Laser Surgery Number 37

Addy recently went in for her 37th laser surgery at Children’s Hospital!  She had a blast.  And no Versed this time, so she remembered the whole thing.

I had lost track of counting these procedures somewhere in the mid-20s, so I was very glad when our curious anesthesiologist, having seen the volume of records in her file, took the effort to count up the number of procedures leading up to this one.  I’d been planning such an investigation but hated the thought (so much paperwork to sift through!), so it made my day to have the work done for me.  Thirty-seven!  How time flies.

It was a perfect day for Addy.  The routine was followed by all, and that made my organized eldest very happy.  We arrived early enough for her to spend a few minutes playing with toys in the waiting room.  The nurse called her back to the pre-op area and took her height and weight.  Armed with hospital jammies, Addy settled into her hospital bed and changed clothes so the medical stuff could begin.  “Here’s my arm, so can you take my blood pressure now.”  She played with her favorite Princess toys (yes, she has favorites here).  Everyone asked their routine questions: the pre-op nurse, the dermatologist, the anesthesiologist, and the nurse anesthetist. No recent colds, history of bleeding, only one slightly loose tooth (not enough to worry about).  Addy’s bed was wheeled into the O.R., she got a combination of bubble gum AND cherry flavors in her mask, and she went to sleep.  She woke up groggily in the recovery area (though with great manners, according to the nurse there), and was returned to me to spend the next hour de-fogging, nibbling on crackers, and eating three popsicles in three different bright hues while Disney Junior played on the room’s TV high up in the corner.

She thought it was a perfectly lovely way to spend the morning.

As her mother, I found it to be a bit more work.  Thinking about our anesthesia options; watching for any signs of a bad reaction somewhere; talking to the dermatologist about the degree of zapping we should try this time (too little means little progress, but too intense will burn patches of skin permanently); verifying the semi-loose tooth myself to see how much the anesthesiologist should concern himself with it; wracking my brain for any recent fevers in our family of five, because heaven knows my mommy memory is so short that my toddler could’ve been puking yesterday and I would’ve forgotten.

It all went smoothly.

Annnnd, not gonna lie, any time spent with only one of my three children is basically two-thirds of the way to a day off…  So I, too, thought it was a perfectly lovely (and refreshingly quiet) way to spend the morning.


            

The Dappled Things of Beauty

Continuing the last post’s theme, I share a poem with you:


Glory be to God for dappled things –
   For skies of couple-colour as a brinded cow;

For rose-moles all in stipple upon trout that swim;
Fresh-firecoal chestnut-falls; finches’ wings;
   Landscape plotted and pieced – fold, fallow, and plough;

And áll trádes, their gear and tackle and trim.

All things counter, original, spare, strange;
   Whatever is fickle, freckled (who knows how?)

With swift, slow; sweet, sour; adazzle, dim;
He fathers-forth whose beauty is past change:

Praise him.

– “Pied Beauty”

Gerard Manley Hopkins


(These pictures are from the days following one of Addy’s recent surgeries, when “dappled” is an apt and lovely adjective.)

Addy dappled

Addy dappled after surgery

Decisions…

.Sleeping Addy PWS

After Addy was born, Keith and I had to decide whether or not to pursue treatment for her port wine stain.

It’s odd – you have this beautiful baby girl, and you know she’s absolutely perfect, but there’s something you have to “fix.”

We were 90% certain we would treat the stain… In hindsight, I realize the only reason it wasn’t 100% was because we felt that, by treating it, we were acknowledging that it was a blemish.  And we didn’t want her to see it as a blemish.

But over time, I learned something rather profound: you can both call the error and call it beautiful.  An the fact is, the port wine stain is an error, a mistake that occurred in development; trying to label it anything else deviates from the truth.  But that doesn’t mean it’s not beautiful.

And once you wake up to that truth, you realize how much of this beautiful world is so, not in spite of, but because of the errors.  It’s the deviations from “perfect” that we find interesting, lovely, attractive.  A towering, twisting oak tree gnarled by age and storm; the jagged edges of a rock cleft by violent wind and ancient water; those tiny little pigment mutations sprinkled on the nose that we affectionately call “freckles”.  The tree, the rock, the skin… all deviate from their error-free Platonic ideal, and yet all are more beautiful for those deviations.

So, we face the error honestly.  We zap the invasive blood vessels that have masked our daughter’s face from birth. And yet, every step of the way, we affirm not only her beauty in general, but the unique beauty of her face for the lovely error she she’s blessed to bear.

