Our Children, Our Stories

So, apparently July happened.

Seriously, how it is that July happened?

But it did, and here we are. And yes, I am still here, despite my unplanned hiatus. And no, there is no major calamity or crisis to report, just life being life and being all kinds of busy and stressful and wonderful and challenging.

At some point in the past couple weeks I read this essay on parenting and writing in the New York Times and between the footnotes, interviews, and word counts and the music classes, swim diapers, and clapping and waving, it stuck.

While a lot of the essay was about the author not wanting her son to hear a reading of her memoir detailing a more colorful time in her life, the part of the essay that resonated with me was the author’s acknowledgment that the people in our lives didn’t necessarily sign up for living with a writer or having their stories out there. That’s something I think about a lot as a nonfiction writer and as a blogger. In fact, I think the more I write, the more tightly I hold their stories against my chest. It is not an easy line to walk—providing enough detail and humanity so the reader is invested without betraying someone else’s privacy.

Naturally I am most cautious when it comes to my daughter. There are so many anecdotes and revelations I think about writing and then wonder if sometime down the road, she will be embarrassed or wish I had refrained, if the line between my story as her mother and her story as her own independent person should be thicker, not more diaphanous. So I write her letters each month and save them in a folder on my desktop, knowing someday I will print them and give them to her and hope I choose my timing well so she doesn’t cringe at the mushiness.

But there are moments that feel appropriate, tiny glimpses of a private life that are meant for public consumption. I can’t believe it has been four months since I wrote a morning snapshot of my sweet girl. I am not one to get too sentimental when one stage ends and another begins because each stage is so much fun and so amazing in its own right, but just like I can’t explain how I blinked and a whole month of the summer has gone by, I don’t know quite how it is that our house doesn’t look as much like a baby lives here anymore.

The bouncy chair she just adored has been stashed away since we were still wearing winter coats. The jumperoo she loved is down the basement because why jump when you can crawl or take teetering, tottering, sideways steps, or swing from one piece of furniture to another? I fear the beloved exersaucer, the scene of so many squeals and pulls and bops! is the next casualty, since the only thing she has used it for since May is something to pull up on and cruise around.

I finally got around to returning the hospital-grade pump, and broke down and cleared out all of the bottles, despite the fact she has used her sippy cup for months. My own little act of denial, I guess. The bottles and the boppy nursing pillow were what gave me pause, and really made me stop and get a little sentimental that she is now 10 months old since they represent such a physical connection to her babyhood. Just tonight as I was weeding through some of her newborn clothes to give to a new baby, a tiny purple Mary Jane sock tumbled out and my breath caught a little at how tiny she once was. (Though so far she has her Mama’s height and can still rock the 6-month clothes…)

It is too good to go this fast.

The baby gates and the sharing entrees with me and the fact that it took twice as long to get through chest PT because she was chasing down the dog, standing next to my therapist trying to pat me, and crawling on my head—all of this points to toddlerhood.

Every stage has been wonderful but even if I could, I would not go back—watching this little person emerge with every wave, every smile, every emphatic shake of her head and every triumphant declaration of “Up!” when she gets up is too good.

(Too good to go this fast.)

On Writing

It occurs to me that I haven’t written about writing in awhile.

Partly, this is because the whole writing-about-writing thing can be a bit too meta unless you’re sitting in a graduate writing workshop surrounded by people who do nothing but write, too.

But mostly, it’s because for awhile now I have been too busy with the writing I do for a living to do much else (except mothering, which comes first, of course). Case in point: it is almost 10 pm on a Friday night and I’m taking a quick break from The Book but expect another hour or two of work before it’s a night. It’s glamorous, the writing life, no?

(And with Le Plague circa May 2011 forging a vengeful comeback, it’s even more glamorous. But I digress…)

It’s been awhile since I’ve been wrapped up this intensely in one project, since I’ve had this much focus. It’s much harder fought than the last time around, or when I was in graduate school, when I wasn’t a full-time lecturer or mother to an infant, so each moment I do carve out for writing is that much more precious.

