Thursday, April 2, 2015

Comparison: The Thief of Joy

A couple of weeks ago, it was the end of Spring Break week and Addie had gotten in the habit of staying up late and sleeping in so I was trying to convince her to go to bed earlier by letting her go to sleep in my bed.  She was alternating between sitting up and bouncing and laughing and then lying back down and stroking my face. I was struggling to be firm in my message that she must go to sleep when she was being so adorable.  Finally around 10pm, she was dozing off so I got my phone out and was reading a blog to wind down myself and it was a mommy blog and it was full of cute and funny tales about her precocious three year old.  I read one about her rocking her daughter to sleep and her daughter telling her she was her best friend but if she really loved her, she wouldn't tell her no so much.  No sooner had I chucked than I felt sadness kicking in.  I looked over at Addie lying next to me and suddenly felt this great loss that she did not talk to me and tell me things like that.  I started thinking about all the cute things 4-year-olds normally tell their parents and becoming aware of what I was missing.  In a matter of minutes, my complete happiness over my sweet little girl whose arm was still wrapped around my back had turned to sadness and grief over what I suddenly felt 'should have been'.  Nothing had changed but my perspective.  The simple act of stopping to compare my life instead of just live it had cost me my happiness.  I gave myself a good talking to and eventually shook it off and was fine but it made me think about how often we do that.  We lose our contentment with what we have when we start focusing on what others have.  

It reminded me of a quote I love that I actually have a printed off version of behind my desk at work: "Comparison is the thief of joy".  I have it placed somewhere that I look every day because it's a reminder I definitely need.  It's actually surrounded by a ridiculous number of quotes because a few months ago I decided that I needed to be surrounded by wise words. 

In October we got Addie's autism diagnosis and for a couple of weeks, it was all feeling very overwhelming. New developmental diagnoses have always been much harder for me than medical emergencies and I can make that claim with a wealth of experience in both over the last four years! In a medical emergency, it is all about right here, right now and there are doctors and nurses making sure you are okay and numbers to follow and people bringing you cupcakes.  It's chaotic and scary but I know what to do with myself and how to stay busy and purposeful and calm.  When I'm facing a new diagnosis and a new change to what I thought my future was going to look like, I get more restless and panicky and sad.  There are no doctors doing anything to fix it, there are no quickly changing numbers to track progress with.  There is just normal life and people handing you daunting packets with names of therapists who may or may not take your insurance.  So, when we got the autism diagnosis, even though it was completed expected, it still started to make me feel all worried, sad and woe is me.  And there was no time for that so I decided some inspirational quotes would help me.  I went straight to the source of all wisdom- Pinterest- and began pinning all these quotes about strength, trials, the future and hope.  It became the perfect project for me when I then printed them out and mounted them all on cardstock and laminated them.  If you know me at all, you know that nothing relieves my anxiety levels like melting plastic onto paper.  As I pulled each freshly laminated warm quote out, I was starting to find my calm again. I taped them up all around my desk and to this day I am surprised that none of my students have asked why it looks like a self help book threw up on my wall.  But, those quotes really did help me!  I would show up at work every day and read all my little pep talks and get my groove back. I was given this life because I am strong enough to live it! The best thing about the future is that it comes one day at a time!

And of course: 'Comparison is the thief of joy'.   Clearly I should have enlarged that one and made an extra laminated copy for every room in my house.  Because it is a struggle.  I need that reminder every time I go to the playground (perhaps I need a little business card sized laminated copy for my wallet) and a little kid asks Addie to play with them and she keeps walking with her hands full of mulch because clearly it is more fun to throw mulch down slides than play princesses with the other kids.  I need that reminder every time I log on to Facebook and see adorable pictures of little boys playing t-ball and I wonder what Max would look like standing up with a little bat in his hand.   I need that reminder when I'm out to eat and I marvel at a toddler eating chicken nuggets because oh my goodness sometimes I forget that other children eat with their mouths and not with a tube.  Come to think of it, I should probably just go straight to a tattoo parlor and get 'Comparison is the thief of joy' tattooed all over my arms because I need to be reminded of it constantly.

