Thursday, June 23, 2011

Just another day in paradise

It's been a month since pukefest '11. That was awesome. No, really superiorly fantabulous. Of course Phil was TDY. Bad things always happen when he's TDY. Always. Despite countless promises post last health apocalypse to avoid unnecessary TDYs- he came home from work 2 weeks ago and says- so um when does your friend get home from Disney?

Me, well I decided I was approaching this all wrong. Enough of the impending doom, they are all out to get us and by they I mean fate. I was going to be positive God Damnit. It was time to embrace the positive and gain back the confidence I lost somewhere. -You miss her too? I ask

Um, well I have to go to Langley. - Ah well, do what you gotta do- we totally need the healthcare.

Wait a minute. Wait a cotton pickin minute- you think I cannot get through one lousy week without a crisis?

No, of course not- I just like to all the bases covered. Plus I don't want you to be lonely.

No you don't think I can do it or no you think I can? I have 4 kids. I. don't. get. lonely. Somebody always wants something, usually when I am in the bathroom or on a call- which is rarely with an actual friend because it is with the pharmacy or the endocrinologist or the oncologist or the public health nurse.  Somebody always wants to give me something, usually it's the flu, or a cold, or a dead insect- all highly preferrable to worms- and by that I mean the intestinal kind. Just like your job takes you to Langley- mine keeps me here with promethean accuracy.

I have been lost between getting through the day and wanting to make a difference. Sometimes just getting through the day does make a difference. It shouldn't be that way. But what way should it be? There are no guarantees. Everything is what we make it. There are always challenges and factors outside of our control. You deal with them and move on.

We drop Phil off at the airport and it seems like we just did this. I push away the sense of impending doom and embrace the opportunity that has presented itself. I clean my bathroom and do a few loads of laundry. The kids are off doing a lemonade stand.  I make them dinner(which is to say I drive and get take out) and then it is time for baths and bed.  1 day down- see, no worries. I got this. Day 2- rinse. repeat. Day 3 is livened up with by the soon to be middle schooler's band practice, gymnastics , art class and a trip to Costco for rations. That night I take a quiet moment to pause and appreciate the normalcy of it all. I can do this.

I wake up day 4- the official half way point of this TDY and think I will get the house cleaned today. I no more than complete the thought and Bella climbs up into my lap with complaints of a tummy ache. Yeah you know how this ends. Within an hour she's puked 3 times- once all over my bed. Well- I was going to wash the sheets today anyways- look at me embracing the positive.  Downstairs she pukes. And again. My neighbor comes over for a cup of tea and after 3 more puking episodes offers to take the other kids so I can take her into clinic.

I am literally on hold with the clinic when I get a call from school. Phillip threw up at band. Here we go. Again.  I go get him and Monica takes the healthy girls to her house. We go into clinic.  We get the diagnosis- it's just a virus. I smile slightly on the way home. Embrace the normal. I am kicking normal's butt. Kids get sick. It makes for a long day, but it's manageable.

When Phil calls I chat like it's an average day- which if you think about it- it is. He wants to talk to the kids. I hand the phone to the preteen fully confident that he will grunt maybe twice and hand the phone back. No- the first thing out of the lil shit's mouth- yeah band was good until I threw up. I feel like I just got caught with my hand in the cookie jar- I shake my head trying to get him to stop- oh noooo he goes on- yeah and Bella threw up alot like 8 times. Between the horror of it all I'm offended- she puked 8 times when HE was around- let's not forget the other dozen or so times.  No we are embracing the positive. I get the phone back.  -So the kids are sick?  - oh yeah- well you know this IS normal for us. He laughs hysterically. I'm sure it's a lot funnier from his vantage point. -Do you want me to come home?  For puking kids? Nah I got this. Just another day in paradise.

