Monday, June 27, 2011

Workin' Mama Drama

First - a little ooh & aah moment:

My bottle is almost as big as I am!

Cool guy hittin' the pool

Alright- I should admit now that I've really only been back to my office for one half day since Cameron was born. My first full day back is tomorrow!  So I'm not claiming to be an expert on/victim of any circumstances quite yet.  But I've realized how completely awful and toxic the whole stay-at-home mom (SAHM) vs. working mom (WM) "debate" is (and how annoyed I am that it's "mom" vs. "parent").  I believe that *good* parents are entitled to do whatever they think is best for their children or whatever works for their family.  If it makes sense for the parent or both parents to adjust their work schedule to care for their children, that's great.  On the other hand, if they are comfortable with or would prefer their children to have an external caregiver (family member/nanny/daycare/etc), that's great too.  There are many factors to consider, ranging from personal preference to financial ability to the child's needs.

Growing up, I realize I was exposed to many different family models.  As I've mentioned in previous posts, for a large chunk of my childhood, my dad was home with us during the day.  Both of my parents worked, but their schedules allowed for them to be home with us most of the time.  I also had an uncle who lived with my family until I was about 13 who at times, assisted/entertained us as well.  I have friends whose moms stayed home and others who went to latchkey or Kindercare.  Generally speaking, none of us have turned out to be druggies, ax murderers or crazies (that I know of), so I feel like as long as the time spent with children is "quality" in nature, you can't really screw anyone up too badly.

Throughout my pregnancy, many different people asked if I would be returning to work after the birth of my child.  At the time, my answer was "Of course!"  I planned to turn off my blackberry and enjoy my maternity leave.  When the time came, I'd head back to work.  Some people, with a rather "knowing" grin, would shake their head at me and say "Just wait.  It will be so different once your baby arrives."  Others would say "Good for you- get out of that house sooner rather than later!" as if I was busting out of jail.  It really surprises me how unshakeable people's opinions are on what's "best" for children.  I wonder where that comes from - is it personal experience or word of mouth??

Being home with Cameron has been a very fulfilling experience.  I've enjoyed his sweet face every morning, played with him as he becomes more aware of his surroundings and relished the little milestones he achieves every week.  This experience has been made more precious because I survived the heart attack.  At the same time that I'm grateful for this time with him, I am also"ready" to go back to work.  Yes, things are so different now that he's here.  And while I'm eager to get back into the swing of things at my job, I realize that I'll have to do it a little differently (i.e. not work from home so much in the evening, finding more work-life balance).  I feel confident that between both grandmothers watching him a day every week, send him to day care a few days and possibly working from home a half or whole day each week, he'll be just fine.  He won't necessarily have the same routine each day, but I won't worry about that until it becomes an issue (if it every does).

I do wish that Brian was able to have this experience - unfortunately his employer does not have any paternal leave and taking FMLA leave did not make sense for us.  It makes me sad that fathers/men aren't always afforded the same rights as mothers/women (not to assume that all parents are in a heterosexual relationship).  I hope Cameron gets enough of what he needs from both of us as he grows up.  And if one day, Brian or I want to stay home with him because we think it's best, then we'll figure it out!

So, to all the parents (or parents-to-be), especially first timers, reading my blog - be proud of the choices you make for your children!  Don't let anyone make you feel bad for staying home or bad for working.  You know what you are capable of and what is best for your kids/family :)

"The biggest mistake is believing there is one right way to listen, to talk, to have a conversation or a relationship." - Deborah Tannen

"If you limit your choices only to what seems possible or reasonable, you disconnect yourself from what you truly want, and all that is left is compromise."
- Robert Fritz

Friday, June 24, 2011

The Golden Girls

I just wrapped up my third week of Cardiac Rehab.  These days, I have my routine down pat: Get up, put workout clothes on, brush teeth, etc.  Wake up Cameron. Change diaper, clothes and feed him.  Let Mowgli out. Eat breakfast.  One grandma or the other arrives to watch him and off I go to St. Mary's hospital. Then, I weigh myself, fill out my intake sheet, get my blood pressure taken, attach my monitor, do the warm up exercise and get started on my workout.  25 minutes on the treadmill, 20 on the bike, 10 lifting weights and 10 on the hand bike (the hand bike is a hilarious sight to see, I'll try to take pictures soon).  Then there's cool down, a 2nd blood pressure, and stopping at the cafeteria to get a cup of coffee (half-caff) before I head out to my car.  This is pretty much my routine every Monday, Wednesday, and Friday. 