I am still a work in progress on this but I do think my being aware of it has been an important step because at least when I do start getting sad in those moments, I have been able to catch myself and re-focus on what IS and stop my mind from stalling on what COULD BE.   To clarify, none of this is to say there is not a place for real genuine sadness.  I think God completely understands when I feel sad that my children experience frustration and pain because of their disabilities.  I believe He wants me to take those very real and fair hurts to him because He too aches for Max and Addie when they suffer.  And although I know there is little merit to worrying or anxiety, I also believe those concerns for the future can spur us into action and therefore have a place.  It is helpful that it is the desire of my heart to help Addie find her voice.  My dream to see her talking and telling me how she feels has helped motivate us to make the sacrifices we are now making to get her into this school that will best help her get there.  That I don't want my kids to be sick or uncomfortable and that I long for them to develop new skills in their future- those make me a good mom. And I believe God honors that.  What is not good or helpful is that I can be in a perfectly happy moment in my home where I am genuinely enjoying my kids and they are both smiling and happy and I can let the thoughts of 'but it could be better' or 'this is not everything I wanted' slip in.  In those moments, I am just letting my comparisons- to other families, to my previous dreams- rob me of the genuine deep joy that day to day life with my adorable family brings.  That's when I need the reminder.  To stop focusing on anything other than right here right now and the blessings God has given me.  

The reason I am sharing all this is because I don't think this is just MY struggle.  I think it's something we all struggle with and I think it is more difficult than ever when social media makes those comparisons much more frequent and hard to avoid.  In the end, my getting sad because Addie cannot tell me she loves me (despite showing me all the time) is the same as if I were being very happy with my home until I go visit a friend whose home is bigger.  It is the same as feeling happy with my marriage until a friend tell me a story about her husband and his grand romantic gestures and I kinda feel slighted.  We do it all the time- we look at one snapshot of someone else's life and it looks better than our reality.  It's illogical because we don't always want to actually put the effort in it would take to have their life.  I can be completely jealous of someone who is really fit and still have absolutely no desire to exercise ever. It's also irrational because we do not always even know the whole story or want the whole story.  I admire their vacations and think I want that!  But I may not want the work hours that would pay for that vacation.  When we start comparing and wanting, we are trying to trade in a real, true, full life for a series of still frames that would themselves only disappoint.

And when we compare and feel slighted, we lose sight of OUR blessings and we forget to thank God for what we do have.  Because, it may be true that someone has it better, but it is most definitely true that someone else has it worse.  And neither of those really matter.  What matters is what we have been blessed with.  My children have a long list of complications but they are ALIVE and God did that (using some pretty amazing doctors).  There were days when I prayed for nothing more.  When I sat by an isolette and dreamed of them being in my home.  When the very idea of Addie laying next to me in bed was the most precious thing I could imagine.  They have overcome enormous odds to be home and healthy today and beyond that blessing, God has given us generally very HAPPY children who smile most of the time and find great joy in their lives.  Sometimes it's in unusual things- like throwing mulch or the fact that to this day Max acts like the mobile he has had since he was 2 months old is the Most Hilarious Thing Ever.  But you know what, it really does not matter whether it is 'normal' things that make them happy- it matters that they are truly abundantly happy.  And that is just talking about my children.  Some days I think about everything they go through and am working up some mighty self pity that I forget how much I have to be thankful for like seriously the best parents and in laws in the world who have the means and the HEART to help us out all the time and who love spending time with us, or a devoted husband who hasn't been home to Australia in six years because he wouldn't leave our kids for even a couple of weeks and who has given up his career to care for our kids, or a workplace that let me take time off when I needed it and supports me and co workers that really should abandon education and take up stand up comedy because seriously they are hilarious.  There are struggles in my life, for sure, but there are SO MANY blessings.  There is so much joy.  And I'm determined to hold on to every part of it and let nothing steal it from me.  Especially not comparison.  

I am going to have to settle for my laminated cards and my memory because I feel like I might look like a sketchy 80 year old if I have quotes tattooed on my arms.  I am probably going to slip and let those thoughts in sometimes and have those moments where I feel sad for the words I do not yet hear or the freedoms our situation does not afford us.  I am, after all, human.  But, I will try not to let it consume me.  I will try and focus on the sweet little arm on my back in my bed and how many miracles have already happened in her life and how many more I know we are on the cusp of.  I will savor the nights when Max is home and soak up his smiles because let's face it, I was never really cut out to be a baseball mom anyway.  And on top of that, I will every day thank God for my wonderful parents, my witty co workers and my warm bed.  There are some with more and many with less but as for me, my blessings are many and my joy, complete. 

