My Pumpkin…Then & Now!

HELLO…

Emerson was born on August 27, 2008. He weighed a whopping one pound, one ounce, but amazingly, he was on a ventilator less than 24 hours. He spent five months and three days in the NICU at SSM Cardinal Glennon Children’s Medical Center. After a ruptured bowel, jaundice, hernias and multiple other medical problems we brought him home in January of 2009. He is now a happy, healthy five year old who loves Legos and playing cops and robbers. He is in pre-k and doing great. He wears glasses and has seasonal asthma as a result of being born so early, but after all he went through, we’ll take it. He is truly a miracle and our greatest blessing.

Light it up…PURPLE!

If you have a dog…

If you have a dog, you will most likely outlive it; to get a dog is to open yourself to profound joy and, prospectively, to equally profound sadness.

Marjorie Garber

Grief over the loss of a pet runs deep…

By:  Joe Yonan

The Washington Post

It’s been four months, and yet if somebody asks me about that day, my voice will crack.

By “that day,” I mean the day I came home from work to find my Doberman, Red, splayed out on my bedroom floor, his head to one side, his body lifeless but still warm. It’s an image I can’t seem to shake, as much as I try.

I’m no stranger to death. I was a mess of anger and confusion when my father, suffering the aftermath of a stroke, took his last gasps one day in 1995, his children gathered around his hospital bed. And three years later, the death of my sweet, beloved sister Bonny after a withering battle with brain cancer was nothing short of heartbreaking.

Yet somehow, and much to my distress, the death of my dog seems even harder. I haven’t felt grief quite like this since, well, the death of my previous dog five years ago.

How could the death of a canine possibly hurt as much as that of a family member? As the sadness lingers, part of my grieving process has been to try to understand the differences.

Researchers have long known that the animal-human bond is strong:  A 1988 study in the Journal of Mental Health Counseling asked a group of dog owners to place symbols for their family members and pets in a circle representing each dog owner’s life. (The distance between the subject and the other symbols corresponds to the relative, real-life closeness of those relationships.) The subjects tended to put the dog closer than the average family member, and about as close as the closest family member; in 38 percent of the cases, the dog was closest of all.

Research comparing grief over the death of pets to that over the death of friends and family members has come up with different answers. A 2002 article in the journal Society & Animals that reviewed multiple studies found that the death of a companion animal can be “just as devastating as the loss of a human significant other,” not quite as severe, “far more intense” or, well, just about the same.

Sandra Barker, the director of the Center for Human-Animal Interaction at Virginia Commonwealth University, who co-authored the 1988 diagram study, counsels grieving pet owners and teaches veterinary students the importance of understanding the process. Studies aside, her own experience has taught her that the intensity and longevity of the grief vary widely. Like me, her clients sometimes begin the process with a sense of surprise and even shame that they’re grieving more for their pet than for a sibling or parent.

“But when they realize that the difference is the pet gave them constant companionship, and there was total dependency, then they start to realize that’s why they’re grieving so intensely,” she said.

It’s true that I spent so much time taking care of Red, and Gromit before him, that when each one died it didn’t merely leave a hole in my single-person household; it was as if someone had rearranged my life, excising without my permission many of the rituals that had governed it.

About nine months after Gromit died, once I knew I didn’t want to replace him but just wanted to consider getting another dog, I signed up as an occasional foster parent at a no-kill shelter. My first assignment, Red, was a living, breathing refutation of the portrayal of Dobermans as vicious guard dogs in such movies as “Hugo” and the animated classic “Up.” The first time he ambled over to me when I was sitting on the couch in my apartment and lay his head across my lap so I could stroke his snout, I knew I’d adopt him.

And for the two months I lived in that apartment after he died, the couch never seemed so empty, nor the place so quiet.

My relationships with Red, Gromit and Consuela (the cat who has survived them both) have been, for lack of a better word, simple. Or at least simpler than that with my sister — but especially simpler than that with my father, with whom I had constant conflicts.

Barker echoes the idea that the unconditional, nonjudgmental love offered up by animals — “they’re just happy you’re there” — can make it especially hard to lose them. Were these losses more difficult because I was living alone? Some studies suggest that just as pets can ease loneliness, especially among single people, it can be harder for us when they’re gone.