It’s been good for me to step beyond the role of writing instructor and really dig into the writing process myself in such an all-encompassing way. I’ve re-learned some important things:

1. Know when to walk away: Last summer, when I tried to get as much done as I could before my health imploded and my baby arrived, I was stuck in the “I must write X amount of words per day” rut. This might be good for discipline, but it’s terrible for creativity and for development of ideas. Sometimes, I am really “on” and I can write several thousand words in one chunk of time. Other days, it’s hard going to get more than a few paragraphs. When that happens, when I am forcing each sentence and not saying what I want to say, the best thing to do is step away—sometimes for an early lunch, sometimes for a short walk, sometimes for a few hours. See, ideas need to marinate a little bit, and I need time to figure out what I want to say about what I’ve just written. Usually, it’s when I am walking with the baby or driving the car or making dinner that I solve the problem or make the connection I couldn’t do earlier.

2. Remember the audience: For real, I teach a whole class on writing for different audiences (in the health sciences) and talk about audience so much during the semester I tire of hearing the word. But with a project as big as the one I am working on now, I need to drill that into my brain as much as my students need to hear it. Nowhere is audience more important than in terms of scope—I am doing a ton of research and I always need to stop and ask myself how much context and background I can reasonably expect my audience to have; in class, we call this audience analysis. This dictates how much detail and backstory I fill in, and it is a constant negotiation, probably one of the most difficult parts of writing for me. I have so much information, now how can I organize it? Figuring out what my readers need to know is a huge step.

3. Tell a good story: From novels and short stories to memoirs and serious nonfiction projects, each genre of writing needs to meet this very basic but oh-so-important criterion. The writer needs to engage the readers, to entertain them and make them want to keep reading. This does not change if the subject matter is serious and the research is intense—every writer still needs to make it a good story. I know when I am getting glassy-eyed with what I am writing that it is time to switch gears (or walk away). You can be informative and still be interesting. It is not always an easy thing to balance, but if you’re genuinely interested in the subject matter, that will come through. I always tell my students to think carefully before committing to a research topic—if after a few weeks, they are bored with it and bored with writing it, I will be able to tell that from reading it.

This is an incomplete list, for sure, but it’s a start. Writers and bloggers out there, what can you add?

On Working From Home

So in my recent post on working with chronic illness, I mentioned a forthcoming piece on working from home.

Now, before I launch into my experiences with and take on working from home, I should point out some illness-specific benefits: There is more flexibility to schedule doctor appointments, tests, and daily chest physiotherapy. On “bad” days I can still work, even if means moving my home office to the couch and typing over the nebulizer mask. On days when other conditions flare and I can’t move my legs well (for example) I don’t have to worry about how I will get from point A to point B. Less commuting on public transportation and less time in crowded places during the peak cold/flu season means less opportunity for me to catch things that leave much sicker for longer than the average person.

And of course, when I am in the hospital, my laptop and wireless access mean I can keep on working.

I must admit that there are a lot of positives in working from home when trying to manage a career and chronic illness. It doesn’t mean working less—in fact, one of the biggest challenges is that there is little separation from work life and regular life—it just means it is a little easier to work better when my body gets in my way.

I’ve worked from home in some way or another for nine years now, whether it’s a couple days a week during the semester or full-time doing freelance work and writing books. This Boston Globe piece on working from home did point out some relevant challenges and opportunities of working home. I particularly enjoyed the response to the claim that it is easy to take care of children and get work done—sure, bring your child to your office sometime and see how much work you get done!

Anyway, I think the key to working from home successfully is knowing your strengths and weaknesses and finding a routine that works for you. It’s not for everyone. It can be lonely and isolating. It can be really hard to focus and self-motivate. It can completely usurp your home/family balance. Some people get strength from social interaction and do best when they draw from the energy of a group. Some people need regular check-ins and accountability for best results. The point is, know the conditions that allow you to succeed.

For me, it doesn’t matter how sick I feel or how late I was up working or with the baby; I sit down at my desk in my home office every morning, coffee in hand, and go through my inbox/headlines/social media check-in. I break for a brief lunch. I don’t make or take personal calls during my designated work hours: those hours are scarce and precious to me, and I try to make the most of them. Sometimes I need a change of scenery and go to a coffee shop; other times I know I just need to plow through it without any distractions or stepping away from my computer. I make to-do lists every night before I go to bed.

Oh, and before my daughter was even born I knew I wasn’t going to try a full-time course load with a full-time writing career, a large part of which happens from my home office, without some child care. As I mentioned before, even if it means working many hours late at night and very early, my time with her is about her, and when I am working, I just want to focus so I can get it done more efficiently and therefore, have more quality time with my family.