Tuesday, March 10, 2015

The Significance of the Signature Smile

I will always remember the first time Max smiled.  He was four months old and I was taking pictures of him and Addie and he started giving us these big grins, complete with dimples and all the adorableness we can imagine.  He actually started really smiling a few days before Addie and he definitely made his reputation in the NICU for being so incredibly smiley.  He smiled at his nurses almost constantly and the smiles brightened the room up.  Those were all days 'before' and his smiles were precious and endearing but they did not yet have the significance and the necessity that they do now.

I say 'before' because being Max's parents did seem to change almost in an instant when we got the diagnosis about his neurological damage when he was 13 months old.  Our expectations and dreams changed dramatically over the months that followed.  Difficult conversations with doctors were frequent and we were constantly hearing about the things Max would not do. We had many dreaded conversations where doctors encouraged us to really think about the concept of quality of life in making our decisions for transplant and long term care.  Some of these conversations were delivered with tact and compassion, others less so.  But the thing that made these talks and the new realities we were facing bearable was his smile.  We did not have to agonize over wondering if Max did have a quality of life because he was pretty much constantly beaming at us.  Al and I quickly realized that although we may sometimes doubt that WE could be happy if we were not able to move or communicate effectively, we never had any reason to doubt for a second that Max was happy.  If you asked anyone caring for Max to describe him in a word, I'm sure most would choose happy.  His smiles were also not random but almost always directly in response to seeing us and they told us that for any of things we were not sure if he understood, it was clear he knew very well how loved he was!

Through all the highs and lows that have followed in the years since, Max's smile has remained extremely important to us.  When he is sick and not feeling well, the smile fades temporarily and that is usually his way of telling us something is wrong.  Then, as soon as he is better, the smile returns and we know he is okay again.  His smile is often more telling than bloodwork or any doctor's assessment.  Frequently we will notice he is not smiling as much but be unsure why and then a day or two later, he spikes a fever or his labs come back bad.  Max does not have words or signs but he has the most expressive face and his smiles and frowns are how he communicates with us and they are how we try and understand what he is feeling in his world.  In that respect, his smile is so much more than just an expression, it is his primary form of communication.

And just as his smile gave us peace during those early conversations and queries about his quality of life, it continues to be our main source of reassurance that for all Max endures that he is ultimately happy and at peace.   There are so many discomforts and limitations that Max endures that we feel powerless to prevent but on a day when his whole body smile is beaming at us, those seem less significant than the things he can do like laugh, enjoy family outings and find joy in his surroundings. If you were to describe Max's limitations and his medical history, it could certainly sound like a very sad situation.  And yet, if you know Max and spend time with him, it seldom feels sad in the moment.  He is charming, personable and his giggling at his mobile is so adorable, it is near impossible not to smile yourself.  I've called Max's smile contagious many times before because being around Max truly is an uplifting experience.  And not just because it will make you appreciate the things you can do (although that too is certainly true) but because he is so happy and his smile is so full of joy that you will end up smiling with him.

The fact that Max's smile is so important to us, to our ability to understand Max and to our sense of peace that there is more good than pain in Max's life is why these past few months when Max's smile had vanished have been so difficult for us. Max was quite happy and smiley through his hospitalizations in December but when he came home in January, we knew something was not right because he was crying a lot and not smiling.  He ended up readmitted a little over a week later, stayed for a little over a week and then came home but still unhappy.  We were worried about him and not surprised when he then ran a fever and was admitted again, and for over a week.  More concerning was that when he came home then, he did not smile once for over three days.  Those were long stressful days.  We couldn't pinpoint what was wrong with him.  No fever, no obvious source of pain.  And yet it was just not like him to not smile and to give us non stop pouting faces and crying.  Finally he began giving some half smiles but for two weeks, the smiles were few and far between and the crying and sad faces were prevalent and really troubling us.

When Max is miserable, we feel very stressed trying to determine what is wrong.  Although he is four, he has no way to tell us or show us more specifically what is wrong.  Although Addie still does not use words to describe what is wrong, she pulls on her ears or touches her throat or finds some way to usually indicate what is bothering her.  With Max, we have this sad pout lip and tears but no real clue as to why.  And when he is sad and his smiles are gone, our hearts are so heavy for Max.  We long to be able to take away his pains and we feel sad that he cannot do the things his sister can that would cheer her up.  His limitations seem bigger, his trials seem less surmountable and our ability not to dwell on the past or fear the future begins to fade.  In a way, his sad faces are as contagious as his smiles.  Without them, the sadness and fears creep back in and his situation starts to feel upsetting and instead of focusing on the great things in his life and that he can do, we find ourselves discouraged and worried.

