There have been many people who have messaged me over the last few months telling me that this blog, about Emma's journey with Chiari Malformation has been a great help to them. Now that this journey has slowed to a snail race, because Emma is doing so amazingly well, I thought I would wrap up Emma's journey with a reflection of the last year. Specifically for those of you who have a child getting ready to go through this and are currently where I was a year ago. Having a child and being the child during this time looks very different. So to be able to take care of your child you need to maintain some sort of sanity, hopefully I can help you do that by sharing with you my experience.
Surprise! Your child has been diagnosed with a Chiari Malformation and the neurologist or neurosurgeon is now recommending decompression surgery. You get home from this appointment (if you didn't go straight to the bar) and stare at your wall babbling to yourself because all you can think of is the fact that someone is going to open your child's brain. This isn't a tonsillectomy or an appendectomy this is the brain, the center of what makes your child who they are and how their body functions. You can live without tonsils or an appendix but you cannot live without a brain, and now someone wants to cut into the brain of your perfect (or not so perfect for us realists) child. There are different types of people on this Earth those who need facts and those who do not. I need facts, if you are not a fact type of person scroll past this.
The part of the brain that makes your child function is not located in the dura mater. Its located below that... now its not much below that, as it is just thin tissue, but the portion of the brain they are cutting into is a protective layer and has no function other then protection. Here is where your research of neurosurgeons comes in to play. This disorder is so widely misdiagnosed and misunderstood finding a neurosurgeon that is knowledgeable in this is hard. So do your research, Seattle Children's has one of the best neurosurgeons in the nation so we got lucky. However, if your surgeon doesn't know a Chiari from a hole in the ground get a different one. There are children who have had to have multiple surgeries because their surgeons were not as educated as they liked to think they were. Don't let your child be that child. Also, pay attention to success stories just as much as you pay attention to the worst case scenarios.
There is a huge network of people who's children have gone through this, use us:
I say this for a couple reasons. First is obvious, we get it. We understand the fear, anxiety, and the chaos that comes with this. We may not have all the answers but when we say "we understand" we do. Just like you, we have cried, been angry, felt helpless, and have lost sleep. Finding those that can identify with you is crucial.
Know that you will be disappointed in some and in awe of others:
If you were as blessed as I was there will be people who step up to help in whatever way they can. Friends, family, and even strangers will hear your need and they will come. Focus on those who show up and don't take personally those who do not. Take an honest inventory of your friends and family. Do not expect the aunt, uncle, sister, brother, or friend who has shown a history of self absorbed behavior to change because your child is having their skull cut open. While this may be the scariest event of your life, its a fleeting moment in theirs. If you love someone who live their life creating chaos or always having to have a crisis I would suggest taking a break from them. Partly for your sanity but mainly so you can maintain the relationship. You will get to a point where people calling you to tell you their problems that are 99% self inflicted will make you want to pull your hair out. You do not want to lose a friend or hurt someones feelings because today you can't handle their drama, when you could yesterday. They don't get it, so do an inventory, assess who has the personality traits needed to be a support, and who will just cause added stress, then limit the added stress.
Expect to have less tolerance for people when this is over:
There is nothing that puts life into perspective more then fearing your child might die. Now it is more likely for you to win the lottery having only purchased one lottery ticket in your entire life then it is for your child to die. However, logical reasoning at no point becomes stronger then the innate behavior of maternal protection. You will hear a thousand times that your child is going to be fine and that nothing is going to go wrong. This won't help ease that fear that sits in the pit of your stomach, this is a natural biological reaction, I would be more concerned if you didn't have it..
Do not even attempt to sleep the night before surgery:
It won't happen, accept it. If you can do something fun the day before with your kiddo, rather then sit around in a state of quiet panic, do so. I think as parents we get so caught up in the stress we don't see how that stress affects our kids or we are unable to see it. Don't talk about the surgery or your fears in front of them. Save that for when they are not around, schedule a girls night with supportive friends use this time to cry and vent. To our children we are the strongest people alive, if they see that this is breaking the strongest person in their life imagine how bad it must seem to them. Put on your big boy pants or panties and smile.