Boundaries are also fundamental. I think many of us, whether we work from home or not, struggle with knowing when to “shut off” work, and this is especially true when our office is in our home and our deadlines are often self-imposed. It’s no secret that balance is hard for me, and I do think working from home exacerbates that.

But creating our own boundaries is just one part of it. The other part is reinforcing those boundaries with the people in our lives. The expectation we can chat whenever, we can make plans any time of day, etc simply because we are working from home can get frustrating, and if I don’t hold up those boundaries (nicely) I can’t expect others to respect them, either.

Sometimes I feel there is an inherent value judgment that other people’s time is more valuable than mine if they happen to work in a traditional office setting and I am at home, that my time is more expendable.

And in a way, it is—that’s both the challenge of it. If I need to or want to, I can step away more easily. I can take my daughter to music class, or go to another doctor’s appointment, etc and make up the time later in the day or the week (or weekend). I don’t work from home a large part of the time for this—it just so happens that writing, editing, being a professor, and consulting lend themselves to a non-traditional work situation—but it is a major positive that is more important than ever now that I have a child. Yet if I am not vigilant and disciplined, flexibility could become a detriment.

Lastly, working from home leaves me in a weird place when it comes to play dates, making friends with other mothers, etc. I am not away at an office every day of the week (during the semester, 2-3), but I am not at SAHM, either. I don’t make plans for evenings often, even on weekends, because I am usually trying to keep my head above water, work-wise.

These are not complaints, merely observations. I’ve made decisions to bring me to this point, ones I hope set me up for the most success in terms of my health, my careers, and my ability to be the mother I want to be. Like everything, there are compromises but for me and in my personal set of circumstances, the compromises are worth it.

Anyone with tips or observations to share? If you’ve made the switch to working from home, are you glad you did? Did you do it for your health?

On Working, Parenting, and Chronic Illness (Part 1)

This week, my spring semester ends.

And while in many ways it was a great semester (engaged, intellectually curious students, new assignments and experiments in the classroom that worked out well), I am profoundly relieved it is over.

I’ve been wanting to write a series of posts about work, parenting, and chronic illness for awhile now; a recent Boston Globe column on working from home only intensified this.

I knew back in December that finding balance would be my main challenge and while I might be self-aware enough to anticipate this, I wasn’t self-aware enough to actually do something about it in time.

During the academic year, I teach a full-time course load, plus other administrative and professional development projects and meetings. I’m also a writer with an impending deadline for an incredibly research-intensive beast of a book. Both are full-time responsibilities.

Like anything, there are compromises and trade-offs to this type of career path, one that is not a traditional office job. I work from home a couple days a week during the year, and work from home full time during summer months. I’ll discuss the pros and cons of working from home in an upcoming post, but the number one benefit of my current career is that it means more time with my daughter than I could ever have in an office job.

(Plus, the health insurance I provide for my family is awesome. Really and truly.)

After all, after working for almost five years and risking my life to have her, I don’t want to miss a thing. This was the promise I made to her and to myself when I went back to work: when I am with her, she gets all of me. No laptop, no hastily typed work e-mails, no frantic checking of the inbox for replies from editors or interviewees or students. I don’t want to be half-present with her and half-present with the other people in my life who need me.

She deserves more than that—and so do my students, and so does my book and all the people who have given me their time and insights during the writing/research process.

Some days (the best days), I am mainly with her. Other days, like when I am on campus, I make sure the mornings and the later afternoons and early evenings are all about her. Luckily, we have had family who have been able to help with watching her some of the time, and a wonderful caregiver some of the time, and the more flexible nature of my work demands means that most of the time, I spend a lot of time with her and make up what I need to do for work at other times in the day. I know we’re fortunate to have help, and I know not everyone does.

In terms of being with her and watching her grow from a precocious 4-month-old just starting to sit on her own to a chatty, giggly little girl who feeds herself and loves turning the pages of her books, in terms of being an active, engaged participant in her everyday life and routines, I have no regrets. I never felt my work took away from her, or took me too far away from her. In this way, my semester was a success.

But, a full-time workload plus a book plus daily chest PT (and all of the logistics of her health needs and doctor appointments) and everything else means that making up what I need to do was pretty challenging. For a lot of the semester, it meant staying up very, very late and getting up hours before my daughter woke up to get stuff done. It meant working almost every single Friday and Saturday night and during weekend mornings and naptimes. And all of that is clearly worth it, because it means I get to pick her up from her crib when she is all smiley and up from her nap, or take her to all her doctor appointments, or watch her devour her sweet potatoes or gluten-free snacks.

