Month / June 2014

by Julie

How Did This Happen?

There has been a story out there in the news media for close to a year now about a young girl who was seized by the state children’s protective services in Massachusetts after a medical disagreement between parents, doctors, and two different hospitals. The Justina Pelletier story.

As with any story that has been filtered, and the details are not all there – citing privacy and confidentiality issues. But the details that are available tell a chilling story about abuse of power. A child with a condition that is not well-known or understood, a disease that has no standard treatment plan or cure, and a lack of consultation with her treating physicians, can be taken from her parents, taken off all of her current medications and treatments, and kept in the psychiatric unit of a hospital with little to no visitation with her family or friends, and the parents accused of medical child abuse.

Horrifying. Terrifying.

 

My visceral reaction is disgust at the doctors and staff who did this to this young girl and her family. I am astounded that there will be no repercussions to any of them for the trauma they have caused this young girl and her family. But my instinct kicks in, and despite the questions I have about what these doctors were thinking, and how could they do this, I start to think of our own situation.

Rare. Unknown. No standard treatment. Many specialists involved. Many medical institutions involved.

I wonder if this could have happened to our family when we were searching for a confirmed diagnosis for Kate.

Could this happen to other children who are rare, without a confirmed diagnosis, medically complex, medically fragile, or perhaps to parents who are not savvy about how to ‘behave’ within the system.

I am a strong advocate for Kate. I feel that I am part of her medical care team and have an equal voice at the decision-making table. I voice my opinion. I appreciate the doctors opinions, but I also take into account my own knowledge and expertise as the expert on Kate. That is patient engagement and patient and family centred care right? Am I naive about the rights that I have to make decisions as her parent?

What makes the Justina Pelletier case hit home for me is that Justina has mitochondrial disease. A disease that few know about, where little research is done, where donation dollars and support don’t flow, where the medical community is still learning, and where there are few experts.

How does something like this happen?

How could the system change so it doesn’t happen again?

 

Julie

by Julie

Work Life Balance #LOL

 

This is a post I’ve been meaning to write for some time now, and I think it will take a few read throughs and edits before I am ready to post it.  Read through and edits aren’t something I typically do with my posts – I want them to be an expression of what I am really thinking at the time – but there are posts that need a bit more careful consideration, and this is one.

Underlying themes for this post:

  • My life since Kate has been derailed. Not slightly. A lot.
  • Making this statement isn’t a quest for sympathy, and it does not mean I don’t love Kate or have regrets.

Since Kate my life has been derailed. I am a planner by design. A forward thinker. A list maker. I don’t dwell in the past but am always moving forward. I have high expectations of myself and what I want to accomplish over my life. I expected my life to follow a certain predictability – with change along the way and some unexpected events. Was this naive? Doesn’t everyone make a plan they expect to be able to follow. Derailed is the best descriptor I can think of to the past 6 1/2 years.

Nothing about life since Kate has been predictable. The very nature of her disease and related illnesses are profoundly unpredictable. We don’t know if she will having a vomiting episode at night, if she will be unsteady and pale in the morning, if she won’t be able to cope with her school day because of extreme fatigue, if we will have to run into CHEO for help…each day, moment to moment is unpredictable. We don’t know what this disease will bring, and neither do her medical team.

And with that uncertainty we try to manage our daily lives. For me, as the mom, the primary caregiver for Kate, the case manager and coordinator, the keeper of records, the medication administrator, the seizure monitor, the laundress of vomit covered linen, the therapist, the chauffeur, the nurse, the researcher, the nurturer, the comforter…it meant my life changed significantly. Kate became my full time job.

I did not return to my career as public servant after maternity leave. We were always in crisis and still trying to diagnose Kate while managing an impossible health care system that seemed not able or structured to provide the support a child like Kate needed. I had little sleep and was constantly managing a sick baby. Work? It wasn’t even a thought.

