Missing the Signs of Stress and Anxiety in My Pre-School Child: Part 2

(For those of you just joining us, the first part of this particular child anxiety and stress story started with my last post, so make sure you read that one first!)

           

            Despite prayer and plenty of self-talk, my mother worry gene remained engaged in high-alert as Parker (now four years old) and I prepared for the sleep apnea study at the Children’s Hospital in San Diego, where he’d be embellished with sensors from head to toes. On a beautiful Thursday evening, he and I made the forty-five minute drive to the new hospital. Chris met us there after work for the introduction and to give a brief, “’at a boy” pep talk to Parker. Then he went home to bed. I would remain with Parker for the eight-hour test.

           

            The twinkling stars on the ceiling of the hospital’s lobby might have mesmerized Parker for a brief moment, but they didn’t do much to smooth my raw edges. Even Parker seemed unconvinced; the suspicious look engraved on his face told me that even he knew the pretty façade had to be a mantle for mysterious, frightening things awaiting him in the inner sanctums.   

           

            After Parker was entertained with an in-house video and mandatory repertoire of mommy-and-son bedtime tunes, I retired to what the hospital had generously described as a cot, (actually more a minimally reclining, padding-free chair), and eyeballed my son dressed in his miniature hospital jammies and the monitors for nearly eight hours. A technician observed the incoming data while filming his movements from the adjacent room. This night, someone else got to be the notebook-keeper.

           

            In the middle of this procedure, Parker coughed and choked, beautifully reproducing his worrisome symptoms, then realized—in horror—that he’d soaked the bed. I don’t need to describe the scene for you to imagine the challenge of unhooking the leads and escorting a tearful little boy into the cold, sterile atmosphere of a hospital bathroom to change his clothes, soothe his broken spirit and then reattach him for the remainder of the test.

           

            To coax him back to sleep, I joined him in bed, lulling him with more songs and caresses. I also gave him the nasal allergy medications his pediatrician had prescribed while awaiting the diagnosis. I didn’t give it to him at the onset, because I wanted them to see exactly what happened without medication influencing the results.

           

            The songs or caresses scored, because—thankfully— he returned to a comfortable sleep. Until four o’clock in the morning when the technician announced the test over. No languishing around the room. No allowing Parker to finish his sweet dreams. We were ushered around quickly to pack our bags, dress and vacate. The hospital register was ringing, and the insurance company had punched a pre-set time clock. Any extra seconds would be out-of-pocket ones. I thought I heard the distinctive sound of a door being slammed behind us as we left. Luckily we moved fast enough not to be bounced by it.

           

            For a treat, I took Parker, and the obligatory stuffed bear the hospital had given him, out to breakfast. He wasn’t particularly interested in sharing the Grand Slam meal I selected, but I needed the coffee for the toothpicks-in-the-eyes, hour drive home. Finally, we ascended the I-15 on-ramp amidst a beautiful California sunrise. The test was complete. Now the waiting came began.

           

            But that sunrise signaled such hope and promise that fear finally escaped me. Another glorious morning had begun.

           

            We all needed the hope it represented.

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            The results arrived soon after, along with a visit to the pulmonary specialist who pronounced Parker to be just fine, and who said my son probably had mucous draining into his throat as the result of allergies, causing him to gag and sit up to clear his airway. The treatment seemed relatively simple: a continuation of nasal sprays and an admonition to be on the alert for those things that irritated his sinuses, including the grass he relished rolling around on.

           

            My worry gene hadn’t yet relaxed to normal, so I took the cautious route and kept him in our bedroom. It took more than a year of successful treatment, and my continual, assessing watch, to finally be satisfied that Parker would truly be safe in his own room at night—without me.

             

            Along with the physical problems, though, Parker started exhibiting insecurity and separation anxiety whenever I left him at preschool or at home with Chris.

           

            It began eleven months after Victoria’s death, that he started resisting my leaving him at the preschool he’d been attending two to three mornings a week since he was two. He would ask often, and nervously, where I was going. Did I have to go to the doctor? Would I be okay? Would I come back to get him? He always reiterated strongly, but without tears, that he was concerned about me and wanted to be with me. That he did not want me left alone.

