who understood me. I didn't yet have a good online support system, and none of my current friends' children had special needs. I almost cried in relief to see other kids accepting my oldest son, not to mention that he enjoyed his time, too! I often look back on this and say that it saved my life. Autism is now our normal. I don't need this support group as desperately I once did, but we still go to the meetings and enjoy the sense of belonging. I have also gotten very involved with another organization that helps children with feeding issues. I will be reaching out to this community for a long time to come, utilizing continued positive connections and giving back of my time, too.

What would have happened if I hadn't pushed myself to seek help when I needed it? If you are having a hard time, I urge you to seek support in the area that concerns you most, or to simply pick up the phone and call a friend who will understand. In addition to that, I believe that we benefit no one when we consistently hide our true feelings. It's ok to tell Facebook that you're sad about something. No one likes "negativity," but we do like honesty. Through opening up, help can almost always be found. May your 2012 be filled with love and light.

Embracing Miracles

It's that time of year again. Christmas is upon us, and it's time to reflect on the past twelve months. It's nice to think about our successes as well as our shortcomings and how we hope the new year will be better. It's a good time to consider what we have learned. Somehow, in the midst of the mundane yet crazy busy year, I have learned to truly believe in miracles. Maybe I always did, though. Maybe this blind faith was always lurking just beneath the surface, but needed something concrete and personal to bring it forth.

Let me explain. My youngest child is now age 3 1/2 and has demonstrated the ability to eat a normal meal only a handful of times. By "normal," I mean an age-appropriate portion or consistency, and I also mean that the meal would take place without gagging, choking, pain, tears or vomit. Actually, just getting him to the table at all is sometimes a feat. The main issue is gastroparesis, a condition that makes it hard for him to take a lot of food in at once, as the stomach doesn't pump efficiently. A recent trip to the nutritionist shed light on the fact that he is getting only half the amount of calories daily that a child his age and size should receive. This is not despite our best efforts, of course. He is still on formula, and it's done well keeping him alive, but he can't drink enough of it or add enough regular food to meet his appropriate caloric intake.

Despite this, he is not losing weight. He is, in fact, gaining. It's very slow, but it has happened. Because of this, he isn't a logical candidate for a feeding tube yet, even though the tube would ease our minds. In fact, his stomach moves so slowly, that if a tube were to be placed, it would go into his intestines instead of stomach, anyhow. That makes me really realize how tough this disease actually is. And yet... somehow... he thrives. Several doctors and therapists have mentioned that they can't explain scientifically how he could be doing as well as he is. In our numbers and facts-obsessed world, this just isn't ordinary.

During another recent appointment, I was told to consider that maybe Joshua simply doesn't even NEED those extra calories the way a typical child would. One theory is that he is often fatigued and therefore not overly active. Still, this thought is hard to feel at peace with. It's asking me to believe in unusual circumstances. It's asking me to trust in things I cannot see or have the knowledge to understand. It's asking me to believe in something that, in some of my darkest days, I have doubted, and that is a higher power.

But, this is what it has come down to. Until we reach a point where something tips the scales the wrong direction or some other decline happens, we have to just trust that all is well. Within that, believing in miracles has really become not an option, but a necessity. On a daily basis, I have learned to coast along on faith. The logical side of me still argues with this idea at times. It is very hard to put your child to bed at night knowing you weren't able to nourish him the way a chart would say you should, and yet trust that he is alright. There are still moments of doubt and tearful calls to the doctors. They question their judgement at times, too. It's a tough situation for all of us to navigate.

However, there always comes the blessing of a new day, with Joshua in his little footed sleeper, smiling and announcing he is ready to cuddle. I am always ready for the challenges we face, even when I feel slightly deflated. His smile and blue eyes inspire me. That, and the chance to look for more miracles. If I have one in my life, there must be more waiting. I look forward to another year of discovering them.

Merry Christmas and Happy 2012!

