On New Years

In the quiet cold

Bright new beginnings emerge

Gray strength resolute

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On Infantile Spasms

In honor of Infantile Spasms week below is the text of my 2015 presentation on Infantile Spasms to the New England Tuberous Sclerosis Alliance. Infantile Spasms are a rare catastrophic epilepsy that begins in early infancy. It is marked by subtle movements that mimic the Moro or startle reflex in series but could also be as simple as a head nod. The following is our journey.

Imagine an infant—their round features, soft skin, new baby smell, their warmth against your body as you cradle them.  Let those feelings sink in—the joy, comfort, love, and peacefulness of the moment.

Now imagine someone rips the infant from your arms and leaves them in the middle of a busy intersection while you are forced to do the unimaginable, stand helplessly by and watch from the safety of the sidewalk.  As uncomfortable as it may be, let the feelings of that imagery rise up—the pure abject terror, the visceral feeling of complete and utter helplessness, the horrifying dread and anticipation, the steadfast hope for safety even in the most perilous situation, the relief as the minutes pass and the child remains safe and sound, the utter anxiety, grief, and sadness of it all.  

Now try to hold both images in your mind—the warm comfort of snuggling a sweet infant and the absolute horror of them in danger.  Try to hold both those feeling experiences simultaneously in your consciousness.  To me this is what it was like having a baby diagnosed with Tuberous Sclerosis Complex (TSC) and learning of the risk of infantile spasm in TSC.  In fact, this is how I explained to a friend what I was feeling when Kaleigh first started experiencing infantile spasms at 5 months old.  I felt as though my precious baby had been ripped from my arms and was placed in oncoming traffic.  Every day I was waiting for the car of clusters to strike her, knowing the results could be catastrophic, yet never knowing exactly what the collateral damage would be in the long run.

Today, I want to focus on the emotional component of having a child diagnosed with both TSC and infantile spasm.  We’ll hear a lot about education, what to look for, treatments, and science around these diagnoses.  But, personally, even armed with all the information and as prepared as I was logically for the event of possible infantile spasms, I was not prepared emotionally.  I struggled and was stymied by the overwhelming experience.  Our experience with infantile spasms was anything but straight forward.  My hope in speaking is to acknowledge what preparation and medical providers cannot—the  very private struggle of parenting an infant having infantile spasms.

Our daughter K was diagnosed with TSC at 29 weeks gestation when an ultrasound showed multiple rhabdomyomas in her heart and increased ventricular volume in the brain.  The devastation of the diagnosis weighed heavy but even then I had a sense of relief that I was able to prepare.  Some of you here know me, so it won’t surprise any of you when I say I am a planner.  I am a card carrying type A personality, academic, research loving, statistical nerd, who likes everything to be orderly and planned.

Did I mention I’m a control freak?  Becoming a parent is especially challenging for us high-strung types, under even the most idyllic of circumstances. I handled the diagnosis in my typical fashion, I wept, I reflected, and then I prepared.  I read all I could from the Alliance.  I looked into doctors, clinics, switched birth plans and OB/GYNs to a practice with a better NICU.  I watched videos of infantile spasms.  

And then my world changed on Dec 1, 2009.  K stopped moving and I was sent for an emergency c-section.  She was born pink and screaming and was whisked away to the NICU where she was evaluated and a few days later officially given the diagnosis of TSC.  We met with a neurologist from our local children’s hospital and TSC clinic before leaving the NICU.  His advice was to enjoy her and call if I had any concerns—he’d see her in 3 months. 

The simultaneous joy and grief made it so very difficult to enjoy the first months of her life.  At four months old, we took K to a regularly scheduled cardiology appointment where we found she was in heart failure.  She was immediately admitted to the PICU for treatment.

There is no preparing for such an event.  There are no words to describe the emotion of the experience.  And it was during this time that we noticed the first whispers of impending spasms.  K was recovering from the heart failure nicely.  Her function was improving and we were moved to a regular floor.

