Monday, May 12, 2014

The Year

Turns out you can get a lot done during chemo. During the year my mother battled lung cancer, I was often the one who accompanied her to her treatments. I went out of a sense of duty, so she wouldn’t have to be alone, and to educate myself about her disease.

I also went looking for shreds of hope that my mother would not die. I needed to be near her.

Her diagnosis with lung cancer in the fall of 1999 changed everything. Just a few years earlier, my 53-year-old mother, a busy realtor, had started working out at a gym and lost weight. She felt younger than her salt-and-pepper gray hair made her look, so she decided to go blond. She looked great driving around to appointments in her white Saab, talking on her car phone.

“Someday I’ll have a convertible,” she said, tossing her hair.

She joked with my sister and me that we shouldn’t rush into marriage and having babies.

“I’m too young to be a grandmother,” she said.

I, too, was having the time of my life when my mom got sick. I was looking forward to my wedding to Matthew, who proposed to one summer night on a beach on Cape Cod. I was 27 and living in Boston since being promoted to State House bureau chief by the newspaper where I worked. Matthew and I were still enjoying the glow of a newly engaged couple. Even at work, typing my stories, I smiled every time the sparkle of my diamond ring caught my eye.

When I visited Matthew, even though my parents’ lived in the next town, I spent little time at their house. It was one of my mother’s running jokes that she had to get reports of my whereabouts from our mutual friend Debbie, who lived next door to Matthew.

“Have you seen my daughter lately?” my mother would ask Debbie. “I heard her car was parked on Garfield Street.

“Is she married yet? Does she have any kids?”

Mom could really crack herself up.

That September, on the night of my parents’ 25th high school reunion, my father raced my mother to the hospital while she held a bag of frozen peas to her side.

I was visiting Matthew when she called me from the hospital the next morning.

 “I’m going to see a specialist,” my mother said.

“Oh,” I said, imagining, just for a moment, that the floor had shifted below my feet.

I leaned against a stool, cradling the phone on my shoulder. My hands went to my forehead, pushing back my hair. I didn’t want to ask the next question. But I had to. I didn’t know it yet, but I was already defying my own expectations of myself.

“What kind of specialist?” I said.

“They found an admor . . . abnormality on my X-ray,” she said.

Mom always had trouble pronouncing certain words. It was something about which my family often poked fun of her. In fact, my mother was always an easy target for my father, my sister, and me. We made fun of her stammering and difficulty articulating herself, especially when she got excited. We made fun of her inability to drink more than one and a half glasses of wine before getting tipsy, calling her a cheap date. When she nagged us for not cleaning our rooms or using too much salt on our food we told her to “take a pill” or “take a back pill.” We called her clumsy or “clutzy” – as my grandmother liked to say – because she was always stubbing her toe on the furniture, a trait she passed on to me.

“What kind of specialist?” I asked again.

I was both angry and relieved when Mom didn’t answer my question directly. I don’t know what forced me to ask again. I knew the answer and yet I couldn’t believe it.

“An oncologist,” she said.

I sat down fully on the stool, not trusting the floor, not trusting my legs.

“But,” I paused, “that’s a cancer doctor.”


“Why would you be going to see a cancer doctor?” I said.

There was something creeping up my throat that felt like a scream. I swallowed hard, stifling it for now.

“There’s what they’re calling an abnormality on my X-ray, a spot on my X-ray,” she said. “So the specialist is going to check it out. Check out the abnormality. It’s good that I’m seeing a specialist.”

A few days later I was lying next to my mother in hospital bed after a biopsy confirmed her doctors’ suspicions that she had cancer. My mother did not ask me to lie with her, but a need to be near her and touch her was overpowering.

She was lying on her side, favoring the hip where doctors had drilled into her bone to test for cancer. I crawled on the bed behind her and wrapped my arm over her side, careful to avoid the painful spot on her hip and buried my face into the back of her neck.

I thought I was comforting my mother by lying with her in her hospital bed, but in doing so, I was hoping to receive some comfort from her.