The morning of surgery will be hell:
Emma was 6 and a very tall 6 she clung to me like baby monkey that morning, it took all I had not to cry, I did good I walked her down to the surgical suite and waited until they put her under before I lost it. I wasn't expecting that, I am not much of a crier, and I don't cry in front of people so I took a few minutes to myself in the hallway, slid to the floor, and sobbed. You will cry, accept it and find the best possible way to allow it. I had my breakdown wiped my tears and met with my family back in the waiting room. The next 6 hours I laid outside of the surgery center on a horribly uncomfortable couch holding a pager from 1980 praying for it to go off with an update. They said they would page with updates, I only got one and that was when surgery began. I heard nothing until the surgeon came out to tell me things went well. Have someone with you who can hear what the surgeon says about surgery and how it went, you will be so overwhelmed with that biological maternal instinct to get to your baby, that you won't hear anything they say. You want to know if it went well and if anything was not what they expected. For instance our NS told us that everything went well, Emma did great, and that he had to remove more "bony structure" then he thought he would. It wasn't until the next day that I remembered him saying that and thought "Well shit!? What does that mean, is that worse or better? Will it change her healing process?" So I asked the nurse who had no clue what I was even talking about. I still don't know what that meant.
Nothing prepares you or anyone with you to see your child right after surgery:
They look dead and you feel helpless. Emma barely woke up and when she did it was only because she was in pain. Don't expect the nurses to stay on top of the pain medication, even the best nurses are busy. You know your child, if you think they will need something make sure they get it. Once you get behind the pain its hard to catch up. Emma didn't get any pain medication regardless of me asking for it the night after surgery. They said it was because she was sleeping, she wasn't sleeping she is shy and I was asleep so when they came in to mess with her she kept her eyes closed so she didn't have to interact. Getting in front of her pain was hard and the first 2-3 days were rough.
The hospital is boring bring something to do:
I know that when they say you will only be there 4-5 days you think that that isn't too bad, but there are 24 hours in a day so that is 96-120 hours... that is a lot of hours to be staring at the wall. Also bring food you and your kid like to eat. The hospital food is terrible and the cafeteria isn't much better. You do have options, if your kid doesn't eat what they are serving for dinner ask for the number to the nutrition center and call them.You want your child to eat, they will feel better so if you need to search and find something they will eat then do what you need to.
Don't expect the nursing staff to take care of your child as well as you would:
They have more patients then just your child and as parents we expect people to drop everything to take care of our children because that is what we would do. If every nurse did that for every patient they would never get anything done. You are your child's best and only advocate. So make sure if you feel like they need something and the nurses are missing it you go out of your way to get it for them. I ended up going to the head of family services after asking repeatedly for us to be moved to a different room. We were originally placed in a room with a girl who had some sort of stomach issue. Her parents were awful, they were mean to her, they were yelling at her about eating and Emma was incredibly anxious being in there listening to these people berate their child. I took her to the bathroom barefoot and she stepped in this girls fecal matter that was on the floor not a whole lot but enough that I lost it. She just had brain surgery and fecal matter was not on my list of acceptable situations.The nurses were not listening to my complaints to get a new room, after I went to the family services coordinator it took less than 5 minutes to have us moved. I did have several administrators throughout our stay come visit me to apologize profusely for my child stepping in another child's feces.
Expect the best, know that you there is power in your words, things will get better:
You may not be able to see it now but things will get better. This will always be probably the most traumatic event you will ever have in your life. I've seen someone shot and I was more terrified during this then witnessing a murder. Expect that you will always have a sick feeling in the pit of your stomach when you look back at this time in your life. When you get that sickness that anxiety go take your kids to the zoo and celebrate them, they are here, they are well, and you survived.