Thankfully Max's smile free streak has come to an end, for now at least.  He woke up happy on Saturday morning and is back to giving us full whole face light up the room open mouth exuberant smiles.  He is still having some grumpy stretches but we have been able to handle those because a few minutes later we can hear his sweet laughter and see him grinning at us. We know that there are challenges of course for Max, but we know that in spite of them, he is happy.  He sees the joy and he knows he is loved and that there is so much goodness in his life.  When he sees us and flashes us that smile, we remember not the struggles but the sweetness, not the limitations but the love.  His smile heals our hearts and are house becomes lighter and happier. It's pretty remarkable the power this sweet little face has over all of us.

I love to share the pictures of Max's huge smile in hopes that I can share his message with everyone.  Yes there are difficulties and challenges in life, but there is also so much joy and hope.  This weekend we got our happiness back and we are so grateful,  We are soaking up the smiles, focusing on the good and praying that we can keep Max happy and smiling in the days, weeks and months ahead.  Just for fun, some of my favorite pictures of the Signature Max Smile... I bet you cannot look at them and not end up grinning and falling in love with this boy!!

First afternoon home from the NICU and we got a smile bigger than we had ever seen in the hospital! He knew he was home!

Watching him smile while he watches Addie play is one of the sweetest joys to me! 

No doubt he knows how loved he is!
One of my favorite pictures, loving the view from his new chair. 

One of his last really great smiles in late December before he went on his two month smile strike

And our most recent picture of the most beautiful smile in the world that was back this Saturday!!!

Saturday, January 3, 2015

Chapter 27: The Holiday Card Assembly Line (Addie's First Hemo)

Once upon a time, when I had a normal life and simpler problems, I taught Psychology.  I loved learning about how the mind works and the tools to treat it when problems arose.  Of all the mental illnesses we would cover, students were particularly drawn to learning about phobias.  From the unusual things people could be afraid of to the creative ways to treat them, it is undeniably an intriguing look at the human mind.  One theory is that the best way to treat a fear of phobia is simply prolonged exposure.  We tend to fear things that we have not experienced and were we to experience it, the irrational fear would be replaced with a logical understanding of the previously terrifying concept. There is plenty of debate as to whether that form or therapy is brilliant or downright traumatizing but it has certainly been widely used.

Obviously I was not always afraid of hemodialysis.  Back in my blissfully simply psychology teaching days, I never even thought about hemodialysis, if I even really knew what it was.  But over the course of the year since Max and Addie, I had learned enough to be truly terrified of it, complete with sweating, heart racing and shuddering at the sound of it.  Any parent could surely identify- imagine holding your new small, dependent, soft, just starting to smile and cling to you new baby and hearing about inserting a plastic tube into their heart.  Then hooking them up to a machine that pulls their blood out of that tiny baby's heart, running it through the machine, easily ten times the size of your wee one, and then after three or four hours returning that blood, hopefully without encountering seizures, blood pressure swings or fatal infections. It would surely be enough to terrify any new mom.  On top of the whole removing my baby's blood fear, we had been warned that babies on hemodialysis often need repeated blood transfusions, even every single hemo treatment and that more than six blood transfusions can make finding any compatible donor for transplant close to impossible. Both the immediate and long term risks scared me to death.

For this reason and because every doctor seemed to say the word quietly as if it was the medical equivalent of Voldimort and simply saying it would wreak havoc, I had a full blown phobia of hemodialysis. And throughout those two weeks in November, it was lurking at every corner and filling me with fear.  I was so adamant against it initially that spending two weeks in the ICU, having chest surgery, and essentially starving my child all felt like a better option than hooking her up to the dreaded machine.  However, my phobia was about to be put to the ultimate test- it was about to receive exposure therapy and time would tell if I would fear it more or less after seeing it face to face.

