How do we return this present?

Home for Christmas

Red and green are quite merry when decorating for Christmas but are less festive when dealing with wound infections in a hospital ER. How’s that for a holiday card message? It was inspired by our Christmas visit to Health Central hospital over the last couple days. Harken whilst I recount to you this Christmas tale:

‘Twas the day before Christmas, and all through the house,
Not a creature was worried, not even my spouse.
The invites to family had all been sent out
For the annual Christmas Eve Crampton cook out.

Low Country Boil

Alright, I won’t make you suffer through ten stanzas of corny holiday poetry. Suffice it to say, after returning from Raleigh on December 18, Shade had been taking it easy in his bed and healing. His scars looked pretty good for scars – nice, clean lines and no redness or swelling. Things seemed positive on the whole, so we decided to carry on with our tradition of Christmas Eve dinner, despite urgings and offerings from good-intentioned family that perhaps we should skip it or allow someone else to host. After all, preparing a big meal was a bit much to add onto our plate. However, after spending most of December away from home and engaging in very little Christmasy activities, we felt that this dinner was our only chance at capturing the real spirit of the holiday. But we simplified. Instead of the big roast dinner, decorated table and place settings, we opted for a fairly easy low country boil – a big boiling pot of crabs, shrimp, sausages, potatoes, corn on the cob and spices laid out over a picnic table. My brother Darren would handle all the fixings. Cooking time, less than 30 minutes. Dinner’s on!

(If you are easily grossed out, I suggest you do not eat any pudding while you continue reading.) During the days before Christmas Eve, Shade’s face started leaking fluid. More like gushing. He woke up one morning with a soaked pillow. But the fluid was clearish and didn’t smell, which was good news. We contacted the doctors at Duke and they said that the area was just trying to eliminate the swelling. They weren’t worried so neither were we, though it was a chore to keep the area dry and clean. They should have installed a spigot on his cheek.

On Christmas Eve morning, however, the stitching on his lower cheek had opened up and it was a bit gooey with pus. Blech! So Aitza took Shade to his primary care physician whose office is at Health Central. The doctor took one look and said, “This is way beyond my expertise!” and promptly sent Shade down to the ER. Crap! Back in the hospital. I drove down and met them. The staff were great and tried to make us all welcome and comfortable, but we still had that Grinch-stole-our-Christmas gloom. The staff pumped up Shade full of fluids and antibiotics, took cultures and blood samples, and said he may have to stay overnight. So much for our big dinner. We resigned ourselves to Christmas in the hospital and called up the family to give them the news. But after the culture results all came back green, the doctor said we could take him home with oral antibiotics. We left the hospital at 2 p.m. and called up the fam. Christmas Eve dinner was back on. We supped well that night with our extended family. We opened presents on Christmas morning as custom dictates. We drank merrily and played games with friends that evening, celebrating the blessing of having Shade home for the day.

The ER doctors had asked us to return two days later for a follow up. So yesterday, (Boxing Day for all you Brits who continue the celebration), I took Shade to the ER, assuming that we’d pop in and out in an hour. A member of the on-site plastic surgery team had a gander at his face and said it was looking fairly good, though the patch of stitching where the fluid was leaking had opened up a bit more, which concerned him a bit. Then the doc took the gauze off his leg scar. The site was swollen, hard and flaming red with purple bruising and it was leaking bloody fluid. Uh oh! Not the present you want to unwrap at Christmas. The intense swelling was quite shocking, as Aitza had cleaned and wrapped the leg the night before and it had appeared fine. One look at his leg and the doctor ordered Shade to stay for 48 hours of antibiotics and observation. Yay! Back in the hospital! So much for popping in and out.

Shade was hooked up to more plastic bags of fun juice. The doc sealed the wounds on his face with silver nitrate, which chemically cauterized the opening to prevent more leakage. Then he opened up a patch of Shade’s leg scar to release the swelling. It was mostly blood. No pus. (So we had the Christmas red but not the green, thank ol’ St. Nick.) The doc’s theory was that perhaps there had been a pocket of blood that ruptured and filled up the area, causing the swelling and bruising. (That morning he had had his first home physical therapy session and perhaps that had caused the rupture.) At around 5 p.m., Shade was admitted upstairs. His face, neck and chest were as red as an embarrassed tomato. Turns out he has a hypersensitivity to the antibiotic Vancomycin, which causes “red man syndrome.” (Don’t get all worked up, ultra-liberal hysteria hounds. It’s not a slur; it’s a description.) They replaced the antibiotic with another and he’s back to his normal color, cracker white. (Okay, now you can be insulted.)

“What a fun Christmas!”