I've gotten to know my classmates (who I now call the Golden Guys and Gals) better -they are quite the cast of characters.  "Gloria" is the most colorful and probably the youngest (in her 50s) next to me.  She comes to class in wildly colorful outfits and large, dangly earrings.  Usually, she's stopped at the cafeteria before class and arrives with a breakfast burrito in her hand - clearly, she's not following the diet guidelines.  The TODAY show is usually on for the treadmillers to watch and Gloria always has interesting things to say (That Ann must be pregnant! Why else would they put her in such loose clothing? Ooh-ee.  Al Roker can be my weatherman! Let it rain, jesus.)  Then there's "Doris", who sort of reminds me of Eeyore or Debbie Downer from SNL.  She always makes sure to ask how I'm doing and when I reciprocate, she goes on to tell me about how she hates Mondays (and Wednesdays and Fridays) or how her muscles hurt from the previous workout or how she sweats too much and her socks get damp.  Doris can't wait to be done with rehab, though I'm not really sure she'll be any happier when she graduates.  Lenny is the class clown.  Probably in his late 50s or early 60s, he wears Tommy Hilfiger polos and jeans to class.  He flirts with the nurses and shows his progress off any chance he gets.  He was very upset that I didn't bring birthday cake to share with the class (though for the record, I did not have my favorite birthday cake this year - Miss Hullings Five Split Layer Chocolate Cake.  This has been my birthday cake since I first started eating cake!  But it is the absolute opposite of heart healthy.)  Marlene and her dad, John, come to class together.  They always arrive late because Marlene waits for the best parking spot.  She keeps an eye on her dad to make sure he's doing everything he is supposed to, but I feel like she might be slacking off a bit herself.  She always asks me about Cameron and then brags about her grandchildren.  Example:

Marlene:  Well, my precious *blah* is in Bible school now.  He can quote Genesis.  And *blah* is taking swimming lessons this summer.  She can swim laps!  How's Cameron?

Me: He's great.  He's noticed the ceiling fan and is blowing spit bubbles.

Marlene:  He's not rolling over?! 

Me: Well ,no. Not yet.

Marlene: Well, don't give it too much time.  My *blah* skipped rolling over and went straight to crawling!

Walter reminds me of Chief Weber from Grey's Anatomy.  Very quiet and calm, comes to rehab, gets his workout done and leaves.  But he always wears these crazy button-down, hawaiian shirts.  Today, his shirt had flowers and dragons on it.  Walter also has an oxygen tank, which his wife ties a ribbon to, to make sure he knows which is his.  And last, there's Padma, who I have mentioned before.  She grew up in India and wears gold bangles to class.  She also wears New Balance sneakers with pink ribbons on them because her sister is a breast cancer survivor.  She also asks about Cameron (having only seen him once) and inquires as to whether or not he takes after his mother (i.e. is getting browner).  I can tell she wants to talk more about India, but she's in the class after me, so we don't overlap too much.

Upon realizing my birthday was Monday, each person in my class took a moment to share where they were when they were 29.  Gloria was pregnant with twins; Doris was taking care of her ailing mother; Lenny was driving trucks; Walter was in the navy and Padma was still living in India.  Listening to everybody reminisce really made me stop and think.  We have led such different lives and were brought together by a significant health scare.  Most of my classmates find themselves in Cardiac Rehab because they ate poorly and did not exercise regularly when they were my age.  They seem to see me as a complete anomaly and rather unlucky. As "unlucky" as I may be, I'm glad I'm still kickin'!!  And hopefully, when I'm their age, part of my regular workout will be chasing my grandchildren :)

“…‘the good old days.’ The only good days are ahead.” ― Alice Childress

"Some people, no matter how old they get, never lose their beauty - they merely move it from their faces into their hearts."  — Martin Buxbaum

Monday, June 20, 2011

29 and FINE (The Bucket List, Part I)

In high school (shout out to Nerinx Hall, WOOT!), there was one class that everyone LOVED to take - Christian Life Committments.  If I recall correctly, it was mostly about relationships and one project was to plan your wedding.  Seriously - we put together three ring binders with pictures of flowers and dresses and venues, with the one stipulation that the wedding ceremony itself had to occur in a church.  I'm pretty sure you even had to involve a male counterpart in the madness to collect all available points.  Obviously, the purpose of the class wasn't to identify the best DJ or perfect your future bridesmaids' up-do.  We were encouraged to give serious consideration to how we wanted to spend the rest of our lives - the careers we would have, the places we would go, the people we would choose to be by our side.  I remember thinking I would go to med school, but also be married (to my high school boyfriend, of course) by 23 or 24 and have two adorable children by 26 (maybe twins?!), and somehow, eventually wind up as the Surgeon General or traveling the globe with Doctors without Borders.  In hindsight, this wasn't really a plan at all- more like a list of what the 17 year old me thought the best case scenario for my "adult" life looked like. 

I love to plan, I love to execute the plan....... but I've learned that sometimes, the best things that happen to you come from Plan B or having no plan at all.  On the fourth day of classes during my first year of college at Loyola University Chicago, I realized that Biology/Pre-Med wasn't for me.  After changing my major a few times, I stumbled into two - Politics and Womens' Studies.  A retail management position with a for-profit company saw me through grad school and into a development role with a non-profit organization.  The first person I was engaged to isn't the person I'm happily married to.  So.  We outgrow some of "dreams" when reality is so much better.

