Up Again

It's 3:05 a.m. and I can't sleep. Joseph was high about two hours ago (247), and Ryan gave him a correction. I just checked him again, and he's 198.

Is this the way it's always gonna be? Night after night.

How is he going to deal with this on his own? It just paralyzes me sometimes. This fear of the future. The unending checks. I can do this. Ryan and I both can. But eventually, this will be his responsibility. To keep checking, correcting, checking, correcting...

I don't know. I'm just tired. And feeling kind of burned out.

This whole thing is just nuts. Why did this have to happen? Why him?

Joseph starts school again on Thursday. Already I'm worrying about his ride on the bus-- worrying that he might go low, and no one will notice. How will his new classmates react when they learn he has diabetes?

I'm just sick of it. Sick of this whole damnable disease.

It seems every day there is some horrible bit of news about a diabetes-related complication. Last night, Joseph was reading Diabetes & You, a magazine we picked up this week at a JDRF meeting. On the cover was a photo of a group of kids and the title, "Kids Speak Out." Sounded pretty good. But inside - among other horrors - Joseph found an advertisement for foot gel that pictured an insignificant looking foot wound-- a small cut, really. The ad's copy read "If you have diabetes, even a foot wound this small should be cause for alarm." And in bold blue letters, "If not properly treated, a diabetic foot wound can lead to amputation." Christ.

I don't want him thinking about ANY of that. He's just a kid. He doesn't need to go to bed in fear of losing one of his feet. It's wrong. This is so wrong.

Joseph is smart. He's a kind, sweet, funny, sometimes temperamental kid. Oh, and he's got the tenacity of a pit bull.

He doesn't deserve this.

No one does.

Extremes

Well, we are home. After nearly two weeks away (including 9 days on a mountain lake in northern Idaho) we're all somewhat glad to be back. Joseph had an awesome time-- he was one of six kids at the lake. And the only boy. In addition to Evan, there were two 10- and two 13-year-old girls.

Initially, I was a bit worried when our friends told us they'd be bringing along two of their daughters' friends. I thought that Joseph would be anxious about being so far outnumbered. So, a few weeks before the trip I shared the news with him:

"Joseph, it looks like Anna and Margot will each be bringing a friend this year-- both girls," I said, rather tentatively.

Then I watched for a reaction-- fully expecting disappointment, possibly a blow up. Best we get that out of the way before we get to the lake.

As Joseph looked up from his breakfast cereal, his mouth formed a huge grin. I simply stared a moment, more than a bit flustered. Then, before taking another spoonful of cereal, he said, while slowly nodding his head-- still grinning, mind you:

"Four babes . . . cool."

Needless to say, he had no trouble hanging out with this group of lovely young girls. (Oh, by the way, they liked him too).

So the vacation was fabulous. Lisa and Daryl are two of our oldest and best friends, and we've been doing this trip since before we all had kids. These are the kind of friends with whom you can cook (we all LOVE to cook), hang, play cards til the wee hours, and not feel like you have to fill every silence.

Simply put, our time with "L & D" was, as it always is, rejuvenating for all of us.

Now, you might think that given my description above, our time away was a study in relaxation. And in many ways, you'd be right. But you know, with diabetes, life is never, even in the most relaxing of settings, a long quiet river. There are always the unexpected rapids. And I'm afraid this trip was no exception.

As I mentioned in my previous post, we decided to try the "untethered regimen," which, for the most part, worked well. Joseph would inject himself with Lantus in the morning, then stay disconnected for most of the day (while swimming, canoeing, etc . . . ) -- reconnecting for food boluses and for the overnight. Now, to make sure he wouldn't be getting too much background insulin, we adjusted his basal rate down in proportion with the Lantus he was getting by syringe.

What really surprised me was how high his sugars got at night-- especially given how active he'd been during the day. Ryan and I shifted off checking him (every 1 1/2 to 2 hours), correcting, and even getting him up to use the bathroom (we'd promised him that we'd keep him from wetting the bed). I even had to do some set changes in the middle of the night-- in case a bad set was behind the persistent highs (which never really seemed to be the culprit).

