Friday, February 26, 2016

Marfan Awareness 2016

February is Marfan Awareness Month and every year when it rolls around I think about how my awareness has changed over the years. When I was first diagnosed in 1988, (you can read an old post about my diagnosis here), my awareness was viewed through the lens of medical information. I was in nursing school so I jumped into the facts and stayed there. I was intelligent and a good student. I could study this condition like I studied everything else and make myself an expert and feel like the victor. I wanted to learn everything so I could control and manage my future. Incidentally, this was not an optimal way to cope with this diagnosis but it took me years to realize that kicking into medical mode—and operating there whenever I dealt with Marfan issues—just shoved down the emotional toll a chronic, life-threatening illness can have. Those emotions usually came out as fear and anxiety or anger. But that’s a whole other post.

If you had asked me then, I was fine. I didn’t have significant aortic dilation; I didn’t have major pain symptoms. I didn’t have any major limitations that I wanted to see because I didn’t want to be 3 years into my 4-year degree and need to re-evaluate everything. I also didn’t want to acknowledge that I felt scared and alone. I didn’t know anyone else who had Marfan syndrome. I didn’t know how to navigate the emotions when an instructor giving us information on a cardiac patient asked me, less than a week after my diagnosis…in front of my whole clinical group, if heart transplantation was a possibility for me some day. “Ummm…what?” I didn’t know how to cope when the cardiologist I saw back at home answered my question about prognosis with “well, that’s pretty hard to predict. Some people drop dead at 17, some live to be 35.” This information was inaccurate and out of date even then. But now, thanks to advances in research and care the life expectancy of people with Marfan syndrome is similar to that of the average person. But can you imagine being told that at 21? “Okay, let me just go break up with my fiancĂ© so he can marry someone who’s not going to die young.” (Thankfully Rick wouldn’t let me walk away). I had nowhere to turn a year later when the same cardiologist told me pregnancy was too dangerous to consider. “Ok, let me go try to break up with my fiancĂ© for the second time so he can plan a family with someone else.”

The Marfan Foundation was founded in 1981 but even in 1988 no one told me about them. Not the American Heart Association when my mom called to learn more about Marfan syndrome. Not my cardiologist. Not even my perinatologist when I became pregnant shortly after my wedding. (You can read about my pregnancy here and here.) I navigated those first years after diagnosis with loved ones who knew less than I did and who were also scared and overwhelmed. I had heard horror stories but I didn’t hear anything about the people who were living and thriving with Marfan syndrome. Which, by the way, if you know someone who was just diagnosed with any disease, please save your horror stories. Don’t tell them about your relative or your relative’s friend or your relative’s friend’s neighbor’s sister who died a horrific death. And if you go back to the late 80’s and someone you know mentions having Marfan syndrome don’t ask, “Isn’t that what Flo Hyman died from?”

In the summer of 1991 I sat down to nurse my baby girl while reading my newest copy of American Baby magazine. There was a single paragraph on a page about rare disorders that mentioned Marfan syndrome and listed the Marfan Foundation with a number you could call. Remember this was before the Internet, before blogging, before email even. So I picked up the phone and made a call while sobbing to my sister Doreen. I was crying so hard I could barely talk when she answered the phone. I finally was able to squeak out, “There’s a whole foundation. There’s a Marfan Foundation. I’m not the only one.”

I called the foundation that day, they gave me the number of a local support group contact and in a few minutes I was talking to another person with Marfan syndrome. Someone who had walked through heart surgery and pregnancy and adversity but was living! And she was about 20 years older than I was (she was still doing well last time I connected with her via Facebook a few years ago). The Foundation also gave me the name of a geneticist at University of Washington who was active with the Marfan Foundation. I left my meeting with him feeling like he gave me my life back. I was given accurate information and referred to a cardiologist who really knew about Marfan syndrome and didn’t spout off doom and gloom predictions about my short life span.

Having accurate information was a key first step to living an abundant life while operating within my limitations. Awareness is about so much more than being diagnosed. Obviously knowing the signs and getting that diagnosis saves lives, but having continued support and empowerment as you navigate the healthcare system and the maze of issues that crop up is vital.