Starting when I married Brian and growing as I had Cameron and then overwhelmingly affecting me when I had heart attack, I felt the need to make some sort of bucket list.  I'm not sure there are any rules for a bucket list, other than you must check them off before you die (as if you could check them off after?!).  So, in no particular order, here are some items on my list so far:

  • Kiss the Blarney Stone
  • Have a Mint Julep at the Kentucky Derby
  • Celebrate my 50th wedding anniversary
  • Attend Fashion Week in NYC, Milan, Paris and London
  • Learn to SCUBA dive (which is funny, because snorkeling made me sea sick)
  • Visit Australia
  • Go on a safari (well, as long as it is eco-friendly/animal preservation focused)
  • Revisit where my grandparents grew up in India
  • Write a book
  • Travel in space!(Btw, I LOVE Star Trek TNG.... don't judge)
  • Adopt a daughter
  • Hike in/near a rainforest
  • Learn to waterski on one leg... learn to waterski in general
  • Attend the Emmys or the Oscars or the Golden Globes (and wear a FAB dress)
  • Ride in a helicopter (but not because I'm being airlifted to a hospital)
  • See my kids graduate kindergarten/grade school/highschool/college

Some things I've crossed off:
  • Get married
  • Have a baby
  • Learn to ski or snowboard
  • Stand on a volcano

  • Touch a glacier
  • Volunteer in another country
  • Stand at the Southernmost Point (YAY, Key West)
  • Visit the 1st Starbucks
  • Receive a Masters degree (can't find a pictures, my mom took them all!)

I truly believe you should have an idea of where you want to go, but be able to embrace where your path takes you.  I probably won't do all of the things on this list and I'm sure that, over time, the list will change.  Maybe Cameron will do some of them with me! Life changes, but for me, this remains the same - I want to be good at my job, I want to be a good friend/wife/mother, and I want to somehow change the world for the better.  How I do these things will be the fun part.

Cheers to the last year of my twenties!  The best is yet to come.  I can feel it.

One more thing - I'd love to know what's on YOUR bucket list!  Comment on this post or on my facebook post of this blog :)

"To accomplish great things, we must not only act, but also dream; not only plan, but also believe." - Anatole France

"If anything is certain, it is that change is certain.  The world we are planning for today will not exist in this form tomorrow." - Philip Crosby

"Always remember to slow down in life; live, breathe, and learn; take a look around you whenever you have time and never forget everything and every person that has the least place within your heart." - Unknown

Thursday, June 16, 2011

Just like Daddy!

I was born on the last day of spring in 1982.  I came four days early, at 3:36am.  My parents had already picked out a girl name, Rachel Rose (Rose after my paternal grandmother), though they weren't sure what/who they were expecting.  Due to my early arrival, I was born on Father's Day and I'm pretty sure my dad started going gray that very day.  He'll tell you I was the best present ever.  When I was born, my parents lived in a one bedroom apartment by the hospital my mom worked at, so the dining room was transformed into my bedroom.  My dad spent hours putting together my crib, tightening every nut and bolt, and positioning it just right along the wall.  While most children with a parent at home typically grow up with their mom, my parents' work schedule allowed my dad to be home with me and my brothers.  He picked us up from school, took us to the park, and allowed us to have cheeseburger Happy Meals as needed.  During the humid St. Louis summers, we would go to the library and Blockbuster a few times a week and stock up on entertainment when it was too hot to be outside.  He did not miss a single father-daughter event, even through high school.  I didn't realize it until I was in my mid-twenties, but I am very VERY lucky to have such a loyal and kind person in my life.   Some of my best qualities come from him - aside from my hairy arms (ha), there's my interest in politics, my experimentation of cooking all kinds of foods, and my love of books.  Presently, he's become an adoring grandpa (both to Mowgli and Cameron!). 

Now that I'm a parent, I have often wondered what my parents were like before I came along.  While I'll probably never know the answer to that, I've been observing my husband's transformation from an "I" to a "We".

When Brian and I got married, I thought I knew pretty much everything about him - his likes, dislikes, pet peeves, etc.  He loves pizza, the outdoors, and conserving energy.  He hates clutter, having too many plans, and the bureaucracy of daily life (i.e. all those "time-suck" types of tasks).  He was out walking Mowgli last August when I took the pregnancy test.  When he arrived home, I had been sitting on my couch fretting about the best way to tell him we were expecting.  As he unhooked Mo from his harness, he said to me "I never get to take time off and just stay in St. Louis.  Everytime I take vacation, we're traveling.  I hope one day I'll be able to take time off and just stay in town."  To which I replied "How does next April sound to you?"  He looked up at me, blinked, and said "You're PREGNANT?"  When I said yes, he had this incredulous look on his face and I couldn't quite tell if he was excited or totally freaked out.  He insisted I take another test just to make sure the results weren't a fluke. And then, the freak out began.  His mind was racing from moving into the right school district to starting a 529 college saving plan to converting our spare bedroom into a nursery.  All these thoughts and Cam was only a clump of cells (an adorable, lovable clump, but a clump nonetheless). 

Throughout my pregnancy, he shifted between feelings of excitement and fear; anxiety and acceptance; uncertainty and understanding.  He insisted on playing classical music for Cam every night before bed and I'd balance his phone on my belly while it projected all kinds of lullabies.  With pride, he assembled the rocking chair and the crib in Cameron's room and installed the carseat bases in our vehicles.  Upon Cameron's arrival, Brian debuted our new video camera and narrated daily shots of our new baby.  He had been frightened to hold a newborn, but once the O.R. nurse had convinced him to cut the umbilical cord, I'm pretty sure he knew he was all in. 

