The Quiet Before the Storm

Raphaela returned to Gan today, after almost two weeks of being awol and spending 24/7 with her Mommy.

Got notification that my crooked mafia slum lord received my official registered-letter notice of moving.

Hired a mover, the same wonderful group who moved me to this apartment six years ago.

I can't get over that niggling feeling that today represents the quiet before the storm.  Mafia bullies don't acquiesce easily.

Grand Central Station

Last night, Raphaela was essentially awake and raring to go from around midnight.  Today I had a constant stream of people in and out of the house, not counting the baby sitter and my scheduled patients.  My cleaner came and had to work around the electricians installing the illegal connection into the apartment below.  A colleague came by with a draft of a contract for me to examine. 

I am functioning on very little sleep and food, and Raphaela G-d willing returns full time to Gan next week.

Bless my friend Rachael, who anticipated that Raphaela would be stir crazy after a week of detention inside, and brought over a new toy.  That Fisher Price play house kept my daughter busy all afternoon.

I myself could not be more grateful for the weekend, which will be kicked off tomorrow on my Hebrew birthday, at the End of the Year Gan party.

A moment of silence to honor my friend A's husband, who was already in a coma at Hadassah Hospital when Raphaela checked in last Wednesday for her surgery.  A young man, a husband and a father to three children, he had been ill for the last several years, and today he died.  I hope that his suffering is over now, though I suspect that A's suffering will continue.

May G-d comfort her and her family.

Surgical Jet Lag

The surgery reset Raphaela's internal clock, and since that stay overnight in the hospital, she now wakes up at 2:30 am, ready to go and greet the day.  Here I thought that her usual time of 5:30 am was godawful early.  I know that this week represents a different and confusing schedule, and hopefully once Rapaela returns to Gan, her sleep schedule will stabilize as well.

I have also noticed an amped level of aggression as another unanticipated side-effect of the surgery.  It is likely that some part of Raphaela is angry at me, after all, I was the person who brought her to the hospital and to the surgical theatre.  It is just as likely that Raphaela has more energy than she ever did before in order to fully express her "terrible twos."  In any case, there has been lots of testing of limits and pronounced Israeli shoulder shrugs, along with frustration at being stuck close to home this week, and eating a more limited diet than she would like.

Tonight it took four attempts before Raphaela would stay in bed, and she ended up going to sleep several hours past her bedtime.  Maybe she will sleep later tomorrow morning?  A Mommy can dream.

Happy Birthday to Me

Today, Sunday, on the occasion of my 43rd birthday,  I will be staying home and keeping Raphaela under observation, feeding her food that she would rather not have.  If I am feeling less paranoid, we will do two errands outside the house, yipee.

In more recent years I have wanted to give my birthday a proper celebration, a change from the pattern of most of my life, so I am bummed that this year will be mostly neglected.  I find it symbolic that as a one-year old, I sat in front of the television and watched the first moon landing, and this past week, NASA shut down its manned space program.

Journal from the Surgery III

The Cough

Once we got permission to go home, I started worrying that maybe I had pushed Dr. Weinberger into releasing us, and I started thinking about all the things I could do wrong for Raphaela once we got home.  As she sat in the stroller on the way to the car, she started coughing, and I thought about turning around and checking us back in.  Rationally, her throat area is still inflamed and she is clearing junk from the system, but irrationally, I imagined worse case scenario.

This train of thought started the day before her surgery, where every action and every small event felt huge and final.  I must keep reminding myself that now that Raphaela is healthy, we have a new beginning, both of us, one that will be even more of adventure once we move to the new apartment in September.

The Bastard Landlord

Lest I forget that I have more on my plate than I can handle, no more than five minutes after I had been escorted to the waiting area by the nurse, I got a call from my current landlord;  he wanted to know when the electrician could come that day and wire up my apartment to his illegal space downstairs. I reminded him that I had informed him that I would be unreachable for the next several days, due to my daughter's surgery.  He didn't even respond with a sympathetic "Get well soon," but rather wanted to be sure that I would allow the electrican into the apartment as soon as possible.