Aitza, who had been working all this time and stressing as mothers do, finally got to the hospital at 7 p.m. and took up the night shift. At least Health Central has had a fantastic make over, and Aitza was able to sleep on a pull out sofa, not another recliner chair like at Duke Hospital. I returned this morning and Shade seems fine. No pain or irritation. He did have a lot of blood leakage from his leg, but that’s good as it releases the pressure. One more day of observation and if all is well, perhaps we’ll be clear of hospitals until his next surgery in six months. I think perhaps the Cramptons should get a holiday redo. What do you think? Christmas in January?

Let the healing commence!

Ah, home. No place like it, especially when you’ve been stuck in a tiny hospital room for over a week – after having your face sliced open and stuffed like a Christmas stocking with other parts of your body – being poked, prodded and probed every 10 minutes by doctors, nurses, med techs and elves, the latter a product of hardcore hallucinations from prescription opioids and sleep deprivation. I’m either describing a miraculous surgery or the plot to a serial killer movie.

Winner of the Bubble Yum bubble gum chewing competition

When last I wrote, Shade had just come out of surgery. Both Aitza and I were not prepared for the sight of our child’s face. The doctors had talked about swelling but the size shocked us. And the skin graft was also something unexpected. The surgeons came to the conclusion during the surgery that the skin was too tight and needed extra skin so they made the necessary decision to add skin. So when we saw the two-inch jagged strip of pale thigh skin down his face, we were both stunned. We fully understood the reasoning; we just were not prepared for the dramatic change in his features. Both of us questioned our choice to put Shade through this procedure. Was all this pain and deformation worth the end goal of Shade having a symmetrical working face? Was his situation so bad before that we needed to subject him to such pain and suffering? I mean, we’re making decisions for Shade, and he’s trusting us to make the right ones, but how can we truly know if it’s the right choice until afterward?

Such thoughts can drive a parent into a spiral of severe gloom because unless you’re clairvoyant, you don’t know what the end results will be for any choice you make. And after you’ve made the choice, you have to deal with the consequences if it turns out to be the wrong choice. Back in December 2015, when we chose for Shade to have a second gamma knife operation to prevent him from having a second stroke. We took the risk based upon the information we received. The result of that operation was that six months afterward, Shade had a second stroke from a burst blood blister formed by the operation. It completely debilitated his left side. All the progress he had made was lost. In fact, he was worse off than after his initial stroke.

So watching our son suffer from his latest post-surgery pain messed with our minds because we chose to put him through this. I feel for Aitza especially because she never left his side. She “slept” in a recliner chair by Shade’s bed every day and was with him through all his agony and hallucinations and despondency. She was with him when he became so severely depressed that he said none of his friends would ever want to see him again because he was deformed and he wished he was dead. She held strong through all those heart-breaking moments.

Shade shows how to work a jaw muscle.

Just to set you at ease, Shade is no longer depressed. We think the heavy drugs caused much of that. After he hallucinated about an old lady trapped under a car inside his hospital room, Shade himself chose to go off the drugs and manage the pain with just Tylenol. He lightened up afterward and was even able to laugh about his massive cheek. After all it’s so big, if he walked into a bubblegum chewing competition, the other competitors would take one look and swallow their gum. Chipmunks see him go by and carve statues to their new god, Cheekzilla, he who holds infinite acorns.

The doctors were happy about Shade’s healing and he and Aitza were finally released from the hospital and got to sleep all day and night in a hotel. The doctors had first said that Shade could only have liquids for a month, but they changed their minds and said he could have soft foods. Soft foods? Bah! After I flew back to Raleigh on Sunday, I got him some smothered chicken from Texas Roadhouse and he scarfed it up. He’s got a super cheek now. He could chew cinderblocks.

Hanging with the Clauses

Yesterday we had a last visit with Dr. Phillips the plastic surgeon. He reiterated that the swelling will subside over time. He also stated that there’s excess muscle, fat and skin in there which can be chipped away at a later surgery to produce a symmetrical visage, much like a sculptor might remove excess marble to create a masterpiece. He was very positive about the final results, which eased our stress.

As we were leaving Duke Hospital through the Children’s Center, the staff had set up a Christmas area with carolers, a Santa and Mrs. Claus, and cake and toys for kids. Shade got a picture with the Clauses. Then one of the happy elves gave Shade a stuffed bear and a gift card for Target. It was our first real Christmas moment this year and I cried like it was a Pixar movie.