My Current Top 3 Things That Work

I've been thinking about parenting, and special needs parenting in particular. So much of it is guess work. I am constantly asking myself if I am doing the right thing. There are many decisions I have struggled with. In the end I generally feel good about choices I have made, but at times I could have used assistance from other parents who had been through similar decisions before. Of course every child is different, so what I have so say now may or may not apply to your situation. However, on the off chance that this helps someone, I will write about a few of the best things I have done so far for my youngest child, now age 3. These are the choices that have helped make our daily living easier.

1. Getting a wheelchair.
I realize for some families this is a necessity and not even a choice. According to our orthopedic doctor, we HAD to get one, too, and yet technically Joshua falls into a gray area. He does walk. Sometimes he can even run! But, his gait is clumsy and he tires very easily. We worked around this issue for years by using a baby stroller, of course. However, it started to become apparent that Joshua was not going to outgrow his issues, and that at times the walking even looks worse than it did before. On top of that, he is extremely tall for his age. His head was uncomfortably above the top of his regular stroller. I had the prescription for the wheelchair on my nightstand for quite some time before I could look at it without wanting to cry. Once I made the call to set up an appointment for measurements and choosing a seat, though, I felt more accepting. And when I saw how excited Joshua was, my heart was even happier. I started to see his wheelchair as freedom... for us both. This will enable us to take long walks or go on long family outings comfortably for years. It does resemble a stroller. It's a nice style. It's even "fire engine red" (per a certain 3 year old's request!) We don't use it every day, but I love knowing it is there. If you are on the fence about getting a wheelchair for a child who is mobile yet struggles, my advice is to go for it. I don't think you.ll regret it, ever.

2. Getting a handicapped tag for my car.
This is related to #1. We got our tag quite some time before the wheelchair, though. It came at the perfect moment, right before a trip to California in which, for still unknown reasons, Joshua lost his ability to walk for a few days. I still use it a lot. Like the wheelchair, I don't use it every day, but I love knowing it is there. I don't abuse it. Whenever possible, we try to park close yet save the actual handicapped spots for people who need them more. I do feel good about knowing we can park in handicapped when we need to maneuver the wheelchair, or when Joshua is sick or low energy. At times, he requests to walk, which I hate to deny, and the tag also comes in handy then. He simply cannot comfortably walk on his own from a far away spot. Being able to park in handicapped and then helping him successfully make it to the door helps his self-esteem, rather than him feeling like everything is too difficult for him movement-wise. If your child is mobile and doesn't always "look sick," be prepared for the potential for clueless, rude folks to question your use of the handicapped tag. This is a downfall, and yet it has only happened to us one time. I think the general public is getting a bit more educated that you cannot always SEE a disability clearly. Plus, when you know you are doing what is right for your child's needs, of course it should not matter what others think, anyhow. Handicapped tags or plates are there for those who need them. If your child falls into this category, even mildly, I suggest you get one.

3. Not obsessing about potty training.
This is tough as a parent. There is a lot of pressure from friends and relatives. Like with other delays, I have had to not think about the chronological age of Joshua too much and "what the other kids are doing." He's always gone at his own pace. I do have days where I panic about the time line a little. And, I have even wondered if his stomach issues and weak muscle tone could make full training an impossibility. I will cross that bridge when we come to it. For now, 99 percent of the time, I am able to gently suggest to Joshua that he could try to go potty, but let it go when he can't or won't. I change his diapers without complaining in front of him. He still drinks formula, eats baby food and sleeps in a crib. It therefore shouldn't be shocking that potty training is on the back burner. There are so many other things to work on! I think his little brain is going all the time. He's improved his speech and has become somewhat social at preschool! These are things to cheer about and focus on. I hope I am not still changing diapers when he is in kindergarten, but one day at a time will lead us to whatever outcome is meant to be. If your child is similar, try letting the potty thing go to some extent. Encourage, accept, don't pressure, and see if you both feel a lot more content with each other.

There are other decisions I feel good about, too, but right now these are my top 3. Of course I have my share of mistakes also. (See previous blogs for some of those confessions!) There are so many important things to figure out all the time while raising children. When kids have extra needs beyond the ordinary, life becomes even more confusing, but remembering to relax and ask for help go a long way towards making daily living easier.