These days, he doesn't rush home to get to the gym before dinner or to watch the big game (unless it's hockey!).  When he walks Mowgli, he takes Cam along in the stroller.  Somehow, in al the busy-ness of the day, he finds time in his evening to read Cam bedtime stories and rock him to sleep.  I can't imagine how hard it is for him to leave us every morning for work (though I'm headed back to my job on 6/22!), so I make sure to send him pictures of our activities throughout the day.  I already knew that I'd married a very kind man, but seeing the way he is with our son opens a new perspective in our relationship.  He is infinitely patient, compassionate, loving and humbled in his new role.  I can't wait to see how their (and our) relationship will grow. 

Happy Father's Day to all the dads in your life!

"It's not only children who grow.  Parents do too.  As much as we watch to see what our children do with their lives, they are watching us to see what we do with ours.  I can't tell my children to reach for the sun.  All I can do is reach for it, myself."  ~Joyce Maynard

"The guys who fear becoming fathers don't understand that fathering is not something perfect men do, but something that perfects the man.  The end product of child raising is not the child but the parent."  ~Frank Pittman

Sunday, June 12, 2011

This Omnivore's Dilemma (aka Where the hell is my cheese?!)

Back when I was living in Chicago, stumbling through my college years, I procured this great shrunken t-shirt from Urban Outfitters.  It's slate gray with a big red heart in the middle and scrawled across the bust, in yellow writing, reads "Love makes life worth living".  Except that "Love" has been crossed out and written above is "Chocolate."  This t-shirt has stayed with me through new homes, new jobs, and new loves.  Now, it has stitched up holes in both armpits and does not stretch lovingly across my new mommy pooch belly, but I can't conceive of getting rid of it.  You see, I've never been shy about eating.  EVER.  I've generally been willing to try anything once and this has yielded some great food finds.  While I enjoy eating healthy, indulging was something that I've always allowed myself.  I don't ever want to imagine what something tastes like - I just want to taste it! 

Celebrating my 28th Birthday at The Bridge with a Riesling

 South Beach has some AMAZING seafood! 
Brian introduced me to mussels and I've never been the same :)
 Brian was busy enjoying a beer on our trip to Vancouver.  I'm digging into a chocolate banana bread pudding.
When we went to breckinridge, they had all you could eat ribs. 
This was my third rack.....

I struggled a bit with my pregnancy diet.  No roast beef sandwiches (which was the one thing I craved in my tumultuously nauseating first trimester), sushi (I LOVE unagi!), soft cheeses (I could swim in a creamy pool of brie), caffeinated coffee ( Venti 6 pump vanilla nonfat caramel macchiato got me through my mid twenties) or wine (which I'm pretty sure flows through my veins).  I did make up for these losses with brownies, peanut butter cups, cookies, and strawberry cheesecake ice cream.  Quite frankly, I'm surprised I gave birth to a little human boy and not a gingerbread man.  I did try non-alcoholic wine and champagne.... definitely not worth the $$$ as both are missing that delicious "burn" when you take a sip.  Clearly the sacrifice was worth it when I first laid eyes on Cameron, but nonetheless, I did purchase all the fixings for an epic wine and cheese plate to celebrate not being pregnant anymore - apricots, dried cranberries, walnuts, almonds, prosciutto, spicy salsiccia, mini rye flats, rosemary raisin flatbreads, brie, dubliner, fontina, toscano black pepper, and a fruity stilton (all of which can be found at Trader Joe's!)  I was preparing for my first pump-and-dump experience when I had my heart attack.

During my stay in the ICU, the hospital nutrionist came to visit.  My heart attack was not caused by clogged arteries, as I don't have any.  But now, it's very important that I keep them that way, through exercise and a heart healthy diet  After she introduced herself, the conversation went a little like this:

Nutritionist: Do you eat desserts like cakes, cookies or chocolate?
Me: Yes...
Nutritionist: Well, now you can have dark chocolate or fruit.  What about salty things?
Me: Well I don't really salt my food, but I suppose I like salty items
Nutritionist: Moving forward, you'll need to make low sodium choices, avoid salty foods and use salt substitutes like Mrs. Dash.  How do you get your dairy?
Me: (laughing) Cheese and lattes!
Nutritionist: (not laughing) You need to start drinking skim milk plain and consider other options like fat free yogurt.  I would avoid sour cream, ice cream and cheese.  If you need to drink coffee, consider decaf.  As for cheese... you can have two servings of low fat cheese a week - the equivalent of two cheese cubes. 
Me: (silent and stunned) Uh.... okay.  What else?

For the next twenty minutes, I felt like Charlie Brown.  There I was, sitting in class, listening to my teacher go "Wahwahwah, wah-wah, WAH.  Wah, wah-wah wah wah."  Brian took copious notes for me as I sat in my hospital bed listening to this woman gibber-gabber on and ON.  Thoughts raced through my head.  No butter? I'm sorry, but margarine is a four letter word in my house.  No half and half in my coffee? You know it's summer when my Starbucks coffee order switches to a grande iced coffee sweetened, with a sizeable splash of half and half.   This may have very well been rock bottom.  I couldn't see my son, I'd just had a heart attack and now I had to overhaul my diet?  What about all the freakin' cheese sitting in my fridge, just waiting till pump-and-dump night?! WHO AM I IF I CAN'T EAT CHEESE?