In addition to the nighttime highs, he had some highs during the day as well-- not nearly as difficult to control, but requiring adjustments nonetheless. We kept increasing his basal rate (from as low as .025/hr to as high as .225/hr at night), adding more Lantus, and changing his insulin-to-carb ratios (from 1:30 to 1:15-18), until he was taking in almost 23 units a day (up from between 9 & 11 units before our trip).

What the hell? Was this it? Was he coming out of the honeymoon? Seems like every time Joseph's sugars go consistently sky high, and stay that way for days, I assume that this is it. Just look at the last time this happened. I was absolutely convinced that he was coming out of the honeymoon. But that time his highs were-- according to his endocrinologist -- caused by a growth spurt.

Well, here we go again.

And all this time, I wondered, was it the out-of-control highs of his week at camp that had killed off those remaining beta cells? Could those highs have pushed him out of the honeymoon?

I felt horribly responsible. If I'd just given the folks at camp more instructions, then maybe he'd still have something. He wouldn't be completely diabetic. I know, I know. Just as it's impossible to be "a little bit pregnant" you really can't be "a little bit diabetic." But I guess part of me still doesn't want to let go of what's left of his islets. I want him to have something. Even if that something can make our lives miserable by adding yet another level of unpredictability to this disease.

Anyhow, just as before, it seems I was wrong about this being "it."

On just our second day back, Joseph crashed in a big way. We were out shopping for new school shoes -- just as we'd been one year earlier, the day he was diagnosed. While sitting on the floor in Famous Footwear, slipping on a pair of Vans, Joseph looked up at me and said "I feel kind of low."

Only it sounded more like he said "I feel kind of slow." Oh.

"Just stay right there" I said as I pulled the meter from my bag, ignoring the inquiring looks of the headset-clad employees who came over to make sure we were "finding everything all right."

Joseph was 37. Good God.

So we remained on the floor as he gobbled down four glucose tabs, and waited. Ten minutes later he was 60. Another two tabs. Another ten minutes. 97.
Okay now. Much better.

We quickly made our purchase, and proceeded to the sub shop in the mall for an early lunch.

After eating we went out and bought him a fishing rod and spinning reel-- like mine. We had done a lot of fishing at the lake, and I thought it would be a nice way to acknowledge the anniversary of his diagnosis-- the fact that we've all come so far, learned so much, and that he's still strong and healthy.

I just wished he hadn't had that low.

Little did I know that it would be the first of many lows he would experience over the next few days-- day and night-- until finally, we would pull his insulin back to where it had been originally (a total daily dose of around 11 units).

Last night, looking for some explanation for what was happening, I pulled out our measuring stick-- the one we've used to mark Joseph's height since he was a toddler.

He'd grown nearly an inch since we measured him last-- just over three weeks ago.

Home from Camp... Something Unexpected

Joseph is finally home. By the time we picked him up yesterday morning I was about ready to burst with excitement AND curiosity about his adventures at camp.

When we walked into his cabin to check him out, Joseph looked at me, and with a huge grin said excitedly, "You're here!" And almost in the same breath, "Guess what! We found a wolf spider, and it was THIS big [he made a frighteningly large circle with his thumb and forefinger] and it was really hairy!!"

"Great, honey. That's wonderful."

"Oh and this is Bryson. He uses an insulin pen. And you already met Logan. Can we get my bag? They're gonna give us some free stuff."

He shuffled us into the common room where other parents were in various stages of the check-out process. While we waited our turn to review Joseph's sugars with the cabin's doctor, two counselors came up separately to tell me how happy they were to have had "Joe" in their cabin. Both said they hoped Joseph would come back next year.

And both had the same shaved head-- as did two other counselors who were walking about the cabin... Hmmmm. Interesting.

They must have noticed my noticing of the lack of hair, because it was soon explained that the counselors-versus-campers archery contest had ended in a tie. And because the counselors were unable to win the contest, their heads had to be shaved-- by the kids.

These counselors rock.

Anyhow, soon I found myself sitting across from "Doctor Pete," the same doc I'd met at check-in. Almost immediately after I sat down, he slid a piece of paper in front of me and quietly said, "Joseph ran a bit high this week... all the adrenaline... extra snacks. We stayed pretty conservative with his insulin though... we just left things the way you had them set up on Sunday." As the doctor said these things I scanned Joseph's log. He was in the mid-to-high 200s almost the entire time. Oh God. And in the high 300s twice. Damn!