Wednesday, June 15, 2011

Risk/Benefit Analysis- Vacation Vaccination

How many times have you heard a person complain- I don't care about such and such- I just wish I had a choice?  The fact of the matter is that you always have a choice- but you perform a Risk/ Benefit analysis of your options before you make that choice. Telling ourselves that we don't have a choice is one of the ways we make ourselves feel better about having to make the tough decisions.   What we choose to perceive plays important roles in our choices. Our faith, belief system, politics, history, genetics, customs, comfort levels- all have a role. When we let these factors play into our choice- it sometimes feels like the choice itself has been eliminated for us. Sometimes by putting events into God's/fate's/the majority's hands- we step back and it is easier to accept control is not ours- or relinquish control a little more easily because someone else is making the decisions.  Sometimes we know from past experiences, or others' past experiences what the result will most likely be and we attempt to save ourselves headaches or time by taking the path of least resistance. There are times that we want to be the person who makes that decision and there are times we just wish someone would go on already and make it.  The disconnect happens when we make the decision and get resistance or provide resistance when the decision has been made for us.

In my day to day activities- I make about 85 choices/decisions an hour. What to eat, what to feed the kids, how much to feed the kids, what to wear, how to get the kids to get dressed, no don't wear that, wear something appropriate- why isn't this appropriate- I don't know it just isn't. Why? Because of what people think? Yes. Why does that matter? Ultimately it doesn't, but it does and you will learn that people treat you different based on what they think of you and I have enough battles to fight- that is not one I choose to fight.  But some people might like it. Yep. So can I wear it? Do you want to fight that battle? Yes, so can I wear it? No. But I want to. I know- but I said no. Then why did you ask me if I wanted to fight that battle? I was curious. That's not right. Neither is that outfit- go change.

So I load the kids into the van and venture off to the new clinic 12 minutes from our house. Yep- 12 minutes. I can't park in that amount of time at Tripler. How's the care you ask? Who cares? 12 minutes. In 24 minutes- I can ask for a referral if I need it. If not I wander the 12 feet over to the pharmacy there and get what I need or 12 feet the other direction and get immunizations or blood drawn. 12 minutes. This week we ventured to Tripler 3 times. Had I been able to make these specialty appointments closer to home- I would have saved myself an hour and a half, 2 gallons of gas and a headache- times 3. If I charge what I'm worth per hour- let's face it- I wouldn't be debating this because world class physicians would be knocking on my door- but let's say 10 bucks an hour, $3.75 a gallon- I would have saved $67.50 this week. We won't even get into sweat/stress equity. Yet in the civilian counterpart world- I would be paying that in co pays alone-at least- so beggars can't be choosers- or can they? Everyone has a choice. It's whether or not you believe you do.

SO A quick physical and TB test for Miss Bella Boo turns in to a vaccination marathon. Apparently over the past few years- I have let her currency on the rare disease immunization front slide a bit. I distinctly remember her getting a whole series of shots not so long ago- so I was a bit put off that she was due for not 1 or 2, not 3 or 4 nor 5- but 6 yes folks 6 shots. It also does not help that I spent the better part of the past couple of weeks reading a fascinating book about Vaccine A- the history and suspicions surrounding the Anthrax vaccine. That book led me to read up on the history of vaccination.  I had a choice. There is nothing that says she has to get the vaccines. If I choose not to, then she can't go to school. If I choose to get them- we face any numbers of complications- but hopefully none. I used to believe vaccination was the lesser of two evils. It is a convenience for both the immunee and the medical staff. The whole point of vaccination is to give your body a chance to build immunity under a controlled situation. Whatever the side effects of the vaccination- they will clearly be less than the full blown disease counterpart. The CDC no longer routinely touts vaccinations as "safe" - they say that they are less risky than contracting the disease. Wow- there's some crazy feel better mumbo jumbo for you. I firmly believe they are correct. I do believe that all vaccines are less risky than their full blown disease.  But no 2 bodies are the same and something as less risky as peanuts to one body could result in death for another. Vaccines are no different. Yet the numbers show that the adverse effects are rare enough to make it worth it. The question you have to ask yourself is worth it for who? 