Now there are local Marfan Support Groups, online support groups, telephone support groups, a yearly conference, Facebook Groups, even groups tailored for my specific mindset of living well after an aortic dissection…numerous ways to connect, be heard, bounce ideas around and vent to people who are living what you live. Brene Brown, one of my favorite authors, says that the two most powerful words when we’re in struggle are, “me too.” Awareness of the support that’s available and waiting, awareness of others like me, awareness of community and empathy and friendships that bloom across the country and the world, that’s the awareness that continues to change my life. That’s the other aspect of awareness that I celebrate every year during Marfan awareness month.

Wednesday, February 3, 2016

Silence, Solitude and Invitations

This past Saturday, I was challenged to spend 3 hours in silence and solitude, just listening. The challenge came at a prayer retreat led by Alan Fadling, the author of one of my favorite books, An Unhurried Life: Following Jesus' Rhythms of Work and Rest. Before our time of solitude we asked ourselves, "What do I bring to this day? What stressors, what questions, what concerns, what anticipation?"  Then we asked God if there was anything he had for us. So I headed into my time away with the awareness of where I was at emotionally and with the insight that God was inviting me to soak in his peace.

Now for some honesty, I was super excited to attend this retreat when I signed up. I attended a 2 day retreat co-led by Alan last year and thought it was amazing. Plus I love Jesus so a whole day just to focus on prayer sounded awesome. But back to my confession...that morning I didn't feel like going. I was tired. The day before was an awesome, busy day and I need recovery time after busier days. The idea of staying home in a quiet house was so appealing. However, I had encouraged friends to go with me so not showing up to a day that was going to be laid back and refreshing because I was tired didn't seem like a good plan. So I went and I'm glad I did. 

One distinction shared with us today is that prayer is not a task you complete; it's a relationship you invest in. During my 3 hours I was telling God that I didn't know why I fight spending intimate time with him. I love time with him, I love the peace he gives me, I love the way he quiets my mind and settles my soul. I love feeling his love and expressing love back to him. I love that he knows me so well and doesn't need me to fill him in on back story or why I'm reacting a certain way. And yet I will avoid designated time carved out just to listen to him. Now, don't get me wrong. I'm not saying I will neglect God; I spend my days talking to him--asking for insight, direction and wisdom, sharing my heart, requesting help for friends in need and I read my Bible most days. But when it comes to sitting in silence and solitude, I let that time get squeezed out by things nowhere near as important. 

As I shared all of this with God he gave me the coolest example. He reminded me that my husband and I have made it a priority to not let our marriage devolve into simply being roommates. We don't want to get so good at co-existing in the same house, doing the necessary things to keep the household running but neglecting focused time with each other geared to build intimacy. Rick and I make a point of spending time together alone. No TV, no computers, just talking, listening, playing, being open with who we are and where we are at in all areas of our lives. We do this most days. Sometimes it's several hours; sometimes it's much shorter. But we know that without this we will miss out on connection that we both love and feel refueled by. 

This is a great practice for any marriage, but even bigger than that--God invites us into the same thing with him. As I sat by the lake I felt God assure me of two things. The first is that no matter what, his love for me is constant; I can't make him love me less. The second is that he's not going anywhere; he will never abandon or give up on me. But an invitation came with that assurance, and it's an invitation for all of us. It's an invitation to make a practice of spending focused time alone with him so that I'm not simply co-existing in the same place with him. God invites us into a deeply intimate relationship. One where he is able to speak words of love and healing to us and we are able to lean in and know him at a deeper level. He longs for this level of connection with us that can't happen in quick exchanges tossed out as we go about our busy lives. He knows this will refuel us and give us peace. 

God doesn't want to be the friend I bump into at church; he doesn't want to be the neighbor I chat with over the fence. Instead he invites me (and you) over and over to come away, to fall into his arms, to be part of a great love story. 


Monday, February 1, 2016

My Beach is Gone


I have a favorite spot along the beach in Coronado. It's a little more secluded, there's a parking lot right there, and reaching the water doesn't require a super long walk across the beach. I love being able to get out of my car, walk down a few steps and be on the sand close to the water.

As I drove to my spot this week, I had the picture in my mind of what it would look like; I've gone there so many times. But this time, as I got out of my car, I noticed the ramp up from the parking lot had a reinforced barrier instead of just the usual metal handrail, and I was shocked when I reached the top. My beach was gone! The bottom half of the stairs where I accessed the beach were completely buried in sand and the waves were coming all the way up to the rocks, there was literally no exposed dry sand. The storms had completely changed my beach. I was reminded that we could think we have control by creating barriers and concrete walkways and stairs, but man-made objects can’t control the forces of nature.