Karma's a bitch, and he's got a real wallop coming.  It comforts me, even if I don't personally see the karma bite him on the gluteus maximus.

Political Statement

I feel like I have to preface this bit of the blog by saying this:  the following represent my observations and opinions on a particular aspect of the Middle East conflict. I have no issue with Arabs as individual people, nor do I think that I can solve the problem of peace in the Middle East.

During our stay, both in the surgical area and in the ward itself, Hadassah Hospital was 75% populated by Arabs and Palestinians, receiving the highest quality care from both Israeli and non-Israeli physicians and medical staff.  I did not feel uncomfortable in the least, and these children were treated with the same compassion as my child, or any other Israeli citizen.  It did, however, make me wonder how they spit in our faces and proclaim war and tell their children that it is laudable to blow themselves up and take some Jews with them; at the same time they enjoy a higher quality of life under the supposed Israeli reign of suffering than they ever would under Arab rule.

There, I said it.

What to Expect?

When we had gone to Tipat Chalav several weeks ago, Nurse Shoshana said that once Raphaela could breathe properly, she would expect to see significant weight gain.  Would Raphaela, a "foodie" to begin with, become a chubby child?  Or do my tall/thin genes prevent that?

I can already report that she is speaking more clearly, and I felt compelled to check on her last night while she was sleeping, because for the first time I couldn't hear her snoring.  This is all good.

What is not so good is the trauma she has suffered as regards doctors, nurses, hospitals and medication.  Since the surgery, she refuses to take her anti-biotics, she is more wary of strangers or people she hasn't seen recently;  and if someone walks up to her wearing scrubs or holding a stethoscope, she starts screaming.  Hopefully time will heal that wound.

Journal from the Surgery II

For he was a Modest Man

I must praise our surgeon, Dr. Jeffery Weinberger.  Every other staff person involved in our case told me how lucky I was that Dr. Weinberger would be performing the procedure, that he is the best in the county.  His care was beyond exemplary, his compassion and post-op supervision beyond any expectation, and yet, when I wanted to thank him, this humble man literally ran away so as to avoid the scene or the attention.

On Friday afternoon, when I began to fear that we would not get home for the weekend, he arranged a last-minute diagnostic test that showed that Raphaela's oxygen saturation was high enough to get us out of the intermediate care unit, into the car and into our own beds for the night.  If he had said that she was not stable enough to get discharged, I would have listened as well, because...he is the best.

It's a Jewish Country

Starting quite early on Friday morning, all sorts of volunteers, religious and secular, started coming around the intermediate care unit with sandwhiches, Shabbat snacks and Shabbat basics (candles, challah etc), to help those families who would be stuck in a hospital over the weekend.  Throughout our stay, the Sherut Leumi volunteers brought around art projects and small gifts to keep Raphaela busy, and to keep her mind off the more uncomfortable aspects of the event.  The man who took Raphaela to the surgical area in the morning, and returned us to the pediatric floor afterwards chatted with my daughter and pointed out pictures on the wall, so she would be less tense.  He told me that he worked with patients because he himself has survived cancer, and he wanted to 'pay it forward.'

With all these wonderful distractions, Raphaela is not nor will she ever be stupid, not my girl.  She realized that the operating room was not a desirable place, and had to be held down.  I have a huge gash across my face where she scratched me, crying and struggling.

Hysterical Mother

I stayed with Raphaela until she was sleeping (from the gas), but before they put in all the tubes.  I thought I could handle it, but as she cried real tears, I fell apart, and one of the nurses had to escort me from the room.  Dr. Weinberger joked with me afterwards, reminding me that I had requested to be in the room during the surgery itself.  "You would have collapsed.  You would have been worse off than Raphaela."

The Royal We

Only once during our three days at Hadassah Hosptial did the JSMBC issue arise.  One of the nurses on staff asked me why my husband wasn't coming to give me some relief from the 24 hour vigil, and I replied that I am a single mother by choice, and have no real family in the country.  The expression on her face looked like pity, that I had to go through this by myself, and she asked me if it was hard on a daily basis, the life I had chosen.  I told her that even sitting here, watching Raphaela recover and feeling it hurt in every part of my body, I did not regret a single moment.