However, a schedule like that is not sustainable, not for healthy people and certainly not for people with chronic illness. (Oh, hey, and it goes against practically everything I’ve written about here and in my book, too.) It’s almost May, and the infection I caught at Christmas is still recycling itself through my lungs and upper respiratory tract and causing problems. By February, I started noticing my lung capacity was limited enough that I had a hard time walking through campus and talking at the same time. By March, my adrenals started acting up and some days, my arms and legs were so heavy and concrete-laden I needed a ride to and from work because I couldn’t get myself from my parking garage to my building on the other side of campus.

I realized a bit late in the game that all of this hard work would be for naught if it meant I was too sick to be what my daughter needs from me. Duh, right? My health affects her. What good are the carefully preserved hours with her if I can’t lift her, or take her places, or play games with her?

I’d like to say I had this huge revelation and made all sorts of drastic changes, but responsibilities are what they are. I did need to prioritize even further, though, and that meant letting go of some expectations of how much research and writing I could do during the semester. I don’t get up well before dawn anymore. I try not to schedule activities on both weekend days. I tell myself regularly (no really, I do—I find I have to repeat it to myself) “all you can do is what you can do” and what I can’t get done I leave behind me when I go to bed at night.

My husband, a fantastic father and a wonderful support system, now has a little more flexibility with his time since starting his own business, and that’s made a huge difference. (Even though he’s pulling very long hours himself, it’s amazing how much more time he has to see her now that he doesn’t have an hour-plus commute on the T every day and can walk to his nearby office.)

In the end, I made it. I made certain decisions that upheld certain priorities and I made it through. We made it. Since I don’t plan on ever having a baby and an enormous book due at the same time again, I do think life will be more manageable from here on in. This semester, my body paid some of the price but that means my daughter and my students did not. The beauty of teaching is that next semester, I can try it all over again and hope to do much better at this whole balance thing.

(And between now and then, I’ll finish that book. There’s nothing as clarifying as a deadline…right?)

I know so many of you out there have done this whole working-parenting-being sick juggling act much longer than I have. Any words of wisdom (or, moments of defeat) to share?

The Stigma of Illness: An Article, An Interview

As a patient, it is always pretty neat to see health-related issues I care about handled in the mainstream media. And when they are handled well? When there is research and depth and narrative all packaged in an accessible yet thoughtful way? That makes me smile.

As a writer, it is a whole different kind of experience to see issues I am so heavily invested in researching and writing appear in popular mainstream media. As many of you know, I am publishing a second book, and it is a social history of modern chronic disease. It is a project that involves an extraordinary amount of research, reading, and interviewing, and interviews aside, most of it takes place by myself, often late and night and before the sun rises. It is an exciting endeavor, but sometimes an isolating one.

So when I read an advance copy of “The Stigma of Illness” that appears in the May Issue of Woman’s Day (on newsstands right now), I was excited. The stigma around illness, including issues of gender, socioeconomics, and politics, is, quite obviously, a major element of the book.

And when I saw research that I’ve used in my own work for several years and discussion of ideas I’ve carried with me everywhere I go for such a long time, I was hooked. People are talking about this stuff. People realize stigma matters.

The article looks at the judgments and blame often placed on patients, particularly those who live with conditions where individual behavior often plays a role in transmission or severity of illness. Individual responsibility for behavior versus genetics or random chance is a comparison I find fascinating, and the inherent (and harmful) hierarchy of patients it sets up is one the most compelling and thorny issues in modern chronic illness.

“For years, social scientists such as Gregory Herek, PhD, a professor of psychology at the University of California-Davis, have been trying to unravel why certain conditions seem to carry “marks of dishonor,” writes article author Joan Raymond. “Their conclusion: Whenever there’s a widespread perception that something can be attributed to personal weakness or poor lifestyle or moral choices, that disease is going to be stigmatized.”

So why such an article right now? Amy Brightfield, a health editor at Woman’s Day I spoke with yesterday, acknowledges these issues have always been in existence, but play an even larger role in public discourse right now, especially when it comes to health care reform and health insurance coverage.

“People talking more and more about what should and shouldn’t be covered…illnesses that tend to get stigmatized don’t tend to get covered as well,” she says. She points to mental health problems a prime example. “You have to prove some physical concrete toll it is taking, which why it is so hard to get coverage for mental health because of the stigma.”