On the morning of her first chemotherapy treatment, Mom wore a button-down shirt. This would make it easy for the nurse to access the catheter that had been surgically placed in my mother’s upper chest, just under the skin near her collar bone. The catheter was connected to a vein and would allow the nurse to deliver the chemotherapy drugs, directly into my mother’s bloodstream without having to stick a needle in her arm every week.

“I probably shouldn’t have worn white,” Mom said that morning.

She was told she’d lose her hair, so she’d picked out a wig even before starting treatment. That first morning, we took photos so she could see what she’d look like wearing it. In one photo, my mother sits between me and my father on the couch in their living room. My father is smiling with his arm around my mother. Like so many photos of my mother, this one captures her between smiles, and she looks as if she was caught by surprise. She looks directly into the camera, her brown eyes wide and mouth in a half-smile. Her hand is at her head, holding the wig as it slides sideways down her head. I sit next to them, kissing my mother’s cheek.

Chemotherapy is much more mundane that I had expected. It’s less invasive than going to the dentist. You don’t have to change into a hospital gown. You wear your own clothes. It’s like giving blood, without all the blood.

Most patients at the oncology clinic had their treatments in a large room. Reclining chairs lined the four walls facing a nurses’ station in the middle of the room. The patients’ chairs were separated by curtains for privacy.  For the treatment, a nurse hooks up an IV that contains a cocktail of chemotherapy drugs to your arm or a catheter. Then, you wait. You wait until the IV bag is empty. It usually takes about 30 minutes for the IV bag to fully drain, and you can be in and out of the clinic in less than an hour.

While you’re there, you can get up to go to the bathroom, with your IV bag in tow, or get a snack or a drink from the communal kitchen. You can even walk around in the clinic or visit with other patients, though that rarely happened. To pass the time, patients usually watched one of the several television sets mounted from the ceiling around the room or flipped through magazines.

Over the next year, my mother and I used the stretches of time during chemo time to plan my wedding. We consulted each other’s calendars and synchronized our daily routines to fit in time for dress fittings and seating charts. During chemo, my mother bragged to her nurses about my upcoming wedding, while I sat beside her with my arms loaded with bridal magazines and disorganized folders of guest lists.

My mother and I always got along well. We never experienced the bitter battles that many mothers and daughters do at certain times in their lives, the struggles for power that often stem from a mutual resentment. But while my mother and I were always close and found it easy to show our love for each other, until her diagnoses our lives were quite separate. We did not discuss the intimate details of our lives. I was not the kind of daughter who called my mother my best friend. She was not the kind of mother who involved me in her arguments with my father. But during the year between her diagnoses and her death – the year that I coincided with my engagement and wedding –I gradually came to know her fears and triumphs almost as intimately as my own.

Those hour-long chemo sessions were jewels of stolen time for use. Chemo paused our hectic “before cancer” lives, forcing us to stop moving, sit together in a room and share a space in time.

There were some things about my wedding that my mom couldn’t help me with. Since she had lost her appetite she didn’t bother tasting cakes with me. When a treatment had left her sick and weak, it was my father who accompanied me to my appointment with the florist to pick out my bouquet.

After chemo, my mother usually felt tired and nauseated for a few days. Sometimes she didn’t feel like eating much. Sometimes she needed blood transfusions to boost her white blood cell count, when her resistance to infections was knocked down by chemo drugs.
At first she tolerated the treatments well. As the months went by, and she began to have more pain, then weakness and seizures – a sign that the cancer had metastasized to her brain. But, through it all, she never asked me to alter my plans because of her illness or to change my wedding date, even when her body began failing her as my wedding approached.

My mother prepared for my wedding in her own way. With the help of friends and family, she had a fresh coat of paint applied to the walls of several of the rooms of her house. She made sure the guest room, my old bedroom, was neat and orderly. Decorated with a rose-patterned bedspread and matching curtains, it was pretty enough for any bride getting ready for her wedding. She had even sent my father out one night to purchase the finishing touch at a local department store – a full length cherry dressing mirror she had seen advertised in the newspaper that morning.

Eventually, she spent a lot of time resting and fighting the pain. When I visited her at home, I often found her sitting in front of the television swaying back and forth in a rocking pink recliner – a gift from her good friend Jeanne that had become her preferred seat in the house – with her eyes closed. When I asked her what she was doing she said, cheerfully, “I’m meditating.”

