Being nicer to myself.

Over the weekend at a restaurant, I overheard a conversation happening at table of friends catching up over a meal. Somehow, the conversation had drifted to one friend’s recent nose job. I heard them rationalizing the surgery to their attentive and supportive friends, and didn’t think much of it other than it seemed a bit shallow. However, when I was talking about it to my boyfriend later that day, I dissolved into tears.

Let me make one thing clear: I do not give two shits about any alterations anyone does or does not make to their face. So why had this conversation made me cry, hours after hearing it? It made me mad. Not because it was a nose job, I don’t care about that. I was envious because they were the ones that got to decide that they wanted a new nose. It was a TRULY elective surgery, they got to decide to improve the face they were born with.

In 2018, I had five surgeries on my face, all of which were performed by plastic surgeons.  Those weren’t plastic surgeries, though. Those were reconstructive surgeries. My accident, my facial paralysis, stripped me of the right to just change my natural face because I don’t like it. I don’t get to do anything to my face for improvement, everything I do is a step back to my normal. I don’t like my face. I don’t like it because it’s a lingering reminder of a terrible point in my life. I don’t like it because it doesn’t really work all the time. I don’t like it because I miss how it used to be.

When I am getting botox injections, it will not be to prevent wrinkles. It will be to partially paralyze my working side, so that my face looks more symmetrical. I know this is an odd point, but wishing you could change your face is a privilege- take a minute to revel in it. Maybe your nose is too big or too crooked or too round, but it’s yours, and you are in total control of how it (or your attitude) changes. In general, I avoid thinking about the things I don’t like about my face. Most of the time, it’s because I choose not to dwell on the things I don’t have. Sometimes, though, it’s because I’m afraid to know how long the list really is.

Reading through this, I’m unsure of whether or not to share it- it’s not exactly light hearted. That said, it’s a good reminder to myself and everyone else to be nicer to ourselves. I still don’t like my face but I will stop picking on her for tonight, she got seriously hurt and she’s doing the best she can to recover. I will be kinder to myself if you do too, deal?

Makeup.

Today, I had my 6 month post-op with Dr. Fung, my corneal surgeon. It’s not like this was anything formal- I have probably seen him roughly 6 times since the surgery. Today was important, though, because this is officially 6 months post-op. At 6 months post-procedure, things should be happening if everything went well. I did the same stuff as usual- they checked my eye pressure, checked my vision in both eyes, looked at the surface in the microscope. One fun thing that happens is when they poke my eye with different-length sticks to check my sensation.

All of the above looked good- my sensation is at about 80%, and the surface of my eye looks about as good as it possibly could. I could care less about the sensation, but the health of my cornea means that the surgery has been successful in the critical areas. I didn’t realize how worried I had been about it until I felt the relief- positive surgical experiences have been pretty hit or miss for me, so this is a huge win.

I had come to the appointment straight from work, and only one eye was made up, as is usual for my makeup routine. We were talking about the next steps over the coming months, when Dr. Fung said something that nearly made me cry. He looked me in the eye(s) and told me that I should wear makeup on my right eye. Not because I needed to, but because I shouldn’t be feeling like my right eye doesn’t get to participate in the rest of my face. It was certainly observant, but I would expect that attention to detail from a world-class eye surgeon. The empathy is what blew me away- all I needed to be was another successful case, another pat on the back for himself. But he sees me, the young woman trying to navigate my self-esteem and droopy face and find a sense of normalcy.

This empathy, this humanity- this is what my own experiences will allow me to give to my patients, and the impact it had on me being on the receiving end is something that will stick with me as I move further towards becoming a physician. I think that I can say with confidence that I have been cared for by some of the most talented doctors and surgeons that exist today, but the things that I remember are not how they treated me but how they treated me. Talent is unquestionably half the battle, but the difference between a phenomenal surgeon and a phenomenal caregiver is the ability to remember that the scans, test results, charts, numbers that one is examining belong to a human being.

Girl Stuff.

The morning that I arrived at the testing center to take the MCAT, I was amazed at the rigidity of the security rules. I had to temporarily part with my mom’s gold signing ring, which is a constant symbol of what can be done by a determined, strong woman. They made me leave my lucky scrunchy (yes, scrunchy) in my purse, which was locked away. The people working at the center didn’t seem to have any patience or understanding for anyone who wasn’t aware of the ‘rules.’ Anyone reporting to take the MCAT is probably experiencing the most stress they have experienced in their recent lifetime, is it really necessary to refuse to empathize when we aren’t aware of the rules?

