Sunday, July 22, 2018

We Are Autism

I feel like I need to get this out...put it down on proverbial paper so that maybe I can reference it when the inevitable questions arise...and arise they do...often...always.  Most are well meaning...some are accusatory, and many are fraught with sympathy and even fear.




Our son, Jackson, was diagnosed with Autism Spectrum Disorder (ASD) on April 2, 2018 (on Autism Awareness Day) at just over 18 months old.  I was not surprised...in fact, I was relieved.  When Jackson was around 13-14 months of age I found myself googling the signs of autism in very young children...I’d pour through YouTube videos posted by parents...searching for my son in these children’s behaviors.  Jackson is my third child...my third toddler.  I knew something was off.  He was a beautiful, happy boy...but he would not communicate with us.  He’d babble, but it never seemed to carry any meaning.  He had no concrete words that he used with regularity.  Beyond that he wouldn’t point to things he wanted or drag us to objects he wished for us to get.  He’d just cry...and tantrum.  He had very repetitive, odd behaviors.  He was obsessed with closing doors, drawers, and latches (he was so obsessed he’d close all the baby locks for us if we forgot!).  He'd get upset if you got in the way of his sometimes obsessive routines.  He also seemed to lack the normal toddler empathy.  Most young toddlers, when faced with another person who is sad, will attempt to comfort that person...they may simply acknowledge the sadness, become sad themselves, or offer a toy as a means of attempting to make the person happier.  Jackson seemed entirely unaware of the emotions of those around him.  Once when I was very sad and crying he sat on my lap and laughed at me...I’m sure my tear stained face with mascara running down was funny to him.  He also seemed to only have two emotions, happy and upset...there was no in between.  

I knew something was different with my beautiful boy.  When I sat in the waiting room for his 18 month appointment I stared at the long list of marks I’d made in the NO column of his MCHAT (modified checklist for autism in toddlers) it started to click that my mom intuition wasn’t wrong.  As his pediatrician went over the form she suggested starting the process of doing speech and developmental assessments.  She didn’t sound concerned and even suggested we could wait...but I knew this was what he needed.  We pressed onward.

Jackson’s speech assessment occurred prior to his full developmental assessment as a scheduling fluke.  As Jon and I sat in the speech therapists office I watched her watch Jackson with her trained eye.  I tried to see him as she did and not simply as his mother.  I watched him throw every toy on the ground...become upset when we would put the toy back.  I saw him walk in circles around her office trying to open and close every door and drawer he could reach.  I noticed how he refused to engage with her as if she didn’t exist.  She asked us questions and towards the end shifted her focus and mentioned several times that she wouldn’t proceed until his developmental assessment was complete “in case he got a diagnosis.”  As we left the office I looked at Jon and asked him if he heard what she wasn’t saying...he hadn’t.  I knew with certainty in that moment that our little boy had autism...there wasn’t a shadow of a doubt in my mind at that moment.

The next few weeks were a flurry of phone consultations and paperwork.  The day of his official assessment I was mentally ready for the outcome.  We sat in the psychologists office as she went through the litany of standard tests with him.  It wasn’t long before she went back to her computer and stated simply that Jackson had ASD (autism spectrum disorder).  It felt as if a weight had been lifted off my shoulders...we had a diagnosis, my mom intuition had not been wrong, and now we could move forward and attack this.  I glanced at my husband and realized his world seemed to be crashing down.  He had not come to the same conclusion I had and instead was waiting to see what the experts said.  This was his first child and he didn’t have years of parenting experience to back up what he was seeing and what would be considered “normal” in a child Jackson’s age.  My heart broke for him as I then realized so many dreams we had had for our son may never come true.  In all honesty I really tried not to dwell in that dark place too long because I knew it wasn’t productive...but there are still many moments that those thoughts come unbidden.