At age 7, Red had been otherwise healthy when he started wheezing one day last October. The vet thought he had allergies and advised me to return if he didn’t get better within a couple of weeks. Two weeks later, a chest X-ray showed a mild pneumonia, and the vet sent Red and me home with antibiotics that she hoped Red would respond to within a few days. I gave him a dose at about 1 p.m. and went to work; when I returned that evening, he was dead.

The fact that our pets are so dependent on us makes it all too easy to second-guess our decisions and descend into a pit of guilt. Shouldn’t I have known? Did I do everything I could? If I had just … what? Taken him to the vet sooner? Insisted he be hospitalized? What if I had been home? I might not have been able to save him, but at least in his last moments he would have known I was with him, and maybe that would have made it a little easier for him if not for me.

Thankfully, many of my closest friends, family members and co-workers have been wonderfully sympathetic, and for that I’m grateful. Others have seemed reluctant to talk about my grief. My least-favorite reaction comes from those who are aiming to be supportive but regularly ask me when I’m going to adopt another dog, a reaction that seems tantamount to saying, “Get over it already. He was just a dog. Isn’t one as good as another?”

That can lead to what psychologists refer to as disenfranchised grief.

“Simply stated, many people (including pet owners) feel that grief over the death of a pet is not worthy of as much acknowledgment as the death of a person,” researchers wrote in a 2003 article in the journal Professional Psychology: Research and Practice. “Unfortunately, this tends to inhibit people from grieving fully when a pet dies.”

Two months after Red died, I’ve had a change of scenery, moving to my sister Rebekah’s home in southern Maine to work on book projects for a year. Here, my sister and brother-in-law’s gregarious chocolate Lab, Maya, helps keep me company and reminds me that eventually, probably sometime next year, I’ll be ready to adopt again. Meanwhile, Red’s ashes sit in a beautiful carved wooden box on a shelf in my bedroom, right in front of a beautiful drawing that a colleague’s son made for me after Red died. Those artifacts have helped, but I’ve needed something more.

My sources for this article noticed the answer before I did: I’m a writer, and I need to process my grief by writing, so that’s what I’m doing. Kathy Reiter, who leads monthly pet-loss support groups in Northern Virginia, admitted that her own work helping others was partly as a tribute to her cat, Prince, who died at the ripe old age of 23, but also as a way to validate and work through her own grief. By writing about Red, she said, “you are doing what I did: It’s self-serving, but it’s a tribute, and it’s a catharsis for you. You want to capture the memories, so you don’t forget.”

There’s one more task ahead of me. Five years ago I buried Gromit’s ashes in the woods outside Rebekah’s house, along with his collar, a note, a photo of us together and one of his favorite things:  a bagel. The headstone says, “Thank you.” Red’s box, meanwhile, went up on the shelf when I got here in January, partly because the ground was frozen solid.

The days are getting longer, though. The ground has thawed. I’ve been looking at headstones and, more important, composing the words that will go on Red’s.

RIP Maxie 2/16/05 – 6/3/13

Well, I woke up last Thursday to a very sick little dog.  He was puking and had used the bathroom several times in the house.  On Friday, he was no longer puking but wouldn’t jump up on the bed, couch, etc.  Other than that, he was pretty well back to normal or so we thought.  Saturday and Sunday, he wouldn’t eat, was very lethargic and had to be carried to his water bowl and outside to use the bathroom.  His breathing was also very labored.  