“What are you watching?” I’d ask, looking at the television.

“Oh, I don’t know,” she’s say. “Some stupid show.”

I have no way of knowing if my mother was meditating to ease her pain or praying that she would not die. Rather than join my father at church every Sunday morning, mom preferred to stay home, sitting at the kitchen table drinking coffee and browsing the sale fliers.

“Don’t worry,” Dad said jokingly, “I’ll pray for you sinners.”

After she became too sick for chemo, her once pin-straight hair grew back curly and white. Faced with the reality that her body would neither tolerate nor respond to further treatment, with the prospect of no recovery, she cried, “I want to see your wedding.” Then, after a moment, she said, “I want to see my grandchildren.”

People say my wedding kept her going. It kept her mind off the pain eased only by large doses of morphine and her fate. When my wedding day finally arrived, she was sicker than she had ever been. Though hospitalized for several days leading up to it, she somehow mustered the strength to attend my wedding ceremony, decked out in her best blond wig – by now she had many to chose from – and the navy blue dress we had picked out together.

After the ceremony, Matthew and I greeted guests as they filed out of the church. Then, I walked over to my mother, who was waiting for me in her wheelchair.

“Come over here and give your mother a kiss,” she said, feigning anger that I had not greeted her sooner.

The next day, we were at her bedside at my parents’ house. She wanted to die at home. Any notions Matthew and I had of a honeymoon vanished. The depth of my mother’s sheer physical pain seemed endless and so did her dying. Large and continuous doses of morphine dulled the pain but also stole away her consciousness. As her breathing became more and more labored, we prayed for her suffering to end, for death to come, for the agony of watching her die to cease.

At 3:50 a.m., five days after my wedding – after she had watched my tearful father walk me down the aisle as I beamed with a joy that couldn’t be stifled by any of the pain we had endured in the past year – my mother died. My sister stood at the foot of her bed, gently touching my mother’s stocking covered foot. I stood at the side of her bed, holding her hand. Matthew stood behind me. My father caressed her face as she took her last breath and cried for his “sweet, sweet baby.” We had prayed for the relief her death was supposed to bring. When life left her, I was startled to feel instead only a consuming desire to have her back, even with all the pain and suffering. I wanted for just five more minutes to hold her warm hand in mine, to feel the smooth, dry skin and examine the long fingers with their large knuckles that look so much like my own.

Sunday, June 19, 2011

The birth of Julian

Julian's birth was amazing and fast. It was a hot, humid morning when things started happening. It was gray outside and the air felt heavy. I was up early, as usual. It was a Monday. I was lamenting the fact that I had no plans for the day and wasn't sure what I would do with Jonah that day. I can't remember what Matthew's plans were or whether he was scheduled to work. We were still living and Dani and Marc's house, and Dani was awake, too, when I realized I'd be having a baby very soon.

I think I'd been having contractions off and on for weeks, but I chose to ignore them or pretend they were still just Braxton Hicks. But, the baby had felt lower in the past couple weeks, and I had been feeling irregular contractions, especially at night and especially the night before I went into labor. Some of these contractions over the previous two nights were pretty strong. I ignored it. In fact, I had suspected that my water had broken the night before but it was just a tiny trickle, if anything at all. Again, I tried to ignore it.

I was determined to ignore as much of it as possible in an attempt to stay out of my head about the birth this time around. But, on the morning of June 28, after I'd eaten some cereal, I started secretly hunting around online about signs that your water has broken. I remember reading that the trickle I was experiencing could mean that my water had broken, but I still wasn't sure. I also read an interesting fact that some women actually feel a popping sensation in their abdomen when their water breaks. I didn't feel anything like that. Soon, Jonah, who was 2 1/2, was up and my mind had moved on from what was going on with me and this pregnancy to breakfast, Jonah and the rest of my day.

A few minutes later I was sitting on the couch in my nightgown reading a book to Jonah. I wish I could tell you which book I was reading to him as he sat next to me, but I only remember that suddenly I felt a small "pop!" in my lower belly on the side. Then, a gush. I jumped up and ran through my bedroom to the bathroom, grabbing a towel on the way. "My water just broke," I yelled.