Luckily, my anxiety-ridden self had only read the rules about 17 times before reporting for the test. When I arrived, I discreetly asked the very stern woman if I would be able to access my purse to get a tampon on my break; I was on my period and didn’t want any distracting ~accidents~ to take place at any point during the test. When I asked, she softened a bit and explained that yes, I could access my bag on the break. She kind of smiled and shook her head and said “sometimes it sucks to be a girl.” I shrugged and said “yeah, but anything they can do, WE can do bleeding.” She softened a bit once I said that, and the exam proceeded without consequence and ~accident~ free.

This exchange kind of broke the ice for the day I think. The day I took the MCAT was a brutal and stressful day, and I was not in any mood to be treated like I didn’t deserve to be there. The stress probably made me more sensitive than normal, but then this small moment of uncomfortable humanity reminded the both of us that there’s no reason we can’t exist as allies rather than enemies. She’s just an uptight test lady and I’m just super duper nervous and BLESSED by mother nature on this day. I’m just trying to make the rest of my life possible, here. The MCAT was insanely scary and difficult and has kept me up at night for the last several months, but then mother nature swooped in to remind me that, the next time she visits, this will be over.

I was fully drinking the cool-aid, twisted in knots over the 5 questions I had been completely stumped on in the practice exam. Then this awkward, but COMPLETELY PREDICTABLE obstacle that every female faces brought me back down to earth. The MCAT is important, but it’s not a force of nature. I am. The things that make me, me, are completely unrelated to how the MCAT went or will go. All of these things associated with my upcoming med school applications are important for my future, but none of this will affect who I am.

I am the girl who can make friends with a brick wall, who can win over the coldest of hearts. Not because I care about this happening, but because my candor and sincerity is something that everyone can appreciate and relate to. Everyone has said (or thought) some of the shit that’s actually PHYSICALLY left my mouth before. When people get over the surprise at whatever I said, sometimes they find that they can relate.

I am the girl that has survived things most people would consider their worst nightmare. I am the girl that has carried on in spite of this horrible accident, and has in fact done better with her life than she would have without it.

Those are the things that are important to the grand scheme of my life. The MCAT too, but significantly less so. A few years ago, getting my ~period~ would have sent me into a tailspin on such an important day, but not this day. Because that’s not the biggest disaster I can think of.

I’m doing it.

I am a morning person. I always have been, and I am physically incapable of doing much of anything late at night. When I was little, I would inform my mom when it was time for me to go to bed. Nobody else gets to work until at least 10, but I wake up at 6AM to arrive by 8:45. My early-morning productivity, however, comes with a hard 10:30 bedtime.

These days, the type of ‘person’ I am is irrelevant. I have to be an all-day person- wake up at 5:45 (allow myself 5 minutes to hide under my blankets), get dressed and out the door to the gym by 6:15. Work out, shower, get ready for work in the locker room, then head to MCAT prep class by 7:45. Sit in my car and review my notes until 8:45. Take notes and listen intently to instructors from 9-12. Head immediately to work. Eat lunch at desk, sifting through the last 24 hours of emails and creating my daily to-do list. Spend the hours between 1pm and 8pm working, doing MCAT studying during periods of down-time which vary day-to-day. Caffeinate as often as possible, but only until 4pm otherwise I won’t get any sleep that night. If necessary, work remotely from 8-9pm at home while also making dinner, packing lunch for the following day, and doing homework/pre-work/reading for class.

9-10pm varies. Sometimes I say ‘fuck everything’ and go to bed, because the day needs to be over ASAP. Sometimes I will do a bit of yoga to wind down. Most of the time, I take the path of least resistance and have a tall glass of wine. I re-watch early episodes of Grey’s Anatomy for inspiration sometimes, imagining myself as a brilliant and competitive intern (before they all died, of course). I know that some of you may think that if i can’t stay up later that I just don’t ‘want it’ badly enough. Or that I should skip the gym in favor of sleeping in a bit. But the truth of the matter is, I had a severe brain injury. Cognitively, I can’t afford to just sacrifice some sleep or endorphins in favor of doing more.

When I start to regret my insanely early alarm (usually the moment it goes off), I remind myself that pre-rounds will start at 5:30. I’m already running late for the rest of my life. I like to think waking up will be easier when I’m excited about the thing I’m getting out of bed for. This is who I am now, and it’s going to mean that I wake up insanely early and go to bed insanely early, and I cannot falter for a second in between. I have stopped caring about how I appear to others long before I had to buy a fancy carrying case for all of my colored pens, long before I started carrying a lunchbox. I don’t think that I cared much about how I looked to my peers before March 13 of 2016, but now I dare someone to try and belittle me for having 17 colored pens. I am going to color-code my way to victory, I’ll worry about being dorky all day over worrying about being alive, or walking again, or breathing on my own.