My husband was holding her in his lap when she made a slight movement like she was doing an abdominal crunch.  I suspected spasms right away and quickly got the hospitalist covering the floor to come in.  The APRN entered while K was still making the motion.  She assured us it was nothing, likely just reflux, she knew what infantile spasms looked like and these were not them, there was no throwing out of the arms, no distress between the episodes, etc.  

This was the first intersection of knowledgeable preparation and emotion for me.  It was a spectacular internal crash.  I knew spasms could look like this.  I knew more exaggerated motion could follow.  I knew timeliness was of the utmost importance.  And yet I so badly longed for none of it to be true.  I wanted to believe the APRN.  After all she was a medical professional, she had to know more than me, she had to know something I didn’t.  I wanted to ease the anxiety, to allay the terror of helplessness, and feel safe, potent, and in control.  This was the underlying experience for me through our entire spasms journey.

K is fast approaching 6.  It has been nearly four years since we have seen a spasm and the echo of these emotions remain.  The call to go down the path of what if instead of what is and what was beckons me. I cannot say for certain if those were her first spasms.  I can only make my best educated guess.  I think they were and I carry a lot of guilt for allowing my emotion to cloud my logic. Nevertheless, I went with what the APRN was saying and I can’t change that decision. I mentioned the episode to her neurologist.  And we waited to see where things went.

When one night she was playing on her infant gym mat and began to repeatedly throw one arm in the air and crunch her abdomen on that side, I again sprang into action recording a video and immediately calling the on call neurologist.  We were again met with professional concern yet assurance.  There was nothing that could be done until Monday but increase her the mediation she was on for her simple partial seizures.   We brought her in for an EEG that Monday and to sign paperwork for Sabril if needed.  The EEG was good.  It only showed left occipital, parietal spike discharges.  The same ones she had for a couple months and the ones she continues to have to this day.  We were told it was unlikely she was having spasms as there was no hypsarrhythmia but they would start Sabril anyway.

Now came the time that the physicians scared the ever loving sanity out of us regarding Sabril and side effects.  The chance of peripheral “blindness” was heavily emphasized.  Another collision of logic and emotion.  

I felt like Seligman’s Dog… True to my nerdiness this is a reference to a famous psychological experiment in which dogs are electrically shocked repeatedly.  At first the dogs have no way to escape.  Eventually, the experiment is changed so that the dogs have a simple way to escape the shock—they can jump to a shock free cage.  But, the dogs don’t.   They lay there and endure the shocks over and over.  It’s what’s called learned helplessness.  It happens to us humans too.  We were in a terrible situation.  We were helpless.  But there was an out and it was Sabril.  It seemed equally terrifying.  So there was an aspect of freezing under the circumstance.  Allowing the emotion to overwhelm.  And falling even deeper into the terror of helplessness.  

We signed the papers and received Sabril soon after, but we were repeatedly told they did not think these were infantile spasm.  I was overwhelmed by it all.  Worried about our baby’s future.  Would she ever sit up, crawl, walk, talk?  Would she be blinded?  I was worried about her present.  I gave her the first dose of Sabril and held her with hope as she fell asleep.  But she really fell asleep.  Into too deep of a sleep.  I couldn’t rouse her after quite some time.  She was breathing and pink but she was not responding to stimuli.  I called the neurologist.  Placed an ice pack on her bare skin as he recommended and when she did not wake took her immediately to the emergency room.  We were told she had Sabril toxicity and to stop the medication.

Over the next few months, K continued to have questionable episodes of clustered movements.  They were subtle at times, and dramatic at others.  My gut said they were spasms, but our neurologist said they weren’t.  There was no hypsarrhythmia.  In fact, there was no electrographic correlate with any episode on the EEG.  We were told they would not try Sabril for her again.  They told us to have her evaluated by GI for reflux, have cardiology see if they were some strange form of arrhythmia or syncope.  So we did.  Even when my gut said we were going down the wrong path, I was overwhelmed by the disparate experience of my knowledge and the emotion of hope.  I could not control any of this.  I was in a whole new territory.  No amount of will power, volition, preparation, or knowledge could change the feeling of hopelessness and helplessness.    