Her questions also made me aware that often, if someone asks me a question about Raphaela, I answer with "Anachnu" ["We" in Hebrew], and allow people to assume that there is a father and a mother making joint decisions for this child.  It is easier that way, but I wonder if I am chickening out of a more meaningful discussion.

Journal from the Surgery I

The Food Factor

On the morning of the surgery, Raphaela needed to be fasting, and I felt guilty eating or drinking in front of her, she is such a "foodie."  And so I fasted along with her, and don't know when I will get a normal meal again.  One of the reasons they allowed us to go home was because Raphaela, less than 24 hours after the surgery, was eating and drinking like there was no tomorrow, and her energy levels were even higher than usual, probably due to all that elevated (ie normal) oxygen saturation in her blood.  For this whole week, Raphaela is meant to eat cold liquid foods, and after one day at home, she is already begging for crunchy "real" food.  It represents a complete step backward when we have reverted to runny Gerber type food and bottles with formula.  I can only eat my grown-up non-surgical food when she is sleeping or not paying attention.  This is going to be a long week.

The Hand of G-d

Throughout this journey, I have seen the direct and almost immediate intervention of The Higher Power.  It occurred to me while sitting in the waiting room that the original sleep clinic appointment at Shaarei Zedek was supposed to be September 19th; and instead, we registered for the surgery itself on September 20th.  It was a blessing that someone canceled and gave the space to Dr. Weinberger for Raphaela.  It was sheer luck that the doctors' strike shut down the operating rooms right after they finished with my daughter's procedure.  I can hardly overstate the gift from G-d that Raphaela was able to breathe on her own immediately after the surgery, and did not need to be in Pediatric ICU for two days.

The human body is the most amazing and complicated machine that exists, and watching Raphaela rip out her IV and monitoring tubes and start running around the hospital ward, one day after her surgery.  She was extremely frustrated, because they had placed the IV on her left hand, and being a lefty it prevented her from using her dominant hand.  I could only think that the Universe has given her super-natural powers.  I have so much for which to be thankful, I don't even know where to begin.

Who are the People in your Neighborhood

Amazing, being in a hosptial in Jerusalem, and bumping into all these people you know, sometimes for the best reasons and often with less positive stories.  I saw Alice, the doctor who performed my IUI and fertility procedures, for the first time in three years.  She and her husband, both Arabs, work in Hadassah as specialists.    I bumped into my good friend A, whose husband has unfortunately been in a coma for the last week and a half.  One of Raphaela's nursery teachers came to see her mother, who works at Hadassah, and stopped in for a visit;  you could see the look of confusion on Raphaela's face, when her beloved care taker appeared quite out of context.  My friend's new wife apparently works in the Hemotology department, and she brought me some food while I sat in intesive care, waiting for Raphaela to wake up.

Of course, a huge thank you to Savta Shira, who entertained a fasting Raphaela in the morning, and who sat with me while I tried not to worry.  (No go, but I tried...)

Briefly stated, Raphaela was discharged from the hospital today, and we got home two hours before Shabbat started.  She ate like a maniac today, drank (water, juice) with abandon, and is basically acting just like herself.  Except that she seems to have even more energy and she is snuffling so much less that you can barely hear her breathe.

More details to follow.  I myself have barely eaten or slept in the last three days, and am about to collapse.

Pre-Op II: By the Numbers

Consultations with nurse:  2
Individual meetings with doctors, in totally different parts of Hadassah Hosptial:  4
Crying when Raphaela saw medical personnel, ten feet away: 6

Number of times I heard "Who told you to come here? You are in the wrong place.":  4

Small random acts of kindness:  Too many to count
Number of times that I had to hold back tears:  Too many to count

Probability that my period would come early, the day before Raphaela's surgery and the day I am wearing my white skinny jeans:  ?!@#$?