This was an easy one to deal with. I just walked farther North down the boardwalk to a spot where a small sliver of beach remained dry and set up there. It was different than I expected but the ocean was still beautiful. The waves were big and powerful, the roar of the crashing waves and the hiss as the water receded pulled me into a relaxed state. As I sat and watched the waves I reflected on my life. I had things so planned out in my 20's. I had big plans for my career, big goals that were attainable with hard work and dedication. I had an idea of what my marriage would look like, when my kids would enter the picture, how independent and in charge I would be. But none of those things turned out how I pictured them.

There have been years where I've surveyed my life and felt the same shock I felt when I stood at the top of the stairs and realized my beach was gone. Nothing was as expected. I have even felt like those stairs, buried under a layer of storm residue wondering if I'll ever make my way out. And unfortunately, those times weren't as easy to deal with as walking north a few feet and finding a new spot at my beach. Life can make me feel like I need to grab on and dig in and fight like hell to maintain things the way they've always been. But that's not natural. Life instead is full of roaring, crashing waves and peaceful receding water and allowing myself to be shaped, to be changed, to be fully transformed by all that happens is not a bad thing. None of it may look like I've expected or planned but it doesn't change the capacity for beauty.

Learning to see the beauty when life looks completely different has required learning to relinquish control. I can only do what I can do. There are things that are beyond my ability--that are truly beyond my power--and I can either fight and claw and reject what I didn't plan, or I can allow life to unfold around me while I find a new way to thrive in the midst of whatever is thrown my way. 

"The ocean is roaring, Lord! The sea is pounding hard. Its mighty waves are majestic, but you are more majestic, and you rule over all. Your decisions are firm, and your temple will always be beautiful and holy." Psalm 93: 3-5 (CEV)


Friday, January 29, 2016

Defining Moments

It’s funny how life has defining moments. My life will forever be divided into two distinct parts, the 28 years before my aortic dissection and the years after. As of today, January 29th, 2016, I’ve had 20 years after my dissection. It honestly just hit me as I typed this that I’m actually only 8 years away from catching up to my pre-dissection total.

On the day of my dissection I went about life as planned. My family and I went to my sister’s house to watch the Super Bowl. We ate and watched the game while our kids played. But I remember the feeling of dread I had deep inside that colors my memories of that day, the feeling that made me want to stick close to my husband’s side and convinces me, in hindsight, that beneath my mind’s awareness my body knew something big was happening. I remember feeling like I couldn’t breathe well in the car. And I remember holding my infant son longer than usual after I nursed and rocked him to sleep--wanting to cherish the feel of him in my arms. Three details that would have faded into oblivion if the day had ended like every other. Those three details also fueled my anxiety in the post-dissection years. Any time I felt a sense of dread or the desire to hold a loved one close, it created overwhelming fear that something traumatic was about to happen.

One of my favorite phrases is, “anxiety is a bitch.” But it would be more accurate to say that anxiety is a thief or maybe a tyrant. I knew my survival after my dissection was a miracle. I knew that my survival didn’t make sense—even my surgeon said he wasn’t going to take credit because he was amazed I didn’t die. Well, he didn’t say he was amazed I didn’t die but he did tell my friend he’d never operated on someone whose aorta was that shredded who made it off the table alive. But every celebration of the miracle, every realization of how amazing it was that I was alive was followed by the suffocating fear that I had cheated death and it was only a matter of time until it got me. Anxiety told me I needed to play my cards right, be constantly grateful for the time I had with my kids, cherish every moment on this earth, make only wise health decisions, be vigilant constantly and fight for the life that had already been given to me free and clear. I guess it’s apparent that anxiety is also a liar.

Each year, as January rolled around I could feel it ramp up. Remember Randall Boggs, the creepy, purple, bad monster in Disney’s Monsters Inc.? That’s the face of anxiety for me. January would start and the low level anxiety I lived with fairly peaceably would creep out of the closet and start circling me, usually beneath my conscious awareness. Then he would slither up my legs and circle around my middle, creating restlessness and stomach aches. Eventually he would climb all the way up and rest on my shoulders, weighing me down as he altered my vision and planted horrible fears in my head while whispering, “this is the year your ‘miracle’ runs out.” Shame would often chime in and remind me that I could beat anxiety if I would only trust God enough.