Worry? Yes, I did selfishly worry about my career and advancement as a public servant. Like I said – high achiever – eye on being a senior manager (Director General by age 40 was the focus). I wondered when I could get back to working hard and moving ahead. I worried I would be ‘forgotten’, that all my good work, long hours, and dedication would be forgotten. I was reassured that wouldn’t happen, that I was “too good” and had “strong managers who would remember me”. So I went from 3 month leave to 3 month leave. Constantly extending, and hoping that in the next 3 months things would settle down with Kate and I could return to work. At one point I did attempt a return to work when she was 2 years old. She’d had a period of stability for a few months, and so I attempted a return starting with the minimum allowable 2 days a week. The week I returned, Kate was hospitalized. The following months, she would be hospitalized or unwell for most of the time. Six months into my return, we were planning a major surgery for Kate with Sick Kids. Kate was not sleeping still, she was regularly sick, she was not growing well, and the caregiver I had for her was unreliable at best. I lasted 8 months.

I left feeling disappointed, frustrated, and worried. I did not qualify for EI as I had a job, I just couldn’t work. There are no EI supports for parents in my situation. We really couldn’t afford for me not to work, and had to make the decision that our line(s) of credit would have to help support our household bills. I realized that things were going to really change for me. I clung to my benefits and kept taking short leaves and extending them regularly.

I was off of work for 5 years when I heard the federal government was “adjusting it’s workforce”. I was on leave, my Director was on extended sick leave and I became a number. I had no insight to this process since I was no longer on the inside, and I knew that I was likely to be a target. I was no longer the ‘go to’ employee, or the policy analyst that was up coming. I was a liability. I had been on an extended leave, and I was forgotten. I wrote an exam in attempt to keep my job. Kate was unwell at the time and in and out of hospital. I was ‘surplused’ two weeks later.

I returned to federal government work 1 year ago. I was fortunate to find a position, choosing to return rather than take a ‘package’.  It has not been perfect, and it has been at 3 days a week – which seems to be the most I can handle with the unpredictability of Kate’s illness, frequent clinic appointments, therapy, and tests.

I no longer want to move up in the management echelons. Actually, it is not a matter of not wanting to, I have a lot of desire, but I realize that my life simply won’t allow me to do that type of work – and there is no appetite to support the possibility. And it hurts. It hurts to see colleagues who are moving along while I am left behind.

I am not yet sure if I am seen as an asset at work. I try to focus and get things done at the rate I am used to, while at the same time fielding phone calls from Kate’s school about her being unwell, planning with her medical team, or making appointments with her therapists. I squeeze in the ordering of medications, supplies, and set up meetings. Some days I am foggy from fatigue, or overwhelmed with stress or worry about Kate.  I am still working my ‘other’ full time job.

I still think about working a 4 or 5 days work week. Wondering how and if it could work. Then I wonder if that is what I really want to be doing. It can be easy to get ‘excited’ about work and really engaged at the end of my three days. Then I come home, and Kate is having a good day, and we go for a walk or to the park. I wonder how long this ‘good day’ will last, and how many more ‘good days’ she has, and I remind myself why I am working part time.

Today, a good friend and colleague asked me, “What do you want to do?”

Simple question. And rather than thinking about it in depth, I answered quickly and narrowly within the context of my current role in government. But the question has stayed with me, and I am really pondering it, “What do I want to do.”

It’s a tough question, and I think what I want to do – what I can do – what my life situation will allow me to do – present a reality that I have to learn to live with. (Again, not searching for empathy here).

What I have learned about myself with the experience of this life so far is this:

– Solid footing may not happen for me. It may always be an unpredictable and stressful life.

– I need to learn how to minimize the stress and highlight the positives.

– I have to take breaks. I cannot go at the same pace all the time.

– I have to really think about the skill set I have, and what is possible.

– I need to have an income.

– I want to feel inspired by my work and know that it is making a difference.

– In all of the above, I need to consider my job of caring for Kate.

 

My full time job.

My full time job.

I am not sure what the future holds. What I do know is that Kate is my priority. Keeping her as healthy as she can be. Keeping her happy and ensuring she has the best life she can for as long as she can.

That is worth more than any paper I can push.