At some point, I remember thinking, "It's June 28." And, that sounded like a good day for a birthday.

Matthew called the midwives and doula. I still wasn't convinced the baby was coming. I had ignored so many of the previous signs. And, now, it seemed like all of a sudden my water broke, but I worried that labor hadn't actually started. I worried it would be just like Jonah's birth, when my water broke two weeks early and we had to use all the tricks in the book to get my contractions going and keep them going and I stayed awake for two days and ended up going to the hospital for pitocin and he was finally born 62 hours after my water broke. On the phone with one of my midwives, I sort of told her all of this, talked about my fears. I also talked a lot about Jonah, about my worries that he would be alright with the caretakers we had arranged to be with him during my labor. My worries were about the unknown. And, about another long, drawn out labor that might end up with another hospital birth, which I did not want. I really wanted this baby to be born at home. One of my midwives, Jharna, gave me a little talking to over the phone. She reminded me that I had plans and back-up plans for Jonah's care and that he would be fine. She told me I could stop thinking about that now. She gave me some instructions: to go make my bed and to start thinking about this birth. This baby is coming today, she said, and it was time for me to start focusing on that. Her words gave me direction and a sense of control, which I craved. I think she knew that. My midwives are so smart.

At some point, our friends, Matt and Kristy, came over to pick up Jonah so he could play with their son, Rex, who is a little younger than Jonah. They kept Jonah all morning and he napped in Kristy's car during a ride. Dani would pick him up after work and, if necessary, drive him up to Brattleboro, Vt., where he'd spent the night at his cousin Hugo's house.

Dani went to work. Marc was also working. One of my midwives, Chana Luba, showed up. About two to three hours after my water broke, and not very long after my verbal smack down from Jharna, the contractions really started. I tried to listen to music but soon decided it was too distracting. Bouncing on the birthing ball or leaning over and resting my head and arms on the bed seemed to work best for a while. At some point, my doula, Katherine, and Jharna, showed up. Several hours passed but it felt like minutes.

Soon, it was afternoon, somewhere between 2 and 3 p.m., I think, and time to decide whether Jonah would go to Brattleboro. I didn't know it, but I was about to go into transition. Still, I went back to worrying about Jonah. We decided he should go to his cousin's house, and even though I had already packed his bag, I listed several items to Matthew to make sure were in there. Jharna was listening and chuckled a bit, but also reassured me that Jonah was in good hands, that Matthew would do a good job making sure all his things were in the bag.

My midwives checked my progress at least once or twice during this time. I don't remember specifically how many centimeters I was dilated, but the numbers seemed to make sense to me and made me feel like I was on track. I was so happy because this time I didn't need to walk and walk and walk. I didn't need to drink castor oil. So far, I hadn't needed any medical interventions. They checked the baby's heart rate intermittently and my vitals and everything was fine. Maybe I channeled my worries into other things, like Jonah's care, but I wasn't worried at all about my health or the health of the baby. It was like somewhere, deep down, I knew it was going well and everything would be fine. My midwives' demeanor, actions, quiet voices, gentle hands and proficiency helped a lot to foster that feeling of calm.

We knew Dani would soon be on her way to pick up Jonah, stop at our house to pick up his stuff and then head up to Vermont. Meanwhile, things really started moving. My contractions were coming faster. I really wanted my nightgown off but had trouble saying the words. I started pulling it off and somehow managed to "ask" Matthew and Katherine to help me. "Pull this," I think I said. Somehow, I asked if I could get in the tub. No sooner had the midwives said, "Sure," that I lost the ability to really speak and was having trouble breathing through the contractions. There was a moment when I noticed Matthew wasn't in the room and Katherine was with me, but suddenly I just really needed Matthew. I barely said anything, but Katherine knew just what I needed and got Matthew quickly by my side. I needed to touch him. I was grunting and my body was pushing. I had to push. The midwives checked me to make sure I was complete, and I was. I honestly couldn't believe it. Just when I thought I couldn't do this anymore, someone said, "Your baby is coming in a few minutes." (Did I tell you my midwives are very, very smart? That reassurance was perfectly timed.) "Really?" I said. "Really?" Soon, the baby was crowning and I touched the head. It was only then that I finally believed I was having a baby very, very soon. At first I was on my hands and knees, but then I tried lying on my side. I have a tweaky hip when I give birth so I naturally ended up lying on my back with my legs pulled back like a frog. It felt totally natural. The head was born after a few very painful seconds. I knew the rest would be easy. Apparently, the body didn't come out during the next push as it should have, so there were a few seconds when things got very serious, but I barely noticed. A shoulder was stuck under my pelvic bone, so Jharna got up on the bed, reached in, turned the baby a bit and guided him out during my next contraction. And, there he was! He was born.