“In nature, nothing is perfect and everything is perfect. Trees can be contorted, bent in weird ways, and they’re still beautiful.”

— Alice Walker

 

Addy sleeping

Baby Addy Port Wine Stain beauty

Addy and Daddy

Siblings & Classmates

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We have three children: Addy is 7, Clarence is 5, and Eloise is 3.  The younger siblings’ awareness of and reactions to Addy’s port wine stain are amusing: a combination of childhood oblivion and concerned observation.

When Clarence was younger, he’d point to Addy’s baby pictures: “That me!”  “No, sweetie, that’s Adelaide.”  “NO! That ME!”  We’d point to the rather obvious port wine stain plastered on the baby’s face: “Clarence, look at that stain – you don’t have one of those, only Addy does.”  He’d stare at it for a minute, think about it, then firmly shake his head.  “No, that me.”  Okay, dude.

Eloise did the exact same thing when she saw family pictures.  It wasn’t until they were about 3 that either one showed any signs of recognizing the port wine stain’s existence in the picture and connecting it to their sister.

Two or three days after her latest surgery, which left her cheek quite bruised, we were sitting around the dinner table when Elly (age 3) suddenly stopped eating, stared at Addy for a long moment,  pointed to her cheek and asked, “Addy, what that?”  Yes, it took three years of life and three days of bruising for the youngest sibling to notice anything out of the ordinary.

When Clarence was three, he saw Addy’s bruised face after a particularly intense laser treatment and became quite concerned: “Addy! That blood!”  She laughed it off and shrugged, “No, that’s just my port wine stain.”  He stared.  “No, Addy, that blood!”  It took some work to convince him that his sister was fine, and that such bruising had, in fact, happened regularly in his first three years of life.  He’d just never noticed it before.

Clarence recently told me, “I want to have a port wine stain, mom.”  “Really?  Why is that?”  “Because port wine stains are good.”  Awww!  My mommy heart swelled with pride knowing that clearly, I’ve done such a stupendous job parenting tha–   “And because Addy gets toys like her new Olaf toy and her new Olaf blanket when she goes to the hospital, and I want an Olaf blanket.”

Priorities, right?  He just wants the goodies.  I can’t blame him; that new Olaf blanket is pretty sweet, as you can see in the picture.  (By the way, on that thought: A million thanks to the volunteers and donors who keep Children’s Hospital stocked with the awesome toys that comfort & distract kids during medical procedures; it’s stuff like that that keeps our Addy looking forward to her hospital trips!)

As far as classmates go, whenever Addy has a surgery, we prepare her for the fact that, because she’s going to school with a newly dark-purple face, people will probably notice it and ask her about it and that’s totally okay, because it means they’re concerned, and that’s awesome.

But recently, no one has asked.  And I realized something – it’s old news already.  She’s at a small school; all the K-12 class sizes are 10-20 kids each, she knows upperclassmen by name, and they know her.  In other words, pretty much everyone in that building has seen her bruising before.  She walks in with a purple face?  Nothing new.  She gets more double-takes when she leaves Children’s hospital, which makes sense, because those strangers have never seen her before.  (In fact, one little girl in the lobby gasped excitedly, “Mom! Look! That girl has a painted face!” like it was the coolest thing she’d ever seen.  I love kids.)

While familiarity may sometimes breed contempt, it can also breed boredom; in our case, that’s a very good thing.  As long as Addy is small, surrounding her with the same people regularly for whom her suddenly-purple face is ‘nothing new’ minimizes the stares and questions she gets throughout her day.  I will always be happy to expose her to the world, to empower her to answer strangers’ questions with grace, and to build her confidence in facing society with a unique face, but I’m also relieved that in her daily routine, she can relax among a few friends and family who know her face so well that there’s nothing left to ask.

Unless she comes home with a sweet new Olaf blanket and stuffed toy.  Apparently, that’s enough to pique brother’s curiosity all over again.

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Comfortable

And for posterity...

After Addy de-fogged from her last surgery, she wanted to see what her face looked like.  She knows that each laser treatment brings bruising – sometimes darker, sometimes lighter.  I didn’t have a mirror with me in the hospital room, so I grabbed my phone and flipped the camera on so it could act as a mirror.  She stared at herself for a minute, then observed the bruising with a matter-of-fact, “Well, that’s purple.”