This is not about how hard my life is, I don’t need anyone telling me how tough I’m being. No, this is not fun, but I am pleasantly surprised by the general balance I have been able to maintain. When I am stressed, without fail, my emotions are all over the place. I have found myself being ‘sassier’ than normal to my loved ones- especially my parents, best friends, and saint of a boyfriend. I have the self-awareness to apologize and think about why I’m so volatile, but I don’t always like the answer. Right now, studying for this big huge life-altering exam makes me worry about not being enough, but this self-doubt spills over to all aspects of my life.

I worry that I’m not ‘committed’ enough to my MCAT studying- should I be pulling all-nighters? I worry that I’m not a ‘dedicated’ employee- does my boss think less of me now that I don’t work 50 hours in a week? I worry that I’m not returning the favor for my loved ones- they have given me the love and support I need to get through this in one piece, and I can’t possibly imagine how I can be doing that for them. I know that these are pretty irrational and I do my best on a daily basis to remind myself of that. This is one of the side-effects of doing something really fucking hard.

But that’s just it- I’m doing it. I am not sleep deprived, I am not constantly sick, I have my mental health (reasonably) in-check. I’m doing it.

Getting Back Up.

I am happy to start off the inevitable barrage of social media nostalgic end-of-the-year posts for you guys. Maybe just read this ONE and then I fully support going underground until 2019. Nobody cares what trash music you listened to this year, so please spare me from seeing yet another ‘Spotify Unwrapped’ screenshot. I have been thinking a lot about the general feeling that this year is ending on, especially compared to last year.

I began 2017 in a weird, unbalanced place; friendships had shifted, relationships had ended, and I was in a hurry to smooth out those kinks. Those knocked me down. I took organic chemistry and didn’t excel as I had hoped. That knocked me down. 2017 ended in a dark place when I was told that my face would likely never get back to where it once was, and that my nerves had stopped regenerating. That knocked me down.  I spent the remainder of that year (all of two weeks) feeling defeated by this news, but then it was 2018, and it was time for me to get back up.

2018 was the year of getting back up. I graduated from college. Had 5 surgeries. Presented my own research at two professional conferences. Submitted my first journal publication as a contributing author. I came back for organic chemistry, and I fucking crushed it. I feel like this year has been an overwhelming success, but it wasn’t all rainbows and butterflies. Of those 5 surgeries, 1 failed and 1 was an emergency fix FOR that one that failed. The other three are probably successes, but I will only know that by their lack of failure.

2019 is going to be one hell of a year. It will be the year that i take the MCAT, the year that I apply to medical school. The year that I get my last (hopefully) round of surgeries. There’s no telling how any of those things will go, but the one thing I know is that I am showing up, and I am ready.

 

 

Three months of hell.

Lots of full-circle posts as of late, but I don’t mind and hopefully you don’t either. Recently, I registered to take the MCAT, right after I complete my prep class in March. The class is several hours a day, every weekday AND Sundays, and my work has so graciously worked with me to figure out a realistic schedule. The date of the exam didn’t stick out to me when I registered, but it dawned on me once I saw it on the confirmation email.

I am taking the Medical College Admissions Test on March 15. The 3-year anniversary of my stroke. I will be taking an incredibly difficult, grueling, and important test knowing that this is not the worst I have faced. Choosing to fight for my own life, despite the paralysis, deficits, breathing problems, that’s the hardest and most important test of my life. And I passed, with flying colors (in my opinion).

Don’t get me wrong, I am incredibly stressed about the MCAT. Right now, to me and other pre-med students, it feels like the single most definitive barrier between us and the rest of our lives. But seeing that date in the email and realizing how it related to me was the perfect reality check. Yes, this test is important. Yes, it will be incredibly hard. But I have seen worse.

My success on this test will largely dictate my eligibility to earn the title of medical doctor. But, in theory, my decision to live and thrive after my accident also affected that same eligibility, among many other things. Throughout the day, I trend more towards panic. I buy into the general feeling of panic and dread associated with the MCAT. I know that there is no logical reason to feel this way, for the reason explained above, but it’s tough to listen to that voice when everything around me is telling me to panic.

It’s three months of hell, but this is the rest of my life we are talking about. And I have known three months of true struggle, and nothing will ever trump that.

A ‘good healer’

I was in NYC these last few days to follow up with my surgeon at NYU who operated on me this past July. This trip, we stayed at the same hotel we were in while I recovered, and being there brought some memories of my recovery. 