Hours spent waiting for various pre-op meetings: 4.5
Hours spent total in Hadassah today:  7.5
Paid for parking:  36 NIS

Raphaela apparently gave fits of happy dancing to all the doctors in the ENT ward, as she fits the perfect profile for a study that Hadassah is conducting, regarding the efficacy of the removal of tonsils and adenoids, as measured in oxygen saturation 24 hours after the procedure. When Dr. Weinberger said, "We have been dreaming of a case like your daughter's," I answered, "My dreams include an entirely different set of wishes."

Raphaela's Pre-Op I

Monday:  Worked like a dog to take in extra patients, since I will have a period of time after the surgery when my clinic hours will be limited.  Strange playdate where the kids were great with each other, but the event itself did not impress the parents or the children.  Blew up at the person who said, "You really need to move from that apartment, what are you doing about it?" (DUH!)

Tuesday:  I have taken an inordinate amount of pictures of Raphaela today.  I got teary at the thought that this would be her last day of Gan before the surgery.  I got teary at the thought that tonight is her last swim lesson, before the surgery.  I am making hysterical lists to keep my mind off the fact that tomorrow we go to Hadassah for pre-op consultations.  What the hell is wrong with me?

I Learned Something Today

Apparently, summer is L-I-C-E season.  The Gan put up a sign for parents, advising us how to avoid catching the notorious and terrible event.

I learned that these clever bugs come in various colors, in order to match the shade of hair of the head in which they wish to infest.  Like soliders in a guerilla war, they don their uniform and reproduce.

Just the thought of it makes me itchy.

Kick in the Butt

As if I was not aware that I need to move out of this apartment, the Universe gave me a monumental kick in the butt this morning.

My landlord (slum lord, to be exact), a religious elderly man, sent one of his goon contractors, an Ultra-Orthodox man, to threaten me; they are trying to illegally hook an apartment into my utilities, so he can rent it out, even though he doesn't have the permission of the city of Jerusalem, or of the Co-op Board of the buidling.  When I stated my objection to having to pay double bills on an illegal apartment for an indefinite amount of time, the goon said that he was speaking on behalf of my land lord, that they had no problem whatsoever kicking me and my daughter out on the street so they could find someone who would be more "cooperative" with their plan.  Then I had to beg to the point of tears, humiliating myself so that we would not be homeless, and you could see the goon jacking off in pleasure at seeing me in such a vulnerable place.

The entire year plus that this construction took place I have put up with many terrible experiences.  There have been long periods of time that I suffered from headaches and Raphaela from panic attacks from the noise of the drills.  There were many days that we had to move out, because the construction beneath us made the living situation unbearable.  One of the cement trucks smashed into my car, and I paid 1600 NIS out of my own pocket to fix it, because my land lord and the goon contractor refused to take responsibilty for the damage.

This tops it all.

On the plus side, legally speaking he cannot actually kick me out tomorrow.  Maybe he will wait until after Raphaela's surgery, though I doubt he cares one way or the other.

On the mystical side, some proof to me that there is a higher power who listens every once in a while, I happened to bump into a patient today, a kind and ethical man who deals in building and real estate.  He told me that he knew of a rennovated apartment in my neighborhood that would be available September 1.  He understood my story and could see the stress in my eyes, and said to me, "If you want it, all you have to do is hire the movers."  Like I said, G-d listens sometimes.

Politeness

This afternoon, Raphaela napped for about an hour; too short for me given that Harry has been consistently interrupting my sleep the last several nights, and I desperately needed to get in some catch-up sleep.

After the hour, I heard this polite and yet strong knocking coming from the inside of Raphaela's door, and when I opened the door to her room, she was sitting there quietly, knocking, waiting for me to allow her to leave to go play.

Growing up, she will receive a blend of my American values and the core Israeli values, and I am pleased to see that Raphaela has already adopted certain manners, including saying "Thank you" and sharing.  Now we are working on that word of all magical words, "Please," and I am being met with some resistance.

