Three MRI's and a funeral

(...oh, and a memorial gathering at my house for my dear friend Sabrina, may her memory be blessed. But that made the title too long)

It has been a crazy week.

One MRI (brain) was at night after a funeral I attended of a friend and wonderful member of our community. She was only 67... cancer is evil. She was a dynamic, friendly outgoing woman who I was quite friendly with, and she also taught my youngest son English on a US level when he was in second grade (Israeli schools don't teach English until 4th grade). Her nieces and nephews came in from the US for her funeral, that's how special she was.

Funerals take a lot out of me, but are so vitally important to the soul. That of the departed as well as that of the people who cared about the departed. All-n-all, though, yeah. I'd rather attend a birth.

The MRI that night was a brain one. Of all the MIR's I've had (and that's a LOT), I never had a brain MRI. I've had brain CT's when my migraines got bad, or switching neurologists, but not an MRI. This one was for the pain doctor in Ichilov hospital who is trying to find a diagnosis for my abdominal pain crisis that happened last year, which [mostly] went away when I got the steroid shots. He said redoing the shots is fine, he can do that any time I need. But he feels we are missing a diagnosis. I'm not sure. We'll see. He ordered brain, spine and neck MRI's, and those are all done now.

The brain MRI is really hard because the noise is at your head. I always had abdominal and hip/thigh MRI's, and *those* are also loud, but the brain one is, well, at your HEAD. The ear phones they give you weren't enough for me. Too much jack-hammering, alien abduction, car alarm and machine gun sounds in my head. Not good for the PTSD. Not to mention the cage over my face... if I opened my eyes I immediately got claustrophobic. Glad it's over. No results yet.

The Ichilov pain doctor also ordered a nasty looking test called EMG/NCS of upper AND lower extremities. That test is not passive at all... electrodes and needles testing muscles-- FULL BODY. I'm not enthusiastic to do that. But I guess I will. Definitely bringing somebody with me for that day.

Then yesterday was very busy... it was Sabrina's (z"l) second year memorial. I was on my feet all day, literally. Only stopped when the actual ceremony started, in my house, that evening, with about 10 other people joining us. Then I sat a bit, but I was really wiped out. I spent important time at the cemetery (for my second day in a row) with Sabrina's daughter and her whole foster family, visiting her grave and cleaning it, being with everyone (especially Tessa, who I miss terribly, but is doing very well, thank G-d), standing, walking a lot. Then down town to get the memorial gathering foods together... along with a few errands I had to do (walked a lot then, too-- couldn't find close parking even with the handicapped parking tag). Food shopping (which I don't usually do, it's very taxing), coming home to prepare. I'm happy to do it, but it was quite a hard day. That's life.

We had a lot of sushi and beer because that was one of the things Sabrina and I did often- either go out for sushi and beer or order to her apartment sushi (and drink beer). I thought she'd smile on my decision. Made me happy. But you know, cleaning the kitchen, arranging everything, I was just non-stop on my feet. Every time I thought I could take a rest another thing popped into my mind to organize and prepare. Thank G-d everything turned out fine, and Sabrina's daughter had a wonderful time playing Barbies with Shifra. (my daughter, who's almost 16, had lots of fun too... this was *not* charity work to play Barbies with Tessa!! We heard their giggles and banter in the living room!)

By the time I cleaned up and got myself into bed, it was midnight. My legs were nearly numb, hips throbbing.

But I forgot to say something important, --but I want to ignore it-- but I can't...

Last night is the second time since I got the steroid shots that I felt that same abdominal pain return. The first time was Yom Kippur, in September, also when I was on my feet all day (and helped a mommy with a nursing newborn long into the night). Then it didn't come back until last night, at about 11pm while I was standing at the sink washing dishes... I felt it. It's like a demon feeling when it comes. I think I have to be careful about being on my feet too long. It goes away when I rest.

But I don't want to have to be careful, you know? 

But it's there, lurking. I guess it's a good idea to try to see if there's a diagnosis, but I'm not convinced there will be. And again- doing that nasty nerve test is involved. Weh.

But wait, not done yet-- I said three MRI's and a funeral, right?