With profiles of three women living with some of the most heavily stigmatized conditions—AIDS, lung cancer, and bipolar disorder—the article does a good job of laying bare the tension that exists when morals, person decision-making, or sanity are questioned as a result of physical illness. The non-smoker who contracted lung cancer anyway and the AIDS patient who contracted the virus in a monogamous, heterosexual relationship profiled in the article know firsthand how painful judgments and assumptions about lifestyle and worth can be.

And of course these are just a few of the illnesses where individual responsibility for behavior is called into question. Obesity and its attendant complications are at the top of the list, too. Brightfield, who is working on a story right now about different communities’ initiatives to reduce obesity and conditions related to it, says personal responsibility is only part of a more complex problem. It’s one thing to say people should eat right and get more exercise, but if you live in an area where fresh produce is hard to find, if you can’t afford a gym membership, can’t walk to school or work, etc, it isn’t as easy or obvious.

“The modern world is not conducive to exercise and making healthy choices about food,” she says.

Turning back to the women profiled about stigma, it is clear that gender often underlies judgments about illness, particularly since more of the nebulous conditions like Chronic Fatigue Syndrome or fibromyalgia, which are harder to isolate biological causes for, affect more women than men. Given the historical context of “hysterical illness” and the huge differences in acknowledging and treating chronic pain in men versus women, there is clearly a lot more to be said about all of this (trust me, I’m working on it!)

Still, as Brightfield points out, and as many patients I’ve spoken to concur, stigma is not gender-specific. Even if we just look at men living with AIDS or lung cancer, it is clear that gender may be a dominant force but it is not always a defining force.

Stigma is equal-opportunity. And because we’re all living with a constellation of hereditary, environmental, socioeconomic, and other lifestyle factors, it’s not our place to assume or blame.

“Don’t judge anyone because they are sick….that’s why we did the story, to show that people get stigmatized…in the illnesses that we featured here, you don’t know the whole picture medically because you are not the doctor,” says Brightfield.

How many times have you felt blamed or judged for your illnesses, whether implicitly or explicitly? Was it by a doctor, a friend or loved one, or even a total stranger?

To read more about this, and perhaps to empathize and commiserate with the brave women featured in the article, make sure you check out the latest issue of Woman’s Day.

IRL: The Rare Disease Edition

So, last weekend I met and had brunch with a fellow PCD patient. (Hello, L, if you are reading this!)

That sentence is actually pretty monumental. You see, it is the first time I have ever met someone with PCD (and bronchiectasis) in person. And, for all I know, it could be the last.

(There was that one time a young PCDer happened upon a book reading I was doing for Life Disrupted totally by coincidence, but we were both a little under the weather and therefore could not come in contact with each other, so I saw him from afar but did not meet him.)

It is a reality of life with rare diseases that we can go years, decades, even lifetimes, without meeting other patients in person. When I was first correctly diagnosed, I can’t tell you how helpful it was to know other people like me existed, and to read their stories and advice online. The impact of the Internet on the patient experience in general and the rare disease patient in particular is so important and so layered I plan to tackle it on its own and in other venues.

As you know, I am staunch believer that our experiences as patients with chronic illness unite us more than our different symptoms and diagnoses, and I will always believe that. At the end of the day, dealing with acceptance, control, relationships, balance, work, families, etc are universal challenges.

However, there is something so different about seeing someone in person. To drink coffee and swap stories with someone whose experience so closely mirrors your own. (In our cases, collapsed lungs and pneumonia at birth; frequent and serious infections throughout childhood and on; multiple surgeries; multiple hospitalizations; incorrect labels and diagnoses; secondary conditions like bronchiectasis and infertility; etc, etc.)

Oh, and we could cough and it was no big deal, and no asked if we needed water or were sick because everyone at the table knew that cough was as natural to us as the inhaling and exhaling everyone else does that we can never take for granted.

I don’t want to say it was validating, because I have my correct diagnoses and treatments now and am past needing validation. I think comforting is the right word, because despite technology and blogs and social media and online forums and everything else, being a patient with a disease nobody recognizes and nobody around you has can be isolating.

How many of you have felt that way?

(And I’m not talking about the health care delivery implications of people not recognizing it; I’m speaking strictly of the social and emotional aspects of living with these conditions.)