I only stayed one night in the hospital, and my room was filled with laughter and food until I kicked everyone out so that I could sleep. My saintly boyfriend slept in the hospital bed next to me that night, and didn’t complain when they drew my blood at 3AM, or when they changed my antibiotic IV bag at 4AM, or when the team of residents came to remove my drains at 6AM. Well, technically the nurse made him sleep in a chair after 4 so that he wouldn’t get in trouble with the residents. 

When we got back to the hotel that afternoon, I was near my limit of human interaction for the day. My pain was manageable, but I was covered in yellow betadine and dried blood left from the surgery. I had rejoined society, and I really wanted a bath. Anyone that knows me, knows that there are few things that make me happier than a great bathtub. This hotel had the MOST amazing tub; deep, standalone, luxurious. The problem was that I had dissolvable stitches in my leg where they removed the nerve graft, and I wasn’t allowed to submerge it. 

I was on the verge of a meltdown- I was exhausted, in pain, and I wasn’t allowed to do the ONE thing that always makes me feel better. My poker face is apparently not nearly as good as I think it is, because my boyfriend immediately got to work on solving this problem. He emptied out the bathroom trash can and turned it upside-down and put it inside the tub, creating a pedestal foot rest so that I could bathe without submerging my foot. At that point, I was well into my meltdown and had decided that nothing would work and that it was just a terrible day. 

But seeing him working to help me accomplish my goal for the day, that’s love. Anyone who knows me well will tell you that I can be incredibly stubborn- I was committed to being upset that I couldn’t make a bath happen that day. But, I didn’t have the heart to refuse to try out his contraption. So I did, and it was a great bath. Not the luxurious experience I wanted, but it eased the part of my soul that was craving it. Sometimes, it is better to let go of that commitment to a terrible day, in favor of something good. I am so glad for Anthony’s on-the-fly engineering skills that allowed me the luxury of a bath one day post-surgery, but I am even more grateful for his refusal to accept my abysmal attitude when I am in pain. 

My appointment with Dr. Rodriguez went well- he was very happy with how everything looked and was progressing. He called me a ‘good healer’. I like to think I’m good at more things, but at least I can say that I am exceptional at recovering from surgery. Wonder how I can put that on my resume. It seemed kind of crazy to fly from LA to NYC for a 30-minute appointment, but I think it was reassuring for me to see Dr. Rodriguez, and be told in-person that everything looks great. 

It’s All Happening

This past weekend, I had the opportunity to present my research on stroke assessment at the meeting of the Society of Vascular and Interventional Neurology. I was the one presenting MY findings, I wasn’t an anomalous case study being presented TO these physicians. I’m not quite their peer- yet, but I was able to explain my research to them on my own two feet, eye-to-eye, as a fellow scientist rather than a vulnerable patient.

I was able to share knowledge with the very same group of people that helped me cheat death just a few years earlier. I went from relying on them to keep me alive, to working towards empowering them to better the care of their patients. Maybe they took it easy on grilling me because I looked more like a 14-year-old wearing a pantsuit than a seasoned researcher, but I made myself proud that night. I stumbled more than I would have liked to, but I answered questions and politely debated the pros and cons of my analyses with people who are far, far more trained than I. The overall theme of these last couple of posts has been ‘full circle’, and I wish I had more diverse things to write about, but I have never been happier to be writing these things.

As an update, the corneal neurotization (eye nerve surgery) went as well as my surgeons could have hoped for; they said it was the best it’s ever went. Granted, that’s a pretty low bar as the third-ever case at UCLA, but I will take it. I have been feeling this positive momentum for a long time, but my right eye is now halfway open- people can look me in my two eyes. It’s showing on the outside, finally. My biggest struggle has been that I feel like my outside doesn’t match who I am internally, and they are finally starting to align. I am happy, I am happy, and I am getting smarter and stronger every day. Nothing is out of reach. IT’S HAPPENING, PEOPLE.

 

Getting Pretty Good at This.

Before March of 2016, I was afraid to get flu shots or my blood taken. Fast forward to October of 2018. Six surgeries. I have had six surgeries. I’m sitting here planning my seventh like I would a lunch date, negotiating everyone’s tricky schedules. Except it’s not other guests I am accommodating, it’s multiple surgeons.

