Sunday, November 6, 2017
‘But what if Mommy’s bus leaves?’
Melanoma. Glioma. Schwannoma. Meningioma. Hemangioma. Craniopharyngioma. Horrenderomas all, so far as I know.
There’s a long pause. I already know what my answer will be. I’m just not certain my voice won’t betray me. I stare out the passenger window instead of straight ahead down the road where I’m driving. I hope for a glimpse. But she’s already on and the bus windows are so tinted. The worst ideas are playing out in my head.
‘That’s the idea, sweetheart. The bus is going to take Mommy to N’Djamena.”
‘And then to America?’
Stroke. Aneurysm. Carotid dissection. Internal carotid dissection. Ophthalmic artery dissection. Thrombotic event. Embolic event. Central retinal artery occlusion. Amaurosis fugax. Anterior ischemic optic neuropathy. Giant cell arteritis. Posterior ischemic optic neuropathy. Lupus.
My chest tightens.
‘That’s right, honey. Then Mommy is getting on the plane to America.’
‘And then she’s coming back next week?’
Retinal detachment. Posterior vitreous detachment. Macular ischemia. Cataract. Ocular migraine.
I swallow hard. The frigging lump in my throat just won’t go down.
‘Yes. Then she’s coming back next week.’
‘Daddy, Mommy is going to see the doctor. She’s sick.’
Optic neuritis. Multiple sclerosis. Pseudotumor cerebrii. Multiple sclerosis.
My histrionic and painfully imaginative and overly-educated mind flies through all the worst case scenarios. She will come back, right? I will see her again, right? No, no. That’s ridiculous to even question. Put that thought out of your foolish mind right now. It’s the right decision to stay here for the hospital while she travels alone with the baby, right? Right?
‘Mommy is just a little sick.’
Multiple sclerosis. That sticks in my mind.
Please let this be an ocular migraine. Please let my fundoscopic exam be off. Let it be her retina or vitreous. Or a partial cataract. I could maybe even be ok with stroke, aneurysm, dissection, even some of the ‘-omas’. Those things can be treated early and prevented from becoming life-threatening. Provided she makes it safely to America. And provided it’s not some of the other stuff.
I’m not an ophthalmologist. This differential diagnosis alone is way over my head. I’m so out of my league here. I’m sure there must be other possibilities I haven’t thought of. And I’m sure I should be able to rule out most of this stuff with what I know already.
What I know. What do I know?
Sabbath morning, Danae came back from the hospital and told me something was up with her eyes. She couldn’t see right. Cover your right eye. Follow my finger. Perfect. Cover you left eye. Follow my finger outside. Great. Follow my finger inside. Earth to Danae. Follow my finger. What do you mean you can’t? It’s right here in front of your face. You can’t see it? You aren’t serious. Promise? You really can’t see it? You’re not joking?
We established that Danae had lost the medial field of vision in her right eye for an undetermined length of time. Besides a recent cold, no other symptoms whatsoever. Being good missionaries, we went to church. In church, I wrote an email to our ophthalmologist friend until Danae caught me not paying attention to the service. I sent it and then put my phone down to continue being a good missionary.
After church, I took her up to the hospital. I ultrasounded her eyeball, but not with an ideal probe and not as I was taught in residency. I couldn’t find any retinal detachment. I did a fundoscopic exam. Looked normal to me. Rollin did a fundoscopic exam too. Normal.
So since her fundoscopic exam is normal and her vision in her left eye is normal, that means there’s a problem somewhere between the retina and the optic chiasm. Can’t really be posterior to the optic chiasm. And less likely to be a mass in the chiasm itself.
Optic neuritis continues to rise in my brain. And the most common cause of optic neuritis is multiple sclerosis. Multiple sclerosis. And the most common initial symptom in multiple sclerosis is optic neuritis. Multiple sclerosis. Demyelination of the nerves in the brain and the spinal cord. And the optic nerve is particularly susceptible. Multiple Fricking Sclerosis.
We decided it would be best for Danae to go back to America to see a specialist. We made the call to the medical evacuation insurance company. They agreed Danae needed to be seen. ASAP. In fact, they insisted it was urgent enough that she needed to go to Nairobi to get care.
We politely declined the insurance and bought tickets for Danae and Juniper to head back to America. Juniper. Our youngest. She’s turning one year old in two days. That means I will miss my last child’s first birthday. Suck. I will stay here with the other three kids. Rollin could handle the hospital by himself. But it would be hard. Tirmon is gone, so Rollin would be all alone. He’s done it before, but it’s no fun.