So not only did I get to sleep over exhausted, in pain, and late last night (with thoughts of Sabrina & Tessa swimming around in my head), but I got up at 6:15 this morning to head to Jerusalem for my two MRI's that the New York surgeon wants to see in order to know if he can do the reconstruction or not. I've had the referral for these MRI's (abdomen & thigh- the whole area of NF's path of destruction) since August, and because of the  special directions the surgeon gave, no hospitals in Israel wanted/could do it for me. He wanted 1mm picture cuts the whole NF area (large area).

So when we got stuck in traffic on our way to Jerusalem this morning and I called the hospital to inform them, the secretary was snippy with me. She told me that I must be early (as if traffic is in my control) because the doctors/ technicians don't understand my MRI order.

Excuse me? You've had my referral in your hands for over a month... the HMO just told me *yesterday* that they will pay for it, so I didn't know if I'd be coming today, but the hospital had my referral for a long time, and sent me a date for the test. *Now* you're telling me that the directions from my New York doctor are complicated?

We got there, a bit late, then the guy who puts in the IV took a LONG time to get a good vein and set me up. (pet peeve- being a full-time patient makes your veins bad- must have EXPERT phlebotomists!!). Then comes the doctor and the technician. They're telling me about the MRI machine's capabilities, this is impossible, we can't do 1mm cuts, that's only done for brain MRI's and this area is so much bigger than a brain. I said maybe program the machine to do what it can do for a brain and aim it where we need? No, I don't know what I'm talking about (true, but sometimes not knowing things helps one think out-of-the-box), this is impossible. I told them of the other hospital that said they can absolutely do it, but only privately (mucho $). Then the technician tells me she spoke to that [private] hospital and they said they have the same machine (apparently standard all over Israel) and can't do it any differently than what they can do. That's not what they said to me, but I was stuck... the HMO already agreed to pay for it, this was my only shot. I was already gowned-up and feeling vulnerable, with an IV tube sticking out of my sleeve.

In the end it was the longest MRI I ever experienced (well it was two, actually)... well over an hour. One cool thing that I never had before was classical music piped into my ear phones! First Mozart, then Chopin (or Liszt?), then a Baroque period Bassoon concerto chamber orchestra and a harpsichord. My mind reminisced about my university days in Boston University, the orchestras I've played with, a typical day at Boston University for me, the apartments I lived in, the guys I dated during that time period. A trip down memory lane. :)

The doctor and technician were proud of themselves when they freed me from the tube-- they succeeded in doing 3mm cuts throughout. OK, dudes, thanks, but my doctor asked for 1mm cuts. Unless I go privately, though, I won't be getting that. I'll send this to New York and see what the surgeon says. If he says it's not good enough, I'll have to consider doing yet another one (two).
That would be much longer time in the tube not moving. I'd need a sleeping pill, honestly. It's not easy. The doctor in Jerusalem today told me it'd take three hours if it's possible for the machine at all. But I need the New York surgeon to be *absolutely sure* of what he may be getting into, and absolutely sure of his plan every step of the way. It's a very scary procedure, this reconstruction surgery. I don't know if I'll go through with it. If it all works out perfectly, it could be VERY promising for my abdominal pain issues and skin graft issues. But I know, and you know, that surgeries don't go perfectly, regularly. What I know I went through, and what I witnessed Sabrina suffer through her last year and a half because of surgeries gone wrong, and what I have seen on my NF support group, I know TOO MUCH. I've seen too much.

OK, I'll back up. I don't have to make that decision yet. I'll have a Skype conference with the New York surgeon after he receives the disk, and we'll be wiser.

Oh, I think I didn't tell you-- here's a good reason *not* to check email before you go to sleep. I did last night- on my exhausted night after Sabrina's memorial- checked my email quickly. What popped up? "On this day last year. See pictures of this day last year!" I think it's from Google+ or something. I clicked. The pictures were from the last day of sitting shiva for my dad, when my brothers and I, standing together, blew out the week-long yahrtziet candle while standing in the living room of my late parent's house (now sold). That's what I needed after Sabrina's memorial and such an intense day?
I sent the picture to my brothers, a reminder to them, too. (for their privacy I won't post it here)

That's how I fell asleep last night (with my new sleeping medicine, thank you, Dr. E!!)-- with thoughts of Sabrina z"l, Tessa; my dad's death, selling their pretty house where I grew up, the works.Then the MRI today and I'm BLOWN.

Good thing Shabbat is coming. I think I'm going to rest a lot.