           

            One evening, when I returned home after shopping—and well after Parker had gone to bed—Chris told me Parker had questioned him repeatedly during my absence about where I was going and if I’d return. Over and over he questioned Chris about whether I was bleeding again, and if I needed to go to the hospital. It suddenly became apparent to Chris and me that our young son was suffering from stress, fear and anxiety. Problems we hadn’t really considered possible in such a small child.

           

            Repeated verbal assurances from us didn’t alleviate Parker’s anxiety. We couldn’t reason it out him. He needed some concrete action, some life changes.

           

            And it was Parker who initiated them.

           

            He stopped outside the preschool door one morning, turned to look into my eyes with all of the seriousness of an earnest four-year-old, and announced with a sigh of resignation and apparent fatigue, “Mom, I need a vacation.”

             

            I chomped my lip and stifled a snicker. He no longer wanted to attend preschool. Maybe he never did really want to attend, I thought. What was clear now, though, was that he wanted to be with me, all of the time. And he was expressing it in the most diplomatic, constructive, effective way he knew how.

           

            I kneeled to his eye level and donned my most serious expression.

           

            How long of a vacation do you think you need?” I asked him, combatting another smile.

           

            “Oh…about five months,” he responded with a tilt of his blond head accented with a shrug and flip of his hands. Careful. Don’t laugh at him, Andrea! I chastised myself.

           

            “Okay,” I agreed. “Beginning next month, you may go on vacation!” His blue eyes glittered. Relief saturated his face and body. He stood up taller, satisfied. Hopeful.

           

            His idea of a vacation was to pile in the car and escape to unknown, exciting places, so his spirits were a bit dampened when informed that he wouldn’t be going anywhere special; that his vacation, for the most part, would be spent at home. Even in his disappointment, he appeared immensely relieved that his sojourn to preschool would soon be curtailed, and he would be alone with me throughout the day—for the next five months.

           

            When he quit preschool, his relentless questions about my health continued for several weeks, then stopped. He suddenly seemed so secure and content—as long as we were together, and I was taking care of him. Until that time, I hadn’t fully appreciated how much he needed me.

           

            In the midst of his emerging independence and controlled veneer, I had failed to remember just how young, vulnerable and fragile he was. I had been profoundly mistaken: He wasn’t really “my little man” at all, as I often called him.

           

            He was a vulnerable little boy—hovering somewhere between toddler and child—only moments in time beyond infancy. Still defenseless and reliant.

           

            The realization hit me like a face slap. Remorse bruised my heart.

           

            So, in April of 1994, exactly one year after his baby sister’s death, Parker and I started concentrating again on that tender, mother-son, parent-child relationship. We played, we laughed, we hugged. We laid firm foundation blocks of security.

           

            We worked seriously on love and priceless family relationships.

           

            And I was reminded how children usually spell love. T-i-m-e.

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NEXT WEEK: Was it now time to start thinking seriously about trying again to have another child? Could we, should we try? When—how—would we know?

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Until next week,

Thanks for joining me!

Blessings,

Andrea

For those of you interested in what recent studies show regarding stress in children—from pregnancy through childhood—read this valuable article, "How Parents' Stress Can Hurt a Child, From the Inside Out," by Alice G. Walton.

http://www.forbes.com/sites/alicegwalton/2012/07/25/how-parents-stress-can-hurt-a-child-from-the-
inside-out/

And here's a great post from Meg Villanueva discussing steps to conquer fear. Join her on her blog: Pebbles Along the Path
Pebbles Along the Path: Fear and worry: Subdue and Conquer

             

Missing the Signs of Stress and Anxiety in My Preschool Child

         I ought to have recognized it. Having experienced my first physical breakdown at the age of 13, the unmistakable warning signs should have triggered a screaming brain alarm between my ears. Maybe I was just too wrapped up in my own pain to see beyond the protective hedge I’d encased around my heart and mind to be able to recognize Parker’s suffering, the daily unraveling of his normally happy constitution.

           

            Sleep apnea symptoms were first on his breakdown list. On several occasions during his daytime naps, he appeared to stop breathing, then gagged and choked to get it jump-started again. Often, he’d wake up crying and scared from these episodes, like he’d just awakened from a hideous nightmare. Other times he’d cough several times and then quickly return to sleep. Thankfully, I was present during the first event, and made sure he napped within my eyesight from then on—in my bed—so I could watch and count his breathing. Then I moved his little red toddler bed back into our bedroom so I could hear him more clearly at night.