This Is Why It Hurts...And Why It Will Get Better

Often there are things that happen during the day which are so draining, I don't feel like talking about them later. They are the ups and downs of everyday life, sometimes too mundane to rehash. Then there are the things that are so painful to me that I can't speak of them out loud, even if I wanted to. Sometimes, though not always, I can write about them instead. I know my last blog was all about looking on the bright side. I'm still in that mind-frame. But I am also a parent, and a sensitive one at that, and I had a tough day.

There is always a learning curve in mothering. At first you have to try and decipher the sounds of different cries, to change a diaper, to breastfeed or mix formula. Later, there is the discipline, potty training, or choosing a preschool. Second or third babies are easier in these regards, unless they have special needs, in which case you are learning all over again.

Such is the case with my third child. He isn't even the only special needs kiddo in our bunch, but of course every situation is unique. So far I have learned how to give him medicines, mix his supplements, clean vomit out of everything, order and feed his special formula, use an EPIpen, carefully read food labels, organize his therapy appointments, do exercises with him at home, keep track of his rotating needs with various specialists, coordinate habilitation and respite workers, advocate for him at school, count calories, order him a wheelchair, use a breathing machine, have him fitted for shoe inserts, smile when he has nights in which he wakes up as much as a newborn, bravely hold his hand as he goes for x-rays, MRIs or endoscopies, stay up late searching for answers on the internet, ignore depressing statistics, and countless other jobs I thought I could never handle. Meanwhile, while I don't do it perfectly by any means, I also have responsibilities with my other kids, my husband, my house, my parents, my volunteer commitments and my friends.

So, the other day when the endocrinologist said we needed to start checking blood sugar levels at home for hypoglycemia, I confidently thought, "Sure, no problem." Ok, I was a little nervous, because the nurse only gave me a very quick demo, but I still believed I could handle it. Unfortunately, I was mistaken. Not only did I not understand how to do the test well enough, but I also got emotional.

Today I picked Joshua up from preschool, and he felt cold and clammy, one of our signs that his blood sugar may be too low. I waited until we drove a couple minutes to the Target parking lot, because he was so worked up at school, and then I got out our blood sugar monitor and the supplies. Still confident despite his wails of protest, I didn't waste too much time bribing him with the promise of a blue icee and getting started. With trembling hands (a surprise to feel), I used the little lancet that came with our kit. It seemed I didn't get enough blood for the test to work. Determined, I got out another strip and lancet, adjusted the setting, and went for it again. This time I drew enough blood and I hurt him on top of it. I think the silent tear and look of disbelief on his face at that point was far worse than the earlier screaming. (In moments like this, I always think of that line from that old song, Mandolin Rain- "listen to my heart break..." - because surely mine is ready to rip in two). I apparently didn't have the strip in the monitor correctly that time, because I still didn't get a reading. At this point, I gave up, went in to Target for the treat, and we went on our way.

After an OT appointment, we returned home and this was all still weighing heavily on my mind. I knew if I could just learn this important job, my mind would be at ease. And so, before Joshua's nap, I somehow worked up the courage to try again. He was not a fan of this idea, of course. In fact, he was flailing, crying and screaming. (What a great time to be wielding a needle, right?) I finally had to get tough and have my husband hold him down while I did the test. This time we were back to the "not enough blood" problem, and I didn't have the heart to try it a fourth time. I ended the afternoon feeling like a failure.

I know that I will manage to learn this, the way I have learned everything else. I need to breathe and get the basics down, which will empower me, which will in turn calm my child. I know I am doing it for his own health and safety, but this is the first time I have had to hurt him. Regardless of the caring intentions behind it all, and the fact that I am following doctor's orders, it pains me greatly. I will eventually file this away under "things that seemed like a big deal at the time but aren't anymore." I can't say I will look back and laugh. I won't. But, it will get easier.