At 9 months old, K began having tonic clonic seizures up to 5 times a day.  At that point, I knew we desperately needed to do anything to save our daughter.  She was admitted to the local children’s hospital and we demanded that if they would not prescribe Sabril that she be put on the ketogenic diet.  We also asked for appointments to be made for us at a hospital with a larger TSC clinic—one that could do a surgical evaluation.  The ketogenic diet controlled her seizures nicely… at first.  We transferred care to the larger clinic, celebrated her first birthday, and made it to the New Year.  

The day after her yearly MRI, Kaleigh had a long cluster of serial head nods.  Again, I knew it was seizure.  Specifically, my gut knew it was likely infantile spasms.  This time I vowed not to get mired in the emotion.  To stick with my logic and get K on Sabril.  We were at one of the top children’s hospitals in the world and one of the best TS clinics as well, this had to be more straight forward.  Another vEEG and another time we were told that what we saw was not infantile spasm—it wasn’t even seizure as there was no electrographic correlate.  Again, my heart was filled with hope.  These were reputable, world renowned doctors, they had to know what they were talking about.  I wanted so badly for what they were saying to be true.  

I wanted it so badly that I clung to the hope and almost every day it was shattered by another cluster of serial head drops.  My heart was broken every single day.  I worried endlessly.  K was nearly two, not walking, delayed in fine motor skills, talking but stalled.  I knew these were seizure.  I feared they were spasm.  I did everything I could to advocate to get these episodes and her other seizures under control. I called the doctor’s office every day.  I had my sanity questioned by her doctors, my parenting skills debated, I was told over and over again that I was wrong for not trusting that these were not seizure.  It was a very dark time.  I stood helplessly by on the sidewalk as car load after car load of spasms slammed into our sweet girl.  I was eaten alive by doubt, guilt, and the utter pain of it all.  But I moved forward, and continued to advocate for diet changes, medication changes, more EEG monitoring—anything I thought might save K from being ravaged by what I was now fairly convinced were spasms.

About four months after we saw the first cluster, 11 days after her second birthday, and with her 8 week old baby brother in tow for the week long vEEG, we finally received confirmation that the head nods were in fact seizure.  They were spasms.  They showed electrographic slowing during the cluster.  The neurologist told us they were juvenile spasms because she was over 18 months old and that these were less deleterious to her development.

I was never so devastated to be right in my entire life, nor do I think I ever will be in the future.

The doctors told us to increase her Keppra and that Sabril was not needed for these spasms.  I was flabbergasted, but knew I needed to raise the issue with her neurologist instead of the neuro covering the floor.  I will never forget what her neurologist said when I pleaded with her to start K on Sabril.  She said, “She uses her eyes.  I will not prescribe a medication that could blind her.”  Seligman’s dog no longer, I got up and took the leap.  I fought tooth and nail, called the patient advocate, and got K placed on Sabril by the end of the week.  After our experience, we transferred K care to a doctor, hospital, and clinic that was a better fit for us and were seen a few weeks after initiating Sabril.  K’s new neuro only needed to look at videos of K’s episodes to say they were seizure.  And with a few med tweaks she had Kaleigh’s spasms and other seizures under control within a few weeks.

We’ve continued to face struggles with TS that have seemed insurmountable; that have rendered us helpless, hopeless, and terrified; but, for now (EVERYONE PLEASE KNOCK ON WOOD), spasms are a struggle of the past and I am able to use that experience to navigate our current difficulties.  My greatest obstacle is to leave that spasm struggle in the past–not to be lured by the emotion back to a timeline I cannot change.  Every time I am confronted with K’s delays, the siren song of doubt and guilt woo me.  What if she was put on Sabril earlier?  What if I did this instead of that?