 

Flight home

By 8 p.m. that night, we had hopped on a plane and made it home to Orlando, where Mayan was waiting to see his big brother. Shade got visits from Abuelita and Bubu (Aitza’s parents) and Uncle Darren late night and from Dadabob (my dad) this morning. And now I sit by his bed writing this while Shade scarfs up scrambled eggs and heals. The future will show if our decision this time was the right one, but now that the pain has subsided and Shade’s surrounded by family at home, we can at least be happy that the stress of the hospital experience is over for a while, enjoy the holiday spirit and focus on Shade’s progress.

Surgery success

Shade looks like half a chipmunk after a +12-hour muscle and skin graft surgery for his cheek yesterday at Duke University Hospital in Raleigh-Durham. He went in at 7:45 a.m. in the morning and got to the post-op area at 8 p.m. Aitza was at the hospital the whole time, having arrived with Shade on Friday for all his pre-op appointments. They met with Dr. Marcus, the plastic surgeon who had performed the nerve graft surgery on March 31. He was very happy with the progress of the nerve graft after Shade told him he kept having little electrical impulses in his cheek, like mini lightning strikes. They also met with Dr. Phillips, the muscle graft surgeon. Both doctors gave Aitza and Shade a rundown of the upcoming procedure.

Meanwhile I had been working in NYC on an HBO special and planned to get to Raleigh on Sunday morning, the day before the surgery. Being a certified idiot, I decided to hit the Manhattan nightlife Saturday with my buddy Larry, daughter Arianny, son Edwin and soon to be daughter-in-law Michelle (yep, Edwin proposed). The kids were smart and bailed on Larry and me before midnight, but we keep going. Suddenly it’s 5 a.m. at the club (Oh yeah, New York doesn’t sleep!) and we both realized that we had morning flights to catch. We Ubered to the hotel, speed-packed our clothes and Ubered to JFK airport in record time. No rest for the wicked.

Shade’s first snow experience

Larry took off for Seattle and I hung out at my gate for the 8:30 a.m. to RDU. But to my dismay, the weather gods decided to dump 13 inches of snow on Raleigh-Durham that morning, causing a chain of flight cancelations. Meanwhile, Shade and Aitza are having a grand ol’ time making snow angels and throwing snowballs. It was Shade’s first snow experience, so the blizzard was a special pre-surgery gift for him…

…and a kick in the goolies for me. After spending 12 uncomfortable hours at JFK waiting for a flight to open up (nope), I decided to fly back to Orlando, get my head on a pillow for a couple hours, and fly to RDU the next morning. But the snowfall caused a chain reaction of delays, so the next morning, after boarding my 9:40 a.m. flight, my plane sat on the tarmac for 1 1/2 hours, then turned back to the terminal where we disembarked until 2:40 p.m. Then we got back on and sat on the tarmac for another 1 1/2 hours before getting clearance to take off. So I missed seeing Shade before he went in. At least I got to Facetime him beforehand.

The black mark along jawline shows originally planned incision. The red marker shows where the two-inch thick skin graft was placed to cover the muscle.

I arrived two hours before he came out of surgery, and Aitza gave me a breakdown of the progress as per the doctors’ updates. Shade was prepped for surgery and went under at 8:45 a.m. Dr. Marcus and the surgical team made an incision from his right hairline down his sideburn, in front of his ear and down his jaw line. Then they lifted the skin up, exposing the cheek muscle, which has been paralyzed since his first stroke on July 14, 2011. Meanwhile, Dr. Phillips harvested muscle from Shade’s inner right thigh, which was placed on top of the paralyzed cheek muscle. Unfortunately, because the original cheek muscle had lost so much mass, the skin on his cheek had shrunk. So when the doctors attached the new muscle, there wasn’t enough skin to cover the incision area. Consequently, Dr. Marcus had to harvest some extra skin and fat from Shade’s thigh and graft that over the opening. Now there’s a two-inch thick strip of thigh skin stitched down his jaw line, which may make for some strange mutton chops. The last thing the surgeons did was put a little stitch at the corner of his right eye so that it doesn’t droop. This will help him close his eye and keep his tears from running out.

The oxygen level going to the grafted muscle must be over 60%. He’s well over that.

Shade’s cheek is the size of a softball because of massive swelling, which is normal. Inside his cheek is a monitor that measures the oxygen level of the blood going into the muscle. It’s supposed to stay above 60%, but currently Shade has 91% oxygen level, a great sign for healing progress. He has a drainage tube coming out of the cheek to release fluid build up. He’s also enjoying a hydromorphone drip, which he can press every 10 minutes. Perhaps “enjoying” isn’t the right word as he’s dealing with some serious pain in his cheek and thigh. He and Aitza also haven’t slept much since the surgery due to hourly scheduled visits by various nurses throughout the night and day, plus random drop ins from the surgical team, residents, nutritionist, admissions and me. And I was complaining to Aitza about not sleeping for two days after my New York party binge.