A sense of community is harder to come by when it comes to rare diseases. There are no disease awareness months, trendy wristbands, walk-a-thons, etc. Thankfully we have the umbrella National Organization for Rare Disorders, and numerous disease-specific work tirelessly to advocate and research for new medications and treatments.

But day to day, in the shuffle of work and doctor appointments and daily chest PT, in the managing of all the other conditions that take second seat to how well can I breathe today, it does feel a bit lonely.

I’ve been thinking about community a lot these days, especially since my post on audience: the power of communities to abandon differences and unite to effect change (the disability right’s movement, for example); the power of disease-specific communities to achieve tangible results (the early HIV/AIDS movement, for example); the power social media has to create and sustain communities and disseminate knowledge (for the better and the worse.) Looking at current events in the world right now, clearly this discussion is not limited to patient communities.

Though I’ve struggled with assimilating my writing and blogging with the new communities I find myself (parenthood, working mother, mother of a patient, etc) I am getting there. And while I have a lot more to write about the points I mentioned above, on a personal level, I am trying harder to connect to the communities I dohave.

An avid reader, I’ve been terrible about commenting on blogs the past few months, and can do a lot more here, too. I’ve also updated a sorely out of date patient/medical blog roll, and added a whole new category of parenting, infertility, and adoption blogs that I read. For either category, shoot me an e-mail if I’ve missed you and shouldn’t have!

Audience

In my writing classes, audience is the fundamental principle we keep returning to for each assignment: Are my health sciences students writing to peers in the professional realm? To a scholarly, academic audience? To the general public, or a patient (ie, lay person) audience? Such audience analysis gives way to decisions about scope of content, vocabulary and diction, and overall tone and approach.

You need to know your audience for your message to be successful,” I hear myself saying over and over.

And yet lately, when it comes to my own writing, I seem to be so hyper-aware of audience and more specifically purpose, that it leaves me wordless. (I know!)

I’ve mentioned having trouble with balance since going back to work full time with a baby, and have also said I’m trying to get back into a groove. And while part of that does mean simply carving out the time to post with regularity, to comment on the posts I read (because I still read them—it’s something I can do one-handed while nursing), and to engage more fully in this online world, that is only part of it.

I need to find my content groove again, too. So often I have concrete ideas, ideas that won’t go away and keep percolating away until they threaten to bubble over, but then I stop short of executing them.

I want to write about aspects of parenting that are enlightening and humbling, like breastfeeding.

(But this isn’t a parenting blog, so stick with issues of parenting and chronic illness, like knowing when to fire a pediatrician, says the little voice.

I want to write about being a parent after infertility, since I never expected just how much that journey would inform my worldview and my thoughts on this joyful little girl I get to wake up to every day.

(But think about the people reading this who might still be going through the infertility nightmare, cautions the little voice.

And I do want to write about finding balance, and feeling like I am falling down the rabbit hole of work again, except that while there is a lot of pressure right now with work-related stuff, there is so, so much happiness and fulfillment and joy with my daughter that I am worried I will not strike the appropriate balance, one that shows how much my heart and mind have stretched and changed and re-prioritized in the midst of the same old problem.

(But can do you that in a way that is accessible?, queries the little voice.

And as cognizant as I am of what I set out for this blog to be a few years ago, and trying to stay true to that, I am even more aware of how much of what is really at the core of where I am right now is not necessarily my story to tell.

(Just because you’re a writer doesn’t make all your material fair game, chides the little voice, a point that speaks to me more strongly than ever.

I feel myself pulling inward. I do think there are ways to discuss parenting and still relate it to chronic illness, and I want what I write to reflect the huge shift in my life, but I also want to protect my daughter’s privacy and not put too much out there about her. You won’t see her name here, or details about her health, but perhaps there is more room for a little window into our lives with her.

There have been so many changes in the lives of people close to me over the past several months, and the repercussions of those changes affect me every day. But other people’s illnesses are not my illnesses, and though we are all connected, I am drawn by the urge to protect the vulnerability I see.

And here we are. The days are getting longer. The snow banks are melting a little bit. I survived the bulk of winter without getting too sick or going to the hospital. There is a happy baby chattering away in her crib right now, thrilled to be awake and content to tell secrets to herself for a few minutes. And, I have stories to tell. I just need to get out of my own way.

(You’ll get there.)