I do believe vaccination is valuable and has deterred innumerable mass outbreaks of disease. But the quest to find the quicker, better, faster, cheaper vaccine has not been without casualties. Many have heard of controversy surrounding thimerosol in vaccines. Thimerosol keeps staph bacteria from growing in vaccines- it was added in the 1920's after 12(of 22) children who received the diptheria vaccination died due to the staph contaminant. The problem is Thimerosol contains mercury- and mercury can be bad when ingested, inhaled, or otherwise internalized. In the 20's they did not know the risks from this compound and had they- when confronted with thousands of deaths from diptheria- it might have had more benefits than risks to continue using it until an alternative could be found. Yet according to the CDC - there have been few reported cases of diptheria in the past 2 decades. So the risk is starting to outweigh the benefit. If you have a very small chance of contracting a disease naturally and there is an associated risk with the vaccination- what is the best choice? That's a tougher decision. Diptheria itself is not a death sentence. It has been shown that caught early- antibiotics effectively treat it. It is still highly contagious thought- so that is a definite consideration. Yet is it the fault of the vaccine-or does the problem lie with the additive to the vaccine or the potential for spoilage. By 1999 they removed thimerosol from most vaccines, yet some still contain fun ingredients like formaldehyde, aluminum phosphates, phenols, or glutaraldehydes.

There is also the association of vaccinations with Autism or other autoimmune disorders. The problems here are many fold. You will rarely find the scientific community lining up to declare causality. Like the medical community- more things are found through exclusion than inclusion. They will point out that there is a correlation, but that correlations in no way imply causality. It reminds me of a study we discussed in college. It was an during infant development study- the correlation between healthy babies and bottled water was made. Study after study was performed- yet causality could not be determined. It eventually was revealed that the socioeconomic fators of the babies were being overlooked. Babies who were given bottled water were from upper class families who had more access to healthcare, better nutrition and higher education. The babies who received tap water were usually from middle to lower class families who did not have the means to buy fancy water or seek routine healthcare. A randomized double blind test(repeated many times over the past few decades and endorsed by municipal water companies!) showed there was actually very little difference between the health benefits of tap vs. bottled water. Bottled water companies will tell you it's better for you- but there is no real evidence of that. If this line of though fascinates you- I highly reccommend the documentary Tapped- it was definitely an eye opener for me- a former water snob.

So here's the thing- the side effects from vaccines are rare. Rare means less than 1 in hundreds who get it. The diseases they buid immunity against are uncomfortable and potentially life threatening. Yet the rare side effects only are rare if they don't affect YOU. Once they affect you- they are anything but rare. Yet the government and varying control agencies have to act like the parent in the situation. There may be a chance someone might have a reaction- yet if that keeps the other kids at the school free from disease- that is worth the risk.  They will be sorry if you have a reaction and they will gently point out in 12 different spots in the literature that there is the potential for reaction, fever, pain, neuroses and brain damage(some view autism as this anecdotally) but the benefit outweighed that possibility.  My advice is this- if you are concerned- do your research. The incidence of reaction is small- but that doesn't mean there isn't a causality either. You can opt out- but if you do- you have to be prepared to fight that battle. That battle might be not getting into school or it might be a rare disease-but the choice is yours.

Friday, June 3, 2011

Still alive.

I firmly believe you should never pass up an opportunity to help someone out. There have been many times in my life I have helped out a stranger who soon became a friend. There have been many times I have been helped by strangers who then became friends. After all, why would anyone try to be friends with a person who walks by them in a time of need?

I hate that I barely have time for me, much less catching up with good friends. I hate that it has been so long since I have talked to many of my friends that I have no idea if the number I have saved is current or even in the right state. I hate even more that I can't be certain which state many of my friends are even in. But I guess that is why reunions are a big deal and a few brave souls with time and effort - spend the time and effort trying to regroup old friends like stray kittens.