           

            After a lengthy discussion with her, his pediatrician recommended a preliminary sleep study analysis. The challenge: getting a four-year-old connected to electrodes and breath-measuring machinery, then having him remain in deep sleep long enough to obtain valid data.

           

            So, one Friday night, a respiratory therapist arrived at our home with the necessary bells and whistles, lines, leads, and monitors to hook Parker up, plug him in, and instruct Chris and me in the use of the machinery. For the second time in eighteen months, we were receiving yet another crash course in home therapy and medical telemetry. After several attempts at trying to keep Parker calm and quiet, and from angrily plucking and yanking sensors from his nose and body, we eventually succeeded in getting him to sleep.

           

            Finally, all seemed well, and the therapist departed, after promising to return in the morning to gather the equipment, review the data, and forward the information to our physician and pulmonary specialist. But within minutes of his departure, the first brain-shattering alarm sounded. Our hearts slammed in our chests as Chris groped frantically for the override switch to kill the sound. But every time Chris flipped the switch back to “ON,” the alarm wailed again.

           

            After a speedy machinery assessment, we figured out that Parker’s heart rate was dropping below the monitor’s set threshold. After reaching the therapist on his phone, we learned how to set a lower threshold and restart the measurement. Through all this commotion, Parker slept soundly, without interruption, sprawled like a pint-size skydiver on our king-size bed. That didn’t really surprise us; he never awakened for any of our house-rattling, Southern California earthquakes either.

           

            Then, several minutes into the new threshold setting, the eardrum-slaughtering EEEEEEEEEE!!!! screeched again. Chris ejected himself from the bed like a rock slung from a catapult and then mumbled several incoherent words. He raked his fingers through his hair while stabbing at the phone buttons to call the therapist again to have him okay another setting adjustment. “But,” the therapist warned, “any lower than that, and I’ll need to return to your house, and we won’t be able to conduct the test.” We re-set, murmured prayers, and then repositioned ourselves for the night: Chris flat on his back in bed, me sitting cross-legged on the floor, propped against the wall, regulation notebook at the ready to scribble mandatory log entries. Every time Parker twitched, sniffled, squirmed, toe-wiggled or breathed, I had to make a note of it. How we were going to ensure that he slept on his back—the mandatory position—I wasn’t sure, but I dimmed the lights, settled in on the floor, and kept my eyes glued to the digital data illuminated on the monitor screen.

             

            Just how and why I was relegated the task of staying up all night, I don’t know. Maybe that job just gets automatically invoked under the Mother moniker. Anyway, up I stayed, A-L-L     N-I-G-H-T      L-O-NG, with the entertaining nocturnal crickets, to take those hallowed notes. Mercifully, we managed to accumulate enough information for a proper evaluation. At daybreak, it took Parker nanoseconds to disengage his airway and toe sensors, his chubby fingers peeling and yanking. I helped his effort by gently removing the EKG pads crammed together on his modest chest. Both of us were relieved to discard the wire and sticky-pad arsenal.

           

            But it wasn’t long before the analyzing specialist informed our pediatrician that further studies were necessary; and this time, “further studies” meant an in-hospital sleep apnea monitoring evaluation followed by an appointment with a pediatric pulmonary specialist.

           

            Like a detonated combustion engine, my mother’s worry gene jerked from zero-to-sixty in five seconds, and the question-that-wouldn’t-die rattled around my brain like a mental pinball against the cranial bumpers:

           

            “God, when will this path of sorrow ever end…?”

           

            Little did I realize that He was using my hurting son to pull my focus away from me.

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NEXT WEEK: The next test: Sleep apnea testing up-close and personal…

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Until next week,

Thanks for joining me!

Blessings,

Andrea

PS Tomorrow’s my birthday! Thank you, Lord, for yet another year, to tell another story about You and your everlasting goodness!

The Ugly Side of Medicine: Malpractice, Arrogance and Money

           So there I was, just barely surviving the first anniversary of Victoria’s death, with an unexpected lawsuit staring at me, and a marriage that seemed to be hanging by the proverbial knot on a fragile silk thread. At that point in my life, I wasn’t even sure I wanted to hang on.

           

            Even though we were obviously going about it in entirely different ways, all Chris and I really wanted to do was to heal and return to living.

           

            Yet a lot of people, most especially doctors and insurance companies—and lawyers—involved in this gut-wrenching mess wouldn’t let us.

