Monday, May 31, 2021

A Visit from the Notification Officer?

I grew up in a military town. I like to say I was an Army brat by default. My dad retired less than a year after I was born. My siblings moved all over as part of his Army career, but I did not. I was born on Fort Riley, KS and never left the area until after I was 18. Interestingly, I live less than 15 miles from where I was born again today.

My childhood was filled with many of the normal military things. I had lots of friends over the years that moved in when their parent was stationed at Fort Riley and then moved away within a couple of years to move to their next duty station. While my dad no longer reported to work on post, I understood many of the aspects of military life. I can recall my dad telling me at some point that you never wanted to have someone in a dress uniform show up unannounced when the soldier was deployed. That was never a good thing. That is exactly what happened in my house in 1991, but it was not at all what I thought.

My brother was in the United States Marines and was deployed to Iraq during the beginning stages of the Gulf War. There was 24 hour media coverage of the war, bombing of buildings, and coverage of the killing of many people. He was in the Force Recognizance unit. Generally this meant that we didn't talk much. When he did call home it was usually to talk with one of my parents and it was also relatively short. He was back in the US at his base for a short amount of time and was talking with my mom on the phone. During that call he received some kind of notification that he had to hang up immediately and get moving. Whatever was said didn't set well with my mom. She had sent her own husband off to deployment many times. She was a veteran. But, however this went down just didn't set so well with her. She was uneasy. The non-stop media coverage of the war effort, and my dad's obsession with watching ALL of it, did not help either. It had been several weeks since we had heard from him. Then one day the doorbell rang.

I believe it was a Sunday afternoon. I looked out through the window in the doorway and there were two soldiers in dress uniform and a black car at the end of the driveway. I couldn't even begin to comprehend what was in front of me. All I could think to say was "Dad! There are soldiers in uniform at the door!" He moved quicker than I can recall seeing him move and opened the door himself. I sat down on the couch and began to cry. I heard about this stuff and saw it in movies. But, I never thought it would be something I would have to handle myself. Fortunately, I did not.

Those "soldiers" at the door were actually a couple of kids from the local ROTC program and they were out selling door to door to support their program. I did not know them, but I suspect they were two high school kids and the guy in uniform at the car at the end of the driveway was simply their ride to sell whatever they were selling. My dad didn't really like door to door sales. But I remember him standing there talking with those guys for several minutes. I think he even bought whatever they were selling. But, I do remember him saying when they were finished, "maybe you guys shouldn't wear your dress uniforms when you are going door to door during a time of war." I couldn't agree more! He knew disaster was averted for our family, but there were also no guarantees for the future.

I have thought about that day hundreds of times over the years. As the war has continued on in the middle east, I have thought about the thousands of families that received a visit from the "notification officer". Always while just going on about their lives doing what they can to support their service member from afar. Just like that an entire branch of a family tree has been altered. I have thought many times about those moms and dads and husbands and wives that have received that devastating news. I had one small glimpse at the fear of that visit, but truly cannot comprehend the way my family would have been impacted if we got a visit from someone else.

Fortunately, in my family, we have several veterans that we honor on Veteran's Day. Also, just as fortunately, we do not have anyone in my immediate family that never made it home from a deployment.

"I am an American fighting in the forces which guard my country and our way of life. I am prepared to give my life in their defense." -- Article One of the Code of Conduct for members of the armed forces of the United States.

It is one thing to say the statement above. It is entirely different to have lived it and have paid the ultimate sacrifice. My prayers are with those families, and brothers and sisters in arms, that have been impacted by the the death of a service member. Peace to you all this Memorial Day.

Thursday, May 20, 2021

Our Journey with CBD

Elise has a rare form of epilepsy called Lennox-Gastaut syndrome (LGS). This is a severe form of epilepsy that is "refractory", or resistant to anti-epileptic medications. Over her more than 10 years of being epileptic, she has progressed into this rare form that impacts her life on a daily basis. Ultimately this is brought on by an infection she contracted on her brain during treatment for cancer. This will not go away when she gets older. She will not grow out of it. There is no magic bullet. Most importantly, there is no cure. As I always say, "it is what it is."

Five or six years ago Elise was having a really rough spell with seizures. Honestly, there have been so many rough spells I couldn't really tell you how long ago it was. But I do know that I called my brother one afternoon and said, "What are you doing this weekend? You want to go with me to Colorado?" Prior to the CBD craze, there was a company in Colorado that was one of the first to make CBD oil started by the Stanley brothers. They were approached by a desperate mom who thought that marijuana could have a positive impact on her daughter's quality of life. The little girl's name was Charlotte Figi and she and her family are thought to be the catalyst that started the movement for CBD treatment of seizures. Their family experienced good success with the CBD oil made by the Stanley brothers which they eventually named "Charlotte's Web". You can still buy this today. Sadly, Charlotte died in April of 2020 from what was suspected to be COVID-19.

When I made that call to my brother 5-6 years ago he was instantly skeptical. In his line of work there were A LOT of people being arrested in Kansas for bringing marijuana back to Kansas. But I didn't want marijuana, I wanted Charlotte's Web! At that time, and still a great deal today, there is quite a bit of gray area in the law about CBD. At that time, you could be arrested for bringing it across state lines, and CBD was not available in many stores like it is now. In the end we decided it was too risky for our family. I was not willing to risk being arrested and them taking Elise away from our family. You can look it up. There are a lot of instances of that sort of thing in the last 10 years. I am thankful that much of this has changed.