We bought tickets a hair too late to catch Saturday night’s bus for today’s flight out. So we could sleep and then drop her off at the bus today. She will fly out tomorrow.
Danae popped an aspirin and we decided against IV steroids, since we didn’t have good methylprednisolone and we didn’t have a diagnosis. We stayed up until 3am packing, hanging out, stressing, joking. I showed her all the presents I had gotten her in America and had been hiding all around the bedroom from her. Granola, granola bars, water enhancer, bridle for her camel, pesto packets, food coloring, lotion, razors so she doesn’t wound my legs in bed, stolen Taco Bell hot sauce packets, the Christmas presents I got for the kids, as well as their Paw Patrol Kleenex and fruit gummies and gummy vitamins.
We slept for a couple hours before waking up. We drug our feet. Sure, we will give everybody haircuts today. Any excuse to not leave.
The kids and I drive the two hours home from dropping Mommy off. The kids go inside. I go to the hospital. Work is a nice distraction. It always has been. We were apart when Danae had her first miscarriage. Sitting home alone, I was left to ruminate on the disappointment. The hospital has always been a bizarre and ironic refuge from personal illness in that way. Somehow dealing with people sicker than you are is cathartic. I round on pediatrics. I take a small break to look at the wall for a few seconds. I doubt anybody even noticed. Just a moment where I couldn’t look anybody in the eye. Work is finished. Nowhere to go but home. Empty home. Full of three kids. But empty.
I get home. I eat. I take the three kids, two dogs and a camel out for a walk. I come home, feed the kids, get them showered and into bed. I pray with them. We pray for Mommy. I cut the prayer short. My kids don’t need the stress of Mommy gone and Daddy breaking down. A quick ‘I love you’ and I’m out of the room. And then I’m left to myself. I’m used to being alone. Danae is often still in the hospital when the kids go to bed. But this time it’s different. She won’t be coming home tonight.
It’s not the being apart. It’s not the aloneness. I just spent three weeks in America. We were apart. We missed each other. But we were fine. I came home. I was home for four days. And then she got sick. Just a little sick. Just a tiny piece of her vision missing. But it could signify so much more. So I sent her back. And now we are apart. And now it’s different. Because one of us is sick. Just a little sick.
Oh, God. Please let her be just a little sick.
During the next several days, I will try to post a blog each day about Danae’s ordeal.
‘But what if Mommy’s bus leaves?’
Melanoma. Glioma. Schwannoma. Meningioma. Hemangioma. Craniopharyngioma. Horrenderomas all, so far as I know.
There’s a long pause. I already know what my answer will be. I’m just not certain my voice won’t betray me. I stare out the passenger window instead of straight ahead down the road where I’m driving. I hope for a glimpse. But she’s already on and the bus windows are so tinted. The worst ideas are playing out in my head.
‘That’s the idea, sweetheart. The bus is going to take Mommy to N’Djamena.”
‘And then to America?’
Stroke. Aneurysm. Carotid dissection. Internal carotid dissection. Ophthalmic artery dissection. Thrombotic event. Embolic event. Central retinal artery occlusion. Amaurosis fugax. Anterior ischemic optic neuropathy. Giant cell arteritis. Posterior ischemic optic neuropathy. Lupus.
My chest tightens.
‘That’s right, honey. Then Mommy is getting on the plane to America.’
‘And then she’s coming back next week?’
Retinal detachment. Posterior vitreous detachment. Macular ischemia. Cataract. Ocular migraine.
I swallow hard. The frigging lump in my throat just won’t go down.
‘Yes. Then she’s coming back next week.’
‘Daddy, Mommy is going to see the doctor. She’s sick.’
Optic neuritis. Multiple sclerosis. Pseudotumor cerebrii. Multiple sclerosis.
My histrionic and painfully imaginative and overly-educated mind flies through all the worst case scenarios. She will come back, right? I will see her again, right? No, no. That’s ridiculous to even question. Put that thought out of your foolish mind right now. It’s the right decision to stay here for the hospital while she travels alone with the baby, right? Right?
‘Mommy is just a little sick.’
Multiple sclerosis. That sticks in my mind.
Please let this be an ocular migraine. Please let my fundoscopic exam be off. Let it be her retina or vitreous. Or a partial cataract. I could maybe even be ok with stroke, aneurysm, dissection, even some of the ‘-omas’. Those things can be treated early and prevented from becoming life-threatening. Provided she makes it safely to America. And provided it’s not some of the other stuff.
I’m not an ophthalmologist. This differential diagnosis alone is way over my head. I’m so out of my league here. I’m sure there must be other possibilities I haven’t thought of. And I’m sure I should be able to rule out most of this stuff with what I know already.