Bring It, 2011

I did a brief 2010 year in review last time I wrote, but I can’t let the upcoming New Year arrive without some sort of reflection.

This time last year, we were battered from a long, tough fall but were also incredibly hopeful about the year about to unfold. In fact, in my New Year’s post I wrote:

“It is one thing to say that having hope is important, but it is another to be truly willing to accept things that are out of your control, to have hope things will work out even if in the moment, you can’t see how or when. That is the hard part for me, anyway.”

What a prescient sentiment to kick of 2010, the year of the highest of highs and some truly significant lows. Having hope things would work out even when I could not see or know how was key to making it through some intense moments this year. A grueling pregnancy and delivery and a serious family health situation certainly demanded hope and faith, and the miracles of life and of survival were (and are) truly breathtaking.

I am someone’s mother. I still cannot believe that sometimes, especially when re-reading thoughts from this time last year, when so much was uncertain.

I do not like listing resolutions; I find them limiting. I’d rather work toward a larger goal. So, for 2011, my goal is to work towards finding balance. That might sound really general or clichéd, but my anxiety for the upcoming year is that I will have trouble with balance, so I’m trying to preempt that. I am someone’s mother now, and 2011 will be all about working everything else (full-time job, book to finish, relationships, household stuff, illness stuff, family stuff, etc) around that.

However, 2010 taught me some important lessons that speak to finding balance, namely:

Be flexible with expectations for myself. (Ongoing breastfeeding saga of 2010, I’m looking at you here).

Know that what works today might not work tomorrow. (This refers to baby schedules, body parts, you name it. Roll with it.)

Make those to-do lists a lot shorter and more realistic. (If bed rest didn’t clarify this, a newborn certainly did.)

Remember that somehow, everything will be okay. (I joke that if my daughter could survive 37 weeks in this body, she can take whatever the world dishes out to her and thrive. Kidding aside, sometimes I need to remember this perspective—no matter what unfolds, we’ll find our way.)

And lastly, take nothing for granted. (Then all of the smaller prioritizations, lists of supposedly important things, and conflicting roles somehow work themselves out.)

So while it’s a few days early, happy New Year. Thank you for reading and for following this journey, especially this past year. Whatever your goals or resolutions are, may 2011 bring you peace and happiness and as much good health as possible.

Transitions

This week is National Infertility Awareness Week.

I’m posting this a little late in the week because I’ve been struggling to figure out how to approach this on the heels of my recent pregnancy announcement and musings on what this development might mean for my blog.

If you’ve read our story as outlined in the announcement post, then you know that infertility is still very much a part of our experience and our pregnancy.

I’ve written about the complexities of chronic illness and infertility several times over the past several months/years, but still many of the specific details of our journey remain offline. That’s just what works for us. But over the last few years, I’ve found myself reading infertility blogs more regularly than I’ve read chronic illness blogs. The humor, grit, empathy, and authenticity I’ve discovered in so many women’s stories have been both informative and inspiring.

I never wanted to turn my blog into an infertility blog. Rather, I wanted to discuss infertility within the context of chronic illness and explore the overall challenges of building a family despite illness, whichever path that entailed. I’ve always been a strong champion of the idea that specific symptoms and disease labels are less important than the universal issues we face as patients: acceptance, guilt, or control, etc.

I’ve realized the same holds true in the infertility community. We all have different stories and different reasons for our struggles. In my case, it was easy to feel a little isolated: unlike so many women (and men), I don’t have reproductive problems aside from those caused by my lung disease. I mean, how many people are out there writing posts about a genetic lung disease making them infertile? The precipitating issue and the ensuing pregnancy challenges my illnesses pose are indeed rare, but the overall experience is similar: we all have to fight really hard for something that is natural and automatic for other people, and the avenues we ultimately take to build our families often differ from most of the people in our lives.

As I processed all of these thoughts this week, the link between what I wanted to say about the future of this blog and National Infertility Awareness Week suddenly became clear: it’s all about transition.

People who experience infertility transition from thinking pregnancy is a given to realizing it will be a struggle. Often, the question moves from when pregnancy will happen to when parenthood will happen, because so many of us who go through this do not end up with a viable pregnancy. It’s a transition in the expectations we had for our families and for the process we thought would be involved.

A colleague and friend of mine remarked that “the waiting makes it all the more precious” and I could not agree more. If there’s one thing we all share, it’s the waiting, the excruciating, mentally and physically exhausting waiting. For those of us fortunate to have some sort of a happy ending, hopefully the preciousness of it is universal, too.