It's good preparation for Chanukah next week! I've been taking these amazing Torah classes and learning some beautiful and mysterious things about Chanukah. The kids have their winter break from school/yeshiva. Oh wait- next week on Tuesday we have to travel three hours to Dov's yeshiva for parent's day, and drive back the same day, but taking Dov with us back home for his winter break. I think I'll be re-fueled by then. But vacation time-- all offspring home-- family doing things together-- it sounds great, but I'm so, so exhausted. And still dealing with pain and PTSD.
I have to get it together. Hashem, give me strength.

It'll all be OK. There is such goodness in the holiday of Chanukah, and such inherent strength built into it spiritually, And the kids love it. And it's over a week, together-- rare these days! It's all good. B'ezrat Hashem, with the help from the Maker of the Universe.

troubling times

I'm still here.

Not writing much because I have no new news, which can sometimes be OK, but in the middle of a PTSD relapse (which started about two weeks ago, I wrote about it in my last blog entry) it's not so OK. I have been externally mostly functioning, but internally not. That can only go on for so long... especially when I'm not sleeping much. The sleeping problems are a direct reflection of the PTSD.

It's actually come to my attention recently that I probably fall under the category of "complex PTSD", or C-PTSD.
I am seeking help for it. It may be another three weeks before I get an appointment with who I feel can help me the best, but that is 'the system'. Three weeks is good, actually. I spoke to that therapist today, after not receiving an answer to my email I sent about 5 days ago. So I need to go through the process of getting the referral and payment from the HMO, sending it to the therapist's office, etc. But just know I'm not just sitting around letting it eat me away.

I've started the four MRI's that have been ordered-- two by the NY surgeon who may be doing the reconstruction surgery (if I choose to do it), and two by the pain doctor here in Israel to try to diagnose why I was in such pain in my abdomen most of last year. I had the first of the series a few nights ago-- yeah, night. Didn't get into bed finally until almost 1am. It was a very loud, very long one. Loud because they only gave me one set of ear phones, not the foam ones to go under those. It wasn't enough (especially when you're already suffering PTSD). It was like I was in the car with the alarm going off constantly, and a jack-hammer at the sidewalk next to me, and an alien abduction all at the same time. And it was long-- longer than usual (remember, I must have already had at least 30 MRI's in my life, maybe more). It was for neck & spine. In the middle of the test, the machinery stopped, I thought (hoped) we were done. But no, the technician came in to tell me that he's sorry, he needs a small break for a technicality, he'll be back soon. I don't know if he needed the bathroom, or whatever, he said it was a technical problem. All I know is that was at least 10 minutes of me not being able to move my body into any comfortable position without the test going on. I was stuck in the white tube. He came back and all the noise started up again... he said he had to redo the test from the beginning, he's sorry. Annoying. But at least it was without the contrast dye, so I didn't feel sick to my stomach and headachey afterward.

Waiting on results from that.

Fighting another migraine today.... they are happening frequently, but not at the strength that they used to be when Robert would take me to the hospital, vomiting, and nearly blinded. But it's so frequent, it gets me down. I went to a wedding the other night... my first public party in over two years because of being in the years of mourning, first for my mom, then my dad. The wedding was fun, but I had a budding migraine beforehand. I had to decide whether to drug myself up and try to go, or slip into bed and do stronger medications and call it a day. I compromised-- I did mildly strong medications (I was driving), and got gussied up (even put on make-up!) and went. It was a good decision.

But it's hard to get back into the public world after over two years of mourning. I have such mixed feelings about it. I miss my daddy tremendously. Tremendously. This time last year we were sitting shiva for him, in the house I grew up in, which no longer is in the family. Thanksgiving came and went last year, even though I was technically in America, there was nothing to celebrate.

Lately I'm just not feeling well, in general. It's physical as much as emotional. We're experiencing some very trying times with one of our children, and that weighs heavily on me as well. I pray our counselor can help navigate us through what is for me very murky waters. That, together with my physical limitations and constant pain, well, sometimes it all comes together in a not very elegant picture.