And with that, she moved on to silly selfies.  I love her comfort level here, so I thought I’d share a few.  She’s post-op, she’s bruised, she’s aware of it, and she’s over it.  Her face will definitely garner some double takes when we leave, and that’s okay.

Yay!

Oooh-aaah

And that side...

This side...

The Best of Times, and the Worst of Times…

(That’s Addy trying to play it cool while telling me what she’s looking forward to at this surgery.  Before I pulled out my phone, she had been talking a million miles an hour, almost bouncing off the bed with enthusiasm.)

Addy had another laser surgery in January. She had looked forward to it for MONTHS. We try to do them every three months now that she’s older, but occasionally we have to push it back an extra month for scheduling conflicts, like this round. So with 4 months between surgeries here, she had an extra month to get excited about going into Children’s hospital.

“Mom! When do we go to the hospital?”
“Another 6 weeks, sweetie.”
“But I thought we were going sooooooner!”

“Mom! We go see Doctor Zelickson THIS MONTH!”

“Only 3 weeks until we go to Children’s!”

“I get to go see him in 2 weeks!”

“MOM! Only 1 week left!”

“GUESS WHAT!! Only 3 days until I see Doctor Zelickson!”

We came this close to making a paper chain like we do for countdowns to vacations.

This kid loves going to Children’s hospital for her laser surgeries. Her love of all things medical is the result of both some intentional parenting during her early procedures and the awesome folks at Children’s. (I’ll post more details about the parenting side later, in another post.)

Addy underwent her first laser surgery at 5 weeks old, and she’s had over 30 so far. She knows the faces of Doctor Zelickson, the nurses, the anesthesiologists, and the Child Life Specialists, and they all know her. She knows the routine by heart and looks forward to it each time.

Here’s the routine: We get to the hospital early in the morning and check in, where she chats up the receptionist. We wait in the waiting room for a few minutes until they call her name, then we follow them back to the pre-op ward. We stop in the hallway to check her weight and get her some hospital jammies. We settle into the pre-op room, she changes clothes and gets comfy on the hospital bed, and then the nurse starts the Q&A session (“Any loose teeth? Recent colds?”) while checking Addy’s blood pressure, etc. As an hour or so passes, we see a parade of people: the pre-op nurse, the pre-op nursing assistant, the Child Life Specialist (Geri, of whom you’ll see more later here), the nurse anesthetist, the anesthesiologist, and, of course, Dr. Zelickson. Everyone verifies what we’re doing (“laser surgery”) and where (“to the right side of the face”). Somewhere in that hour, either the nurse or Geri hooks Addy up with toys, even remembering from visit to visit which toys are Addy’s favorite (princesses, of course). Then, when it’s time for the procedure, they wheel her back to the Operating Room, and I give her a kiss while they drug her and then leave once she’s asleep so they can do the zapping. They wheel her back to the room within 20 minutes. (It’s a fast procedure.)

I should pause here to explain that in the past, we’ve had some trouble coming out of anesthesia. Addy was 3 or 4 when she experienced ‘emergent delerium’, which means that her body woke up before her brain. Anesthesia is steadily breathed out of the system, and if the body wakes up before it’s all out, the brain is still fogged, drugged, and weird. With Addy, this manifested first as weepiness, then quickly turned to an angry, inconsolable tantrum that lasted an hour. It was like being on the set of “The Exorcist.” It. Was. Miserable.

After that, I’ve always asked the anesthesia team to please keep her asleep as long as possible, to let her sleep off the drugs. At September’s surgery, they gave her Versed, which is a hilariously loopy drug that helped knock her out until her brain was de-fogged. Worked like a dream, and I got some very cute videos of a trippy Addy.

This time, we did the same thing. The nurse gave her Versed at 7:25a.m., and because Versed wipes out memory, he reminded me: “Her memory stopped at seven-fifteen.” Ok, cool, whatever.

Wrong.

When Versed wiped Addy’s memory, she lost the memory of seeing Dr. Zelickson, of being wheeled down to the O.R., and really, of most of the routine she had so intently looked forward to.

When she came out of anesthesia, she was confused and weepy and demanded that we do it all again! She cried because she didn’t believe us when we told her that we’d already done everything, and it was over now. “No, we haven’t! I haven’t seen Doctor Zelickson! You haven’t wheeled me down the hall yet! You need to wheel me down the hall!”