Tonight I will forgive myself for not being perfect. Tomorrow I will cover Joshua with kisses and hugs when he wakes up and we'll look forward to a new day together. I need him to know that I am not always good at things, but that I am not afraid to try again. I want him to understand that sometimes life does hurt, but that the great moments outweigh the hard ones. It's a tender age to learn such lessons, but I believe it is within his realm to understand. When he is older, I will be able to explain more to him, like how truly privileged I feel to be on this journey with him, to be his mother, and to have been entrusted with his care.

Focusing on Ability

I have written before about the ways in which Joshua, due to health issues and developmental delays, is still babyish, and how at times this is a blessing in disguise. I still feel this way. The sentimental mommy in me is never in a hurry for him to grow up. But I realize that there are undertones of negativity to this, too, as it focuses on what he CAN'T do. For example, right now, at age 3 1/2, he is still not potty trained, still walks awkwardly, still drinks formula as his main nutrition and rarely sleeps through the night. I do spend a considerable amount of time thinking about these concerns, writing about them, or discussing them with close friends.

About a week ago, we needed things at two different stores within a shopping center, and I decided we would walk between stores rather than re-parking. Given that Joshua has had a bit more energy lately due to a new med (hooray!), I didn't even bring the stroller. Joshua's brothers were with us also, one of whom is pretty much never in slow motion. In an attempt to keep up, Joshua was walking pretty fast, with his feet turning inward and his left hand raised slightly more than what is normal for the age, with his right arm flailing. I found myself watching him a little sadly and thinking, "He lacks the ability to walk normally." Then, I stopped myself and re-worded this internal observation to simply this: "He has the ability to walk." He can walk! Seriously, what a miracle, given the early days where we never thought he would! It certainly put things in perspective for me. Since then, I have used this as a mantra on days where he seemed really behind with his motor skills or when I made the mistake of comparing him to his peers. I would think, "He has the ability to walk," and then suddenly nothing else mattered much.

This lead me to think... what if I looked at all of his struggles this way? Then, "He lacks the ability to eat properly and is still on formula" could become: "He has the ability to drink formula." See what happens when you take out the negative details? This could even work for other things in my life, and not just pertaining to special needs or to Joshua. I see it as a way to slow down and calm myself when thinking about my many responsibilities or when the future seems to be way too much to process. One example I can think of is how I always criticize myself for what I can't get done rather than what I can. This can be overwhelming. So, instead of thinking, "I lack the ability to keep the house clean and organized," how about: "I have the ability to clean or organize small things one at a time when the schedule allows." Or, for that matter, how about, "I am grateful to have the ability to get out of bed in the morning and accomplish all that I can."

There really is a lot of power in positive affirmations. Words, whether spoken out loud or thought in my mind, have always held a lot of power for me. It is therefore crucial to me that I remain aware how truly lucky we are, and that I am as positive as I can be with my vocabulary. Try choosing your words more carefully. What do you have the ability to do? What do your kids have the ability to do? Maybe the inabilities will fade while the good stuff moves to the forefront where it belongs.

Letter to a Younger Me

Dear Debbie at age 16,

I know life seems hard now. You worry a lot about what everyone else thinks. There are events that seem monumental currently, but that won't matter in the big picture. It is difficult, at your age, to understand this. There is so much coming down the line that will be challenging, so you should have fun now while you can. By the same token, in ways, the wisdom of age will make you a happier person. Years from now, this will all make sense.

Let me share with you a few things I have learned:

Beauty is not all about being young and skinny with great hair and perfect clothes.
I regret that it took me so long to realize this, but it is true. It's the reason that mom I know from the pre-school who is bald from chemotherapy has never looked more gorgeous. It's the reason my 93 year old grandmother radiates with beauty when she smiles. It's the reason that, much to my surprise, I feel most attractive not when thin and made up, but with weight to loose, a baby on my hip, and his sleepy head on my shoulder. Beauty comes in many forms and does not have to be found in a conventional way.

Heartbreak doesn't last forever.
I know it feels like it will. But the world is big, and the relationships you form now are just the beginning of a life of connecting with others. If someone is cruel to you, run and don't look back. You are so much better than that. By the same token, if someone does treat you right, don't assume that will come again easily. True love is rare. If it matters, it will endure, and you should embrace that. Also, don't overlook people. Sometimes the ones you take for granted now are the ones who care the most, and who will do anything for you, even decades later.