I agreed that we did rather he ran high than risk a serious low (just one week before camp he'd had a number of lows-- one 47 and several in the 50s). But still, I didn't tell him that those high numbers were really unsettling. I guess I just assumed they would do more to keep his sugars closer to normal. I thought, "Next year. Next year it'll be different. I'll write up a flow chart for them. Should have done it this time. Well, at least Joseph seems to have had a terrific time... and he's okay."

Moving on, the doctor said that he'd asked each boy in the cabin what they liked best about camp, and then jotted down their responses. This was Joseph's comment:

"I really like this place because I fit in. Everyone here is like me."

I just looked at the man a moment, trying not to lose it. Then I asked:

"So will it be at all difficult to get him into this camp next year?"

During the drive home Joseph told us all about his week. He'd gone swimming, fished, shot arrows, played LaCrosse (How does one play LaCrosse? Who plays Lacrosse? Certainly not I. But this week, my son did), and (dare I say it) discovered that a young female camper thought he was "cute." Fantastic.

"And mom, we got to take a boat out on the lake alone. Well, I mean without any adults. We went out with other kids. And, there were nurses in a rescue boat too. But every day we could go on the lake and do anything we wanted.. like take out rowboats, canoes... fish, swim... for an hour... just us kids. It was awesome!"

It was at about this point that Joseph dropped the bomb.

"So I was thinking that I'd like to try using an insulin pen. Most of the other kids in the cabin use them, and I think they're pretty cool. And besides, I'd like to be able to dose myself if the pump fails."

Now, Joseph did give himself shots shortly after diagnosis, but he never drew up his own insulin or used a pen.

"Honey, don't you think you'll miss your pump?" And that's when it came out.

"Mom, at least with shots you know what you're getting. I mean, dosing with a pump is easier, but you never know if you're really getting the insulin."

That's what this was about. A week of high sugars, with corrections so tentative they barely made a dent.

And that's when I realized that Joseph no longer trusted his insulin pump.

"Honey, I know you were high this week, but I asked them to be pretty conservative with your insulin dosing. I was wrong. And next time we'll know to be more aggressive."

"But mom, I really want to try this."

Deep breath. "Well, we're leaving for vacation on Sunday. Since we'll be staying on a lake, it might be a good opportunity for you to try shots again. Maybe you could do both. You know, have an infusion site, but do shots too." Strange. As I said this, I felt the oddest combination of pride (in my son's desire to take on more responsibility for his care) and abject fear (that he might actually prefer shots over the pump).

"No mom. I just want to do shots. Please. I want to do it all myself."

So yesterday afternoon he drew up insulin for his lunch and, without hesitation, jabbed himself in the belly and injected. He used the pen at dinner (I'd purchased one right before we'd gotten the pump), and gave himself a small dose of Lantus at bedtime. He actually said it was fun to give himself shots... to do everything.

His numbers were great the rest of the afternoon and early evening, but spiked later that night. Crying, he said "I don't want to be high. I've been high all week." And then, through tears, he told me he'd wet the bed every night at camp.

Every night.

"Did you tell anyone?" I asked, with my arms around him.

Wiping his face, he said "Nah. Why would I? I was just so tired of being high. Every morning, everyone would shout out their numbers-- '103!' '110!' '112! -- and I'd have to shout out '236!' I was just so sick of being high!" Then he broke down. We both did.

We did two corrections (.5 and .75 of a unit) with the syringe in two hours. I felt uneasy about this, but he wasn't coming down. Between midnight and 3:30 am he went from 196 to 229 to 86 to 53. Four glucose tabs brought him up to 97. By 7:30 am he was 124, and by then I was about ready to throw every syringe in the house out the window. I just kept thinking that a new set (his cannula was kinked when we removed it yesterday), some fresh insulin in his pump reservoir, and an increased basal rate would have done wonders overnight.

I had promised him that we wouldn't let him stay high overnight, that he wouldn't wet the bed. And he didn't. But it took all night to get him down-- only to have him go too far down.

I hate shots.

And by the time Joseph sat down to breakfast, he did too.