This is where Geri (the Child Life Specialist) comes in. As soon as the staff saw that Addy was distressed, Geri stepped up. Planted next to Addy’s bed, she calmly and clearly spoke to the confused little girl, firmly reiterating that yes, we’ve already done all of that, and then she reminded Addy of the yucky-tasting drug she took earlier, explained to her that it wipes out memory, asked Mommy to pull out the phone with which we’d taken a few pictures ahead of time (to show Addy evidence of the routine that did in fact take place), and explained to Addy in clear step-by-step terms that her big-girl brain doesn’t like being confused about sequence and routine, and that it’s okay to be a little stressed about it. She didn’t mince words, she held her ground when Addy insisted that we do it all again, she was kind, she was patient, she was empathetic, she was firm, she was clear, she was basically everything you’d want someone to be when they’re giving your kid a pep talk like this.

She helped catch Dr. Zelickson between procedures, so he could come back into Addy’s room and we could check that off Addy’s mental checklist (again). She even arranged for the two of us to wheel Addy’s bed down to an induction room (which looked like an O.R. but wasn’t in use) to fill in some of the routine ‘gaps’ in Addy’s brain. Check.

Can you see why I love going to a Children’s Hospital?  These people know their clientele.

When we were all done and Addy was ready to go, I took her down to the hospital cafeteria for a special breakfast, just the two of us. (A rare treat when you’re the eldest of 3 kids.) Her brain was de-fogged and she enjoyed herself.

All in all, I felt awful about wiping Addy’s memory of the experience that she had so wonderfully anticipated. She’s already counting down to the next one, and we’ve all agreed (me, Keith, Children’s staff, and especially Addy) that we’ll skip the Versed next time. Apparently, the risk of emergent delirium peaks around ages 3-4, so it’s less of a risk now anyway.

Each year of treating Addy’s port wine stain brings something different; we’ll see what Age 7 has in store for us.  (So far, it appears we’ll be dealing with a strange tear-drainage problem around the eye, but more on that later.)  Whatever it brings, I know that Addy’s in good hands at Children’s, and that we’ll figure it out together.

 

Having breakfast after Addy's latest laser treatment.

Having breakfast after Addy’s latest laser treatment.

Talking to Addy (part 2)

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In response to a dear reader’s inquiry, my last post discussed how we prepared Addy for the concept of having a huge dark-pink mark on her face; in this one, I tell how we actually talked about the port wine stain itself in more concrete terms.

As you’ve probably noticed in parenting, kids are oblivious to some things for an amazingly long time. For your child with a port wine stain, as long as she ignores it (or is oblivious to it), you can ignore it, too. You don’t want to force the topic and make it ‘An Issue’ before she’s ready. As I mentioned in my last post, only worry about laying the groundwork for her to believe that a distinguishing mark is a *good* thing.

But that oblivion doesn’t last forever, and at some point she notices it. She also becomes aware that all those comments from other kids and adults do, in fact, refer to her. She realizes that there’s something on her face, something others don’t have. This stage I found very, very tricky; you want to beat the world to the punch, you want to be the first voice she hears regarding her stain, her first impression and the last word. But you don’t want to make it ‘An Issue.’

So what do you say? Facts. This is the stage to be factual, neutral, and yet still calmly positive. Let her absorb the facts: That her face is pink (or purple). That it is a port wine stain. That she has a port wine stain. That Mommy does not have a port wine stain. Simple facts can be profound to a toddlers and preschoolers as they order their universe, so offer factual comments with a positive, contented attitude. The universe is in order; all is good.

If you catch her staring in the mirror at her port wine stain, offer a simple comment: “That’s your port wine stain.” Say it with quiet gladness, like you’re a garden-tour guide answering a question about local flora on a summer day: “That’s a purple lilac bush.” Pleasant, and neutral. Just a nice fact.

I found it helpful to focus on the words themselves: make this a language lesson. Toddlers are constantly learning how to speak and annunciate, and they’re thrilled with their accomplishment. “Can you say Port Wine Stain? Good! That’s right, po-oh-rr-t, make sure you say the ‘t’ there…” This accomplishes 4 things: 1) she knows it’s not a taboo topic, 2) you open the door to any questions that might be simmering in the back of her little mind that she keeps forgetting to ask you, 3) you’re empowering her to answer strangers’ questions for herself by speaking it clearly, and 4) there’s no pressure to Have A Talk about it. You’re just working on speech, that’s all. Happily.