Well, it turns out I'm really stubborn for one.  If I can't eat the way I used to, then I'll figure out how to eat the way I WANT to.  Brian and I have always enjoyed cooking for each other and together, and we'd just have to pay a little more attention to what we prepare and how.  My aunt Lisa and uncle  Doug (who was born with a heart issue) surprised me with a four inch 3-ring binder of heart healthy recipes.  I purchased Gwyneth Paltrow's new cookbook after reading about it in SELF magazine.  In the last two months, I've slowly learned how to integrate more beans, fish, fruits and vegetables into my diet.  If I need to "treat" myself, I pay attention to portion sizes - I don't feel guilty having 13 jalapeno potatoes chips or half a dark chocolate peanut butter cup every once in a while. Upon a visit to Trader Joe's a few weeks ago, I was lured into the wine aisle by a woman giving out free samples.  One "plus" of a heart healthy diet is drinking a glass of wine a day.  You better believe I enjoy my 5 oz. every night!  But the cheese part has been hard.  I realized that day, gobbling up tiny pieces of aged parmesan and sipping a dixie cup of syrah, that I can't give up cheese.  If I'm going to eat it, I limit my portion to the serving size and make a point to avoid saturated fats during my other meals that day. 

Dining out has been difficult, but not impossible.  I have to scope out the menu before I go anywhere.  Celebrating my aunt's birthday at a great spot in the Central West End, I had already picked out my meal (trout with green beans).  However, I listened to the waiter's specials anyway. "Oven roasted chicken with root vegetables (YES!) basted in butter (NOOOO!)"....."Pork tenderloin with sweet potato puree (YES!) breaded and fried in bacon drippings and its own juices (NOOOOO!)  I'm glad my family had a sense of humor too, because my aunt was laughing along with me when the waiter left the table.

At the end of the day, it is hard to change.  But I have enjoyed spending more time in the kitchen, with Mowgli and Cameron as my helpers....

I appreciate my meals more and the people I share them with most.  Really, this new "diet" is the way that all people should eat, if they want to be truly healthy. Most of the people in Cardiac Rehab (now called "summer camp" my some of my friends, since Cardiac Rehab sounds a bit depressing) are there from years of poor eating and inactivity.  I'm sure if they had it to do over, they would have made different choices.  So now, I choose to treat my body more respectfully while putting good food in it!

"We are indeed much more than what we eat, but what we eat can nevertheless help us to be much more than what we are." - Adele Davis

"One of the very nicest things about life is the way we must regularly stop whatever it is we are doing and devote our attention to eating." - Luciano Pavarotti

Thursday, June 9, 2011

Sweatin' with the Oldies

I can't believe it's June.... Cam is two months now and though he's flaunting quite the chubby thighs (12 lbs, 12 oz!), he's only in the 50th percentile for his weight/length/head circumference.  Funny the things you things you make note of when you become a parent.  He's discovered his hands, his reflection, and the ceiling fan.  Here we are, at his first Cardinals game - against the Cubs, and we creamed 'em!

I FINALLY started Cardiac Rehab this week.  Unfortunately, when I went to fill out my paperwork last week, I learned that my cardiologist is moving away at the end of the month.  This is VERY sad!  After all, this is the person who diagnosed my SCAD and literally saved my life.   I briefly contemplated making the 90 minute drive to Springfield, IL to continue seeing him, but (rightly so) am going to hunt down a new doctor here with the assistance of my cousin's husband (also a cardiologist).  The conversation took a humorous "It's not you, it's me" tone when he stated "I was planning to call you..... your mom told me I could never leave the area."  I do recall my mom making this statement in the hospital, once I was out of the woods, and quite frankly, I can't promise that she isn't going to hunt him down and drag him back here.  Oh well... this was an unexpected bump in the road, but the road's already been very bumpy to begin with!

Cardiac Rehab takes place in the basement of the hospital.  I am required to attend three times a week for at least four weeks and up to three months.  It's sort of like going to the gym, but you're hooked up to heart monitors and supervised by cardiac RNs.  Oh, and everyone working out around you is at least 60 years old.   When I walked into my first class on Monday, there were about nine other people.  Two were wheeling their oxygen tanks from station to station and three were using walkers.  I checked myself in, picked up my monitor and started my warm-up.  The warm-up includes sitting in a chair and kicking my legs straight out in front of me and moving my arms in tiny circles.  Once the nurse checks your vitals, you are free to start your workout.

Getting my blood pressure taken. 

 On the treadmill for the first time since my 3rd trimester!

It's funny how old(er) people talk really loud to each other.  As I was doing my cool down, the next session's participants were trickling in the door.  This is the conversation that took place about three feet away from me (as I'm doing my arm circles):

Eloise: How ya been, Harold?
Harold: You know Eloise, same old same old.
Eloise: Who's that young thing over there?
Harold: I don't know, but she's pretty cute.

At this point, I am struggling so hard not to laugh that I had to turn around and face the wall.  It gets better:

Eloise: Harold, don't talk like that.  I wonder why she's here.
Harold: Well.  She must have had a heart attack.  That's why we're all here.
Eloise: Oh that's sad.
Harold: Yep.
Eloise: I bet she's wondering how she got stuck with a bunch of old farts.