This fruitless exercise takes me away from the beautiful, smart, sassy, vibrant child I have loving me and driving me absolutely nuts, in the best way possible, every single day.  It is what leaves me in heaving sobs in the doctor’s office thinking I am personally responsible for her latest discouraging neuropsych results instead of listening to my girl trying everything she knows to try to get me to laugh.  

I am certain I am my harshest critic.  Nevertheless, it is true that I made many mistakes in our spasms journey.  I lost myself in emotion.  But, that was not one of the mistakes I made.  It was emotion that pushed me on and it was my gut that told me to keep seeking treatment in the face of objective medical data.  Another one of the big lessons I learned was that preparation and knowledge are not everything.  Knowledge alone did not get K the proper diagnosis and on the best treatment regime.  In fact, knowledge in absence of the bigger picture failed her first physicians despite their best efforts.  It was the marriage of clinical knowledge, parental advocacy, and passion that helped K.

Lastly, I may have characterized hope throughout this journey in a negative way.  It was my clinging to hope that often overshadowed my gut feeling that something was very wrong—that K was having infantile spasms.  But, hope is often all we have.  It is what holds us together when we are the dog chained to the shocking cage, when we are the imaginary parent watching our imaginary child in the path of oncoming traffic, when we are the parent of a child with Tuberous Sclerosis Complex and infantile spasms doing everything we can to help get the spasms under control.  Hope fosters resilience.  Spasms are devastating, uncontrolled spasms decidedly more so, and our children are resilient.  So, have hope.  

On Trading Places

El Jaleo
Forever trapped oil on canvas

I grew up in a small town in the New England; it’s rumored that when I was born there were more cows in the town than people.  As a teenager, pre-license, I resented the long expanses of subdivisions, corn fields, and barns housing dairy cows; they kept me from freedom.  I dreamt of big cities and bright lights; art and music; most of all, I dreamt of freedom.

I dreamt of a place where I was free to shed the cloak of expectation that shrouded me and manifest my own destiny.  Perhaps, it was not this at all, but rather, the familiar dream of trading places.  Perhaps, I was caught in the universal theory of mind game–what would it be like to be her, or him, or anyone other than me in this stifling place?

When you grew up in a town where everyone knew your name they tended to also know your business.  Ironically, nobody there really knew me at all.  It was the strangest sense of isolation.  I spent my life surrounded by those who had the utmost familiarity and simultanseous estrangement.  It was the confusion of being met with the assumptions of others then surprising them, letting them down, or simply being completely misunderstood.

This was a strikingly similar experience to parenting a child with rare and extraordinary needs.

Recently, another mother of a child with rare disease told me that she never thought about running away when she was young; but that she probably thought about it way more than she should as a parent to a child with special needs.  Her experience is not unusual.  Research has shown that mothers of children with autism have stress levels similar to combat soilders.  Who in our line of parenting wouldn’t at least imagine themself somewhere, or someone else?  Nevertheless, she likely wouldn’t share her deep desire to escape or trade places with most of her mama friends (yet I’m the one who goes writing it on the internet for all to read) for fear of being judged or misunderstood.

Parenting a child with rare and extraordinary needs is like living in my childhood small town–there is a simultaneous familiarity and estrangement.  Most of the people we run into in our day to day interactions are other parents who have some understanding of what it is like to raise tiny humans–there is a familiarity.  Yet, our world is so very different than theirs; it is full of complex medical jargon, life or death emergencies, therapies on top of therapies, the bittersweet meeting of milestones, and milestones that will never be met–there is a complete and utter estrangement.

Much like my adolescence, parenting my children has been an isolating experience.  I am surrounded by others who hold assumptions of what both me and my brand of tiny humans are and should be like.  Over the years I have learned to brush the well-intentioned yet oblivious, parents aside, but it remains a part of my daily life to deal with doctors, nurses, therapists and school administrators who I must educate and shake free from their shackle of assumption in order to see me, but more importantly, my children clearly.