We took him to the vet first thing Monday morning.  They had us wait outside with him because he was “sick” and there were puppies in there.  When it was our turn, they called us in.  Checked his stool and said there was some bile in it but didn’t explain what that meant.  Then they took blood from his arm to check for diabetes.  The vet said it was like 168 so he didn’t think that was the problem.  He left the room and came back in and closed the door.  He told us he didn’t really know what was wrong.  He tried listening to his heart again but couldn’t hear it because Maxie was breathing so heavily.  He told us he needed to keep him to give him fluids and do more blood work.  He shaved his neck to get more blood.  Tried twice and couldn’t get it.  Then he told us to leave.  Never mentioned how serious things might be or asked if we had other end of life plans so he didn’t suffer.  He told us that he was going to give him fluids and then try for the blood again.  He told us that if he perked up in the afternoon he would call us and we could come and pick him up.  He called later that afternoon and I was all excited thinking he had “perked up”.  He said I have some bad news.  The pug didn’t make it.  I was dumbfounded.  He said he gave him some heart medicine and he seemed to perk up so he left to run some errands.  When he came back, “the pug” was dead.  He only referred to him as “the pug” which really irritated us.  Anyway, he said he could do an autopsy if we wanted or he could just bury him.  I asked if we could just come and pick him up.  He said yes, but he was only waiting 30 minutes.  So, I had to call my husband at work, get him home, and get to the vets office (about a 10 to 15 minute drive) in 30 minutes.  When we got there he was with someone else and then saw someone else before acknowledging us.  He then told us the story again and then went in the back and brought out our baby in a black trash bag.  

Had we known the seriousness of the situation, we never would have left him.  Now, I’m dealing with not only losing my dog suddenly but he was alone in a strange place all by himself.  My heart is broken.  

I called the vet the next day to see about the lab results he had sent off.  He told me he thought Maxie was in kidney failure and his potassium was high which might have been an indicator of a tumor.  I was still in shock and there are so many questions I wish I would have asked.  My husband went by there today to talk to him and was told that the vet was very busy and if we wanted to talk to him, we needed to make an appointment.  

We buried Maxie in our yard, on his bed, wrapped in his blanket.  I ordered a stone to put on top of his grave.  

I see one of his hairs and ball.  Can’t go in the yard without balling.  We explained to our four year old son that Maxie got sick and went to Heaven.  Now, he wants to know if we can get a rocket ship to go see Maxie because he misses him.  He had me pick him up the other day so he could pet the pug sticker on the back window of our van.  Our other pug, Wrinkles, is depressed and missing his buddy.  I wish we had just taken him somewhere over the weekend.  I just never expected a dog to be rambunctious one day and dying the next.   

                                                                                                                                       

Crohn’s & Colitis For Dummies Cheat Sheet

Crohn’s & Colitis For Dummies

Crohn’s disease and ulcerative colitis are the two major types of inflammatory bowel disease. They’re part of a group of disorders in which the small and large intestines become inflamed. The exact cause is a mystery, but scientists have discovered some clues as to what may cause Crohn’s and colitis. The symptoms of the diseases can vary in each individual, but some symptoms are more common than others. The good news is, you can take steps to reduce your symptoms and keep them from interfering with your life.

The Major Causes of Crohn’s and Colitis

People all around the world from different ethnicities and races are affected by Crohn’s disease and ulcerative colitis. The exact cause is still a mystery, but scientists have hit on some clues:

• A faulty immune system: Scientists believe there could be a fault in the immune system that allows bacteria to invade the intestines and cause inflammation. The inflammation lasts longer than it would in a healthy person, because the immune system of someone with Crohn’s or colitis isn’t capable of flipping the inflammation switch.

• Environmental factors: Smoking, diet (such as those high in refined sugars, animal proteins, and fats), certain drugs (such as non-steroidal anti-inflammatory drugs, or NSAIDs, like aspirin, Advil, and Aleve; oral contraceptive pills; and antibiotics), and stress are thought to change the function of the immune system or alter the population of intestinal bacteria and cause chronic inflammation in the intestines.

  In addition, because of the improved hygiene conditions that we have today in the developed, children aren’t exposed to as many germs. So, the immune system has shifted away from fighting infection to developing autoimmune diseases like Crohn’s and colitis.

• Genetics: Gene mutations are thought to be unique in Crohn’s and colitis patients and may be the culprit in causing defects in the immune system and other mechanisms, leading to persistent inflammation in the intestines. In addition, if you have a family history of Crohn’s and colitis, you’re more likely to have the disease yourself (especially if the family history is in a first-degree relative — parents, children, or siblings).

All these factors are just potential causes of Crohn’s and colitis. For example, plenty of people with a family history never develop the disease themselves, and plenty of people with the disease have no family history.