From there Jackson went through many, many more assessments...from our local regional center, Applied Behavioral Analysis provider, and even our school district.  It was during this time that we realized how rare an actual medical diagnosis of ASD at his age was.  As I always do I dove into the research to see why.  Most of it seems to be insurance driven.  As of 2017 California is one of 46 states that mandate treatment for children diagnosed with autism...but that treatment is costly (an estimated $17,000 per year and 1.4 million over the course of that child's lifetime) .  Although the American Academy of Pediatrics recommends screening children beginning at 18 months, most insurance providers will not give an official diagnosis until age three...even though research as shown that early intervention services can greatly improve a child's development.  As early as 1992 it was recognized that developmental trajectories were already well established by the preschool years and delays in communication could have lifetime affects on these vulnerable children.  However, if these same children were intervened upon early and given a substantial "dose" of treatment (in the form of behavioral, occupational, and speech therapy among others) then by the time they reach school age they have a chance at being indistinguishable from their peers.

I'm still unsure as to why there is a huge disparity between the research in favor of early intervention and the actual diagnoses being made.  Many have pointed out that even if Jackson did not receive an official diagnosis from our insurance he could still be evaluated and treated by our local regional center.  While this is true, the actual therapy hours available to him stand to be much less and therefore would decrease the "dose" of helpful interventions he would be receiving.  As it is now he has been approved for unlimited therapy hours by our insurance.  He also receives services from the school district and the regional center.  Some families that do not receive medical diagnosis from their insurance are only approved for 10 hours or less per week...they are then faced with paying for needed therapy out of pocket.

The other problem we've seen since entering this mystifying world of autism is the prevalence of families who want to ignore the warning signs.  Many have asked us if we are going to get a second opinion.  Our answer is a resounding no.  At the end of the day neither of us care what label they give our child so long as they are giving him the treatment he so desperately needs.  To fight the diagnosis and label would be to fight and perhaps lose the countless hours of therapy he gets...and that is simply counter intuitive in our book.  The therapy he undergoes causes him no harm.  It is all play based and usually fun for Jackson.  Although they impose demands upon him, he is rewarded for complying with those demands.  His life is getting easier as he is learning how to effectively communicate with those around him (via sign language as he remains non verbal).  Our little boy is blossoming with all the hard work his team is doing...and we couldn't be happier.

I know that our family and friends simply want the best for us...but I assure you we are carefully and thoughtfully navigating every aspect of this journey.  I feel for those families who have to struggle to obtain services for their children and I'm thankful every day that we have a team of doctors and an insurance provider who understand and agree with the overwhelming research in favor of early intervention.

At the end of the day we only want what is best for our child and our family.  We have embraced this journey as best we can...some days are a struggle but we have an army behind us who are there when we fall.  Thank you to those who have been there for us...your support and love is not unnoticed.  We also rest firmly in our faith and know that God gave us this child because we were well equipped to help him...for that and so much more we are eternally grateful.


Friday, September 29, 2017

Between Nothing and Everything

There are moments in life that you know you'll look back upon someday and remember.  Maybe you'll remember them with gratitude...or a smile...or an element of sadness.  How I'll look back on today is not yet determined.  

Let's back up a bit because I feel as if I'm being a bit vague.  My point in immortalizing this is not to garner sympathy, but rather to share this crazy journey in an effort to someday help others...in the meantime I'd rather not walk it alone.

I started having headaches a few months ago...but not just headaches, migraines.  Ones that didn't seem to fade and instead increased in frequency.  One afternoon it all became too much and I asked Jon to please take me to the ER.  Once there they had to do a complete workup as I've never been diagnosed with migraines.  I had the complete run of testing including a CT scan and MRI of my head.  Nothing showed up that could be the cause of my headaches...but they did find a small meningioma (or brain tumor).  I later learned that meningiomas are fairly common and almost always found incidentally.  Mine was small (1 cm by 0.5 cm).  It wasn't pushing on any other structures nor did it seem to be an issue at all.  I was advised to follow up with my primary care doctor.  