Fast forward to about three years ago and the FDA approved a CBD oil named "Epidiolex". With that FDA approval came regulation of the quality of this product and also insurance assistance! I was on the phone within days of it becoming legal trying to get Elise an appointment. When we met with our neurologist he told us that getting Epidiolex was VERY difficult and getting approved for it was nearly impossible. The only way we were going to get approved was if Elise was deemed to have Lennox-Gastaut syndrome. That was not something we had ever heard of before. "There is no consensus in the medical literature on the exact definition of Lennox-Gastaut syndrome. Generally, three findings are necessary for the diagnosis: multiple generalized seizure types; a slow spike-and-wave pattern (less than 2.5 Hz) on EEG; and cognitive dysfunction." (source raredisease.org)

We knew that Elise had multiple generalized seizure types. She was experiencing those every day. We also knew she had cognitive dysfunction. That was pretty obvious to all that encountered her. A simple EEG scan showed without a doubt that she had a slow spike-and-wave pattern. And like that, we were approved for the FDA approved drug Epidiolex! All of my prayers had been answered and a "cure" was just around the corner. Well, if you have followed our family at all over the last many years you know that was not the case.

Just like with all new anti-epileptic drugs, the CBD was great right away! In only a matter of days we started to see improvement in her seizures. There was some tweaking of the amount we gave her and some adjustments to other medications and she was doing pretty well. The seizures were not gone, but they were far improved. It was more hope than I could recall in the few years prior. Then, everybody's friend puberty came into our lives. Let's just say that puberty and epilepsy don't play nicely with each other. From what I understand of girls, this change in hormones is a doozy for the average female teenager. For someone with epilepsy it is horrible. Maybe I'll write more about that in the future.

I have received more questions in the past month about some of the conversations going on in the state house of Kansas where they have been debating medical marijuana and its approval. Everyone wants to know my opinion. As I have been telling all that have asked me, I really don't know what is going on. Once Elise was able to get on the FDA approved drug, I knew I personally didn't have to fight that fight any longer. However, I do know that it is a fight that deserves to be had. But, I don't have the capacity to do it right now. I'll leave it to those that are most affected. 

Like all anti-epileptic drugs, Epidiolex has been found to be successful at eliminating seizures in about 33% of patients, found to reduce seizures in 33% of patience and have little to no impact on seizures in the remaining 33% of patients. We are in the "found to reduce seizures" group. It has not been a miracle drug, it certainly did not bring a cure with it, but it has brought on some improvement. There are currently more "good" seizure days than there are "bad" seizure days. But, there are rarely ever seizure free days.

In the end, CBD for Elise is one more tool to try and treat a debilitating condition. CBD has little known side effects which makes its use very attractive to many. The one thing I like about this FDA approved version is that it is regulated. All the other CBD products that we can find in the general public are not regulated. It is the wild west in CBD land. Manufactures can claim whatever they would like to claim and do not have to provide evidence. The products that you find could have trace amounts or no true CBD at all. To me that leads to way too much false hope and disappointment. I don't know if CBD is right for everyone, but I do know what it has done for my daughter. I'm always glad to talk about it to anyone that asks.

Sunday, May 9, 2021

It's Always the Little Things

 

My mom passed away a little more than 10 years ago. Time flies for sure. I think about her a lot. There aren't many days where something doesn't trigger a memory or a thought about a time from my childhood. I guess that is a blessing of getting older.

During most of my childhood my mom worked for the Kansas Social and Rehabilitation Services (SRS) now known in our state as the Department of Children and Families. She was an 8-5 worker. Often she was leaving the house a little before me in the morning and she got home after I did at the end of the school day. If she had to take me to an afternoon appointment, she might take me back to her office while she worked the final hour or 2 of her day after the appointment. She would generally set me up in an empty cubicle to work on homework, draw/color or keep myself occupied in some way. One of those days she set me up in the break room where I could spend the last hour or so of the day. 

While sitting in that room, the vending machines caught my eye. We had junk food around our house, but neither of my parents were soda/pop drinkers. We just didn't have it around. I had seen the commercials for all of the usual brand names, but there was one drink in there that I was not familiar with. Always curious, I asked if I could try a bottle of Squirt. To my surprise, I loved it! Who knew that a "grapefruit soda" would actually be great!

When I moved up to junior high school, the school was located only a little over a block away from my mom's office. On days when I didn't have practice (which was rare), I would generally spend the last hour of the day at her office. It was not a daily occurrence, but I got to enjoy Squirt more and more over the years. It has become increasingly hard to find over the years, and I quit drinking soda about seven years ago myself. But, every now and then I have something.

Yesterday I stopped in the convenience store on my way to pick up pizza for dinner. Thinking about my mom throughout the day, I just had a hankering for a Squirt! They only had two left, but I was glad there was one in the cooler. I thought about my mom as I drank it. I thought about her making space for me in the midst of her busy work days. I thought about her parading me around her office each time I came in so she could "introduce" me for the 100th time to her coworkers individually. Each time telling them that I was her "baby". Even as a 20+ year old college kid that was 6+ inches taller than she was. She was always proud.

It is a random childhood memory I know. There is nothing of significance attached to a single event involving Squirt soda. But, each time I see it I think of my mom. Each time I drink it I think of her office and those days of my childhood. Mother's Day is not the same when your mom is no longer with you. There are lots of people that come through to fill in the gaps, but there will always be a space that my momma held. 

Happy Mother's Day to my mom in heaven, and to my many friends that are mothers. Remember it is the little things that your kids will remember 30 years from now.

My Hospice Experience

As I have been looking back over this past year, I realize how much of November and December of 2021 was a blur to me. Life crawled by, yet ...