Common Symptoms of Crohn’s and Colitis

Crohn’s and colitis are two different diseases, but they share many of the same symptoms. Here’s a list of the common symptoms of Crohn’s and colitis:

• Chronic diarrhea: Diarrhea is the frequent passage of watery or semi-formed stools. Everybody gets diarrhea from time to time, but chronic diarrhea (lasting longer than 30 days) is a common symptom of Crohn’s and colitis.

• Blood in the stool: You may notice bright red blood in your stool, or your stool may be black in color (which is a sign of old, clotted blood).

• Abdominal pain: You may experience abdominal pain, anywhere in the abdomen.

• Rectal urgency: When you have Crohn’s or colitis, you may experience a sudden, compelling need to have a bowel movement. This is known as rectal urgency.

• Tenesmus: Tenesmus is a constant sensation of fullness and incomplete relief during a bowel movement. You may feel like you need to go to the bathroom, but then you don’t have an actual bowel movement.

Consult your doctor right away if you experience any of the following symptoms:

• Intolerable abdominal pain: If you develop intolerable abdominal pain, it may point toward intestinal obstruction, perforation, or severe inflammation. You may also notice other signs like nausea, vomiting, and abdominal distension.

• Weight loss: When you have Crohn’s or colitis and you’re losing weight, that’s a sign that inflammation is still active. Most of your body energy is being diverted to control inflammation, and your nutrition isn’t keeping up with the amount of energy your body is expending.

  If you’ve had colitis for many years and you’re now starting to lose weight, this could be worrisome. Longstanding colitis puts you at risk for cancer, so be sure to notify your doctor immediately about any weight loss you experience.

• Fever and chills: If you develop any fever with or without chills, this may point toward worsening inflammation, infection in your intestines or an intestinal abscess (collection of pus).

• Severe bleeding: If you notice blood in your stool every time you go to the bathroom, it may be a sign of severe inflammation.

If you experience any of the signs or symptoms above, consult your doctor right away.

Eight Things That May Worsen Your Crohn’s and Colitis Symptoms

Taking your medications as prescribed is one way to keep your Crohn’s and colitis under control. However, the disease can become active despite taking medications. Certain things are known to trigger Crohn’s and colitis flares or increase your symptoms. But if you know about these triggers ahead of time — and avoid them — you can help yourself stay in remission and avoid flares. Here are the common triggers for Crohn’s and colitis:

• Smoking: Smoking not only increases your risk of having Crohn’s disease, but also makes the disease worse, causing you to have more flares. Studies have also shown that smoking brings Crohn’s disease back after surgery.

• Drugs: A variety of drugs can trigger Crohn’s and colitis symptoms, including frequent use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Motrin, Advil, or Aleve. Certain antibiotics (such as ciprofloxacin and penicillin) increase your risk of having infection of your intestines, which can mimic acute flare.

  Talk with your doctor if you have any concerns about medications you’ve been prescribed. Don’t stop taking a prescribed antibiotic without consulting with your doctor first.

• Diet: Certain foods may give you more problems than others, but everyone reacts differently to different foods — so what your sibling with Crohn’s or colitis can tolerate and what you can tolerate may be different. Pay attention to which foods are giving you trouble and avoid them in the future. Here are some common culprits:

  • Artificial sweeteners

  • Fatty foods

  • High-fiber food

  • Gas-producing food (lentils, beans, legumes, broccoli)

  • Caffeine

  • Spicy foods

  • Nuts and seeds

  • Dairy products (if you’re lactose intolerant)

  • Wheat and other products (if you’re sensitive to gluten)

• Alcohol: Studies have not shown that drinking adversely affects the inflammation in Crohn’s and colitis patients. Alcohol does, however, irritate the intestines and can worsen symptoms of diarrhea in some patients. It can also interact with certain medications you may take for your disease, such as metronidazole and methotrexate.

• Dehydration: Active disease makes you go to the restroom frequently, causing you to lose water and salt and putting you at risk for dehydration. Dehydration itself can cause stress to your body functions and cause more weakness and inability to cope with illness. And a vicious cycle starts. . . . Bottom line: Stay hydrated by drinking at least eight 8-ounce glasses of clean water a day.