The good news is the swelling will reduce dramatically over the next days and then keep reducing for the months of healing to come. Dr. Marcus said that in another 10 months, Shade should have a third surgery to remove much of the grafted thigh skin and clean up the scar so that it’s following his jawline and isn’t visible from the front. In that time, the grafted nerve should have a chance to attach to the muscle and get it moving. Shade has a lot of therapy ahead of him, but by next year he should have a somewhat symmetrical face that can smile on both sides.

Hanging in the hotel

Shade enjoys a smoothie. He can’t have solid food until Tuesday. Notice his “Shadenator” shirt, which Julie Creus made him after his very first stroke in San Antonio, in July 2011. It has buttons down one whole side, so we don’t have to put the shirt over his head.

Shade was discharged yesterday around 12:30 p.m. The night before went smoothly for him, mostly sleeping. He was so out of it, he didn’t even feel when they removed the catheter. I wince just thinking about that. Aitza stayed with him and had to sleep on a recliner that didn’t recline all the way. Luckily, she’s the size of a hobbit, so she curled up like a cat and slept just fine. If I had been on it, I would have looked like Buddy the Elf with legs and arms hanging off the ends.

We brought Shade back to the hotel after discharge and he slept in the hotel for a few hours. Then we took him for a ride in the car to get some fresh air and let him hunt a few Pokémon. He’s been unable to feed his addiction for two days and Pokémon just released a new feature called Research, which are like missions to collect certain Pokémon or engage in battles. It was a good hospital release gift for him, but he did criticize the city of Durham for having very little Pokémon activity. Guess he’ll never move here.

Shade didn’t have much pain yesterday, but today his leg is aching, especially when I help him stand up to transfer to his wheelchair. His jaw and lip feel fine, except for the one time I helped him out of bed and banged his face against my shoulder. Dad is a clumsy ox. He’s only taking Tylenol for the pain. He had Oxycontin right after the surgery, but he doesn’t need that level of pain management anymore. (Or addiction. Pokémon is enough.) The doctor also prescribed Doxycycline for his acne. As acne is really just a skin infection, the surgery scars will heal much better if his face clears up. No need to further irritate healing skin.

The Courtyard Marriott hotel where we are now staying is lovely. Compared to the crack-house accommodations at Quality Inn, it’s the Ritz. We’re on the third floor overlooking the fire pit and pool. It’s peaceful and the hallways do not smell like farts and pot smoke.

However, yesterday there was a group of motorcyclists, maybe 100 people, checked into the hotel. They were having a rally during the day, and the parking lot was full of shiny bikes roaring back and forth. Then at night it was time to party … around the fire pit right below our room. They pulled out speakers and blasted music. They were laughing and talking and yelling. Bikes were revving in the parking lot. I kept looking out of the window, kind of wishing I was down there with the party, as they had beers and Jell-O shots and mason jars full of dubious liquids. But I was busy writing some articles, and plus we had to get Shade ready for bed. Doctor’s orders are to brush his teeth, but don’t go up into the lip where he has stitches. Then he has to rinse his mouth multiple times with salt water to keep the area clean and help the healing process. He’s also not yet ready to roll himself to the bathroom, so I help lift and lower him from bed to bathroom, from bathroom to bed.

We finally got Shade prepped for sleep, but the hubbub downstairs irritated him. Aitza put an earplug in his right ear, but she couldn’t on the left side where the incision was made. So he had to suffer the noise with a pillow over his head.

The party petered out by 9 p.m. I assume the revelers moved the scene to some local bars and restaurants. I went down shortly after to have a beer by the fire pit. There were four guys left. One of them—a six-and-a-half foot, 350-pound monster—was passed out in a chair. His buddy was wiping down the front of his soiled shirt with a towel. Then the three semi-sober guys roused this drooling linebacker and managed to lift him out of the chair. They corralled him, one on each side and one behind, as he shuffle-staggered toward the hotel lobby door, and right by where I was sitting. Each shambling step involved a stop and a glaze-eyed wobble. At one point he loomed right over me, and he swayed like a tree hewn by lumberjacks. For a second I envisioned a river of vomit exploding from the putrid reservoir in his guts and dousing me head to toe, then his bulk toppling, dragging his three helpless friends to crash down on me and crush me to death. A horrific, malodorous way to go, but my funeral would be hilarious. However, his boys kept him upright and he shuffled inside … hopefully to bed and not on a motorcycle.