After a surgery, she might stare longer at her reflection, observing the new shade of purple on her cheek. Sometimes just a solidly honest “You are so beautiful” is all she needs to hear; it’s enough to tell her that all is good with the world. “Yep, whew, I’m still beautiful, good, moving on.” Sometimes she’ll need a little more from you, as Addy did when she stared bug-eyed at the mirror at some especially intense post-surgery bruising: the reaction I used is the quietly-rolling “Oooooo!” that we adults use when we see an intriguingly lovely exotic fish in an aquarium: calm, admiring, hushed, and affirming yet neutral – “Ooooo, look at that amazing shade of blue.” “Ooooo, look at that, Dr. Zelickson really did a wonderful job with the laser surgery today.”

Then immediately start another language lesson: “Can you say, ‘laser surgery with doctor Zelickson’? That’s right – lay-zerr…” and so on, until she accomplishes the sentence. Then she’ll proudly show her accomplishment off by announcing “It my lay-zer zur-dur-ee wit doctuh Zeckickdon” to anyone who’ll listen. And when you see your daughter proudly (proudly!) telling others that her face is purple from a port wine stain treatment… it feels pretty awesome.

One last piece of advice I got from my mom: don’t call it a beauty mark. I called it that a few times when Addy was a toddler, in an attempt to soften the topic and make her feel good about it. As my mom pointed out, if I were to tell Addy that it was a beauty mark, I’d be setting her up for disappointment at the first reality check when a blunt playground kid impulsively responds: “No, it’s not.” Don’t attach beauty to its title. Call it what it is – a port wine stain. You can separately help her understand that her port wine stain is beautiful (as in my last post), but don’t tie its presence or absence to beauty. Just be factual and honest, with a pleasant demeanor every time. She’ll learn to accept the stain matter-of-factly, she’ll understand that it’s not a bad thing, and she’ll be equipped to face the world herself, big words and all.

Talking to Addy (part 1)

FacePainting

Back after a long hiatus!

In my last post (long ago), I responded to a dear reader’s question regarding what we tell others about the port wine stain. In this one, I’m belatedly following up to respond to the same reader’s question regarding what we tell Addy:

“…Any advice on how you talked to Adelaide about her PWS when she was Sylvie’s age [23 months]? Sylvie doesn’t notice it normally, but after this last treatment, she did touch her face when she looked in the mirror, so she notices that it looks “different.””

Ah, childhood oblivion; it’s a lovely thing.

As I was writing a response to this question, I found my answer to be getting ridiculously long, so I’m splitting it into two blog posts. Number 1 here is how we prepared Addy for the concept of having a huge dark-pink mark on her face; Number 2 will be how we actually talked about the port wine stain in more concrete terms when she was little. So if I seem vague here, or like I’m coming at the question from a 30,000-foot view, don’t worry – I’ll get more specific in my next post.

First, let’s cover the advice I won’t give you. When it comes to facing a blunt world with a unique face, other parents may empower their darling with the same indignance that soaks our culture. When Junior stares at the mirror confused, the parent crashes in with, “You’re PERFECT, don’t ever let ANYONE tell you otherwise.” Before Junior even sees a stranger doing a second take, Indignant Parent chimes in with, “ReMEMber, some people are just plain ignorant. Keep moving.”

I’m not that kind of parent. Indignation is great for making a sassy kid, but I don’t think it empowers them to be comfortable in their own skin. I’m a realist, and the reality is that you don’t need a sassy attitude to have positive encounters with other humans in the world; in fact, if anything, it hinders that goal.

My big-picture advice? Give your daughter a head start on feeling comfortable with her different, stained face. Start early, while she’s still mostly oblivious, and be subtle. We didn’t directly talk about the Port Wine Stain with Addy until she was in preschool, so in her early years I basically trained her to believe that having a different, marked, pink face is a good thing. Then I hoped that, when it finally dawned on her that *she* had a different, marked, pink face, it would be a happy and comfortable realization. So far, it’s worked.

To do this, send lots of little messages gradually, consistently, and frequently. You want to subtly convince her that port wine stains are awesome.

To begin with, I applied blush during my morning makeup routine when Addy was present. A lot of blush. Often. And I made sure to admire myself (think “exaggerated Hollywood starlet” kind of self-admiration) in the mirror. “Ooh, how lovely!” “Do you think that’s pink enough?” “I really want my cheeks to be nice and dark.” “Hm, I should make them pinker.” “Well, a classy lady needs nice pink cheeks!” And then I called in reinforcements: my mother, my mother-in-law, and the daycare lady each admired their pink-blushed cheeks in the mirror when Addy happened to be with them, applying rouge liberally and happily. “You can never have too much pink!”