"Mom, I think that going back on shots was a bad idea. I kind of miss my pump."

"I'm glad you want to go back to the pump, but it wasn't a bad idea to want to try something different. "

So after breakfast-- for the first time -- Joseph filled his reservoir, rewound his pump, loaded the cartridge, primed the tubing, and helped with his insertion.

"Mom, I really do love having the pump."

I'm finally finishing this post, at... 5:55 pm. Joseph's had good sugars all afternoon as we pack for our upcoming trip. We'll try the Lantus/pump combination at the lake, to give him a bit more freedom and to try to prevent any crazy highs. And, to let him do something different.

In the meantime, I'm still thinking about his experience at diabetes camp. He's been talking a lot about the fun he had and the friends he made. Joseph very much wants to go back next year, and I can understand why. For the most part, the experience was really, really good.

But it was a little sad, too.

Diabetes Camp

I'm feeling a bit lost this morning. Joseph's been at camp since Sunday afternoon, and I won't see him until Friday.

He's more than a hundred miles away right now.

You know, this would have been kind of tough for me even if he didn't have diabetes. After all, it's the first time he's been away for more than one night. His only other camp experience was at the school forest. And even then, his dad was one of the chaperones.

Some of you might wonder how he did when we left him. Was there anxiety about the fact that he wouldn't know a soul at camp? Had there been a long, tearful goodbye?

Well, not exactly.

During the drive to the camp site, Joseph, who had been quietly listening to Barenaked Ladies on his cd player for some time, suddenly interrupted Ryan and me as we talked about how wonderful this experience was going to be for him.

"Mom, I really wish we hadn't gone to the newly-diagnosed camp last October."

"Why is that, honey?" I asked, thinking "here it comes, finally, he's going to say something like 'then we wouldn't have found out about the summer camp'."

"Because then this would all be new."

Oh.

"Well darlin' there'll be plenty of new things. Many more kids. Many, many more activities. You'll get to actually SWIM in the lake instead of just looking at it. There's a mud pit, archery, kayaking, boating, climbing wall, campfires... tons of things."

"Yeah, it's gonna be great!" Joseph replied with gusto.

Who is this boy? This child who nursed for two years. The one who slept in our room for so long (and still does every so often when he's feeling scared).

Well, we'll see what happens when we get to camp.

So we got to camp, and he was high. Very high. Like 349. Yikes! And he hadn't even had lunch yet. Since we got there 30 minutes before check-in was to begin (a process that would take two hours), I figured we had time to bring him down. Half an hour after correcting, almost no change. The set had to come out. We'd just put it in before leaving for camp. Tubing looked good, but I couldn't take any chances. Even though I knew that the persistent high was more likely due to the sweet cereal he'd had at gramma's (where we'd spent the night, since she lives about 45 minutes from the camp site), and an adrenaline surge from all the excitement.

Joseph was not happy about being high. In fact, he was very angry about it. In a tearful voice he said "Mom, why did this have to happen? I don't want to be so high. Can I just rip out the set?" He seemed very self-conscious, scanning the crowd around us as he said these things.

"Don't worry. This will just take a couple of minutes." I don't think he was truly cognizant of the fact that the majority of the people waiting with us in that ungodly heat, huddled under the shade of a tree, would understand exactly what we were doing and why. There were a number of nods and knowing smiles as I ushered Joseph into a nearby camp building to wash our hands and change out the set.

Within the hour his sugar came down, and we embarked on our visit to each check-in station. Joseph was assigned to the "Explorers" cabin. He compared the experience to that of the students at Hogwarts being assigned to their "House" by the sorting hat in Harry Potter. "Cool," I thought.

Next up was a visit to the Health building to review Joseph's general health, then on to his cabin to unpack and to discuss the specifics of Joseph's diabetes care with the doctor assigned to "Explorers."

As we walked to his cabin, Ryan whispered "this is the meeting that is really going to put you at ease about all of this."

What? What did he mean by that? Then I realized that I'd been clenching my teeth at every station. I knew this would be great for him, but still, how could I leave my son in the care of strangers? Even the docs at his clinic deferred to my judgement about Joseph's bolus and basal rates. Often I made changes on the fly. By feel. How could they really take good care of him?

