Monday, August 10, 2015

I Walked on Water Last Year

One year ago today….I stepped out in faith!
And walked on water!
It was exactly one year ago today that I left my former job and stepped out in faith to open my own practice.  I have been filled with emotion and tears the past few weeks as I knew the month of August would be emotional for me.  My first born is leaving to start his sophomore year at ETSU as a premed student, my youngest started her junior year at Renaissance high last week (a second chance to find her way and thrive in school), I miscarried twins at 12 weeks 16 years ago that would have been due this month (yes, if you do the math…I would have had 4 children 4 and under), I have my first ever speaking gig at a conference in Denver this week….all during the same month I am celebrating my 1 year anniversary of opening Integrative Family Medicine!  No wonder my adrenals are screaming at me!!

The past year has reminded me of the sermon my pastor Pete Wilson preached earlier this year on “Water Walkers”.  Matthew 14:25-32 is the story of the 12 disciples in the boat who were afraid when they witnessed Jesus walking on the water toward them. There were 12 in the boat, but only Peter had the courage to GET OUT OF THE BOAT.  He walked on water toward Jesus, but began sinking as he took his eyes off of Jesus…once again he was rescued and safely got back in the boat.  For the first time in my life I sat quietly for nearly a year without making a move.  I prayed, I sat, I waited on God to give me a sign if I was to leave the security of my job and open my own practice.  And in July 2014 I heard it as clear as day while at the beach alone; “It’s time, go now”.  I have spent my entire life in warp speed and never taking the time to listen or obey.  This time I did both and even though it has been a wild ride and not without bumps in the road, adversity and fear on my part, I have stayed the course and kept my eyes on HIM the past year….

Needless to say my last year has been a whirlwind of chaos (not organized most of the time), blessings beyond belief, uncertainty as I pray every day that patients will actually show up and pay to see me, gratitude that THEY DO and that I can pay my bills and student loans every month!  Here’s a little refresher of the last year in the life of me and Integrative Family Medicine……
August 11, 2014 I gave my notice at work…August 11, 2014 UHOHHHHH…no notice needed! I was free to leave that day. That afternoon after I left my job of the past 4 ½ years for the last time I posted on Inside Out that I would no longer be working at my old position and would be opening my own practice …and low and behold….the phones started ringing and the voicemail filled up in a matter of less than an hour.  Jackson was at the gym working out (and had the new cell phones with him) and called me asking what to tell people. I was speechless, I had no idea if anyone would really call, if anyone would really want to come see me in private practice.  I was loaded with insecurity, determination and scrappiness! That night as the phones rang, and it was just me and Jackson at the house I remember telling him “this is a night we will never forget son.  This is the beginning of something amazing. Let’s don’t mess it up”! 

August 12, 2014 command central was set up at my house with some of the most incredible friends ever who dug in and did whatever was needed to get my practice set up.  Jackson took charge of the phones and worked 18 hours a day as the scheduler! He had patients texting him at all hours of the night to set up appointments and I couldn’t have set up practice in 3 WEEKS had it not been for that kid!  Ella jumped in and helped haul supplies, office furniture and any work that needed to be done!  It truly is a FAMILY practice that got the foundation laid with the best family of all…my kiddos!
The next 3 weeks were a blur of building out the new office, finding mix and match furniture, Jackson hanging shelves, pictures, putting together desks, painting, ordering supplies, setting up my supplement vendors, finding a lab company to work with, being wined and dined by various reps,   getting computers bought (we had no internet for the first 6 weeks and borrowed from the neighbor), the electronic medical records crashing one night and us losing ALL appointments that Jackson had worked so hard on making, me breaking down and crying more than once that day and afterwards, food brought to the house and office from friends and patients cheering us on!  The list of tasks needed to do was done in 3 weeks times was overwhelming…but it never occurred to me that we couldn’t get it done!  All the while you all were cheering us on through the Inside Out Healing From Within Facebook updates! Showing up willing to work, clean, paint, make appointments or whatever needed to be done. 