(I know what some of you may be thinking – “What kind of message is she sending her daughter by relying on something as superficial and false as blush for beauty? True beauty should come from within!” That’s fine and dandy, but in our case, Mother Nature and Cultural Norms conspired together and slapped Addy with a big birthmark in the very color that women around the world aspire to have on their cheeks, so I’m pushing Addy to the front of the pack on this one. We all want pink cheeks? SHE WINS. And I’m not taking that away from her.)

So play up the pink-cheek thing; she might not realize yet that she herself has a super-pink cheek, but for now it’s adequate that she absorb the knowledge that it’s a very, very good thing to have.

Another thing we did was embrace face-painting at every single festival we attended. This one was harder for me at first; I don’t like anything touching my own face, and on top of that I’m a little nervous to have her port wine stain touched or pressured. But once I saw how happy she was to have her (other) cheek painted with elaborate girly unicorns and hearts and stars, I knew we could use this to our advantage.

So we made face-painting into this huge deal, this happy thing that happens at summer festivals. She looks forward to it throughout the year, and when those festivals come, we celebrate with painted faces. Because painted faces are awesome. Because it’s a desirable thing, a worthy thing, a beautiful thing to have SOMETHING on your FACE. And pick your words so that, again, she absorbs the knowledge that having a mark on her cheek can be a good thing: you don’t just say, “I’ll get my face painted, too!” -– you say, “I want something on my cheek, too!”

We also started using more wardrobe statement pieces for ourselves. I realized that my little toddler was watching everything I did down to dressing for the day. And the sweet little copycat would later go into my closet and stand in front of my mirror and mimic my actions, clomping around in my heels. So I decided to talk out loud while choosing an outfit: “Hm, I like this shirt… and I’ll wear these pants because they look nice…Very classy… But, hmm, I think I need to have something noticeable, something bright that will get people’s attention -– here, I’ll wear this!” And I’d grab one of my hundred brightly-colored accessory scarves and tie it around my neck, or my biggest, shiniest, cheapest earrings and secure them saying, “There, this will make people say ‘WOW!’”

I’m a conservative dresser; no one ever said “Wow!” But day after day I told the mirror (and my copycat) that I wanted something to catch peoples’ attention and set me apart, even if just for a moment. Some days it was a bright scarf, other days those big cheap earrings, and sometimes a lovely hat, because no one really wears hats and I said it would make me ‘stand out.’ (Likewise, my husband occasionally started wearing a nice hat, too, telling Addy that he wanted something to distinguish himself from other men that day.)

Her port wine stain never came up while we were dressing in front of that mirror. But now, when her port wine stain comes up in conversation and we mention that it’s ‘a little different’ from the other kids, her face lights up like she’s just won a beauty pageant. And when she was getting ready to go to preschool with a bruised face a couple years ago, she expressed sympathy that the other kids didn’t “get to have purple” on their face like she did.

Embrace distinguishing characteristics; if you wear glasses, then you can tell the mirror (and your copycat) proudly that “not everyone gets to wear glasses,” as if you’re lucky for standing out from the crowd. I showed her my little cross tattoo to prove that I had wanted something unique so badly that I actually employed needles to get it (and I hate needles). I bought face paints and let the kids have a blast painting their cheeks (and noses and foreheads and ears) crazy colors, because face color is fabulous and beautiful and fun and happy. When Addy whispers loudly that she sees a stranger with something different (“Mom LOOK! He’s missing a leg!”) I whisper back like we just saw a movie star (“WHAT?! No WAY!”).

With effort, luck, and time, you can help her know that distinguishing marks are awesome, and that pink cheeks are awesome, and that purple is even more awesome. With that knowledge in place, talking about the port wine stain itself will be easier. Instead of being defensive toward the world, she’ll be comfortable in it with her own unique skin, because she’ll know that unique is fabulous.

FacePaintingComplete

Talking to Others

A dear reader (whose daughter has a similar stain) asked me the following question:

“…I do struggle with how to respond when people ask questions about her face, especially after a treatment. I want to educate them, but at the same time, I don’t want to be judged. I don’t think the average person understands how extensive these port wine stains become with age and without any treatment. Do you have any advice on how you respond to these types of questions?”