I can no longer stifle my giggles and start to laugh.  The two of them, realizing they've been caught, quickly look around innocently.  It does not occur to them that while they can't hear each other very well, they've been talking SO loud that anyone with a normal range of hearing have heard everything they've said.  Eloise gives me a little wave and then scurries away to put her monitor on.  And Harold winks at me.

I can tell that rehab is going to be a journey all on its own.  I definitely want to push myself harder than the nurses will let me and they gently remind me that I'm still a stroke risk and need to ease in slowly.  Once I get the hang of it, I'll be able to push harder.  But, I'm actually a little excited to get to know some of the "old farts" and glean some bits of wisdom from them.

"So many tangles in life are ultimately hopeless that we have no appropriate sword other than laughter."  ~Gordon W. Allport

Sunday, June 5, 2011

The first day of the rest of my life.... Heart Attack, Part III

Whew.... I hope this will be the last retrospective post for awhile.  But, again, to know where I'm going, it helps to understand where I've been.

When I opened my eyes, from a predominantly sleepless night, on the morning of April 14th, my head was throbbing.  I had been on a nitro drip all night to ensure a strong supply of blood and oxygen to my heart.  One rather painful side effect is a pretty violent headache.  There were also about 12 people crammed into my little room - a new doctor (we'll call him Dr. W) along with a few cardiac nurses, some residents, two med students, a pharmacist and a nutritionist.  I immediately felt mildly amused, perhaps a little bit like a spectacle or circus freak.  In all fairness, it's not every day, week, or month that a post-partum female in her 20s enjoys a stay in the cardiac intensive care unit.

The group had plenty of questions (here's a small sample) -
  • Do you drink/smoke/take drugs? NO
  • Do you have a history of high blood pressure/high cholesterol/diabetes? NO
  • What about family history? NO (My grandpa did have some stents in his 70s)
  • Do you have marfan syndrome or any other connective tissue disorder? NO
  • Do you have lupus or any other auto immune disorder? NO
I was asked these question at least 15 times over the course of my stay and always had a good laugh when they ended with the marfan (notable for causing "giantism") question.  No one could really explain what had caused the SCAD in my LAD.  But they were very determined to find out.  None of the staff had ever dealt with a case like mine nor had they known anyone who did. 

That first day was pretty surreal - doctors in and out, nurses drawing tons of blood to test me for everything under the sun, and lots of overwhelming emotions.  In the afternoon, a nurse, Amy, from the Cardiac Rehabilitation program came to visit.  As everyone did, she asked how my baby was.  This, obviously, started the water works.  Cameron was only nine days old and I hadn't seen him in 24 hours.  That's a long time when you're with someone every minute of every day!  And since you really aren't allowed to bring babies to the hospital, I wasn't going to get to see him until I could go home.  When I calmed down a bit, Amy handed me a packet entitled "A guide to heart healthy living".  She provided a summary of what I would find and how it would help me adjust to my new reality.  "Since you've had a heart attack, you're at a higher risk for a second heart attack and a stroke." And I replied "Oh, I didn't have a heart attack yesterday, I had a dissection in my artery."  I suppose I hadn't given much thought to heart attacks ever and assumed a heart attack was when your heart stopped momentarily. WRONG.  Amy paused for a moment and opened the packet to show me the section on heart attacks.  The dissection in my artery had a caused 100% blockage in my LAD, depriving the bottom portion of my heart of oxygen.  When the heart is deprived of oxygen, the cells begin to die - and THAT is a heart attack.  This new bit of information hit me like a tidal wave.  Old men have heart attacks.  So do obese people.  Not young healthy women. Not me.  But sitting in the CICU, I began to realize otherwise.  She gave me the packet to look over, along with her contact information, and left me mulling over the new information.

The good news was that I was stable less that 24 hours after the episode and could be taken off the nitro.  My vital signs were good - indicative of a healthy response to the medications I'd been started on.  Medications that my 89 year old grandpa takes as well- Blood thinners, ACE inhibitors, beta blockers, and anti-coagulates.

I was also visited by a lactation consultant (no more breastfeeding), a nutritionist (new heart healthy diet = low fat, low sugar, low sodium), and a pharmacist (since I am a walking medicine cabinet now).  But all day long, I waited for Dr. Pacheco to come by.  He had saved my life....I decided he would have all the answers too.  He arrived later in the day, when I was finally allowed to get out of bed.  Attached to a portable heart monitor, I was allowed to walk up and down the hallway with supervision.  Brian and I walked to a window that overlooked Clayton Road.  It had rained and the sky was pink and purpley-blue, dissolving the storm clouds to make room for the sunset.  We watched cars drive by and traffic lights change.  Funny how the rest of the world had continued to march on, whereas mine felt frozen in place.  My mom and the doctor found us there.  He explained that things were looking good.  I was responding to the medication, I wasn't having chest pain, and the incision site from my cath procedure was healing nicely.  The research that my team had done indicated that I would be able to get back to close to normal.  I would have to participate in cardiac rehab and adjust my diet to prevent future heart problems, but if I wanted too, I'd be able to train for and run in a marathon.  AND, he let me sneak Cameron in for 30 minutes!!!

Almost all good news....