Perhaps hardest with which to deal is the desire to feel free–it is similar to that adolescent desire for freedom.  Parenting children with excptional needs can feel stifiling.  All parents trade some dreams to care for children and for special needs parents it is more than that.  There is no end date in which you can say, “when my child is in kindergarten I can return to work” or “I will get my Master’s when my child is in middle school.”  We are forced to surf the wave of our child’s needs no matter how capricious the sea.  There is an inexplicable trapped feeling that accompanies that reality.

Despite the stark reality of parenting a child with extraordinary needs, there is great love and great hope.  Unlike the dial-up days of my adolescence there are a wealth of resources online to find your Tribe of fellow parents and decrease the isolation.  There is also freedom in the very imagining itself–to dream of yourself as someone else, somewhere else–and to run away in your mind–if only for a little while.

I used to dream of bright lights and big cities, art and music; unfortunately, I spend way more time than I would like in a big city, Boston, for medical appointments with my crew.  Not exactly what I dreamed of; yet, I still permit myself to dream.  I find the time when I can to get lost in my favorite place on earth, The Isabella Stuart Gardner Museum.  I stand at the foot of John Singer Sargent’s, El Jaleo and I imagine what it was like to be the Andalusian flamenco dancer.

John Singer Sargent, El Jaleo
Photo from my last sojourn

I trade places places in my mind’s eye and imagine myself deliciously free and moving to the beat.  And, in that moment my burden is lighter, my dreams more vivid, and my soul reinvigirated.

I have a magnet of El Jaleo on my refridgerator.  In moments of deep despair, when I feel as though I cannot meet the challenge that has been bestowed upon me, I imagine myself the great Andalusian dancer and I buy myself a moment of freedom.

How ironic that a woman forever trapped oil on canvas can make my soul feel so free.  I guess that is the magic of dreams–we can imagine ourself anyone and anyway we want to be; whether that be far away from small town New England or the high-stress, high-demand world of special needs parenting.

On Origin Stories

superheroThe screen came to life in graphic bursts of vibrant color and the sounds of symphonic movie scores swept through our home.  The meteor crashed into Earth in a spectacular explosion spewing Vibranium everywhere; my son’s widened as he drank in a seven year old’s dream—the origin of a Superhero.

My wrist faintly vibrated, startled me and caused my heart rate to instantly rise; the Apple Watch strapped around my wrist was like some sort of Pavlovian torture device that induced momentary panic whenever it alerted and my daughter wasn’t right with me.  I was stolen away from the screen and into my own world—like Batman called by the Bat Symbol.  When the watch buzzed my body would instantly flood with chemicals readying me for the potential emergent phone call until my mind could process and reason with the automated physiologic response and back down. It was only a text message; I forced a breath out and willed my heart to slow and read.

“Last update they were placing #9 of 16,” accompanied by a heartbreakingly gorgeous photo of my friend’s daughter.

Surgeons were placing the ninth out of sixteen depth electrodes into the brain of my friend, Blair’s, sweet baby girl to invasively monitor her epilepsy (stereoelectroencephalography—sEEG) in hopes of gaining enough data to resect or ablate some of the abnormal tissue and halt the barrage of seizures caused by Tuberous Sclerosis Complex (TSC).  

“11”

I felt the blood rush to my face and suffuse my body with the superhuman strength that is required to respond when emergency strikes—damn watch!  I brought my brain back online.  I was like the Hulk willing the transformation to stay at bay.  

I channeled my energy into my response of support to Blair, read our friend Bridgett’s response on the group text, tapped out what words I could muster, and thought of how improbable it was for our lives to have crossed.  Blair lived over 4 hours away, Bridgett another 2 from there, and we had little in common practically; we were all brought together when TSC exploded into our lives like the meteor blazing across my TV screen and became the source of our superpowers, our connection, and our bond.

It was our origin story.