Thankfully I'm actually friends with my primary care doc because I used to work with her at Mercy.  So I sent her a quick email asking what I should do next.  She put in the requisite referrals to neurology to follow up on the headaches and neurosurgery to follow up on the meningioma.  When I met with the neurosurgeon we devised a plan to simply monitor the tumor with another MRI in 6 months.  If it grew at all in that time we'd remove it...if not we'd continue to watch it until it inevitably grew large enough to be removed, "but that could be when you're 60," he said.  I casually mentioned my history of cancer and he thought that maybe it would be prudent for me to get a PET scan to rule out any metastasis as that is the only other thing this tumor could possibly be (besides the very likely benign meningioma).  

Again I typed up an email to my MD and she put in a quick referral to oncology.  They were on board with the idea of the PET scan and I got an appointment rather expediently.  As the day of the scan approached I was more concerned with the 10 hours of fasting than the actual test results...but I did as they said and only consumed clear liquids for the day...even though I was working and probably a beast to deal with that day (sorry guys)!

The test was uneventful...boring and long, but not too awful.  They inject you with radioactive glucose, you wait for it to work, and then you lay in the scanner while the machine looks at how your cells use the glucose.  Cancer cells utilize glucose more readily and hence have more avidity (they light up) on the scan.  

After the test Jon took me to get some food and we went home...sadly I couldn't come within a meter of the kids since I was still harboring some of the radioactive agent...so I drank plenty of water to clear it quickly (mama needed to hug her babies)!

The next morning I logged into my computer at work and pulled up my chart.  At the facility I work at we are allowed to read our own chart (just not that of our family members).  I found the scan from the night before and double clicked it to read the radiology report.  I've been a nurse for a long time and read hundreds of radiology reports.  I'd already read my CT and MRI reports numerous times.  I understand the lingo...I usually scroll to the end for the concise reading.  This time I read every word.  

3 avid nodules.  Three.  In my left axilla.  My lymph nodes.  Three of them.  One 11mm.  One 9mm.  One 6mm.  "Further testing recommended to rule out active disease"...

I logged off my computer and walked to my charge nurse.  I was crying.  I could only motion him to a computer where I logged on again and had him read the report.  Maybe I wasn't reading it right.  His face said I was.

Ok...maybe it's nothing.  Possible.  Maybe it's something early.  Also possible.  Maybe it's everything...

So that's where we are at.  This weird limbo in time between nothing and everything.  I've spoken to my doctor and our next move seems to be biopsy.  Let's see what those little lit up suckers are.  Why are they lighting up so readily?  Why only on that side?  What are they trying to tell us?

I guess we'll find out...soon.  Until then, we wait...and pray...and hope...and tell ourselves it's nothing, but prepare ourselves for the everything.  

So maybe someday I'll look back on today as the day that started it all...and maybe I'll look back on today as the day that was nothing.  Either way today was a stark reminder that life is all those little Hallmark sayings wrapped up in the mundane moments.  It is precious.  It is short.  It is meant to be lived...and enjoyed...and loved.  It is dirty, and ugly, and difficult.  Life. Is. Everything.

So whatever these three little nodules say...I mean to live through it.  Whether it's nothing, or everything.  Life is meant to be fought for...and I'm ready for a fight. 

Thursday, June 23, 2016

Always Go Towards The Light

It's a beautiful morning...I'm alone in my king size bed covered in fantastic new linen (gifts from our insanely perfect wedding two weeks ago)...my husband just left for work...I'm sipping coffee and looking out my bedroom window on the 2.4 acres we own...I'm missing my kiddos more than words as they are spending some quality time across the country with their dad, but I'm feeling the little man inside me kick up a storm to remind me that I still have one baby with me. 

Life. Is. Good.