The other day I got a call from a classmate of Phillip's- she is taking courses in holistic medicine and needs patients to practice on. In a normal Mallory universe- I would have jumped at the opportunity- I believe there are many benefits that our "traditional" medical establishments miss due to the overwhelming capitalistic nature of the pharmaceutical arena and forces that drive healthcare in our nation. I felt great sadness that I had to decline the opportunity to help or be helped because I just don't have the hour to spare. That is to say- if I have an hour to spare I am choosing not to spend it focused on any sort of health care- because far too much of my day to day time is held hostage by that very subject. And part of me wonders if I just passed on an opportunity to help a new friend and it makes me sad. So I took an hour out of the past 3 days to call an old friend just to say hi. I have to say, it felt better.

I feel horrible that through the past few years turns of events in the healthcare of my children that I have to spend all my spare time fighting with and for them that I can no longer contribute to the many friends, causes, friends causes and day to day gatherings that were an instrumental part of my past.  It is my job, my directive and my priority as a parent to fight for my children- but I deeply mourn the opportunities at friendship, partnership and community that we miss out on because the fight for them is so time consuming.

I hate that instead of making and taking a meal to a friend in need- I have become that friend in need. I hate that simple gatherings become a huge source of stress. I worry about the roid rage ups and downs of Lily and the blood glucose ups and downs of Phillip. I worry that simple owies and illnesses always brought about by these gatherings will become hospital stays, or worse. I worry that Kiera is slipping further away and hate that she wants to be anywhere but with us and alternately grateful that she does. I worry that all that Bella knows is a life of being surrounded by sickness and she will spend her life sick or trying to be sick to get the attention she deserves. I worry that I worry too much. It sure as hell isn't for lack of inspiration.

I hate that my husband rarely asks me to do anything, as he is the one person who knows exactly where I am coming from. Yet this morning he gently reminds me it is drill weekend, a reminder that we have 2 more days without a break. A break that will not come after those 2 days because the air conditioning in the van needs to be fixed, the house needs to be cleaned, bills need to be paid and paperwork needs to be mailed. He also gently asks, if I could find the energy to maybe come to a readiness briefing and potluck at work on Saturday. Readiness for what? I ask sarcastically. Disaster? Deployment? Do I really want to sit for an hour(yes) and listen to someone tell me how to prepare myself and and family to handle impending doom(No)without my partner? Because what will end up happening is I will spend an hour being mortified that Lily will announce loudly every time she or anyone else farts and then Bella will giggle hysterically and I will have to remind them to be quiet. Phillip will be annoyed that we all exist and between being alternately moody and goofy will have to be reminded to keep his hands to himself. Kiera will ask me every 3 minutes if it's over yet and if any of her friends will be here. Every 5 minutes someone will have to go to the bathroom. Despite having just gone in the last 5 minutes. I will wonder if it is worse to get up and go to the bathroom again or call the little cretin's bluff and lose.I will silently know that I have faced impending doom and the only way to handle it is to face it and deal. Phil watches me as I go over the scenarios in my head, with an apologetic grin, it's just that we haven't been to anything in awhile and I think people are beginning to wonder...

Wonder what? If I'm holding up? If I can carry on like nothing is wrong? Are they wondering if we can survive this latest hit? Do they wonder if we are part of the team?  I never faulted working moms for not participating in squadron events. Many did. I don't always want to deal with mommy stuff after dealing with a day of mommy stuff- I know that dealing with mommy stuff after a day of work can be equally overwhelming. I wonder if we are the family that makes other families feel better that they are not us. I wonder if I have the energy to smile and be nice. They say it takes more energy to be mean- that's really not true- it takes the same amount of energy the difficult part is the choice.

Phil looks me in the eye- I just think people are wondering if you are still...alive.  That I am. And so are the 4 monkeys. No small feat. So I guess it's time to get out there and live, even if it's just to show people that you are in fact still alive.