There is a before—there is always a before in an origin story—and an after.  Splitting the before and the after is an event of immense, life altering significance—one that changed the person and became his or her new beginning.  The person emerged from this event fundamentally changed right down to the fiber of their very being; when they emerge they ofter struggle to find their footing and own the power they have gained through the soul changing experience.  

Once one was able to walk through the fires of grief and tumultuous period of change one emerged with new powers that other simply did not possess—superpowers. Like Marvel’s X-Men those with superhuman abilities gravitate toward each other and find others in their own tribe.  Once there they share their own origin stories and it is what bonds them.

Special needs parents are typical people who all have an origin story and now possess some superhuman characteristic.  We are protectors of the true Superheroes and we are powerful in our own right.  To hand one’s child over to a surgeon for brain surgery, 1500 miles away from one’s home, while one’s other two children are back home with family takes superhuman strength.  It takes a tribe of those with superhuman strength to hold one up. Blair’s strength as a mother was superhuman and she had Bridgett and me to hold her up—regardless of how different our origin stories.

The life altering event could be a diagnosis of TSC, cystic fibrosis, autism, a car accident, or something else unnamed, and for those who have just experienced this—welcome.  Forget, “Welcome to Holland”; welcome to the Tribe.  To those who are crawling out of the radioactive pit of their origins you will find us—in doctor offices and therapy waiting rooms, on Facebook groups, and in charitable organizations.  We will whisper the stories of our begins to you and offer you our shared strength.  You will learn from us and, in turn, us from you.  We will become forever bonded.  Our Tribe is one of fierce love, superhuman feats, and a dash of the mundane.  We are the protectors of Superheroes and those who have gained superhuman love and strength from a life-altering event.  

“With great power comes great responsibility.”  There is no greater power than the love of a special needs parent and no greater responsibility than a child.

On Anniversaries & Grief

person wearing blue pants and black low top sneakers

I have no words

They fell from my mouth

Like leaves from the tree

Stars from the sky

Hopes from my dreams

You can’t put them back

They must be grown

Nurtured

Loved

Time must pass

The tree will bloom

Stars will shine

I will speak of hope once more

 

 

***

Mid-October steals my words every year since we received the diagnosis of Tuberous Sclerosis Complex for our daughter on October 15, 2009.  It took me a bit, but my words are back and I hope to be writing more regularly again.  Welcome back to those who I have been neglecting or welcome in general.

 

 

 

 

 

On Simple Joys

cars on highway

My hair whipped back and forth rhythmically, stray strands tickling the tip of my nose, as she squeed with delight.

“Fresh air!!!!  Aahahah!  Hahahahahaha!!”

The dark road stretched before us as the individual lines of tree trunk and limb blurred into mottled earthen browns, yellows, and greens; cars whizzed streaks of metallic hues; the world spun around us as we continued windows down, wind rushing in.  The sound of rushing air and passing traffic was surpassed only by her delighted squeals.  She erupted in spontaneous song; it was an exercise in pure and ecstatic joy.  I felt my shoulders slacken and melted into the drivers seat–the hint of a smile crept across my face.

For me, the car is a 2,000 lb torture chamber; it signified everything tortuous, dangerous, and arduous about the day to day managerial parenting of a child with Tuberous Sclerosis Complex(TSC) and accompanying exceptionalities.  I used to love to drive–the freedom, the escape, monotony, the sense of adventure–and it was yet another thing that TSC had tainted.  Driving was a task, a risk, a means to an appointment, a tense, fast, emergent drive to the hospital, it was an interrupted family outing dashed by another seizure; I drove hands muscles tensed, knuckles white, nerves raw, and adrenaline flooded.

All of this melted away as my body loosened and swayed with the movement of the road; she was happy–ecstatic, in fact–and that was all I ever wished for on the darkest of days was for her to know happiness.

***

Cars blurred past and Kelly Clarkson wailed on the radio.  It was early October and I was driving, belly round and in the way, headed for another glimpse of our growing girl.  It was bitingly cold for October, clear and beautifully autumnal.  We were headed out to start the celebrations for my husband’s best friend’s wedding the next day on the Cape.  The world was hopeful and full of beginnings.