But if you know me, really know me, you know that it hasn't always been this way.  I did not arrive at this point by accident, nor luck.  I arrived here through trials and tears...through the traumas of war and the trauma of a marriage no longer salvageable...through blood and sweat...hard work and dedication...faith, hope, and a whole lot of grace.

I've been meaning to write this for a while...to put into writing the evolution of my life over these past few years...to remind myself someday that life can change unexpectedly and one must always be thankful for what they have...cherish it, hold it tight, and work like hell to keep it.

Two years ago I was still in Afghan land...in that place that I still haven't really put into words...that place that changed me at my core...made me more grateful, made me not take anything for granted, slowed me down and woke me up.  Even though I was surrounded by trauma and sadness...I found my tribe, my people, my Afghan family.  The people who saved me everyday, gave me sunshine in the rain, and held me when I fell...out there and back at home. 

Two years ago I was out there...but my life at home was falling apart.  Had been for years, but now it was in a full on collision course with the end.  That train never stopped and the day after I came home from nearly a year away we began the official process to end our nearly 11 years of marriage.  Although it was what I wanted, divorce is NEVER easy.  It's a process that strips you to your core and examines parts of your soul you've never seen.  It takes two people who were once a team and puts them into the arena for a Hunger Games type battle.  It drags family and friends into the muck to choose sides, hold up alliances, and make the waters even murkier.  It's ugly...even when it's mutual.

As I laid in bed next to my mom one night before we moved (since I was no longer sharing a room with my ex), I cried.  I cried because I didn't know where we were going to end up...I didn't know how custody was going to play out and if my ex would truly fight me for our kids...I didn't know anything.  I just didn't know.

We sold our home and I moved with my mom and kids to a rental nearby.  In the course of all this I had surgery to repair my knee that had been injured in combat training...I was reduced to crutches and was no longer the strong, solid chick who could outlift some of the dudes...but rather a former shadow of myself.  Sleep deprived from stress, unsure of my future, limited by my new disability...

It's in these moments when your life has shattered to pieces that you have a choice...you can choose to sit among the wreckage...or you can choose to take the pieces and rebuild them into something stronger and more beautiful.  You can choose to see the light that is always at the end of the tunnel...even if it's so far off in the distance that you have to use binoculars to see it...and move steadily towards it.  I assure you that in this process of rebuilding that you will make mistakes.  Pieces you thought fit, won't.  You'll possibly have to begin again and start from scratch.  But the light will never move...and if you keep your eyes fixed upon it you'll reach a point where you are blinded by it's brightness.

I finally got to a point, on my own, where I was making it happen.  Custody had been worked out, the kids had started at a new school and were happy, I'd started a new endeavor as a health and fitness coach, I was slowly regaining my strength and with it my confidence.  Things were looking up...and then they took a drastic turn.

A long time friend was returning from his own tour of Afghan land and wanted to meet up for coffee to discuss life-post-Afghan and catch up as we hadn't spoken in almost a year.  I agreed...but as the day grew closer some strange part of my personality took over my better judgement and asked him why he wasn't just making this coffee meet up into a date...like a real date.  He took some time to answer (as I now know he always thinks carefully about what he says before he utters it) and told me simply that he never thought I'd be interested in going on a date with him...I told him he should ask.  And he did.

With that one small turn of fate my life changed course entirely.  I firmly believe that once your feet are on the path they are meant to be on, doors open and opportunities arise around every corner. God, the Universe, whatever you believe in (personally I choose Him) rewards you for moving in the right direction by consistently giving you more chances to keep going forward.  But this is not a passive process.  You have to try.  You have to work.   You have to be willing to struggle a bit.  It's not easy, but at least you finally are moving towards that light with a vengeance and a purpose.

He moved in, we got engaged, the kids loved him...my ex and him even got along really well...we got pregnant (wayyyyyy earlier than we planned, but again, you take the chances and keep moving forward)...we found our dream home and bought it, we moved, and we had the wedding of our dreams.  Life is far from perfect now, but I wake up every morning, look over at my sleeping husband, and say a prayer of thanks for this man and this beautiful life we are creating.