I was supposed to leave on a flight this morning as Mayan is back in Orlando and has school tomorrow. He’s been staying at friends’ houses over the weekend. But last night by the fire, I was thinking that I couldn’t leave Aitza by herself to wrestle Shade back and forth for three days in the hotel, in the car, to the hospital and finally to the airport on Tuesday. I flew up here on a standby flight, which was easily changed through Virgin Holidays, Aitza’s company. So now I’m staying until Tuesday. Mayan will stay with his friend or my brother. He’s been so independent lately and spends so much time hanging with friends that we barely see him in the house anyway. Teenage life.

Happy Easter everyone. Remember to bite the ears off the chocolate bunny first so it can’t hear where you hid its eggs.

Doctors, Diners and Dumps

The line in front of Shade’s ear is where they will make the incision to insert the harvested nerve. the writing says “normal.” The doctor forgot to but “ab” in front of it.

Travel day today. We flew in from Orlando to Raleigh-Durham, departed at 9:30 a.m. I was on standby, but the flight had 30 empty seats so the attendant sat us all together and gave us the seats right behind business class. More legroom. And we boarded first, so no slow shuffle to the back of the plane.

When we got to Alamo and handed our reservation to the attendant, he traded up our economy car for an SUV for free. Said he thought we would need the extra room for the wheelchair. Great guy.

This is one of the benefits of traveling with Shade. People like to upgrade him. Unfortunately, it didn’t work with the hotel. We’re at what Aitza has dubbed the No-Quality Inn. It’s awful. Carpets from 1962. Sagging popcorn ceiling where a previous leak had swelled the stucco. The hallway smells like stewed mildew. The bathroom door is too narrow to allow a wheelchair, so I have to wrestle Shade through the door every time he has to take a whizz. It is better than a motel we once stayed at in Boone, NC, which overlooked an empty pool full of stuffed trash bags, a rusting grill and a foot of green sludge that seemed to have grown tentacles. Suspicious parking lot deals carried on into the wee hours. I believe they had hourly rates. That was the worst hotel we’ve ever suffered through. This is a hair better. But what it lacks in basic living conditions, it makes up for in descriptive storytelling potential.

We had time before our 2:30 p.m. appointment to stop at Elmo’s Diner – a bit of a hometown institution in Durham. Great biscuits and gravy and super-thick chocolate shakes. Shade scarfed down as much food as he could today because he won’t be eating solid food for a while. Fasting tomorrow, liquid diet for a few days, and then soft, mushy food. Savor that bacon cheeseburger, Shadenator!

At our doctor’s appointment, Dr. Marcus walked us through the procedure. After Shade is knocked out, the doc will make two or three small incisions in Shade’s left calf to harvest about 16 to 18 inches of nerve. (The thought makes my sphincter tighten.) He’ll then make an incision along the front of Shade’s left ear and a bit down the jawline. The nerve will be attached to live nerves in this cheek. Then using a very narrow “feeding tube,” he’ll snake the nerve along his upper lip. An incision will be cut at the inside top of his lip to help feed the nerve along. And then they’ll stitch him all up and let the nerve start taking root. The procedure will take about four to five hours.

In nine months, when the nerve has branched out sufficiently, we’ll return for Shade’s follow up surgery – a muscle graft. Dr. Marcus said he’ll wait until then to do his eye brow lift as he’ll be working on the right side. This time the surgery is all left.

We are currently prepping for bedtime. We have to be at the hospital at 9 a.m. We’ll keep you updated during the day on Shade’s Progress Facebook page, and I’ll give you an entire rundown tomorrow night on the blog.

Smile time’s a comin’

Shade sporting the Tarantino Suitcase, a hitman’s goatee that we had to fill in with Sharpee to connect the stache to the beard. Universal policy. It lasted about a week until Aitza put a stop to it because all his white sleeves were stained gray from where he wiped his face on his sleeves. Doh!

Shade is embarking on a new journey. This is sailing across the uncharted Atlantic to search for a new world. We’ve booked a surgery for him. Nerves harvested and grafted. An electric journey across his face. It’s going to do wonders for his smile.

On Thursday, at 2:30 PM EST, March 29, 2018, we travel from Orlando to Raleigh-Durham for Shade’s appointment with Dr. Jeffrey Robert Marcus, MD of Duke University. He’s one of the top Plastic and Reconstructive Surgeons in the country. They did various scans and tests and determined he was a good candidate for a nerve graft. Of course, I told you all this on the Facebook post for his fundraiser so sorry to be redundant.

So this Friday, he’ll be prepped for surgery. After he’s under, Dr. Marcus will remove a nerve from his calf and graft it from his left cheek to his right. They go in under his lips and insert the nerve.