Next up on the list is a surgery that will help me regain some feeling in my eye, called corneal neurotization. It’s basically the same thing I had done for my smile, but for my eye. They take my (other) foot nerve, and graft it from my forehead on my left side to my eye on the right. Ideally, my forehead will sprout a new nerve branch through the graft over to my right ‘numb’ eye. This regenerates for 6-9 months before anything changes. If this is successful, my cornea will be ‘nourished’ by the nerve supply, and I will have feeling again. Simple as this sounds, there’s a bit of a catch.

This surgery has been performed a handful of times- less than 50, I’d venture, and only twice at UCLA, ever. These are not ideal stats, but let me explain why I will be the next case at UCLA. The surgery was invented in Toronto, Canada. They have performed 22 cases total. Ever. Nobody can deny that 22 is more than 2, however I know better than anyone that pursuing the perceived best-in-the-field does not guarantee the optimal result. Because this procedure is so new, I know that I’m not going to find a surgeon who looks me in the eye and tells me this is going to work out. Because nobody knows that.

There are other factors at play here, too. Dr. Goldberg will actually be performing some of the more intricate parts of the surgery, and I trust him implicitly. I trust the ‘main’ surgeon as well, but I’ll trust him even more after he’s perfectly executed this procedure. Objectively, this is low-risk. I lose my other foot nerve as a viable option for some unforeseen surgery, and I gain a few (more) scars. I am confident in UCLA as a hospital, and I am confident in the team I will have working with me.

Anyone who knows me, knows that I don’t like sitting on my hands for long. There’s no rush to do this surgery, but there’s also no good reason to wait. So I’m doing it.

Time to Run

Last week, I had a surgery to help my ‘tracking’, to help correct my double vision. They do this on little kids all the time, you may even know someone who’s had it. For those of you who didn’t know this about me, my right eye was basically crossed, like the opposite of a lazy eye. This causes extreme double vision- like, the two images are not even close. This is a really common issue after head trauma, but usually resolves on its own. Like everything else, I waited two years for it to wake up, then decided it was time to get moving.

The surgery couldn’t restore my nerve function, but the fantastic surgeons at UCLA were able to rearrange my eye muscles so it’s at least straight. I still have slight double vision and will likely wear special glasses, but I will be able to look someone square in the eye (once they’re BOTH open). When I had pitched this idea to the surgeon who originally sewed my eye shut (Dr. Goldberg), he was not thrilled about it. He wanted me to wait just a little longer, give it one more chance. He came and checked my eye every day that I was in the hospital at UCLA with about 17 residents and medical students behind him, like ducklings. I would feel like a science project laying in my bed with all of these curious eyes on me.

The way that I was able to feel powerful was when Dr. Goldberg would quiz me on the cranial nerves in front of the students. I had known them before, but I became an expert as I was living through the issues that arise when they are interrupted. I would recite them seamlessly, and would pretend that maybe some of these brilliant, young, able-bodied students were envious of the feeble girl in the hospital bed. When he pushed back about pursuing surgery, I asked him what my other options were, because I was NOT going to live my life with one eye. I started to cry, and I think that’s when he realized how serious I was. In the hospital, I was stoic and positive through every poke, prod, every “sorry sweetie, it’s almost over.” But I was tired, and mad.

In his defense, he has tried to un-do my eye, let me have a little freedom, and I got a minor infection. But this is a much more supervised, structured path to freedom. We started with this tracking surgery. A very predictable, straightforward procedure and he was in the room to stitch my lid closed as soon as Dr. Demer was finished with the muscles. That was the deal I made with him, very low-risk for my cornea, and more-delayed gain for me. It was a problem that would need to be fixed eventually, so why not start with it? Baby steps. I spent more energy talking him into the surgery than I did myself.

When I saw both surgeons (separately) at my post-op appointment today, they were practically levitating. I don’t think either of them could have fathomed a better result. I would have loved for the double vision to go away altogether, but my cornea is clear and healthy, and my eye APPEARS straight. My lid is still mostly closed, but I have a peephole in the center so that I can actually use my eye. This is best-case scenario. Now, I need a nerve graft to my eye, the next surgery. This will help give me that ‘blink’ reflex to protect my cornea, something I do not have since I have no feeling in my right eye.

This is a very new, but very promising surgery where they take a piece of nerve from my (other) foot, and connect it from my good eye to my bad eye. Basically, the eye-version of the surgery I had in July. Dr. Goldberg, my very conservative surgeon who doesn’t like taking big risks, is rearing to get going on this next surgery. I don’t know if it was the ease with which I healed from this surgery, or the positive momentum of my recovery, or my attitude, but I’m not questioning it.

I feel like, for the past year, I’ve been saying “ready when you are” to the world. And now, the world is ready. The ground is rising to meet my feet, and it’s time to run.