Oh, I'll end with this thing that has been sticking in my head this past week, although really not at all contributing to my PTSD thankfully. Just a heavy thing that is on my mind.
Most of you know about the bandage-ripping-off trauma I suffered at the hands of my plastic surgeon when I had the skin graft surgery for NF, right? I'll reprint here for you the CaringBridge post Robert wrote about that immediately after it happened:


Sunday, May 20, 2007 4:04:00 PM


Today's news is very positive, though there's much to talk about. But first just this: Sarah is coming home tomorrow!!! We are so excited and thankful, and also a bit apprehensive. But mostly, we're just thankful: thankful to HaShem, to the Soroka medical staff, and to all the family members and friends who have supported us throughout this ordeal. With that thanks given, I do want to share the ordeal we had just this morning, if only to underscore how even with great progress there is still a lot of hard work and pain ahead. The day started with two instances of classic hospital insensitivity to patient pain, a topic which in my opinion deserves appropriate legislation vis a vis patient rights. This morning the doctors woke Sarah up and removed her donor leg bandages and the debridement wound bandage in order to inspect the progress and teach interns. Unfortunately, they were quite callous, not administering any pain killers after a night of sleeping, and not warning her of the impending intense pain. Just afterwards, Sarah called me in pain and in a desperate mood, and I got out as fast as one can with a toddler and baby to feed and dress (and bathe after a diaper blowout!) and drop off at their respective child carers. When I got there, Sarah was still in a lot of discomfort, but after about half an hour, she was ready to eat a little, take her antibiotics, and then shower before having her staples (used to reinforce the grafted skin) removed. We were worried about that procedure, but the attending nurse did an excellent job, patiently and caringly extracting some 89 staples in about 15 minutes. Only a handful caused pain (Sarah is mostly numb there as most of the nerves have been cut), and even that pain, though strong, passed within 10 seconds. Now it was time to put on the new dressings. Unfortunately, the aforementioned callous doctors left the donor leg with the bandages strewn across the wound, and so they got stuck, making it impossible for Sarah to stand up without acute pain from the pull of the dangling bandages. She eventually managed to get up briefly and transfer to a wheelchair, and thusly was she showered. That went OK. But then nobody warned her that the first dressing change for the donor leg burns for about 30 minutes like "a blow torch being waved up and down" the length of the wound, as Sarah described it. Narcotics take about that long to kick in, so the Percocet she then received on request couldn't rescue her from the intense suffering she had to endure. Why isn't there a standard procedure in the plastic surgery ward to administer a narcotic 30 minutes before bandage changes, just like in Surgical Ward A at the same hospital?? I posed this question, perhaps a bit more diplomatically, to Sarah's surgeon, and he shrugged in a "hmmm, that's not a half-bad idea" kind of way. Hopefully they'll institute that policy in the future. Anyway, Sarah's is doing much better now, and after a visit from an acquaintance who also got necrotizing fasciitis after a hernia surgery at Soroka (in 1994/different surgeon), has overcome her apprehension about coping at home. The 1994 NF victim lost all of his lower stomach muscles and part of his lower chest, was hospitalized for a longer period, and then on top of all that contracted bacterial meningitis, damaging his right hemisphere and leaving him with left-side paralysis. After 3 months in Soroka, and 6 months in the Loewenstein Rehabilitation Hospital in Raanana, he recovered full use of his left side, and is active and healthy today. Sarah learned a lot from this story, and especially that she's fortunate to have not had more damage, and that she should mimimize her risk of infection by coming home tomorrow, even if it means not having nurses and doctors on-call around the clock. And then there's Hilary, Sarah's midwife-nurse friend, who'll be helping us with checking and dressing the wounds. So we'll be fine. G-d willing, tomorrow I'll post a description of Sarah's homecoming!!! L'hitra'ot, Robert


It turned into a huge trauma that I had to work on (Shuli, you helped me through that with EMDR! Do you remember?). Having that bandage ripped off, the whole scene and details around it were very, very traumatic. I hated the plastic surgeon for that.

So, this weekend, my friend Hedva told me something very shocking that happened in July with him, and I hadn't heard of it. Here that is: https://www.timesofisrael.com/senior-plastic-surgeon-kills-himself-in-soroka-operating-room/

That was my surgeon... so, maybe he wasn't playing with a full deck the whole time?
I feel bad for his wife and two kids.

There but for the grace of G-d go I.

That hole opened up again

First of all, BIG shout out to my loving husband for buying me a mega-light laptop computer so I can continue writing without it hurting my leg! I am now the new owner of an Asus VivoBook S14.
Yay Robert! Thanks SO much!

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Having already mentioned leg pain...lets launch right into that.