Here’s the truth. I couldn’t trust God enough. I couldn’t will my way out of anxiety. I couldn’t figure out a way to make my body believe that it had actually survived, that the trauma of the dissection was not still happening. And having Marfan syndrome means that health issues stay constant for me, which makes it even harder not to feel like the threat is imminent and very real. As health issues ramped up because aging with severe Marfan syndrome is not easy, the anxiety also became a constant companion. Which is when my therapist entered my life and helped me reclaim it.

I’m not going to go into the details of what she does, or how she helps me, or what’s in my tool chest. If you are looking for those details so you can also find some freedom let me tell you not so gently, but with great compassion and empathy, get yourself to a therapist. You truly can’t do this on your own. I know you’re reading this and thinking that you’re the one who can—I thought that too. I wasted a lot of years thinking that. I had measures of success on my own. But the freedom I have now exists because an objective professional helps me hone the tools that work for my personality and life.

This is the first year that I feel like I’m wholeheartedly celebrating. I’m reflecting on what has happened and feel like I can feel God’s presence and love no matter what is going on in my body or with my health. I don’t know why I survived my dissection. Many people don’t survive that. God also extravagantly loves them. Their lives also had meaning and value; they also had loved ones who needed them, prayed for them, begged for their survival. I’m not more special. I don’t have some huge amazing purpose to fulfill that they didn’t have. So I don’t pretend to understand why I’m still here. I don’t have to understand to embrace it and be thankful.

I do believe that these “after” years are a gift. Every year, every birthday, every gray hair, and every wrinkle—all gifts. Whenever I’m bothered by signs of aging on my body I remind myself that it was almost all stopped at 28. I would have been frozen in pictures with unlined skin, dark brown hair, forever young. Each health challenge gives me another reason to celebrate.

January 29th, 1996 my life was saved through the hands of a skilled surgeon who replaced a portion of my aorta and my aortic valve.

January 23rd, 2012 a fantastic neurosurgeon completed the second, and ultimately successful, attempt to repair a spontaneous cerebrospinal fluid leak, ending six years of spinal headaches and worsening weakness to just name a couple symptoms.

January 28th, 2015 a general surgeon repaired an obturator hernia ending 15 years of intermittent episodes of debilitating abdominal pain. (Obturator hernias are pretty rare, extremely difficult to diagnose and therefore dangerous, and often seen in frail old women who’ve had a lot of kids. That last part never fails to amuse me.)

20 years, 4 years, 1 year. All occurred at the end of January, which is the month when we Americans celebrate fresh starts, new beginnings, and setting aside old ways. Last year as I prepared for surgery amidst panic-laced anxiety, God reminded me of a favorite verse. Isaiah 46:4(NIV) says, “Even to your old age and gray hairs I am he, I am he who will sustain you. I have made you and I will carry you; I will sustain you and I will rescue you.” I love the fact that God will sustain me—I don’t have to sustain myself. But I also love that he reminds me that he was the one who made me. Marfan Syndrome and all of its challenges aren’t a surprise to him. He made me and he promises he will carry me. He’s not going to get tired, neither my problems nor I are going to get too big for him, he’s not going to regret making me in the first place because I need to be carried more than I see others needing it. That’s love that I can celebrate.

This year, as I journaled and prayed about celebrating my life, God led me to another verse. Isaiah 64:3 & 4 says, “We remember that long ago you did amazing things for us that we had never dreamed you’d do. You came down, and the mountains shook at your presence. Nothing like that had ever happened before—no eye had ever seen, and no ear had ever heard such wonders, but you did them then for the sake of your people, for those who trusted in you. (VOICE) The first line is the one that really gets me, “You did amazing things for us that we had never dreamed you’d do.” Before my dissection I firmly believed that if my aorta dissected I would die. Not that I might die, that I WOULD die. As I endured 6 years of headaches and 15 years of abdominal pain I thought maybe this pain was just something I needed to get used to, maybe healing these things wasn’t going to happen for me. God didn’t need unwavering faith, he didn’t need my vigilance, and he didn’t need my expectation for these amazing things to happen.

Over and over again, in all of our lives, God does amazing things. He redeems and he reclaims and he puts the right people in our lives when we need help to heal. He gives life—a free and clear gift, assuring us we owe him nothing in return. I remember and I celebrate.