Why, certainly. 🙂

First, don’t worry; there will always be people who disapprove of your decisions. They can’t do anything about it, so let them stew.

Second: my rule of thumb is to always (always!) strive to make the other person feel comfortable. Not only is it kind, but in our cynical culture it’s also unexpected, and therefore disarming to any potential jerks. (In other words, if they’re expecting me to be defensive and I’m not, they soften up immediately. Works like magic in most of life, actually.)

So, kindness is key. But how do we make others comfortable when we’re toting a small child who looks like she’s been in a barfight? And in only a quick minute or two of passing conversation?

I’ve found myself using the following lines the most – they’re simple, they sum up the problem quickly, use imagery that people understand, and are casual & humorous enough to put people at ease. Sprinkle them into the conversations as you wish:

• “Oh, she’s fine, she just had another laser treatment for her port wine stain.”
• “It’s a proliferation of blood vessels – basically, they never got the signal to stop growing in utero, so they just keep growing, and growing, and growing.”
• “The laser zaps them – they heat up, explode and die. So then we can zap the next layer – there are a TON of them.”
• “It’s like weed-whacking – those vessels are constantly growing, we’re just beating them back. The sooner, the better.”
• “Yep, as she grows, the blood vessels keep growing with her. The whole thing will get thicker and darker and even nodular over time. It’s crazy!”
• “It’s not a big deal, we just have to keep weed-whacking for a while, that’s all.”
• “We’re going in for another zapping next week.”
• “I think it’s pretty much the same thing they do for varicose veins.”

The ‘weed-whacking’ analogy clicks with people – they suddenly ‘get it’ that this is a long-term process against constant growth, and it makes them smile. (Who hasn’t battled weeds in their yard?)

‘Zapping’ also sounds casual and surprisingly noninvasive, and makes people smile. (What kid hasn’t shuffled their stockingfeet on carpet and zapped a door handle?).

Pointing out the relation to cosmetic surgery seems to make people more comfortable that this is a simple, noninvasive procedure.

When you speak with easy confidence and a smile, rolling your eyes at how these blood vessels just keep growing (and growing, and growing), waving your hand when you tell them “Oh, she’s fine,” and shrugging when you tell them she’s going in for another zapping soon, they’ll usually relax. You’re cool with it, they can be cool with it, too.

When you’re with your close friends and confidants, you can relay your anxieties, fears, and worries – after all, this is your daughter and there’s a lot to worry about. But as long as you’re in casual conversation, just make people comfortable, and you’ll find that most respond with kindness.

Keith’s Summary of Last Week’s Dropoff:

As promised – the following is a quick summary from Keith, which he wrote after dropping Adelaide off at kindergarten with her purple-bruised face.  (And by the way, Happy Thanksgiving, all!)

Yesterday, Adelaide had her first laser surgery for her port wine stain since kindy (kindergarten) started. Jennica and I have been warned that kindergarten is when kids “become more aware” (polite code for “get nasty”) of port wine stains.

This morning I dropped her off.  I really wanted her to be her normal happy self. I thought, “if she can just do that so that the other kids are comfortable, and therefore more willing to engage her, she might have a much nicer day.”

And, I thought that I would cheat a bit. I opened a Halloween-sized pack of M&Ms and handed it to her, hoping to pump her up on chocolate-released endorphins. (Don’t judge.) She ate two and handed the little packet back to me saying, “No thanks, Dad. I don’t want to have too much sugar before kindy.”  

Yes, my five-year old is now more responsible than I.

Her first two interactions were in the hall before class. The first was with a tall girl who stood staring at Addy Rae, with a forced ‘I-like-you’ smile, while she listened to Addy talk. Then, she nodded politely and went into the room without saying a word. Addy had a ‘that-was-odd’ face, but wasn’t at all bothered. (Later, the teacher told me that she had prepped the class on how to be polite. Good effort, sweetie!)

Her second interaction was with Mikey (alias).  Mikey stumbled down the hall to hang his coat up but stopped when Adelaide accosted him with a bombardment of words. He stood staring at her with the same ‘it’s-morning’ scowl that he had been wearing the whole time. Then Addy said, “Mikey, I look different today. Can’t you tell?” Mikey smiled, nodded, and they both laughed while he put his coat on the hook.

Man, I love that kid. (Addy, that is. Mikey’s okay.)

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