They’ll also lifting his right eyebrow and lower eyelid. It doesn’t close properly and tends to droop, causing his tears to run out and his eyeball to dry. It’s painful and we have to constantly keep his eye lubed and taped at night. The stitch will pull the corner of his right eye up so it holds the tears and potentially allows him to close his eye.

Then comes the recovery period.

I’ll keep you all informed about Shade’s Progress during this procedure. Here’s to symmetrical smiles and blinking eyes.

Hero’s Journey

Shade is home after five weeks in multiple hospitals. After a second stroke, and then a third stroke. After multiple sessions of MRIs and MRAs and angiograms. After weeks of intensive therapy at the best damn therapy hospital I’ve witnessed. (We’ve seen a few, and no disrespect to the other fine establishments, but Brooks was extra superduper special with ice cream.)

Shade had gotten in the rhythm of six sessions of therapy daily with an army of occupational, physical, speach, music, and recreational therapists, and their assistants, interns and volunteers helping him through the tough job of getting his left side to wake back up. Not to mention the fantastic doctors, nurses and techs checking up on him and the meal staff taking his order and delivering his three hot meals to his bedside. Shade became a veritable celebrity patient amongst the staff. On his graduation day, when he gave his speech, it was accompanied by laughter and tears from the gathered crowd. Employees kept popping into the room the last day to say goodbye.

And then he was released. Everyone take a deep breath and sigh. It’s all over.

Except for the part where Shade has to get used to living in his house, which he used to be able to navigate easily by scooting, crawling and, most recently, walking. Except now he can’t use his left arm. Despite the great strides he’s made on that side, it’s not enough to help him get down the stairs, even scooting on his bottom. He can’t raise his arm above his shoulder or support himself on a handrail. He can very slowly close his hand, but he cannot maintain even the slightest grip and opening  his hand is extremely difficult. Thus, no picking up anything, even a sock. Forget tying a shoe. His left leg is a bit better than the arm, though it’s still much weaker than it should be. It tends to drag when we assist him with walking and he often rolls the ankle or step on his other foot. He doesn’t have the strength or balance to stand. We’re planning lots of therapies to work on this, but it’s a road that disappears into fog. We don’t know how it will end.

After the first stroke, and the recent second and third strokes, he never complained or questioned the reasons. But the day after Shade and Mami got back home from Brooks, Shade came to the realization of what he’d lost after putting in so much time and effort to recover. For the first time ever, he turned to Mami and said, “Why did this have to happen again?” He didn’t dwell on it, but the thought is now lingering there.

I wonder the same thing. My big brain tells me that this happened by chance. Random mutations in some tucked away DNA strand in the embryo that became Shade. The small flaw in the architecture that blew it up. Like the exhaust port on the Death Star. (The incompetent space engineer that designed that beauty got fired. Literally.)

The part of my brain that believes in the force and elves and the Greek gods and awesome (Adj. inspiring awe) stories wants to blame some invisible sky man or some virulent spirit or a glitch in the Matrix for the barrage of shitty luck that’s plagued Shade. After all, a story is always better with an antagonist. But blame wouldn’t help the situation at hand.

Shade’s at that point in the hero’s journey where he faces the abyss. He’s overcome great odds only to be thrown down hard, his lowest point, where it would be easiest to give up. Like when Luke got his arm lopped off by his daddy (Noooo! That’s not true. That’s impossible!) and then fell into the shaft and hung on with one arm for dear life on the ass end of Cloud City, questioning everything he ever knew and waiting for the worst. Sure, his arm was gone, but it was the damage to his psyche that threatened to make him quit.

Guess who got Luke out of his predicament. His friends. After sending out some force instant messages (Come get me), he got picked up by Leia and Chewie (and Lando, too), and they got him back to working order (with some robotic assistance.) And then he saved the galaxy … for a while.

That’s what Shade needs now. He needs good friends who are willing to spend time with him, exercise with him, play games, or just chill. We’ve got the therapy lined up and the doctor’s appointments scheduled. If you can help with the friendship part, that would help immensely.

(By the way, thanks Cody for coming over today and hanging out and all his friends that Facetimed him in the hospital.)

This Path

Back in my college days, I read a book by Richard Bach entitled “One,” in which the main character encounters alternate paths of his life, all of which were happening simultaneously. To boil it down, it’s Fate meets Chance: the particular life you are living is one of endless lives that have happened and could happen and yet this particular life couldn’t be any different. A choice, a happenstance, a situation is merely a turn down a path that was already there and could be no different because it’s that path. And yet another quite different path could be chosen — or stumbled into or thrust upon — because that path is there, too. Infinite options all laid out.