Sometimes the road seems long...but look hard for the light and never, ever stop moving towards it, because standing in the light is the most beautiful experience you could ever imagine.



Saturday, February 14, 2015

Unraveling

I apologize in advance if this post seems overly personal and the thoughts extremely scattered.  They are and it is.  This is merely MY experience coming home.  From deployment.  From a combat zone.  From a trauma hospital.  Back to my life that has completely changed in the time since I've returned.  I'm not the same person who left over a year ago.  That girl is gone...

Dear Mom,

I've been home almost four months now.  Four months since I set foot on US soil again.  Yet some days it feels like I left yesterday.  I've struggled to put this all into words... but I'm going to try because I feel like it may be a form of therapy, and trust me, I could probably use that about now. 

People constantly ask me questions..." How was it?" "How are you?".  Such well intentioned, innocent questions.  And yet the answers still allude me.  It's not that I don't try to answer, but in all honesty I don't think I can.  So usually I just give the same answer, "life changing."  It was...

They prepared us so well to go there.  Every element of trauma, combat, and life covered in excruciating detail.  Of course they glossed over the things we could expect upon return... and then again as we processed out in Germany.  But we barely listened.  We were tired.  Really tired.  Bone deep kinda tired.  Seven months in Afghan land will do that to a person I guess. 

We were given lists of symptoms we might experience as we returned to our "normal" lives.  And I truly think if life occurred in list form I may have understood the signs.  But that's not the way it works.  Life isn't organized like that.  Life is messy.  Sticky fingers, kids yelling, people shouting, world changing kinda messy.  It was easy to miss the signs.  I missed the signs.

Put me in a small space with crowds and you'll find me pressed against a wall on the verge of tears.  Normal. Perfectly normal.

Sleep... or the lack of it.  Waking up every few hours from the nightmares not always of things I'd seen... but of being trapped, unable to get home.  Of course sometimes there were bombs and broken bodies, but that isn't always the case.  Normal.

Racking sobs at a commercial or a movie trailer that vaguely reminds me of life there.  Tears running down my face dragging my mascara with it.  Normal.

But it's not normal, is it?  I'm not "normal" anymore.  WE aren't normal.  Those of us who have lived in that place aren't normal.  We have to adjust to our new normal, but we aren't the same.

But why?  I wasn't beyond the wire constantly on guard and fearing for my life with every step.  I wasn't wearing my body armor knowing it was the only line of defense between me and an IED.  I wasn't the one rolling into the trauma bay on a gurney and full of blood.  That wasn't me. 

I've been a nurse for a while now.  I've worked in a trauma center since day one.  I've seen death on every level.  The expected, the senseless, the hopeless.  I've seen it all.  I've held hands as life has slipped away.  I've been the only witness to last breaths and final prayers.  Why was life and death in this place so different?

I've figured out a small piece of that difference.  A small string in the unraveling of this post-Afghan life.  It was about walls.  Those high, almost insurmountable walls I had built around my heart.  In the states we all know that every patient has a story.  But I don't know it.  I don't live it.  I can keep them at arms length and not let it get to me.  Those walls came down there.  The patients there were not merely patients.  Many were friends, comrades, brothers and sisters in arms. 

The boy in trauma bay one had sat at the next table at the DFAC that morning.  The girl in bay four had passed me on the street on her way to the motor pool to head out on her mission.  The Major standing at the foot of the bed had been in front of me at church last Sunday.  The boys milling about the trauma bay had been here before, many times.  Some so often they'd earned nicknames.

I'd stood beside them at countless Purple Heart ceremonies.  Seen their faces in too many crowds.  Knew their names.  They were fighting for me, with me, next to me, in front of me.  They were so familiar to me that every time my pager went off it came with the fear that I would know the face in front of me on the gurney.  These patients were personal.  They were not nameless.  I knew their stories.  Even if I didn't know them directly, I lived the same life they did.  I wore the same uniform. There were no walls.  Only us against them.