I hope I never take a second of this for granted, knowing the four years of difficulties that went into it and knowing there are women who are not as fortunate, women who have to transition into totally new realities for their lives, ones that may not include children.

So while we’re discussing transitions, I so appreciate all the warm wishes and support as we transition from infertility to high-risk pregnancy and impending parenthood.

I do plan to discuss our pregnancy, but within the context of chronic illness and, again, the more universal issues of parenting with chronic illness. This won’t become a pregnancy or motherhood blog, and for many reasons: the privacy of our expanding family; my readers still living through infertility; adhering to the main purpose of this blog, which is to discuss chronic illness in young adults. I’m not a belly-shot person, and if I write letters to our child, they, like a lot of this personal journey, will remain offline. When I do have pregnancy stories and moments I think will resonate with the community of young adults living with chronic illness, I will definitely share them.

In fact, I’ve got a bunch of posts in mind already, tidbits I’ve been storing up for a few months now.

But this week? This week is about transition, so I will hold off. I’m getting there, and I’m so grateful to have you along for the ride, and so grateful to have learned so much from so many of you as we’ve progressed.

Book Review—Balancing Diabetes with Pre-existing Diabetes: Healthy Mom, Healthy Baby

I don’t even remember how I first stumbled onto Cheryl Alkon’s blog, Managing the Sweetness Within a few years ago. After all, I wasn’t a type 1 diabetic, nor was I undertaking a pregnancy with diabetes. But I know why I kept coming back anyway: her humor, accessible tone, frank candor, and overall pragmatic, down to earth attitude.

I totally dug her style, and since we’ve become friends in real life since I can attest to the fact she’s that funny and refreshing in real life. When she first shared her book proposal with me, I was so excited—I could see her book on managing pregnancy with diabetes unfolding, and I knew it was a necessary resource.

I am proud to see her project come to fruition, not because she published a book (though that is a feat all by itself) but because she published such a good book. Balancing Pregnancy with Pre-existing Diabetes: Healthy Mom, Healthy Baby, which pubs this week, is a comprehensive and essential guide to planning and living through a pregnancy with diabetes.

With the meticulousness of a seasoned professional journalist (she went to Columbia Journalism, after all), Cheryl interviewed dozens (seriously, dozens) of patients with diabetes, as well as physicians and other experts, to offer hands-on advice and information. In addition to anecdotal experience, the book is crammed with well-researched facts and resources. From pre-conception blood sugar control to the intricacies of each trimester to the delivery and beyond, Cheryl covers all the bases.

What’s more, she is diligent about including multiple perspectives. Struggling with infertility in addition to diabetes? She has tons of tips and resources. Contemplating an alternative birth plan or curious if a doula might work for you? She has plenty of information on that, too.

Just need some encouragement that a healthy pregnancy and a healthy baby are indeed attainable? That’s where Cheryl’s veteran experience as a type 1 diabetic and the many patients she interviewed prove so valuable. It’s one thing to hear from doctors or disease organizations what is possible, but it’s another altogether to hear from people who’ve actually walked the walk: they’ve dealt with first trimester lows, third trimester complications, and figured out the best way to deal with their insulin pumps during labor and delivery. They’ve juggled breast-feeding and fluctuating insulin needs, and know how (and when) to advocate for themselves.

But what I love is that it isn’t just about the content. Cheryl brings that same accessible, engaging tone she has on her blog to the book, evident from the opening lines of the first chapter:

“As a woman with long-term type 1 diabetes, I know this disease intimately. Reading this with type 1? Hi—you are my people. Type 1 is very-much-insulin-dependent, ain’t-going-away-with-weight-loss-or- after-the-kid-is-born diabetes. Type 1, despite what much of the mass media or well-meaning but clueless people will tell you, is a separate condition from the far more common type 2 diabetes or gestational diabetes.” (p.3)

But don’t worry-this book isn’t exclusively for T1s. If you have type 2 diabetes , there is plenty of material to meet your needs, and its conversational tone makes even the most serious subject matter in the book seem less daunting.

As a writer who published a book on chronic illness in young adults because I felt there was nothing out there that addressed that audience, I really appreciate a book that fills a true void. For the many readers out there contemplating a pregnancy with diabetes or managing one right now, this is the definitive resource for you.