Exactly two weeks after Addie initially came to the hospital with fluid in her chest, we are sitting in the hospital room with a new chest tube in place, restricting her fluids and providing pitifully insufficient dialysis and feeling thoroughly defeated.  The kidney doctors rotated weeks on service in the hospital so after a year of being immersed in hospital culture, we knew that Mondays would mean a new doctor, a new perspective and a new plan.  Dr Doom and Gloom had moved to another hospital a few months ago so at this time, there were only three kidney doctors who would alternate: Dr Optimistic, Dr Nice and Dr Funny.  I even told them I had them all pegged and really with those descriptions, we clearly liked them all and felt they all brought something useful and distinct to their way of interacting with us.

That Monday, Dr Optimistic came on to replace Dr Nice.  This doctor was also the head of dialysis and the head of transplant so the doctor we had the most experience with and attachment to.  She loved Max and Addie and had invested in our family and did always try and encourage us that we would survive all of this and see a great outcome.  That Monday though, she walked in looking very sad.  Since she had been one of the key ones emphasizing how hard hemodialysis would be on them, she definitely came in with a heavy heart to tell us we needed to start Addie on hemodialysis.  By this point, though, we definitely saw it coming and had begun to make our own peace with it.

Dr Optimistic (or Dr S as we actually call her) went through all the reasons why we did not really have any other option.  It was pretty clear that we did not know how to stop her from leaking fluid into her chest and continuing to withhold food, run poor dialysis and leave a plastic tube coming out of her side were not appropriate long term solutions.  I will never forget Dr S saying to us that we needed to move to hemodialysis immediately because Addie was getting very sick on the inside and if we did not act soon, she was going to be backed into a corner that we could no longer get her out of.  Right now, we could still help her and get her sorted out but if we left it much longer, it could be too late.

Those words were exactly what I needed to sign all the consent forms for hemodialysis confidently.  I knew we needed to help Addie now and that this was the only choice we had.  After all, everyone knows you never put a baby in a corner...

We actually could not act as quickly as we would have liked though because Addie was actually too sick and compromised for anesthesia that Monday.  I always assumed you could be so sick you needed anesthesia,  I had only recently learned you could be so sick you were denied anesthesia.  Without good dialysis, all the electrolytes in Addie's body had become so messed up that it was not safe to put her under.  The plan was we would substantially increase her peritoneal dialysis, running it with greater amounts of fluid and for longer for the next day.  This would cause much more fluid to go into her chest but we had a chest tube in place to handle that.  And then once we got her levels acceptable, she would go to the OR and have the plastic hemodialysis catheter tube placed into her heart.  It would protrude out of her chest, in the area where you hold your hand over your heart to say the pledge.  Then, because she was needing good dialysis so badly, the plan was to take her directly from the OR to the PICU and go ahead and have her first dialysis treatment that day.  We were assured that there would be lots of doctors in her room and standing by during that treatment since we were not sure how she would respond to Hemo and especially having just been under anesthesia.

After that, we would remain in the hospital for a week or so for healing and monitoring.  And then we go home and return five days a week for a three hour hemodialysis treatment. That which I had so feared was about to become a very big part of our lives.  But, her home machine would no longer be used, there would no longer be fluid in her belly to get into her chest and she could breathe comfortably and sleep free of any machines.  It had its clear pros as well.

For the 48 hours after we formulated that plan, Addie got a lot of dialysis and the doctors measured her bloodwork carefully and we prayed and worried.  It was the worst part- knowing what was in store and knowing how many bad things could happen but having nothing to do but still in a small room and wait for it.  Finally, the waiting was over and Wednesday arrived.   They wheeled Addie off to the OR to get her catheter placed and we sat and waited.  Normally, we were waiting for the surgery to be over and the relief to set in that the worst was past.  This day though, we were anxious to get her out of surgery and our eyes back on her but knew that it would be a short-lived relief as we then went straight to dialysis.  This day, more than any other, was jam-packed with anxiety and uncertainty.  My mom, her best friend Becky and I spent the day together, trying to make small talk or read or tell each other stories, anything to take our minds off it all but the anxiety was so thick, it was as much a presence in the room that day as we were.