How Much is Too Much? (Modern Parenting)

A recently popular article in the Atlantic Monthly (entitled "How to send your kids into Therapy")  suggested that this generation of so-called Helicopter Parents and closeted Tiger Moms have given their children too many choices, and have sheltered their children too much from certain formative experiences.  As a result, children who should be happy, content and secure,  feel depressed and unable to cope, like their lives are missing an essential piece.

I read the article and tried to understand the author's approach, and today saw actual proof that she might be onto something:   while changing in the dressing room at the pool, after Raphaela's swim lesson, a group of ten or so teenage girls were complaining about the horror that is their life.  These super-fit girls are part of an elite swim team, they train on a regular basis at our pool, and some of them may even make the Israeli Olympic delegation, high achievers all.  Each of them took turns listing all the lessons and classes their parents forced upon them - music and art, gymnastics and karate, chess, extra languages and sciences, etc - and how much they hated it.  Lucky for them the swimming stuck, right?

I found myself listening to this discussion and feeling more preplexed than ever.  As a parent, I want to expose Raphaela to ideas and activities that will open her mind, affirming experiences that will help her find that niche where she excells.  I do not plan on over-programming her week, but how will she figure things out if she sits at home all afternoon watching television or in front of the computer?  How much is too much?

Perhaps the most important lesson is this, no matter what we do for our kids, no matter how good our intentions, they can find (if they wish)  some area of failure, some way to blame us.  As one of my aunts told me when I was pregnant, "As soon as you accept that 'it is all your fault,' you will have real fun with motherhood."

Menu Planning

One of the pre-surgery items on my To-do list involves grocery shopping, not only for Shabbat, assuming we make it home in time for the weekend, but also for the following week, in which Raphaela's diet will be limited. 

I don't want to serve her ice cream all week, and so I am asking my readers, specifically those whose children have undergone a similar procedure of tonsil and adenoid removal:  what can I feed my daughter that week that will provide her with nutrition as well as relief from the post-op pain?

All suggestions are welcome, I thank you all in advance.

Medical Sleuthing

For the past two days, the Gan has called me in the middle of my work day with patients, asking me to take Raphaela home because she had one episode of a runny diaper.  The Gan's major concern involves one those Viruses of the Month that is currently circulating, and justifiably so, they do not want the other kids to spread it around. 

And so I drop everything, re-arrange my day and pick her up, and lo and behold, she does not have diarrhea for the entire time she is home with me, and behaves like the normal happy child she is.  As well, there are no other signs of an illness, viral or otherwise, which leads me to believe that there is a specific food that Raphaela eats at Gan, in the morning, which causes this event.

I am grateful that the Head Nursery Teacher attempts to prevent the spread of illness among the children, but I feel that she is ignoring the obvious:  the kids, and some of the other staff, only have diarrhea during the day at Gan.  Is it the food service? Is it the air conditioner, which has been constantly running since the start of the heat wave here in Israel?  Do the kids wash their hands often enough?

I received permission from the Head Nursery Teacher for Raphaela to return to Gan as normal this morning,  and when I dropped her off, I explained that her diapers had been clear, but that Raphaela had been coughing during the night;  a fact I attribute more to her sleep apnea issues, which will hopefully be resolved  with the surgery.  The teacher's response was, "I don't know, Raphaela looks a little pale..."

My great prayer is that Raphaela stay healthy enough to undergo the surgery next week, so that she can enjoy a higher quality of life.  I hope that once Raphaela's breathing is full and deep and efficient, it will also strengthen her overall immunity.

New York Times Letter

Sorry to wait so long for the heads-up, but I only recently found out that a letter of mine on the subject of single mothers and sperm donors was printed in the International Herald Tribune/New York Times.  I responded to an opinion piece by Colton Wooten, an 18 year old son of a SMBC, a child who loves and appreciates his mother but regrets not being able to know more than the basics about his so-called biological father and sperm donor.

Being a techno-idiot, I don't know how to post the direct link, but if you are interested in reading the letter you will find it on http://www.nytimes.com/, under the Opinion section on July 1, 2011.