  The amount of water you need may vary depending on your age, weight, activity level, and body fluid losses (such as water lost during diarrhea). Talk with your doctor and dietitian about your total daily water requirement.

• Depression: Studies have shown that depression can cause disease flare. You can have more symptoms and an increase in inflammation of the intestines when you’re depressed. Your doctor may prescribe an antidepressant to treat depression and, thus, reduce the symptoms of your Crohn’s or colitis. Be sure to talk with your doctor if you’re feeling depressed.

• Lack of sleep: Sleep can affect the immune system, and poor sleep or sleep deprivation can activate inflammation. Poor sleepers tend to have more inflammation of their intestines and are at risk for future flares. Getting an uninterrupted seven to eight hours of sleep can keep your symptoms at a bay.

• Stress: Stress has a negative impact on the immune system. Physical and emotional stress has been shown to cause disease flare and an increase in symptoms. Nobody has a stress-free life, but do what you can to keep your stress at a minimum, even if that means taking a yoga class or dropping the kids off at your health club’s daycare center while you sit in the sauna for 30 minutes. (Just make sure to stay hydrated if you’re sweating out your stress.)

How Preemie Moms Are Chosen

How Preemie Moms Are Chosen
(Erma Bombeck)

Did you ever wonder how the mothers of premature babies are chosen?

Somehow, I visualize God hovering over Earth, selecting his instruments for propagation with great care and deliberation.  As he observes, he instructs his angels to take notes in a giant ledger.

“Armstrong, Beth, son.  Patron Saint, Matthew.  Forrest, Marjorie, daughter.  Patron Saint, Celia.  Rutledge, Carrie, twins.  Patron Saint…Give her Gerard.  He’s used to profanity.”

Finally, he passes a name to an angel and smiles. “Give her a preemie.”

The angel is curious. “Why this one, God?  She’s so happy.”

“Exactly,” smiles God. “Could I give a premature baby a mother who knows no laughter?  That would be cruel.”

“But does she have the patience?” asks the angel.

“I don’t want her to have too much patience, or she’ll drown in a sea of self-pity and despair.  Once the shock and resentment wear off, she’ll handle it.  I watched her today.  She has that sense of self and independence so rare and so necessary in a mother.  You see, the child I’m going to give her has a world of its own. She has to make it live in her world, and that’s not going to be easy.”

“But Lord, I don’t think she even believes in you.”

God smiles. “No matter, I can fix that.  This one is perfect.  She has just the right amount of selfishness.”

The angel gasps, “Selfishness?!  Is that a virtue?”

God nods. “If she can’t separate herself from the child occasionally, she will never survive.  Yes, here is a woman whom I will bless with a child less than perfect.  She doesn’t know it yet, but she is to be envied.  She will never take for granted a spoken word.  She will never consider a step ordinary.  When her child says momma for the first time, she will be witness to a miracle and know it.  I will permit her to see clearly the things I see– ignorance, cruelty, prejudice– and allow her to rise above them.  She will never be alone.  I will be at her side every minute of every day of her life because she is doing my work as surely as she is here by my side.”

“And what about her Patron Saint?” asks the angel, his pen poised in the air.

God smiles. “A mirror will suffice.”

FYI: Intercranial Hypertension

Intracranial hypertension (IH), sometimes called by the older names benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC), is a neurological disorder that is characterized by increased intracranial pressure (pressure around the brain) in the absence of a tumor or other diseases. The main symptoms are severe headache, nausea, and vomiting, as well as pulsatile tinnitus (buzzing in the ears synchronous with the pulse), double vision and other visual symptoms. If untreated, it may lead to swelling of the optic disc in the eye, which can progress to vision loss and even blindness.

IH is diagnosed with a brain scan (to rule out other causes) and a lumbar puncture; lumbar punctures may also provide temporary and sometimes permanent relief from the symptoms. Some respond to medication (with the drug acetazolamide), but others require surgery to relieve the pressure.

A Patient’s Perspective

What is it like to have chronic IH? Sometimes, it’s hard to understand what a friend or loved one is going through with this illness. The following are some helpful suggestions for friends, family and caregivers submitted by IH patients.