After a couple of hours in the OR, we got to go see Addie in recovery.  She was groggy, whimpering in pain and now sporting her large new plastic tubing.  It was nearly unbearable to fathom putting her through another traumatic event that day.  The emotional part of me wanted to unhook her, grab her in my arms and just run.  But, any time I thought about that, I remembered the metaphorical corner she was backing herself into without hemodialysis and knew that loving her meant holding her hand while she faced this and not whisking her away from it.  So, I swallowed the pain and fear and walked with as they wheeled her into the ICU room and placed her next to the machine that towered over her in size.  Addie was still drifting into and out of sleep so largely oblivious to the chaos in that room.  There were two dialysis nurses- one of whom was our good friend who was their peritoneal dialysis nurse and another nurse who would be running the machine with her.  Her PICU nurse was in the room and several PICU doctors were either in her room or just outside of it at all times.  Dr S also wanted there to be a nephrologist kidney doctor in the room for the entire hemo treatment and could not be there herself for it all as she had clinic appointments that afternoon.

So into the crowded room where we all were hushed and stressed, entered Dr Funny.  As with the other kidney doctors, I had known him close to a year now and always welcomed his stints as his jokes and cheerful approach lightened the atmosphere.  Back in the NICU when Max's breath holding spells were scaring the other docs, he would make quips about how interesting it was that I decorated one babies bed in pink and one babies bed in blue and they had each matched their surrounding in their own coloring.  He was no stranger to seeing us mid crisis as he had been on the terrible week when Addie was on the ventilator with heart failure so he did not seem particularly surprised to walk in and see me pacing the room in my yoga pants, sweatshirt and ugg boots and crazy hair thrown up in a ponytail looking stressed out and overwhelmed.  He didn't seem surprised that I had my mom and Becky with me, as he was used to my support system always being a few feet away.  He sat down at the end of the sad little hospital windowsill couch and pulled out a bag of cards.

We were surprised and intrigued as we saw him carefully take a letter on pretty paper and fold it, enclose a picture in it, stuff it in an envelope and then place address stickers and stamps on it.  When I stared at him quizzically, he explained that he expected the next three hours to be completely boring and uneventful so he may as well work on his holiday cards while he was sitting there.  It is hard to explain how much those words filled me with relief.  Here I had been convinced the next three hours were going to be horrific, filled with blood splatterings, seizures, monitors alarming and utter panic and heartbreak.  I had prepared myself for the worst few hours ever,   But he who knew so much more than me had instead expected boredom and some down time.  Surely if he expected blood to shoot from the machine, he would not have his precious cards out.  Surely if he anticipated having to leap up to do CPR or dramatic medical interventions, he would not want a lap full of cherished photos.  Certainly if he thought he was going to be making constant life and death decisions he would be pacing and scowling like me and not chuckling at his charming family's letter.  But he did not seem to be worried about any of those things.  And with that assurance, I exhaled, calmed down and paced at least a little bit less.

My mom and Becky, sitting there as bystanders to this scene and feeling quite restless, asked Dr Funny if they could help with the cards and so he handed one a stack of letters and pictures and the other a stack of envelopes and so the Holiday Card Assembly Line began.  As the dialysis nurses fiddled with the machine and watched the monitors and Addie slept and I paced, they sat and chatted and stuffed.  And that simple set up at once made the room seem less tense and less scary.  As other doctors would come in and out, they would check on Addie and see that she was doing fine and then go over to check out the holiday cards, smile over the adorable children, debate about which recipients' names had changed and make cheerful small talk about the upcoming holidays.  It was the next best thing to setting up a Christmas tree or placing Santa in the corner.  In a room of anxiety, a little bit of cheer had snuck in.

Three hours later, the cards had been finished and Addie's first dialysis treatment came to a completely boring and uneventful finish.  She had either slept or just tiredly glanced around.  The dialysis nurses diligently managed and watched the machine but the handled it so well that from the outside, there was no obvious issues.  Her vitals remained stable and the PICU team who were circling around found there to be nothing for them to do.  The bag of blood standing by in case she needed a transfusion remained untouched. Addie's blood was cleaner than it had been in weeks, and we had just faced and survived our biggest fear.  We were exhausted but also at peace that evening.  That which had felt completely insurmountable had just had happened and we were all okay.

I won't say that I was 'cured' of my fear of hemodialysis.  Nor should I have been.  We would learn in the months ahead that the dangers of hemodialysis are real and that one uneventful treatment does not garauntee the same for the next one.   I will never not fear hemodialysis for my children but my first exposure to it certainly removed my deep phobia of it.  My panic and dread of it was replaced with a much more appropriate caution and rational concern.  There would always be risks but if Dr Funny could waltz in with his holiday cards, certainly I could handle this and did not need to be on the constant look out for disaster.  It was clearly a success story for Exposure Therapy.