           

            Not long after the volatile first anniversary, a bill from the attending physician to Victoria’s delivery arrived in the mail one fine spring day. At first I stared slack-jawed at it, shoulders slumping south under the weight of yet another reminder. Then anger churned and shot to the surface as read it.

           

            It bore one of those big, bold, screaming scarlet stamps stating that if the balance were not paid in a certain amount of time—amounting to days—they’d ship my name to a collection agency. It was agony upon agony, insult upon insult. 

           

            Several months after Victoria’s death, the medical group that had misdiagnosed my placenta previa had blatantly refused to pay any of Dr. Gordon’s charges. In addition, they hadn’t forwarded any of his bills to my insurance company—which had already paid the five-figure hospital bill. Their excuse? They kept up their monotone repetition that “the case was under their review.” Translation: Legal foot-dragging.

           

            Gracious Dr. Gordon announced that I didn’t need to be responsible for his portion, which amounted to thousands of dollars, adding that he was prepared for a legal fight with them. My brittle emotions sagged under the burden, but I promised him that I would do everything in my power to make sure he was paid. He nodded compassionately and said, “Thank you. But don’t worry. I’ve seen this kind of thing before. I’m ready for the fight. You just need to heal.”

           

            But I wouldn’t let it go like that, so I donned my mental galoshes and waded into the legal muck. After five months of verbal battling with my former medical group, calls to my insurance company, and stacks of mailed bills, letters and explanations, Dr. Gordon’s fee was fully paid—five months after Victoria’s death. My insurance company lamented that they never received the original bills and gave me the lengthy explanation that the payment needed to be denied three times by my contracting medical group before they—the insurance company—would pay the amount.

           

            On one of my final conversations with her, the woman at the insurance company divulged an ugly secret: “This medical group does this kind of thing to us all of the time.” Then she added the icing-on-the-cake information: The contracting medical group had no right to deny the charges originally because they were incurred during a lifesaving emergency.

            I think it was the first real smile I’d cracked in months, and those game-changing tidbits set my mental wheels to churning at a blistering pace. Armed with this new, insider information, glee bubbled around the edges of my embittered heart. Then disgust surged to swirl around glee’s edges. How could people in the business to help others deliberately set out to cause so much harm, so much emotional pain? How could they have been so callous?

           

            In that first question, I found my answer: To so many of them, it was a business, not a calling, privilege or gift given by God to benefit others. It was a business, with all of the ugly attributes often associated with that sometimes-dishonorable pursuit. To them, I had become a liability, a dollar sign bleeding their profit coffers. They would fight for every precious penny.

           

            What they hadn’t counted on was this broken mother fighting back. Unfortunately, the fight would consume strength and arrest healing, but the battle against injustice had to be waged.

           

            The consummate insult came to both Dr. Gordon, a highly-skilled and compassionate physician, and to us—the bereaved parents—when the medical directory of my former high-volume, cut-rate medical group, (remember from my story the doctor who wanted me to wait several days for an ultrasound when I was bleeding and who wouldn’t pay for me to be admitted to a hospital for my severe morning sickness?), boldly proclaimed that I probably did not have the complete previa Dr. Gordon said he found on ultrasound and within my uterus when he opened me up. They also insisted that Dr. Gordon had been “very uncooperative” with them. Subtly, arrogantly, they tried to accuse Dr. Gordon of malpractice. It was another pathetic, groping tactic to find a “reason” to avoid cracking open their piggy bank to pay the bill, which was high by 1993 standards.

           

            This supercilious woman—a family practice physician—presumed to tell an experienced specialist in obstetrics and infertility, that he had misdiagnosed the situation over which he had so closely presided. She hadn’t seen me in months, and only communicated by phone with Dr. Gordon on a handful of occasions. And there she was, pointing her culpable, bony finger and shifting blame.

           

            Poor Chris. He couldn’t regain his balance. Men loathe feeling helpless. They rebel and flail against it, and often lose good judgment in the midst of it.  In the middle of this added misery, helplessness— brewing in a toxic blend of smoldering anger and fresh hate—took center stage in Chris’s psyche. He repeatedly insisted that we file a malpractice lawsuit against her, my former obstetrician, and their medical group. Even Dr. Gordon confirmed that he would support us in any decision we made. (And he felt confident in his diagnosis, not only because he was inside me and saw the previa first-hand, but because he tirelessly traversed the halls of the University of California—Irvine Medical Center to review my case with his former medical school professors and respected perinatologists, who all confirmed that he’d done all that he could have done.) 