1. Be a good listener. It’s difficult to watch a friend or family member deal with a chronic illness that is not well-understood. It can be an incredibly frustrating experience for everyone involved. Sometimes, the best thing you can do is simply listen, without any judgment, and understand that the person who you care about is still there, despite this illness.

2. Avoid comparisons. Chronic IH is a very real and disabling illness. But its effects are not necessarily seen on the outside. A person with chronic IH may look okay but feel terrible. As a result, the seriousness of chronic IH is often downplayed. Old names for the disorder like “pseudotumor cerebri” and “benign intracranial hypertension” only add to this misinterpretation. There is nothing “pseudo” or “benign” about this illness or the pain and disability that it can cause.

3. Be an advocate. There may be times when you literally find yourself acting as an advocate for your relative or friend, who may be too sick be his or her own advocate. If you are a caregiver, you may be the person who helps relay your relative/friend’s medical experiences to a physician. It’s helpful to document that information, in a journal or daily record.

Educating yourself—and other people— about chronic IH is also important. Don’t be afraid to ask questions of physicians or seek out others if you feel your questions have not been answered satisfactorily.

4. Know when to give advice. It’s normal to want to help others who are suffering or in pain, especially when it’s your daughter or your best friend. But sensitivity is important. A chronic IH headache is still very mysterious. We do not know what causes it, though lowering intracranial pressure often brings relief.

There is still a lot to learn about this disorder and its effects on the brain and body. Keep in mind that an IH headache does not usually respond to traditional headache remedies and pain medications. When in doubt, first ask questions about your friend or relative’s experience. Then you can gauge whether to offer advice.

5. Today is today. Chronic IH is unpredictable, which means that there will be good days and bad ones for the person who is ill. It’s hard to know what your friend or family member will feel like or what tasks he or she will be capable of tomorrow, which is why it’s best to concentrate on the present. Be patient because abilities can change quickly; it’s not intentional but the nature of this illness. At the same time, never give up hope that the future can bring long-awaited answers and better treatments for your loved one.

One Ounce At A Time

Here is another article that was written about Emerson after his birth. It was written for the Heartbeat magazine which is a Ronald McDonald House publication.

As most parents and children count down the days until presents and holiday fun, Elizabeth and Carl are counting up.

Each day is yet another their son, Emerson, born three months premature and weighing only once pound, one ounce, is alive and growing.

Five months into a surprise pregnancy, Elizabeth Vincelette developed preeclampsia, or high blood pressure brought on by pregnancy, and was rushed to the hospital in Carbondale, IL. At only 26 weeks gestation, Emerson was delivered by emergency cesarean section at St. Mary’s Hospital in St. Louis. Without the quickness of surgery, doctors feared neither Elizabeth nor Emerson would have survived.

While some parents dread the sounds oh their baby crying, Elizabeth and Carl, live for it. On the fifth of September, Elizabeth and Carl first heard Emerson cry; on the sixth the couple got to at last hold their son — nearly two weeks after his birth day.

Every evening at 9 p.m. a nurse at Cardinal Glennon takes everything out of Emerson’s incubator, removes his diaper, and sets him back down on the scale built into his bed, hoping for even an ounce of weight gain.

Elizabeth and Carl are only able to hold Emerson for an hour a day because when removed from his incubator he gets too cold and burns calories to try to stabilize his body temperature. Emerson must learn to breathe on his own and fight to keep his body temperature and blood sugar regulated.

In the meantime, they play with Emerson’s toes and fingers and sing to him while praying he keeps gaining weight. He is now two pounds, two ounces.

When Emerson reaches four pounds, doctors will repair his bowel and he will be placed once again on a ventilator to help him breathe.

Elizabeth and Carl fill their days with trips back and forth from Cardinal Glennon to their room at the Ronald McDonald House. Without the warm meals prepared at night by the RMH volunteers, a bed to sleep in so close to Cardinal Glennon, and other families to bond with, Elizabeth and Carl don’t know how they would cope.

The couple looks forward to when they can bring Emerson home, or even hold him for more than an hour a day, and return to normalcy.