Struggles make you stronger.
This is something your parents or teachers will say often, and that you will roll your eyes at. It turns out it is good advice. Not only does adversity make you stronger, but it also makes you a more interesting person. It sets the stage for challenges that will come down the road, because life definitely is not easy. You can choose now how to view things, whether to see them as road blocks or blips on the radar. Try to do the latter. Also realize that out of those situations that are the most difficult can come your finest hours. It's this ability to get beyond a D on a test, being picked last for the team every time, or having a fight with your best friend that will empower you to, years later, be able to pick up the pieces. There are things that will happen to the adult you that you can't begin to imagine now. You will need to learn to advocate for yourself so that you can fight for your children. They will need your positive but firm voice to help them get what they need at school, in doctor's offices, and in life. You will be their biggest fan, but not if you can't believe in yourself first.

Maybe part of the joy in our lives is not knowing what lies ahead, but I also think glimpsing the future can make you slow down and realize what truly matters. You will have so many good moments to outweigh the bad, you will laugh more than you cry, and you will be loved.

Sincerely,
Debbie at age 36

On Thinking You Know...When You Really Don't

One of the downfalls of sharing so much online is that it occasionally opens one up for criticism. I have had a little of that here and there, and it has never been anything too dramatic. Something happened the other night, however, that shocked myself and many who saw it unravel. I don't like to continue negativity, but in as positive of a light as I can spin it, I need to talk about this. It isn't just for me. It is for the other parents who also share online through blogs, Facebook content or Twitter. I have enjoyed reading their ups and downs, their daily anecdotes as well as their struggles. We need to continue to tell our stories, because they matter. I plan to do so. I will not let one cruel person make me question what I share.

In the midst of an ER run with my youngest the other night, (because he had a very high fever), I went on Twitter via my phone to pass some time in the waiting room. I asked if anyone was still awake, because, hey, the ER in the middle of the night is a little lonely. One of the first people to respond was someone I share mutual friends with, but do not know well. She has caused waves with others in the past, but I, because I am a nice person, continued to follow her online and allow her to follow me, too. It started out with her asking if I needed anything. Sounds nice enough, right? Then it very quickly proceeded to her accusing me of lying about not being able to attend a pot luck she was having over the weekend. After that she started making cryptic comments about how she hoped my child would get better and for me to read into that however I wanted. It really made no sense. Then right after that, which I unfortunately did not catch until the next day, she "happened" to post a link about a mental illness in which a parent somehow finds the time to fake illnesses in their child, make them appear sick and "hospital hop" seeking attention. This was followed by the hashtag: #justsayin.

This person has met me only twice in real life and has NEVER met my child. If she would have taken the time to learn the whole story, rather than just the window crack she could see on Twitter, she would know this:

Joshua has developmental delays as well as some health (mostly gastro-intestinal) concerns. I have spent a lot of time in my writings saying how fortunate we are, and that our problems are nothing compared to so many. I don't seek sympathy, but I enjoy sharing what I do know and reading about others who have similar concerns with their own kids. When someone tells me that a blog entry, or even a tweet, was something they could relate to, it makes me feel good. Our doctors have had a hard time getting Joshua to fit any one clinical picture, which is not unusual. It may make unkind and closed-minded people, such as the woman mentioned above, assume there is "nothing there" then, but that is not so. For lack of knowing what else to call it, for now, our doctors use "mild cerebral palsy," while also being quick to tell me they know it is more than that. Again, this is not unusual. There are so many neurological, genetic and metabolic conditions that it is like throwing darts in the dark sometimes. Some children never receive a conclusive diagnosis.