While I still don't entirely understand the why of it all, this is a start to figuring out why a piece of me will always be at the base of those mountains in Southern Afghanistan.  A piece of all of us will be... and in that we have an everlasting camaraderie and kinship that will last a lifetime.

I know this is only the beginning of putting these pieces back together.  It's a long road and I'll always be a bit different now.  But I'm not broken, just bruised.  Fixable.

Life.  Changed.

XOXO,

Me

Monday, February 9, 2015

The Low Down Skinny (or Healthy)

There's a reason this blog was named Identity Undecided.  Basically this girl goes down so many different life tangents it would have been impossible for me to stick to one topic, so I gave myself the ability to be ADD with this blog (didn't need hindsight for that revelation!).  That being said, I'm sure many of you are wondering what the heck I'm doing lately with this "fitness coaching" stuff... let alone with a multi level marketing company like Beachbody.  Well, let me tell you a story...

In reality, this was not a spur-of-the-moment decision.  My journey to coaching started years ago.  When I was a new nurse on night shift I was tired.  Like Tired (with that on purpose capital T).  There isn't quite a tired like the after night shift tired.  But a girl needs to look good in those scrubs and stave off the dreaded nightshift weight.  I wasn't really training for any crazy run or triathlon at the time (and I hadn't gotten the CrossFit bug yet) so I needed to do something.  I had heard about this program called Insanity.  It seemed totally something I'd be in to.  So I conned my friend (fellow nightshift nurse) Alli into joining me in this program.  We'd meet daily to complete the crazy, heartpounding, sweat-inducing suffer fests (I say all this tongue in cheek because I LOVE Insanity).  Turns out, that sh*t works.  Like really works.  I felt comfortable rocking a bikini after that program.  And then I moved on to Insanity Asylum... and then P90X.  I did them all... with Alli, alone... whatever it took.  I loved it... every awful second. 

And then I found the next race to train for and got lost in my world of endurance sports... joined the Navy Reserves, and eventually deployed to Afghanistan... where I fell in love with CrossFit.

But before I left I saw that my coworker and friend Jaclyn had begun her Beachbody journey.  She has always been someone I've looked up to.  She is a beautiful soul who has poured her heart into her business, her coaches, and her customers.  Her love of people and their fitness journey was inspiring.  She reached out to me but I wasn't quite ready to join her... leaving for deployment kind of threw a wrench into life.  I told her then, over a year ago, to keep me in mind... something in her journey resonated with me...I felt like that could be my niche.

Fast forward to a few weeks ago.  I was post surgery, looking at months of rehab and not going back to full time nursing in the very near future.  Jaclyn reached out to me again.  She wanted me to join her team.  In the year I'd been gone she had built a thriving following.  She was real, genuine, and truly had a heart for helping people reach their goals.  I wanted a piece of that.  A chance to help people reach their best version of themselves.  An opportunity to enhance wellness instead of combating illness.  So I said yes.  I jumped in, became a customer and a coach with Beachbody...and haven't looked back since.

You know, it becomes exhausting as a nurse to constantly deal with illness.  Don't get me wrong, I love what I do with a fierceness.  But there is something so satisfying about helping someone along the road to wellness.  Not popping a pill, but truly getting into the nitty gritty of life.  The dirty laundry of bad habits, poor nutritional choices, little to no exercise, and an overall lack of accountability (or anywhere on that spectrum really).  To be a ray of hope.  A voice of reason.  Someone to hold a person accountable and tell them that you know what... you can do this.  Honestly.