Ryan was right. Joseph and I sat in front of a doc and his assistant. Reviewed his basal rates and insulin-to-carb ratios (both of which I pulled back considerably given the high activity level at camp), discussed corrections, looked over his pump. That's when they told us that, for the camp duration, Animas, the maker of Joseph's pump, actually had a CDE and two reps on site. They also informed me that, in addition to the many checks throughout the day, blood sugars are checked at 12:30 am and 2:30 am. When the kids are in the water, there are a number of rescue boats with nurses on board there as well. Children need only raise their hand if feeling low, and they will be checked immediately.

This. Place. Is. AWESOME.

With check-in complete, Joseph immediately introduced himself to his bunk mate (a boy who, his parents confided, did not want to even get in their van that morning because he wouldn't know anyone at camp).

"Hey, you wanna play catch?" Joseph asked. As they tossed the ball to each other in the common room, a third boy shyly walked over. Joseph stepped back and said "we have room for three." Then he asked both boys, "Do you play baseball? Any little league?" He told one of them "hey, you throw like a pitcher, I bet that was your position."

I asked Ryan, "Should we go now?"

"I guess so."

Just as we were leaving, the three boys had abandoned their indoor game of catch and were now pouring over a large container of toys. I called out "Hey Joseph, we're going now."

He looked up from the floor and said "Okay. Bye mom." Then continued yuckin' it up with his new friends. I looked at Ryan, and just stood there a moment, at a loss. Then, as I turned to leave, I suddenly felt Joseph's arms wrapped around my waist. He smiled up at me and quickly said "I love you mom. And I'm fine. This hug's for you." Then he ran back to his buddies.

We haven't spoken since. I miss him very much. But I am trying to enjoy this break from diabetes management. It's so strange. I never realized just how much I thought about his diabetes care until now. Yesterday I went on a 20-mile bike ride with Evan. We rode along a creek, then a large lake. Stopped to watch a duck and her charges cross a river; sat and talked about fish and birds. Then we had lunch, and never pulled out the Calorie King, never thought about the timing of the meal, the postprandial sugar...

It was wonderful.

And because it was so nice, it makes me sad to think that, until a cure is found, Joseph will never have a break like this. Never be able to just eat without thinking about the carbs. Not be wary of the possible high or low.

But you know, he does have this camp. It's probably the closest thing to a real break he'll have for a while. And it is pretty damn fantastic.

Needless to say, I'm already thinking about camp for next year...

Coffee No More

Okay so. I admit it, I am -- make that was -- addicted to coffee. I love the taste, and simply could not do without the pick-me-up of that first, second, and oh (she says lovingly), that third cup. Up until the end of June, I was consuming at least 7-8 cups a day.

Probably more.

Upon waking, the remaining half pot from what Ryan would make before leaving for work -- gone. A second, albeit smaller pot later in the morning-- gone. It got to be so bad that Joseph noticed my increased consumption, and actually seemed concerned by it.

"Mom, I think you drink too much coffee."

"But honey, I really need it to help me stay awake."

"Then why don't you just sleep some more?"

Why indeed. Up late checking blood sugars. Resettling a waking toddler. Worrying about the present. Fearing the future. "Yup," I thought, "getting more sleep would help, but it ain't gonna happen soon."

But then the fluttering started. In my chest. Like little butterflies flitting about on a lovely summer day. Only it didn't feel as charming as all that. Actually kind of creepy. Because it would go on for hours. And it occurred over a period of weeks....

So here I was, preaching to my diabetic son about how important it is to take good care of himself and stay healthy. How healthy eating AND drinking habits are a huge part of the whole picture. And this is how I modeled that for him. Hmmmm.

That was it. On July 2nd (the day after my sisters departed for Massachusetts), I stopped.

Cold turkey.

Yeah the first few days truly sucked. Massive headaches. Really, really tired.

In an attempt to lessen the blow, I took to drinking one cup of lightly-brewed tea in the morning, and on some days (surprisingly fewer now), a cup in the afternoon.

How civilized.

In the past 21 days Joseph has kept track, telling me each morning (in a very proud voice, I might add) "Day 8, mom. Day 8 without coffee." And so on...