The bone scan and blood tests were all clear, no Osteomyelitis, thank the Good Lord. Because that disease is Very Bad News. I am entirely grateful it's not that.

But what is it?

My left thigh bone (femur) and hip are *killing me*. Oddly enough I can keep working out though. I can do my 5km on the exercise bike, lift weights with upper and lower body machines, and swim. But the swimming the other day left me barely able to walk...not from pain as much as weakness. I've been very weak of late, and I don't understand what is happening. It's the bones themselves that hurt, not the muscles.

My right hip joint is going, too. It hurts while swimming even more than the left sometimes. They've both had their share of surgeries, and have no cartilage, and will both need replacing at some point. I'm not sure which one is more desperate, although day-to-day my left one is hurting more. My femur- it's so crazy- but the femur bone is so painful.

In other news, that hole that took four months last year to close up? The one on my skin graft that kept oozing stuff constantly? Yeah, that's open again, and oozing sticky stuff. You can imagine how excited I am about *that*. Last year it took four months of draining, was completely antibiotic resistant, and only closed up when I used Manuka honey on it.

My infectious disease doctor swabbed it a few days ago, we'll see what bug it is, but I don't think it matters so much. Last year it was totally antibiotic resistant.

I am reticent to use the honey now again, though. Why, you ask? Because last time, one week, to the day, after that hole closed up after using the honey on it (took two weeks of treatment with the honey), one week later was when my belly pain started. I see it as connected. I somehow feel that whatever infection there was dripping out of that hole, it got internalized and inflamed possibly my mesh/clips or whatever else (not seen on CT scan), and maybe it needed that outlet of the little hole? I don't know. I haven't used the honey on it yet, I am traumatized by what happened last year, and don't want a repeat. I don't even know who's opinion to ask about that because it's not empirical data, like 1+1=2. It's just my gut feelings and fears.

So this week I have lined up a visit with my orthopedic oncologist. They are in Ichilov hospital (same place I went a week ago and met that pain doctor). They deal with my left hip/thigh, with the PVNS issues. It's my next stop on this journey to see what is wrong with my leg. It could be that the PVNS tumors have returned. This pain could be from that. PVNS does have a 50% return rate, *but* usually only within the first five years. I had the disease in 2008, and had the tumors surgically removed, and have had no recurrence, so my probability goes way down after that. But not impossible. Just this past year's visit- last June, they changed me from twice-yearly MRI's to once yearly. But I now need another one to rule it out. I am in so much thigh pain, this is the bottom of the totem pole to rule out, because I have a history of it.

I have to do so many MRI's in the coming months, I think I'll likely be sticking to the refrigerator by the end of them. The pain doctor ordered a bunch, the NY surgeon ordered one that I still haven't had done, but do finally have scheduled, and now I'm sure my orthopedic oncologist will be ordering one. I really hate having to fight for close dates for the tests, and then to have the insurance give me a payment voucher for wherever I am having it done. It's a whole process that often takes many calls and waiting periods. And faxes, yes faxes! In 2018 in Israel, we are still faxing, believe it or not.

I need answers though. I have more pain than answers. The abdominal pain is still for the most part behaving itself, thank G-d, but what would happen if I used the Manuka honey and closed up the skin graft hole again? I shudder to think. For now I'm not doing anything. Just swabbing the gook out of the skin graft hole periodically throughout the day.

The fact that I can still work out in the gym is good, but weird, right? Let's pray that stays that way.

OK, on to a new week, and with G-d's help I will be able to give my kids what they need! It hasn't been easy to do that...giving them what they need. Another of my children has now asked for counseling, and I'm working on getting that set up for them. It hurts my heart to see how hard life can be for them, and I do the best I can with the situations.

The migraine situation is a little better since I'm off gluten (Celiac), but I still get them, just not as strong as they used to be. I haven't needed steroids for a migraine at the hospital in a long time. Now when I get them (still once or twice a week), I can take a select handful of pills, smoke some Cannabis, and it goes away by morning usually. But often the next day I am tired...spent...from dealing with the migraine and sleeping problems from it.
And the Cannabis doesn't really take away the leg pain, which intensifies at night. I use Percocet semi-frequently for that.

I PRAY I get an answer about what the heck is up with my leg...it's just so far from normal. There is something hugely wrong in there. And is it connected to the hole in the graft (same leg, inches away) oozing stuff again? More questions than answers.