But let's be fair.  Beachbody sells products, right?  Yep, they do.  Great ones at that.  I have never been one to sell things I don't believe in.  I have to be fully invested and in love with something to even think about promoting it.  And I love Shakeology.  I love Insanity.  I love P90X.  And I'm loving my 21 Day Fix kit.  I also love running, biking, swimming, and CrossFit.  That will never change.  I've incorporated the products into my life.  Sipping my Shake O after a tough workout.  Popping in a DVD when I really don't have time or energy to get to the gym.  I'll never be the girl who exclusively works out at home.  And honestly, right now I'm so limited on what I can do that I'm relying heavily on my 21 Day Fix and it's portion controls to keep me in check.  And you know what... again?  That sh*t works.  Like really works (I'll prove it soon).  Fancy that.

So really I say all of this to say that I'm not here to be a gimmicky salesperson.  I'm here to help you.  Honestly.  Genuinely.  I want to join people on their journey to health.  And I want to be joined on mine.  I want people on my team that have the same vision as I do.  I want people who push me to be the best coach I can be, and I need accountability too.  I believe in the products Beachbody offers.  I spend my money on it...I work hard for that money and I believe in investing in my health and the health of my family. 

I hope this gives you all a clearer understanding of this new "thing" I'm doing with my life.   I'm happy, working towards healthy, and ready for this new adventure.

Got questions?  Please ask.  I'm an open book. 

Wednesday, November 26, 2014

It's Time


I feel like since leaving Afghanistan I’ve had what I can only describe as writers block towards putting a proverbial pen to paper on my experiences being gone for a year.  I have scribbled notes and half written blog posts from along the way... but nothing worthy of posting just yet.  Many moments couldn’t be written about at the time due to operational security risks.  But now I’m home.  And it's time.
 
It's time to give voice to the crazy memories made over a year.  Many were wonderful, some were terrible, others were life changing.
 
It's time to put in words the vast sacrifices we all made.
 
It's time to validate the time I took away from my family... to list reasons (if only for me now and maybe someday for my children) why I had to be there... why I made a difference.
 
It's time to at least slightly crack open the vault on moments I never, ever want to forget.
 
So here it goes... mostly in letter form as before... some in poetry.  Starting from where I left off (which was months ago).  Wish me luck, it may be a bumpy ride...
 
 

Friday, April 25, 2014

Boots On Ground

 
 
 
 
 
Boots On Ground...literally
 
Mom,
 
I know it's been a while since I've updated you on life here...but unfortunately now that I'm "in country" there is so much that can only be shared in retrospect.  So I may be quiet for a long while, but know that eventually you'll hear about my life and adventures in this crazy place.  For now I'll share a bit of what I can about my new world and daily life here...
 
I've been here for about two months now (I think)...time is a funny thing here...you never really know what day it is or what time zone you are on when you initially get here, but also, everyday seems to blend into the next and each day is roughly the same.  It's like a perpetual groundhog day, same faces, same food, same job...and yet the time just flies...
 
Starting right away on the night shift really helped me adjust to the time difference as I essentially stayed on the same time zone as home.  I have since continued on that shift since our move to teams.  It's been quite a transition though.  When we first arrived we came in every night for orientation and then came to meetings in the afternoon...so I had about 10 hours of sleep in about a 72 hour period at one point.  Needless to say I was a total zombie and wasn't very communicative with anyone! 
 
Things have continued on that busy trend and there are some days where I'm mostly awake for over 24 hours.  You know I'm a huge fan of sleep...so this has been quite a lesson for me, but a helpful one (learning how to be less of a brat on less sleep).  I'm so lucky to have a team of people with me daily who tolerate my tired antics, lack of a filter, and hangry (tired and hungry) tendencies and know how to support me when I'm down.  I think this is one huge benefit of living/eating/training/breathing with the same group of people since day one.  Although there is room for lots of drama...there is also room for understanding, support, and tolerance.  We know each other...sometimes too well.  The best example is my roommate and I...not only do we live together but we work on the same team.  We live,eat, sleep, and work the same schedule...and usually spend a significant amount of our down time together.  This could be a really bad deal if we didn't get along, thankfully we do and I am so blessed to have her.