An unanticipated side effect of this coffee stoppage has occurred. Folks, I have energy. For my birthday, Ryan sent me off on a bike ride by myself. In all the time we've lived in Wisconsin, I don't think I've ever gone on a ride completely alone. I rode about 20 miles.
It was grand.

So grand that, over the last three weeks, Joseph and I have taken to going on bike rides together. Lots of them. At first he complained about the hills, but then his legs grew stronger. Yesterday we went almost 15 miles miles-- hills and all. He was absolutely thrilled. And since I went nearly 15 miles while hauling a Burley full of a toddler, among other things, I was pretty pleased myself.

Joseph and I have also spent a lot of time playing catch (I have my own well-worn mitt, thank you very much). This is something we haven't done since late spring-- again, because I just didn't have the energy. I had almost forgotten how much fun tossing a baseball and snagging a seemingly uncatchable wild pitch could be.

And hey, although I'm still getting up in the night to check blood sugars, and comfort my little girl, I am sleeping better. Feeling a bit calmer about things.

Oh, and those butterfies flitting about inside my chest-- gone.

But the most awesome (and unexpected) thing about this whole experiment has to be the effects on Joseph's sugars. With the increased exercise (over and above the usual skateboarding/scootering, and just general running around with his buddies), his blood sugars AND his insulin intake have consistently gone down.

And THAT is a beautiful thing.

Paranoia

While the previous post gives you a sense of the events that book-ended my sisters' recent visit, I never did share the very personal hell I put myself through for two days in the middle of that oh-so-very stressful week. For it was during those two days that I noticed my 2 1/2 year-old daughter was drinking a lot.

Let me say that again. My youngest child was drinking A LOT.

She's still nursing (with so much focus on Joseph's diabetes care, weaning has been moved to the "things I'd like to do, but don't quite have the energy for" list). For two nights she was nursing every 1-2 hours-- which is not unusual while teething, except that she finished teething months ago. Further, during one afternoon she asked for water repeatedly-- at one point draining a sippy cup, then asking for more twice. Just two times. But that was two times more than she'd ever asked before.

Was this diabetes? Excessive thirst was certainly one of the symptoms. But she didn't seem to be urinating more than usual. Or maybe she was, and I just hadn't noticed.

Oh God. Not my little girl too.




The sibling of a diabetic child has a 5% risk of developing the disease. My sister's in-laws discovered that their 2 1/2 year old daughter was diabetic just two years after their son's diagnosis...

For nearly two days, while constantly on the verge of tears, I obsessed over the possibility of Evan becoming diabetic. I could hardly think straight.

Despite being petrified of what I might discover, I had to check her. I had to find out for sure what was going on. So later that second day, when we got back from Joseph's little league game -- four hours after we'd all had lunch -- I checked Evan's blood sugar. Not surprising, she was completely unafraid of the lancet. After all, she'd watched her brother use it countless times. She was actually quite happy to be getting a turn (as she put it). I set the lancet to it's lowest level, held my breath, then poked. Evan didn't even flinch-- just watched, fascinated, as I touched the tiny bubble of blood on her finger tip with the end of the test strip.

Her blood sugar was 132. In the normal range, but definitely high for so long after eating.

A few minutes later, barely holding it together, I shared my fears-- and Evan's sugar result-- with my sisters. And that was when my sister Marion reminded me that Evan had eaten a whole package of peanut butter crackers at the game.

I had completely forgotten this vital piece of information when I had checked her sugar.

So an hour later, I repeated the test. Her sugar was 82.

And her voracious thirst, which probably had more to do with the salty crackers, and two days of ungodly heat than anything else, subsided.

Though relieved that Evan was fine, I was still shaken for several days after-- making me realize that, among many other things, this disease has the capability of turning an otherwise rational human being into a bloody basket case.

Calm... then Chaos

It's been a while, hasn't it?

Well, back in mid June we were out of town-- and I mean WAY out of town. This was our annual sojourn to Amish country in western Wisconsin. No phones, no tv, no computer. Just me, Ryan and the kids. And a big ol' fireplace (in which Joseph built his first fire) in a lovely cottage on an organic farm.


Hikes, games of catch, books read alone and together. That about sums it up. The hammock photo takes me to that quiet place whenever I need to go back. And lately, that's been often...