           

            Yet, I was reluctant to weather a lengthy battle while lawyers gathered evidence, interrogated everyone remotely involved, drudged up my past medical history, and bantered back and forth for legal ground, while any award I’d receive was being magically siphoned from my bonus sheet and tacked onto the ledger column for the lawyers doing battle for me.  Since our former medical group informed Chris one day that, “Our lawyers are already working on the case,” we reasoned they must have been preparing for a fight. That comment stunned us into the realization that maybe they thought they needed to prepare.  We had a difficult decision to make.

           

            Yet, after exhausting mental gymnastics and prayer, and consultation with my pastor, I elected to avoid a lawsuit. I was tired; I wanted to move on. So many things had kept me from doing that, from having what people refer to as “closure,” which, I really doubt anyone ever truly experiences. But an ugly malpractice lawsuit wasn’t going to undo the already done; it wasn’t going to bring our precious daughter back. My decision to forego a legal battle wasn’t based on financial reasons, or fear.

           

            It was based on sanity.  The outcome of a lawsuit would alter nothing. I’d still be a grieving mother with a vacant nursery. With only mildly registered disappointment and resignation, Chris respected my feelings.

           

            But I had just enough energy left in me for one thing: I needed to see my promise to Dr. Gordon fulfilled. So with one last mustering of mental strength and physical energy, I set out to be as sly as a serpent and as harmless as a dove. What Chris couldn’t do, his fast-talking, fast-thinking, heartbroken wife could.

           

            I got Dr. Gordon paid his entire bill, and he responded by sending me a gracious thank you letter saying he appreciated and recognized what it cost me to see that happen. That letter sits today in my locked security box.  

           

            And the case was finally closed.

           

            Or so I thought, until that overdue bill from the assisting physician arrived that glorious spring day.

           

            I didn’t even attempt to conceal my anger when speaking with his bookkeeper on the phone.

           

            “Why haven’t I received a bill before this insulting statement?” I demanded.

           

            “Oh, we don’t send the patient the initial bill as a courtesy,” she countered condescendingly.

           

            “Well, how did you expect me to pay the bill when I didn’t know it existed?” I hissed at her. Fortunately for her, I couldn’t slither through the phone.

           

            “We do that as a courtesy to our patients,” she kept repeating like a broken record. “But now that I know the situation, I will make sure that you are not reported to a credit agency.”

           

            “You are not going to get paid unless you send me the bill directly. Send a copy of the bill to my insurance company, not to the provider, and a copy to me. I will then send it on to my insurance company with a letter, and I will call them to let them know it’s coming. I have a personal contact person there, with a huge file; they know all about my situation,” I rattled on. “But you have to send me the bill, too!”

           

            After more phone calls, and bills shuttled back and forth, the last financial issue was resolved. One more problem solved; one more step toward that illusive closure.

           

            I was so very tired…

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            I sometimes wonder if I should have commenced with a legal battle. If I thought that a lawsuit would result in curtailing their practice—making it impossible for them to harm another woman or unborn child the way they harmed my baby and me—I would not have hesitated.

           

            Doctors are hard to curtail, but maybe I should have made the effort. Maybe that’s the higher justice I should have aimed for, particularly since in the fall of 1994, nearly six months after my loss, my former obstetrician lost both a mother and her unborn baby to toxemia.

           

            Yet even Dr. Gordon was quick to point out how rapidly toxemia can begin without warning, resulting in a tremendously difficult situation to treat. Like I said, doctors are hard to curtail, particularly since they quickly stick up for and protect one another.

           

            What I did do was act as a modern-day town crier, roaming the area, cautioning everyone I knew against using that medical facility.

            And bringing it up today—nearly twenty-one years later—unlocks loathing in my husband’s heart. Although Chris refrained from pressing me then, he still believes we should have taken them to court for malpractice. Maybe, as a father, he feels as though he didn’t fight hard enough on behalf of his baby girl.  

            All we can do now is forget that which can no longer be, and press on.

           

            May God have mercy upon all of us.

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Chris and I weren’t the only ones suffering from this loss. Death affects all ages. NEXT WEEK: See what an emotional breakdown can look like in a four-year-old.

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Until next week,

Thanks for joining me!

Blessings,

Andrea