Alright, maybe that’s a bunch of hippy shit, but it helps me cope with Shade’s recent stroke Saturday, May 28, his second in five years. Aitza, Shade’s blessed mother, the rock of our family, was called from slumber by Shade’s distressed calls last Saturday. He couldn’t move his left side. She dialed 911 and he was rushed to Florida Hospital.

I recieved the call from the other side of the damned continent, The Gorge in Washington, where I was working the Sasquatch Festival. I was shooting a Chet Faker concert for Yahoo, my first time behind the camera at a live music venue, so I was pretty stoked. As I focused in on the singer, I felt my phone vibrating in my pocket. It stopped, and then went off again. And again. And again. I knew something was wrong before I ever pulled the phone from my pocket.

Many already know the circumstances through Aitza’s Facebook posts. (Those posts were all her, by the way. And I think she’s a damned great writer.) For those unaware, the gamma knife surgery he had back in December caused a blister in the pons (brainstem) which burst. It wasn’t a huge bleed like his first stroke, but it did release blood, which caused swelling in the brain and the paralysis on his left side.

Aitza and I discussed what I should do. Despite his injury, Shade’s life wasn’t in immediate danger. And obviously we were going to need the paycheck from this job to pay the ominous mountain of hospital debt now looming once again on the horizon. So we both decided I should stay. It killed me, but it was the best thing. God bless Facetime. I at least got to see and talk to my boy.

Florida Hospital for Children ran tests and monitored him. The bleed area is contained so now it’s a waiting game. Yesterday he arrived at Brooks Rehabilitation in Jacksonville, which is considered one of the top rehab centers in the country. We’ll update you more on that. (To join Shade’s Facebook page click on the column to the right.)

When I finally made it back to Orlando at 6:00 a.m. Wednesday, I drove straight to the hospital to find Shade and Aitza asleep. It was a weird deja vu moment recounting 2011, my family hunkered down once again in the PICU. But this time, I wasn’t afraid. We’d already battled the beast once and crushed it. This pathetic attempt to strike again will face up to the same strength that destroyed it before.

I only had to spend one day in that hospital to know this. Because Shade was cracking jokes and wooing the nurses and trying his damnedest to move those limbs. And yeah, he cried a few times, because there’s genuine loss, near half his body. But he didn’t drown in sorrow. It was more like a quick rain gust that washed over him before the sun poked out. That boy is the strongest person I know. (Mom’s a close second.)

There’s a path in which our family falls apart. There’s a path in which Shade never had a stroke. There’s a path where Shade died. We’re not on any of those paths. We’re on this one, the one where Shade’s healing, and our family is going to love each other and laugh with each other no matter where the path takes us.

Dramatic Plot Twist

Inside Fort Matanzas

In a movie, whenever the camera pans across a scene of natural splendor, you can expect something bad to happen. It’s a cinema trope. Make the protagonist comfortable, and then drop a boulder on him. Without conflict, story doesn’t exist. So if a director says, “Let’s capture this stunning snowcapped mountain range glistening in the sun,” you can guarantee an avalanche is coming.

Last week I took Shade camping with the YMCA Indian Guides at Princess Place Preserve in Bunnell, Florida, about 15 minutes from St. Augustine. It’s a 1500-acre parcel of bucolic Florida wilderness. I never liked that word bucolic. It sounds like a respiratory infection. However, I think it fits here as the park is home to historic buildings such as an old livery stable, equestrian trails, a huge salt marsh, massive live oak stands, and Florida’s first in-ground swimming pool, fed by an artesian spring. It’s the epitome of a Southern pastoral setting nestled on the shore of the Matanzas River.

Standing atop Fort Matanzas

During the campout, we visited Fort Matanzas National Monument, which guarded St. Augustine’s back door. It’s about 14 miles south on the Matanzas River. The approach is dramatic. We started on the nature path which passed the banks where Spanish soldiers slaughtered a few hundred lost French soldiers who had surrendered. That’s how the fort got its name, which loosely translates to “slaughter.” We took a pontoon ferry across the river toward the looming fortress, giving us a good look from an invader’s standpoint. Guards in traditional Spanish soldier uniforms walk about and explain elements of the three-story stone fort such as the big cannons pointing down river to stop those nasty Brits or Frenchies from sneaking up and causing havoc. Shade climbed up the stairs and ladders to the top, where a large flag flapped to Hurricane Jaoquin’s distant exhales while gray clouds boiled overhead. We got a pretty cool pic of our entire group on the roof.