Shortly after our return, two of my sisters and their children arrived for a week-long visit. Including Joseph and Evan, there were six kids in all. And four of these children were under 5-years old.

Did I mention that this was a week-long visit? Uh-huh.

I love my sisters-- the three of us are very close. But the events of their stay pushed all of our stress levels to the brink.

Let's start at the very beginning, shall we? Teresa and Marion (4 and 8 years my junior, respectively) completed their two-day drive from Massachusetts on Thursday, June 23rd. I should have known that the timing of their arrival would not bode well-- it was the 1-year anniversary of the tornado that came through our neighborhood, literally ripping mature trees out by the root just a half a block away. Marion (or "May") was here last year for that event. It was her first trip to Wisconsin.

And now here she was. Back again -- this time with Teresa and all their kids.

Soon after their arrival, Teresa was sitting on the dining room floor doing a jigsaw puzzle with Joseph and her 10-year old daughter, Alanna. I was chatting with May in the adjoining living room, and "The Littles" (as Teresa liked to call the younger kids) were scattered between the two rooms. Just as I turned to ask Teresa a question, I saw her 4-year old daughter Valerie, who was standing just a few feet from her mom, lean into our very old, very beautiful, antique floor lamp. And in almost the same instant, I saw the lamp go crashing down. This is the lamp Ryan got before he ever met me. The lamp with the extremely heavy glass shade.

For a split second I thought "Ryan's gonna freak." But only for a split second, because as I bounded into the dining room and looked from the fallen lamp to my sister, all thoughts of the lamp disappeared. Teresa was still sitting on the floor, surrounded by puzzle pieces, the lamp's glass shade, and the shattered remains of the broken bulb. The upper half of Teresa’s body was swaying in half circles, as if she were dizzy. And with one hand, she held the top left side of her head.

That's when I saw the blood.

It was pouring out from between her fingers, as she continued to hold the injured side of her head. Quickly, we went upstairs to the bathroom. She tipped her head over the sink– I guess hoping it wasn't that bad, and that if we just cleaned the wound it would be all right. But when she lifted her head, blood poured in frighteningly wide streaks down the side of her face.
For an instant, I froze.

"Help me," Teresa said in a voice that was both calm and full of fear.

Immediately I ran and got a clean dish cloth to put on top of the wound. I told her to hold it there.

"Call 911," was the next thing she said.

The folks at 911 asked lots of questions. It was hard to hear because the kids were completely losing it. Except for Joseph, that is. He was helping May try to keep the younger ones calm.

Alanna was nearly hysterical. You see, on top of having been seated next to her mother when the glass shade struck her, Alanna is deaf. Although she has two cochlear implants, she still sometimes misses a lot of what is happening around her, and for now, relies heavily on lip-reading. I can only imagine how frightening it must have been. To have witnessed such a gruesome-looking accident--involving her own mother-- and only be able to pick up bits and pieces of what was going on. She kept desperately calling out for her mother, crying "is she going to be all right? is she going to be all right?"

"Yes," I kept saying. But I wasn't so sure. As Teresa sat on our bench in the front hall, awaiting the arrival of the paramedics, she told me the left side of her face was going numb.

"Am I going to be all right?" she asked several times. I held her shoulders, looked into her face and answered in as firm a tone as I could muster, "yes, you're gonna be fine." But I was so damn scared. If she started vomiting, that would be bad. If she passed out, that would be very bad. Thank god, she did neither. And after the paramedics arrived, and examined the ugly looking, more than an inch-long gash, we were told that "yes, she's gonna be just fine."

Instead of an ambulance, I drove Teresa to the urgent care clinic, where a doctor confirmed the paramedics' prognosis.

The remainder of the week consisted of wound-checks, constantly feeding kids, some kid-friendly activities... but only a few moments when my sisters and I really got the chance to just hang out and visit.

On the eve of their departure, tempers flared between we three sisters over a disagreement that seemed so important at the time, but was soon made ridiculous after Teresa got a call from back home. It seems a young acquaintance of Alanna's -- a 10-year old girl who was also deaf -- had just died.

She choked on a fruit roll up. A goddamn fruit roll up. Dear. God.