I think I asked, "Is it a boy or girl?" Someone, probably Matthew, said, "A boy." Another boy!

The baby had sucked in some fluid on his way out so they did a lot of suctioning. Kristen, a midwife, explained that she would like to use a special tube to get it out, rather than the bulb syringe. I think she may have even said she learned how to use it in England, while training as a midwife. I agreed and she pulled out quite a lot of fluid. I learned later that Matthew was very nervous at this point, but I still had that calm feeling of knowing everything was and would be fine. Maybe it was the hormones, the lack of medication in my system, the midwives or a combination of things. I do remember that this baby was pinker at birth than Jonah had been. And, Jonah was completely healthy and fine, just a little gray at birth. But, I loved that pinkness. We hadn't weighed this baby yet, but I heard my birth attendants remark about his big size.

Soon, the baby was crying and making noise and breathing fine. I had him on my belly and chest and concentrated on seeing if he wanted to nurse. He seemed interested in being near my breasts but didn't want to latch, which was fine. I let him do his thing. Meanwhile, we waited for the placenta, which took a little longer than they liked, but was also fine. At some point, my midwives commented that they were slightly concerned about my bleeding. I turned inward to pay attention to how I felt, so I could tell them if I felt symptoms as a result of blood loss, like light-headedness or nausea or weakness. I was paying attention to myself, but, I learned later, that the serious look on my face worried Matthew. In the end, my midwives gave me a little shot of pitocin in my thigh in an effort to contract my uterus to help stop the bleeding. They were so kind about having to stick me and cause me pain, even though a little needle stick seemed like nothing after giving birth. I do remember that this birth, especially at the end, hurt a lot! I remember that I yelled and screamed through most of it, which is kind of funny because Dani and Marc have tenants who live downstairs. I still don't know if they were home at the time and heard me. I don't really care, but it's kind of funny. I was making a lot of noise. I also remember thinking soon after the baby was born and the pain stopped that now I really, really know why people get epidurals! Soon after, I learned that I had only pushed for about 15 minutes, which amazed me because I pushed for more than three hours during Jonah's birth.

My water broke at 8:15 a.m. Active contractions started around 11 a.m. And, this baby was born at 4:20 p.m. The baby had come before Dani or Marc got home from work, and even before Jonah went to Vermont. Soon after he was born, Dani arrived home with Jonah. We decided that Matthew would run his stuff down to the car, and Dani would come in to see me and the baby for a few minutes, but that we'd have Jonah stay in the car and then head right up to Brattleboro. Dani told us that he had been verbally prepped for his sleepover and was really excited about it. We thought it would be good to put off introducing him to his baby brother until the next day and have a night with only one baby at home. I desperately wanted to see him, but Matthew assured me he was fine and happy and looking forward to going to Hugo's house.

The midwives stayed until about 6 p.m. Before they left, they helped me take a shower. Kristen did some craniosacral therapy on the baby. "I think he has a little headache," she said. Within minutes of laying her hands on him, he fell fast asleep. At some point, they weighed him with a fish scale. Jharna was holding the scale. With a big smile, she said, "You're not going to believe this. Nine pounds, eight ounces!" He was almost two pounds bigger than my first baby at birth! No wonder it hurt so much!

I loved having such a big baby. I felt like he was just that much healthier and safer. He didn't even really look like a newborn. He was chubby and solid. A ton of black, curly hair on his head. Long limbs. In fact, Kristen told me that he was big enough that I didn't have to worry about waking him to nurse every two hours. "If he sleeps for longer stretches, you can just let him sleep. He'll be fine." That was the most wonderful thing anyone could have told me going into the first night with a newborn.