Fishing in the Salt Marsh

Afterward we went fishing in the salt marshes. The sun was positioned perfectly to reflect in the mirror water the cloud-blotched blue sky. We caught no fish (I don’t think I’ve ever caught one), but the view was magnificent. As we finished fishing, Shade’s buddy Cody noticed hermit crabs on the stones by the bridge. I grabbed twenty hermit crabs to tote back to camp for crab racing. I had big plans for a betting ring. We learned that hermit crabs are extremely shy and horrible at racing and within the hour, I had returned them to the salt marsh. We spent the rest of the night enjoying bonfires and brisket.

A beautiful weekend. From a movie standpoint, you couldn’t get more ominous.

The plot conflict came on the Tuesday afterward when Aitza took Shade to see Dr. Trumble. A few months back they performed an angiogram on Shade and discovered that he still has a small nidus, that little tangle of arteries and veins that caused his bleed four years ago. The Gamma Knife treatment performed on him in December 2011 destroyed most but not all of the arterio-venous malformation.

Here’s the dilemma. With each year, his risk of a bleed increases by 1%. The doc said if you’re 70-years old, no big deal. You may get up to a 10% chance of a re-bleed. You’re nearing the end of your rental agreement anyway, so to speak, and making big renovations wouldn’t be worth the risk. But a 16-year-old boy still has a good 60-70 years, maybe more. So in your later years, your percentage of a re-bleed may be 60-70%. The procedure has an 80-90% chance of destroying the rest of the nidus completely. I hate math.

The procedure has its own risks. The location in the pons (the brain stem, which is a dense nerve bundle) leaves him open to some more damage to surrounding healthy nerves, especially a few cranial nerves. Shade’s already got facial palsy and can’t shut his eye, but we don’t know how much more damage to his face it may cause. His coordination might be more at risk, too. Plus, the brain swells a bit when you shoot it full of radiation. Go figure.

The full effect of any damage is unknown until they do the procedure. Afterward, we’d have to wait three years to see if the procedure was totally successful. This would also be his last shot at destroying it because of the level of radiation Shade’s brain would absorb from this second Gamma Knife procedure.

Of course, damage from a bleed would be much more devastating. If it happened at all. Whatever decision we make, it’s going to affect the plot of this movie. I just wish Shade wasn’t the protagonist and that the dramatic plot twist didn’t involve his poor abused brain.

Fantastic Voyage

Shade prepping for angiogram

I’m old enough to remember The Fantastic Voyage. Not in the theater. (It’s possible I heard the audio track as a simmering fetus in the womb.) I saw it on TV sometime in the early 70s, and I was blown away by what the future held. Sexy secret agent Raquel Welch, with her retinue of doctors and assistants, would shrink to a millimeter and drive her submarine through the bloodstream of a sick man, right up to the brain to remove a blood clot. What a fantastically ridiculous piece of fiction!

So, last week Shade went to the hospital for an angiogram. This is a process in which a retinue of doctors and assistants drive what amounts to a submarine camera through his bloodstream, right up to the brain to check out where his AVM took place. This was a real process! It differed from the sci-fi in that none of the surgery participants looked like Raquel Welch. I’m pretty sure none of them were secret agents, either. Also, thank goodness, there were no saboteurs as in the original, so the procedure went smoothly.

What I want to know is how do they know when to turn left or right? Are they using Google maps? Are there landmarks? Is there a backseat driver saying, “Okay, like in thirty seconds you need to take the exit ramp off the femoral artery and then merge into hemo-traffic at the next … Watch out for that platelet!”

The purpose was to find out what was left of the AVM since the gamma knife surgery back in December 2011. (A gamma knife sounds like it could have been in The Fantastic Voyage.) Preliminary results are mixed. 95% of the AVM was destroyed by the gamma knife. That’s great. But there’s still 5% of the veiny knot that’s being fed blood. The doctor who performed the angiogram didn’t give any definite indication that this was dangerous or not. (Doctors seem to prefer vagaries when making predictions.) But he did say that there might possibly be, maybe, perhaps a slight danger because, well, it’s there.

We won’t know the full word until the results of the procedure are analyzed by the doctors. Then we will have to consult Dr. Trumble to see if he might need another gamma knife procedure. Maybe Dr. Trumble says there’s not enough risk to warrant it. Maybe he says that Shade has already received his full dosage of radiation from the last gamma knife and more would turn him into a raging green beast. (You know, the Hulk effect.) Or maybe they decide to perform this brand new procedure. It involves a sexy secret agent, with her retinue of doctors and assistants, who will shrink to a millimeter and drive her submarine through Shade’s bloodstream to destroy the 5% leftover.

I’m hoping for the third option.