 

Julie

 

 

 

 

 

by Julie

CHEO Turns 40

Before my son was born, I had never given a second thought to having a children’s hospital in our community. The Children’s Hospital of Eastern Ontario (CHEO) was barely on my radar screen, and my only connection to it was through the media should it be mention on the radio, or in the news. I didn’t think much of those sick kids. It was sad, but it wasn’t my reality – it wasn’t something I thought much of other than to catch the CHEO Telethon from time to time.

After my son was born, CHEO still didn’t really register for me. My friends were young and just starting their own families and no one had any real experience with taking their child to the hospital. But as a new mom, I became more aware and more in tune with illnesses that might affect young children. I understood the need to protect him from illness and injury, and the stories I heard about ‘other peoples children’ battling diseases like Cancer and Cystic Fibrosis, or being treated for injuries caused by the typical childhood accident, were now more important to me and carried a different weight of parental concern, and now those brief glimpses of the Telethon were more important to me and I started to donate.

I am lucky to have a very healthy 10 year old boy, who has rarely needed to visit CHEO. We’ve had to wander through the doors of the Emergency Department for a suspected broken leg (age 2), pneumonia (age 2.5), and a concussion (age 9), and I’ve lamented the long wait late at night in the ED and then been grateful of the nurses and doctors who took such care and attention with him.

But I never really tuned-in to what it meant to have CHEO in our community until Kate was born.

Kate is my now 6 year old daughter who we thought was born healthy, but who has been diagnosed with an ultra-rare form of mitochondrial disease called SIFD. Her story is incredibly unique and at the same time is very similar to many CHEO stories. Endless visits to the Emergency Department, frequent admissions to CHEOs in-patient units that parents ‘in the know’ refer to as 4 East, 4 West, 4 North, 5 East, and endless tests and procedures. When our medical odyssey with Kate began, the importance of CHEO became front and centre to our lives.

What CHEO has to offer our community and our children could never be replicated in an adult setting. When you enter the doors of CHEO, particularly if you become a frequent user, you feel a sense of family and community. You recognize that these are medical professionals who understand children and unique approaches needed to ensure they are cared for the way they need to be. Child life specialists, physicians trained to work uniquely with diseases that affect children, nurses who understand that the littlest patients need and deserve more patience and understanding, a fabulous clown who can cheer your child or help them through a procedure like no other professional can – these are just some of the things that make CHEO special.

CHEO guides itself along a principal of “patient and family centred care”, which means the hospital sees patients and families as an integral part of the hospital culture. CHEO works with families to ensure that values, customs, cultures, beliefs and preferences are part of the decision-making that surround a child’s care. Families are seen as integral to the team and respected as ‘experts’ on their child and in providing essential information about their child’s health. It is a shared approach that is unique to a paediatric setting, and it makes an incredible difference in caring for a sick or injured child.

CHEO is celebrating it’s 40th year as a hospital. 40 years ago, a few moms in our community recognized the importance of having a hospital for our kids in our own community. I am grateful to them for the incredible challenge they took on and the pillar in our community that CHEO has become.

If you are reading this, and you know our family, you are likely someone who has used CHEO, or know someone who has. You already know how wonderful CHEO is and how important it is to our community. What I hope you do is share that message with others. Tell them your CHEO story.

This year, the CHEO Telethon is June 7 & 8 on CTV. I remember in years past watching parts of the Telethon as I went about my day, curious about the stories that were being told. I never thought our child would be one of those stories, but in 2012 she was. Sharing our CHEO story was our way of giving back.

This year I am honoured to be a ‘co-host’ for the CHEO Telethon and will get to share my experiences as the Co-Chair of our Family Advisory Committee and talk about the fantastic Champlain Coordination of Complex Care Program that has been an amazing support to Kate and our family.

CHEO Telethon 2014

CHEO Telethon 2014

CHEO Telethon Co-Host

CHEO Telethon Co-Host

Though it might still fly under the radar for you. If you have a child in your life, I am sure you feel an extra comfort in knowing that CHEO is there. You never know when or how CHEO will touch your life.

I hope you tune into the CHEO Telethon this year (June 7 & 8). Listen to the stories. Donate what you can. Take a moment to appreciate.

 

Julie

 

Post-Script

The CHEO Telethon raised over $7 million dollars this year! Incredible generosity and wonderful for our the CHEO patients and families.