I undressed and lay on the cold table of the ultrasound suite drinking in the floating images of our little girl preforming her water ballet.  We fought over middle names and barely noticed the solemnity that fell over the face of the sonographer.  She became quiet and was concentrating taking picture after picture, measurement after measurement.  She invited me to sit up and I did so smilingly; she informed me that there was something wrong with our baby’s heart and brain and that she needed to immediately call the maternal-fetal medicine specialists in, specifically the cardiologist.  I was instantly furious; I couldn’t process; she was wrong and how dare she say without certainty that my baby girl had multiple tumors in her heart and some brain abnormalities.

The minutes stretched on for hours.  My husband magically put himself aside to calm me until the specialist came.  I again had to submit to for more images of the sweet child swimming around innocently inside.  Then came a march of medical students to view the “abnormal fetus” and word after word levied like blow upon blow of mortally wounding weapon; they were giving her a death sentence.  These m*therf*ckers in their white coats with their fancy degrees were talking about my child–our child–who was dancing around on the screen–lit up like stars in the sky, already the apple of our eyes– calling her a fetus and talking about fetal demise–robbing our cradle–without even knowing our names or looking us in the eyes, offering what they equated to a death sentence and they sent me home with a diagnosis that these m*therf*ckers didn’t even pronounce correctly–tubular sclerosis.

I just wanted her to live.

Beyond that, I just wanted her to know happiness.

I sobbed and sobbed and sobbed until I had no breath left in me.  Then snow fell from the sky.  Snow in early October.  I thought it was a very cold day in Hell indeed.

***

The elevator catapulted me back up to the 17th floor.  My shirt flew up and ballooned ever so slightly at the bottom as we went up–it reminded me of the wind blowing in the car window.  The doors opened to the aquarium-esque elevator lobby outside the locked doors to the children’s unit; it filled me with dread and a macabre sense of joy simultaneously.  Ellison 17 is a little slice of home–we’ve slept here, cried here, rejoiced, played with both our babes, railed against God and the cruelty of the Universe.  I was buzzed in and ran back down to our room.  She smiled chubby cheeks pushed in even more by the enormity of the gauze-wrapping turban that kept the EEG leads in place on her head.

“Mama!  I made a duct tape purse with Hole in the Wall!”

“It’s so pretty, baby!  Look what I found,” and I pulled a huge stuffed Darth Vader I got on Target clearance from my back pack.

Her eyes lit up and she clambered to grab the villain.  I snuggled in next to her in the hospital bed, barely aware of the small computer on her back that was hooked into the wall by a wire, or the camera lauding over us like the Eye of Mordor recording every small quirk in movement to correlate it with the computer recording her brain waves.

“You want to play Dr. Panda on your tablet together or with your Ryan’s World figures?”

She snuggled in tighter.  “Make a magnet house for Ryan.”  She smiled, as best she could, ear to ear.

This was our normal.

***

Nine years past the coldest October day my soul has ever experienced and I still think of it often.  What I think of more are the resounding giggles that rise from what seems like the base of her very being and erupt out her mouth like a joyous bubbling fountain when the air rushes in and whips across her face.

On that day 9 years ago, I just wanted her to live, my only other wish was for her to be happy.  It has been my wish every time Tuberous Sclerosis Complex has tried to take her from us and every time this world and her body challenges her: let her live and let her live happily.  Because, from my mind’s eye it seemed impossible to live happily with a body attacking itself with tumors and errant electrical discharges that overcome one’s brain and cause one’s body to go haywire, and with life threatening emergency after life threatening emergency.  This is why I drive white knuckled and shoulders tight and walk around raccoon eyed on the daily.

And, she is a fount of ceaseless joy for me.  I am reminded again, and again, by her that the purest of things–the sweetest, most exuberant emotions–can spring from the simplest, most unexpected places if only you let the window down a bit and give the breeze an opportunity to blow across your path.