We ordered Chinese food, since it was dinner time. I devoured a giant plate of brown rice, chicken and vegetables and a bowl of miso soup, which is good for restoring energy after a birth. We were so happy that this baby had come at such a convenient time of day. Marc got to meet him when he got home from work. My dad came over after dinner for a while. And, we got to go to bed at bedtime. I had not been awake for two days trying to keep my labor going. This labor happened on its own and my baby was born at home, in my own bed, surrounded by the people Matthew and I had chosen to help us.

We didn't know what to call this baby, but at some point in the middle of the night, I started thinking about it. He was born on June 28, but his due date had been estimated for early July. I started thinking about July and the name Julian formed in my head. Later, I told Matthew and he liked it. We let it sink in for a few hours before deciding, but, from the start, it seemed like the perfect name. We had already decided his middle name would be Dean after my father. (Jonah's middle name is Thomas, after his other grandfather.)

There he was. Julian Dean Cavanaugh. And, my family was complete. ~ Nicole

Monday, May 23, 2011

Letting go

It's been raining a lot. Too much for my liking. It's nearly Memorial Day and we've only had the briefest taste of warm, spring weather. That's New England for you. I've been spending more time indoors due to the wet, cold weather. But, as I look around my house today, I see a little less grime, a little more shine. I've been vaccuuming a bit more. Sweeping. Dusting. Tidying. Partly, it's because I've been in the house more due to the weather. I can't ignore the dirt and mess. I've also been spending more time inside because Julian naps in the morning while Jonah is at preschool, and the kids seem to appreciate spending the afternoons at home most days, especially Jonah who has spent a very stimulating morning at school. But, I am realizing, too, that the other reason my house is a bit more kept is because things are just a little bit easier for me. Taking care of a 3 1/2-year-old and a nearly 11-month-old isn't easy exactly, but it's much less of a struggle most days than it used to be. We've settled into a pretty predictable routine, especially now that Jonah is in preschool four mornings a week. Julian has stopped crying every time he sees the vaccuum cleaner. He plays well by himself and enjoys roaming around on the floor as long as I'm nearby. But, I've also gotten just a little bit better at letting go. My standards for housekeeping have gone way down and I'm mostly OK with that. While it can still be very frustrating that I usually can't finish any job I have started, I know that this is the norm and no longer expect to get everything done in one day. I've gotten to the point where I can do just a little bit every day, at certain opportune times. Over the course of about a week, I can do a little bit of work in almost every room or in our small yard. Just enough to maintain the order I require to feel sane in my house. It's still hard because there's a lot of deep cleaning I really never get to. I have piles and piles of papers to go through. Lots of closets and storage areas that need to be cleaned out and organized. The bathtub could use a good scrubbing. But, someone always needs to be fed. Someone's boo boo needs a kiss. Someone needs a diaper change. Someone needs help finding a favorite toy. Someone needs help sharing. Someone needs me for something other than cleaning and tidying. So, I stop what I am doing. I leave the bedroom only half vaccuumed. I pat myself on the back for wiping down the sink and mirror even though I never got around to mopping the floor. It's good enough because it's better than it was a few minutes ago. And, I know that this is just the state of my house -- and my life -- right now. At any time, things could pile up and it could become more difficult. I've learned not to see anything as a trend, necessarily, because things can change at any time. The most important piece of all of this is that I have let go of judging myself for having a messy or dirty house. It's just the way things are for me. It's not my fault and it's not even a bad thing to have a messy house. In fact, it is evidence that I am doing my job, that I am paying attention to my children and doing what they need me to do. I am happy to say that I have lightened up a lot since having kids. I still have moments when the chaos drives me crazy and I need to vent -- or kick everyone out of the house so I can just take care of things uninterrupted. But, for now, as Julian takes his afternoon nap and Jonah sits next to me on the couch watching Thomas the Tank Engine and chatting with me now and then while I take advantage of a little time to work on my computer, I look around and enjoy the shine coming off of my floors and the crumb-free rug at my feet. I notice there's a bit of dust on the coffee table, but nothing in this house is perfect, now or ever. And, that's the way it's supposed to be, and that's fine by me. ~ Nicole