Bis, me, and the roomie Smo
 
 
As for daily life...the base is actually quite nice...for Afghan standards.  We have beautiful barracks (I'm not being sarcastic here) that are rocket proof.  The hospital is also rocket proof...which is a huge blessing.  The strangest thing I miss however in terms of my surroundings is color...any color other than brown or grey.  I miss trees...and flowers.  The only scent blowing on the breeze is the one that comes from the pooh pond.  I miss the ocean terribly...any body of none pooh infested water actually.  It's easy to get lost here because every conex looks like the next...the cement walls that protect the buildings from rockets all look alike, except for the occasional graffiti that differentiates one from the other.
 
The food isn't awful..well it is...but I've become accustomed to it I think (I constantly say that my standards have dropped significantly in all areas of my life).  We currently have 4 DFACs (dining facilities) to choose from...all serving roughly the same menu, with a slight difference between the Bristish one (the Cambridge, and my current favorite) and the Asian one (the Far East).  There are lots of selections, but some I can't even pronounce, let alone recognize...breakfast is by far the best of all 3 meals here and I religiously attempt to make it to a DFAC in time for the full meal...otherwise I am stuck with midrats, which are a pared down version with only fake, powdered eggs and all the meals leftovers.  We don't have a DFAC at the hospital so I've stocked up some food I had sent from home or friends have sent in my cubby to eat during my night shifts...that and candy sustain me!

The NATO gym is beautiful and close to our home.  It's usually pretty busy but there are plenty of machines and I haven't yet had a problem getting onto a machine I want.  I also found the spin classes there, you have so sign up super early (or have a good friend do it) because they are really popular...but it's allowed me to attempt to keep my bike fitness thousands of miles away from my beautiful bike and winding San Diego roads. Honestly though, my heart has gone the way of Crossfit and I've been a regular there since we arrived. I love the workouts and getting stronger, but I keep coming back for the people...an international group of friends here for many different reasons and jobs all coming together to suffer for an hour.  Lately the number of Navy yellow has been increasing...they say we multiply like flies, I think they are correct.

 

There isn't much to do here on a regular basis...you could hang out at the USO, the MWR, or the liberty center...or you can simply walk the boardwalk, and watch the people.  The motly crew of contractors and troops from every corner of the globe is a feast for the eyes and ears.  In one sentence you can hear French, Dutch, German, Afrikanns and Pashtu...or english with any flavor of accent you could dream of.

Overall things are going well and time is flying.  When we aren't working we are on call...so it's a constant thing here...we are tied to our pagers and you internally (or externally) curse whenever they go off...because unfortunately it's never good news.  Everyone here also rotates through the duties of charge nurse and OOD (officer of the day...the civilian equivalent is the house supervisor).  After this deployment I'll have plenty to add to a resume!  I'm also going to be working in the trauma department starting in May.  They added a fourth team and needed another nurse...and I'm so blessed to have the opportunity.  I'm even more blessed to be able to be working with Warner again.  We haven't been able to see each other much with our vastly different schedules, but now we will and it will be awesome.  Our doc is Aussie so deciphering what he's saying will be a challenge, but a hilariously welcome one.

I'm excited about being here...though I really miss home, it's a strange mixed emotion.  But we are truly doing great work...creating miracles in the midst of chaos.  I'm blessed to have a hand in it...especially during this pivotal time in the history of this country.  I never knew what this would feel like and I believe that even I will struggle to put this experience into words as I go...but I'll try.  For my own sake...so I don't forget the lessons I'm learning.  Lessons more in humanity than medicine...in compassion and empathy.  This place will change me, I know that now, in subtle and not so subtle ways...but all for the better I hope.  I know if that isn't the case I'll have you to whip me back into shape when I return.  Until then know I love you and miss you all so much...you all are always in my heart.

Afghan sunsets are still beautiful

 
Love,
 
Me

Where all the magic happens