As for the hospital trips, maybe this person could have taken the time to ask about our schedule. We go to the children's hospital here once or twice a week just for simple pediatric therapies such as OT. Also, all of Joshua's doctors work out of that hospital, so whether we have a check up with a specialist or just a run of the mill cold to look into, that is where we go. Our ER visits are likely an average amount. I go if there is an alarmingly high fever, vomiting that will not stop, or an injury, as any good parent would. So yes, you may see a "check in" to the hospital more than what seems average, but it is not always for something major. It is definitely not for something I have made up for "fun" (in all that spare time I have, you know!)

Maybe this person has seen me say that we are going to California and Wisconsin for medical care soon. I happen to know many parents who have traveled out of state to seek medical care for their children. It isn't that abnormal. If this woman would have taken time to ask, I would have explained this: We were told to seek a second neurological opinion on Joshua. The question of metabolic/mitochondrial disease has also been considered, and so I was fortunate to find a doctor somewhat close to us in California who specializes in all of these areas. We are going to Wisconsin because our gastro-intestinal doctor said it is the next step. In fact, he wanted us to go to programs back east that lasted two months! I was happy to find a shorter plan in Wisconsin. Joshua has already been through feeding therapy at the hospital here, and it didn't increase his volume of how much he ate. He has flat-lined on growth. (Miraculously, he is not losing yet!) He will not be able to sustain long term on the amount he is eating. We don't know enough about his gastroparesis to know what his stomach really can handle in one sitting. He may have hit a ceiling as far as his eating ability. Our doctor feels that it is vital to get more information and maybe do some intensive feeding therapy, seek alternative ideas and gain knowledge for what the future holds. It may still result in a feeding tube being placed. I asked about twenty times over the course of several months if we really needed to travel for this, and each time the doctor or his nurse reminded me of the reasons that we do. I hate to fly and be away from my other two kids. This is not something I want to do. It is something it turns out I HAVE to do for my baby. Who wouldn't?

I choose love and explanation over hate and yelling. But I still had to speak out about this because the woman behind the ridiculous assumptions was so wrong, and because I am sure there are other parents who have been in this situation before. I will continue to share our journey. I will be open about my bad days as well as the good. I will do everything I can to help my child until his doctors and myself are at peace with knowing we have turned over every rock within reason. It is not crazy. It is responsible, logical parenting.

Precious Time

Given the experience I have had with special needs and the time I have had to get used to the idea, I have been pondering why I still feel such a roller coaster of emotions over it constantly. Sure, autism is tough to manage, but I have been down this road before. And yes, boy number three has more physical movement struggles than I have dealt with before, but there is something else. I thought about this all week and then it hit me: I have a chronically ill child. Yes, autism is chronic, but what I mean is: my third born feels physically sick more often than not. I am talking about the extra diagnoses that make him medically fragile.

Some of the things we deal with are reflux, gastroparesis, food allergies and fatigue. On a daily basis, he may feel too full after just a few bites of food, might have a burning throat or upset stomach, or be overly tired while his peers run circles around him. It is heartbreaking as a parent to see your child in pain so often. Our medicine cabinet is much fuller than I would like. We have tried many medicines to control the symptoms as well as added some vitamins to the mix. His formula is a special kind that requires a prescription as well.

And then there is the great unknown, and the fact that his collection of symptoms suggests a larger, all-encompassing diagnosis that has so far alluded doctors. The immature gait, the unexplained fevers, the slow stomach, the lack of energy, it all adds up to something, they say. "Something"- and yet no one knows what.

At certain times I have expressed my desire to appreciate every day, but I doubt I have ever written with brutal honesty this simple fact: I do not know how long my child will live. Yes, his ailments may turn out to be pesky things that will improve some with time, and he may learn to adapt and live a full life. Without a clear diagnosis, we live in doubt and sometimes fear. I do realize we are not alone in this, and that many other parents, TOO many other parents, share this experience. And yet somehow it has been hard for me to identify my feelings about it or want to share.

This is why I drop everything and lay down with J.C. when he wants to cuddle. This is why I sneak into his room to look at him sleeping at night, or why I sometimes am secretly excited if he wakes up. This is why I do enjoy my breaks but miss him after a few hours away. He calls to me... time calls to me... more precious when it might be too short.