...... Unfortunately, there's always a "but".  The research also indicated that the high levels of hormones produced during my pregnancy was the likely catalyst to my heart attack.   Brian was much braver than me - he found the courage to ask the doctor something I could not spit out: "What are the chances this could happen again?" The answer: "I can't say for sure.  You must understand that the reported cases of SCAD are autopsies.  There are very few scenarios with survivors available to us.  But.... but if it were my family - if it were my wife - we would not get pregnant again."  There was my "but." 

Talk about overwhelming.  I know I'm lucky - and I do feel that way.  I have a beautiful son and survived a rare heart attack.  Brian and I can foster and/or adopt our next child when we decide it's time.  However, that pesky "but" gets in the way.  If I'd known I wouldn't be pregnant again, I would have enjoyed and savored my pregnancy so much more.  I wouldn't have wished it away at the end when the swelling became intolerable and I was peeing every chance I got and everything was sore.  Never had it occured to me that Cameron would be our only biological child.  I figured he'd have a little mischief maker sister or brother to pal around with, who shared his same features.  I had pictured a future Rachel with another humongous bump, toting Cameron on one hip.  It won't happen.  And this part feels incredibly unfair, no matter how lucky/blessed/fortunate I feel.    Outside of my heart attack, we are healthy people.  We could make a healthy child, maybe with Brian's eyes and my lips.  And then I remember - I HAVE a healthy, beautiful child.  And we'll have another that we'll love just as much, even if he or she isn't a genetic part of us.  But it is still hard. And I suppose it will continue to be hard, until one day it fades away and isn't hard anymore.  

For some reason, I'm still here.  I think maybe for Cameron to have a mama and for Brian and I to grow old and wrinkly together.  And I'm sure for a whole host of other things I have yet to find out- and will share in this blog when I do.  Thank you for sharing this journey with me.  At the risk of sounding super corny, do me a favor - take a minute today and really appreciate who you have in your life - and TELL THEM.  Trust me. Circumstances change in the blink of an eye. Don't wait.....

"We tend to forget that happiness doesn’t come as a result of getting something we don't have, but rather of recognizing and appreciating what we do have."    -Frederick Keonig


"Happiness is an attitude. We either make ourselves miserable, or happy and strong. The amount of work is the same." - Francesca Reigler

Thursday, June 2, 2011

The Golden Hour - Heart Attack, Part II

I love Grey's Anatomy - been watching since the very first season.  I learned about "The Golden Hour" on an episode that aired this past February.  Oddly enough, I would recall this episode months later, realizing that one of the characters suffered a condition similar to mine, with a very different outcome.

The opening monologue:

Meredith: How much can you actually accomplish in an hour? Run an errand maybe, sit in traffic, get an oil change. When you think about it an hour isn't very long. Sixty minutes. Thirty-six hundred seconds. That's it. In medicine, though, an hour is often everything. We call it the golden hour. That magical window of time that can determine whether a patient lives or dies."

On the day of my heart attack, Cameron and I were having a breastfeeding breakthrough.  My milk took 6 days to come in and the lactation consultants from the hospital had me and Brian doing all manner of craziness to ensure a good latch and strong milk supply.  It was SO stressful and finally, we were getting into a consistent routine.  I woke up at 6:00am on Wednesday, April 13th to feed Cameron.  My mom had given me this "maternity" nightgown - a sleeveless pink dress with white polka dots - which had been coming in handy for our late night/early morning feedings.  Usually, it took us about an hour to fill his little walnut sized belly.  Brian, who'd taken the week off from work to enjoy his new little family, sent me back to bed around 7:45am to get a bit more sleep before it was time for our little goatlet (Cam's newborn nickname, because he made little goat noises in the hospital) to eat.  Around 9am, Brian brought me freshly baked cranberry muffins and decaf coffee in bed - such a sweet treat after being up every three hours for the last few days.  After eating breakfast and feeding Cameron, Brian asked if I was okay with him heading to the gym. All I needed to do was brush my teeth and change before he left.  He took Cameron and Mowgli outside to get some sunshine while I got dressed for the day.

I stood over the sink washing my hands when it hit me. I've described it as being hit by lightning or getting kicked in the chest by a horse, but I'm sure neither really illustrates what I felt.  I was in excruciating pain - a pain that radiated across my chest (from my collarbone to my sterum), down the backs of both of my arms (but stopped at my elbows) and underneath both of my shoulder blades.  I wasn't struggling to breathe, but the pain was so intense that I kept holding my breath and had to remind myself to inhale and exhale.  I walked out to the couch and laid down - I remember something my doctor had said about changing positions if you were in pain. And, if the pain didn't go away, it could be something serious.  It felt like my chest was being crushed and set afire.  I could almost "hear" the pain sizzling in my ears because it hurt so intensely.  There was no nausea or lightheadedness as some women tend to experience in a heart episode - just incredible pain.  After a minute or so, I went to the back door and called for Brian.  "I think there's something wrong.... can you call the doctor?"  Using my phone he called my OB/Gyn who was working out of his O'Fallon office that day.  The receptionist indicated we could either drive to his office or go to the ER.  At this point, there was no question - there was not a chance in hell that I would submit to driving to O'Fallon.  The closest ER was St. Mary's hospital (where I was born) so we decided to go there.  I threw my robe on, grabbed my purse and got in the car.  Everything happened so fast, I didn't have time to put shoes on and we forgot Cameron's diaper bag (I'm surprised we didn't forget Cameron, given how new we were to parenting!)