What I know. What do I know?
Sabbath morning, Danae came back from the hospital and told me something was up with her eyes. She couldn’t see right. Cover your right eye. Follow my finger. Perfect. Cover you left eye. Follow my finger outside. Great. Follow my finger inside. Earth to Danae. Follow my finger. What do you mean you can’t? It’s right here in front of your face. You can’t see it? You aren’t serious. Promise? You really can’t see it? You’re not joking?
We established that Danae had lost the medial field of vision in her right eye for an undetermined length of time. Besides a recent cold, no other symptoms whatsoever. Being good missionaries, we went to church. In church, I wrote an email to our ophthalmologist friend until Danae caught me not paying attention to the service. I sent it and then put my phone down to continue being a good missionary.
After church, I took her up to the hospital. I ultrasounded her eyeball, but not with an ideal probe and not as I was taught in residency. I couldn’t find any retinal detachment. I did a fundoscopic exam. Looked normal to me. Rollin did a fundoscopic exam too. Normal.
So since her fundoscopic exam is normal and her vision in her left eye is normal, that means there’s a problem somewhere between the retina and the optic chiasm. Can’t really be posterior to the optic chiasm. And less likely to be a mass in the chiasm itself.
Optic neuritis continues to rise in my brain. And the most common cause of optic neuritis is multiple sclerosis. Multiple sclerosis. And the most common initial symptom in multiple sclerosis is optic neuritis. Multiple sclerosis. Demyelination of the nerves in the brain and the spinal cord. And the optic nerve is particularly susceptible. Multiple Fricking Sclerosis.
We decided it would be best for Danae to go back to America to see a specialist. We made the call to the medical evacuation insurance company. They agreed Danae needed to be seen. ASAP. In fact, they insisted it was urgent enough that she needed to go to Nairobi to get care.
We politely declined the insurance and bought tickets for Danae and Juniper to head back to America. Juniper. Our youngest. She’s turning one year old in two days. That means I will miss my last child’s first birthday. Suck. I will stay here with the other three kids. Rollin could handle the hospital by himself. But it would be hard. Tirmon is gone, so Rollin would be all alone. He’s done it before, but it’s no fun.
We bought tickets a hair too late to catch Saturday night’s bus for today’s flight out. So we could sleep and then drop her off at the bus today. She will fly out tomorrow.
Danae popped an aspirin and we decided against IV steroids, since we didn’t have good methylprednisolone and we didn’t have a diagnosis. We stayed up until 3am packing, hanging out, stressing, joking. I showed her all the presents I had gotten her in America and had been hiding all around the bedroom from her. Granola, granola bars, water enhancer, bridle for her camel, pesto packets, food coloring, lotion, razors so she doesn’t wound my legs in bed, stolen Taco Bell hot sauce packets, the Christmas presents I got for the kids, as well as their Paw Patrol Kleenex and fruit gummies and gummy vitamins.
We slept for a couple hours before waking up. We drug our feet. Sure, we will give everybody haircuts today. Any excuse to not leave.
The kids and I drive the two hours home from dropping Mommy off. The kids go inside. I go to the hospital. Work is a nice distraction. It always has been. We were apart when Danae had her first miscarriage. Sitting home alone, I was left to ruminate on the disappointment. The hospital has always been a bizarre and ironic refuge from personal illness in that way. Somehow dealing with people sicker than you are is cathartic. I round on pediatrics. I take a small break to look at the wall for a few seconds. I doubt anybody even noticed. Just a moment where I couldn’t look anybody in the eye. Work is finished. Nowhere to go but home. Empty home. Full of three kids. But empty.
I get home. I eat. I take the three kids, two dogs and a camel out for a walk. I come home, feed the kids, get them showered and into bed. I pray with them. We pray for Mommy. I cut the prayer short. My kids don’t need the stress of Mommy gone and Daddy breaking down. A quick ‘I love you’ and I’m out of the room. And then I’m left to myself. I’m used to being alone. Danae is often still in the hospital when the kids go to bed. But this time it’s different. She won’t be coming home tonight.
It’s not the being apart. It’s not the aloneness. I just spent three weeks in America. We were apart. We missed each other. But we were fine. I came home. I was home for four days. And then she got sick. Just a little sick. Just a tiny piece of her vision missing. But it could signify so much more. So I sent her back. And now we are apart. And now it’s different. Because one of us is sick. Just a little sick.
Oh, God. Please let her be just a little sick.
During the next several days, I will try to post a blog each day about Danae’s ordeal.
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