Black Eye

Last week, Raphaela enthusiastically embraced the idea of a walk through the forest, and at some point fell and scraped the side of her head on a rather sharp rock.  This morning, another parent brought her daughter to Gan with a similar looking black eye.  I said to the other mother, "Was your daughter in the same bar fight as mine?"  And then we both said, simultaneously, "You should have seen the other guy..."

Raphaela was very brave this morning, and cried only minimally when they took some blood as preparation for her surgery and hospital stay in less than two weeks.  She seemed to sense, as soon as we walked near the nurses' station, that something was amiss, and I am torn between trying to prepare her and explain to her that soon we will have an "adventure" at Hadassah, and springing the idea on her the morning of check-in to the hospital.  We have come full circle, the procedure will take place at the same hospital where Raphaela was born; I wish for both of us that we not see the inside of any hospital for a long time to come.

This girl of mine is a "foodie," and the hardest part of that morning will be distracting her so she forgets that she cannot eat breakfast or drink any water past six am.

Meanwhile, her breathing during the night gets worse and worse, and I am grateful that Dr. Weinberger was able to arrange the surgery this month, rather than the anticipated September.  Seeing my daughter post-surgery and breathing normally will be the best birthday present ever.

Thank you G-d, the Universe, and...

the person who canceled their appointment at Hadassah.

I received a call yesterday from Dr. Weinberger that a potential spot had opened up for Raphaela's surgery in two weeks.  Nothing in life is guaranteed, but this is as close as we get.

The Big "But"

Last night, Raphaela and I (accompanied by a friend of mine for moral support) had our surgical consultation at Hadassah Hospital, with Dr. Jeffery Weinberger.  He is a modest and warm man who gave me as much time as I needed and answered all my idiotic questions until I felt more informed about what lies ahead for Raphaela and the removal of her tonsils and adenoids.  He seems absolutely competent as a surgeon, worthy of his fine reputation.

Dr. Weinberger concluded the appointment by saying, "This kid isn't breathing.  If I had my way, I would schedule the surgery for tomorrow. But..."

With the doctors' strike and the already busy summer surgical schedule, combined with the fact that Raphaela is considered a more complicated scenario and would need the Pediatric ICU, Dr. Weinberger is having a hard time actually setting a date for the surgery.  Furthermore, even if he can find a date sooner rather than later, he explained that it is absolutely possible that Raphaela could be prepped for the surgery and then sent home, if an emergency case arises.

If this were a straightforward case, she could be snuck in between other already scheduled procedures.

Knowing that Raphaela needs the intervention, and knowing that beaurocracy and fate are preventing the scheduling, it has made me angry and frustrated and depressed.  I have spent all day today, when my brain was otherwise unoccupied with thoughts of work, trying to formulate a plan to make the surgery happen, so we can move on, and so it does not G-d Forbid, interfere with Raphaela's long term development.

Everlasting Gobstopper

Those of you who have read the book Charlie and the Chocolate Factory will understand the reference.

For several weeks now, we have been going to Gymboree and I hand the woman at the door my pass.  She is supposed to make some mark that indicates that one session of Gymboree has been used, out of the total of ten on the card.  I recently realized that she has been pretending to mark it off, and has been giving Raphaela free sessions.

I first thought that maybe her eyesight was weak, since she recently had emergency surgery.  So today I made a point of making sure that she marked it off properly.  The woman's face fell, and she indicated in so many words that she had been purposely giving me a free pass, and that in my insistence I have ruined her 'gift.'

I can be dense sometimes.

Major Milestone

This weekend, Raphaela started using a new word, in Hebrew: "Ani" [I, Me], representing the first time that she has expressed herself truly as an individual, separate physically and emotionally from her mother.  I could not be any more proud.

Good Thing about the New Door

I have been getting obscene phone calls on my cell phone, on and off since last Thursday.  And early this morning, a burgler climbed onto my porch and tried to break into my neighbor's house.

The new door makes me feel a lot safer.  That, and some prayer doesn't hurt.