We arrived at the ER and my pain went unchanged.  Brian put me in a wheelchair and put Cam on my lap - because I was post-partum with chest pains, we didn't have to wait.  They wheeled me back to triage immediately and then to a small room.  A nurse started an IV in my right arm and hooked me up to a heart monitor.  When the ER doctor conducted his evaluation, his suspicions indicated a pulmonary embolism - blood clots in the lung.  This is a "common" post-partum complication and he ordered a CT scan.  Brian and I made small talk as we waited for someone to take me to my scan.  As we chatted, I felt a fluttering in the center of my chest.  It didn't hurt at all - it sort of tickled, like a hummingbird was trapped under my skin.  Brian's eyes lifted to the monitor behind me and before I could explain the tickle, a storm of people rushed into my room.  The "hummingbird" feeling was my heart in ventricular tachycardia - a fast and irregular heartbeat that can lead to fibrillation or sudden death.  An EKG turned up no irregular findings, but still, the ER doc decided to call in a cardiologist.  I was whisked away to the CT scan, which show my lungs to be clear.

At some point, my mom arrived at the hospital and Brian left to take Cameron home where his parents would meet him.  While Brian was gone, the ER doctor gave me nitroglycerin to alleviate my pain.  As the somewhat fruity pill dissolved under my tongue, the pain began to melt away.  Don't get me wrong - it still hurt like hell, but it lessened.  My mom, who's been a nurse for over 30 years, asked if I felt better.  Happily, I did.... and it was at this time that my mom told me nitroglycerin relaxes blood vessels and increases blood and oxygen flow to the heart.  The pain had nothing to do with my lungs - I realized something was wrong with my heart.  I was so confused - I remember being worried because I had friends coming to visit the next day and had set up a play date for Mowgli.  I called my friend Jim and asked him to clear my schedule.  So funny the things we worry about when we find ourselves in trying situations.  But I think the day had taken such a strange turn that I needed to focus on something simple. Even so, while Brian was gone, I found myself rattling off to my mom a long list of  to do's. 
  • If I die, tell Brian to quit his job and move to Colorado with the life insurance money.
  • Make sure he puts some away for retirement and  for Cameron's education
  • I am insanely hungry - do you think they'd let you bring me something from the cafeteria?
  • I think I want to be cremated and sprinkled somewhere.  And you should have a party instead of a wake.
The cardiologist on-call, Dr. Pacheco, arrived after I had taken my second nitro.  He indicated that based on my symptoms, there were two possibilities - peri-partum cardiomyopathy or spontaneous coronary artery dissection (SCAD).  The next hour moved so quickly -He ordered blood tests and an ultrasound of my heart.  The blood tests came back with elevated cardiac enzymes - indicative of the death of cells in the heart muscle.  My ultrasound caused a room full of nurses, med students, doctors and even the ultrasound tech to fall silent.  Midway down, my left anterior descending (LAD, also known as "the widow maker") coronary artery was 100% blocked.  The diagnosis was SCAD(http://www.spontaneouscoronaryarterydissection.com/). 

I was taken into to surgery so quickly, I didn't even sign my own consent forms.  Brian and my mom wanted to call a family member (currently in a cardiac fellowship). Dr. Pacheco, while rattling off orders to the staff, thrust his cell phone number at Brian.  "You can call whomever you want.  Here's my cell phone number, you can give it to him.  She's going into surgery now." And then I was whisked into the Cardiac Catheterization Lab where, over the course of an hour or so, a catheter would be inserted into an artery in my right leg and fed up into my heart.  The tear in my LAD required two stents.  In the CCL, you are given local anesthesia - I was awake for most of my procedure.  I watched my heart, illuminated with iodine, beating on one huge flatscreen, and I watched the catheter move through my body on another.  I felt a sharp, stabbing sensation as tiny balloons were inflated in my chest to place the stents.  And then, I felt a rush of calm wash over me, as the blood flow was restored to the bottom (apex) of my heart.  My incision site was healed and Dr. Pacheco shared that my heart was in great shape, despite the day's events.

My parents, brother, cousins and husband were waiting for me when I was wheeled out of the cath lab.  Each looked like they'd been hit by a bus.  All day long, I had known that something serious was happening, but it was so surreal that I didn't really feel it until that moment, seeing the looks on their faces.  I had survived something HUGE. I didn't, and still don't, understand how I'm still here.  I was taken to the cardiac ICU where I'd be closely monitored for the next few days.  I hadn't pumped or breastfed for hours and I had wet spots on my hospital gown.  The cardiac nurses had to borrow a pump from labor and delivery so I could keep up my milk supply. I didn't sleep much that night, partially from the noise of the monitors and blood pressure cuff and partially because I was scared I wouldn't wake up.  And, at this point, no one had said the words "heart attack".  In fact, I wouldn't realize until the the next day that I'd even had one. 

To be continued............

  Meredith: An hour, one hour, can change everything forever. An hour can save your life. An hour can change your life. Sometimes an hour is a gift we give ourselves. For some, an hour can mean almost nothing. For others, an hour makes all the difference in the world. But in the end, it's still just an hour. One of many. Many more to come. Sixty minutes. Thirty-six hundred seconds. That's it. Then it starts all over again. And who knows what the next hour might hold