We got that office up and running by the first week of September and dang if a few weeks into it, Tammy called me late one night in tears telling me that Blue Cross was going to make me use a different supervising physician. I scrambled to find a new one and then they said “nope, you now have to credential all over again the time limit has past and you can’t bill for one patient you have seen.  They cost me 40,000 in claims since I had not billed anyone with BC/BS. I was calmer than Tammy and quietly decided that there was no way I was fighting that.  I would take the loss (I hadn’t even been open 2 months yet) and move on.  And pray my patients stayed with me. 
Thank YOU to every one of you that has been a part of something short of a miracle the past year.  I can’t name names because there are too many to mention, but you know who you are.  You have supported me, loved on me, lifted me up when I was doubting, fed me and the kids, drank wine with me and simply stopped in the office just to say hello! I love you all more than you will ever know and am eternally grateful and humbled daily that you show up!! I promise to keep showing up…if you will! I’m by no means the smartest NP out there, but I love my patients like family and will walk this journey with you as long as you want me to!

My kids have seen me divorce 13 years ago, receive Food Stamps and be on a Medical Card for 5 years while going back to school in KY and then starting Vandy for 3 years, seen me cry as I left Vandy with 200,000 in student loans and no way to pay the minimum payments, seen me scratch my head the first 2 years in practice wondering what in the heck I was doing…and have now been an integral  part of their mom deciding at 48 to take one more chance and GET OUT OF THE BOAT….I hope they remember this past year as the year we were WATER WALKERS together all the while giving God the glory for anointing me to do what I do and giving me the courage to STEP OUT IN FAITH and walk on water!

Hoping for 20 more years in practice…actually, I am hoping Jackson changes his mind and decides his true calling is endocrinology and NOT orthopedic surgery!!  J

Wednesday, August 5, 2015

Marching to the beat of a different daughter's story

Marching to the beat of a different daughter's story

March 26, 2009 at 9:10am
Many of you know that as a parent I have struggled with my daughter and her learning style, personality and her short term memory difficulty. Since she was in kindergarten I have fought to find out just exactly what might be going on with her. She has always "marched to the beat of a different drummer" as her father says. But as a mother, I was certain something was "amiss"  with Ella Kate.

Long story short.....after discovering last year that she has a 70% hearing loss in her right ear she was given an IEP at school to have work modified etc. Still, something was not right. I took her to the TRIAD center at Vanderbilt, which is the premier Autistic Spectrum Disorder diagnosing center in this part of the country. We spent 6 hours in testing; the doctor said to me " I can tell you what she doesn't have, but I am not sure what she does have going on inside her". Again, another vague answer. It appeared she is not autistic, but had several Asperger autistic traits.

Fast forward to Dr. Lanpher a geneticist at Vanderbilt; Dr. Lanpher did extensive DNA testing on Ella Kate in August. We have now discovered that she has a micro-deletion on the short arm of her 16th chromosome. This kind of discovery has only been possible for the last three years. As he told me this week, our technology is ahead of our actual research. Therefore, what we don't know about this sort of DNA mishap is far more than what we do know. We know that this area of the 16th chromosome that is missing is related to learning difficulties and autism spectrum disorders!! Unbelievable!! Like he said, this is not a definitive diagnosis, but it is a start and will help her with getting services at school. Is it connected to the hearing loss? No one knows. Both Greg and I will be checked to see if we too have this sort of deletion. Highly unlikely, but not impossible. So, once again I have another gray area!! But, also one that is wide open for research. Given the fact that this research is so new, she is on the cutting edge of research and hopefully her DNA analysis can be used to further research into this amazing field of genetics.

Moral of the story, I have been persistent for years in attempting to find a way to make learning easier for EK. Nothing has worked, and because I didn't have a medical diagnosis, many services are not available to her. I am a true believer that as parents we know if something is askew in our children. I have now come to believe that the reason I was accepted into the MSN program at Vanderbilt might very well be because God knew that this is a place that we could finally get to the bottom of EK's learning difficulties. Had I not been here, we would not have been able to take it to the next level and actually analyze her DNA. And to think I though I came down here for a man that ended up breaking my heart!!! He doesn't get that much credit anymore!! God knew all along why we were on this difficult journey in Nashville....and to think I thought it was all about me!!!

It looks like we have found Ella Kate's drummer that she has been marching to for so many years.....will it make a difference in her life? In many ways no it won't. But, in many more it will give me the knowledge to continue the fight to get my daughter the very best help she can get. Do I know what her potential is? Do I care if she wants to work at PetSmart (like she told me last week) the rest of her life? I don't know what her potential is, but if it is working at PetSmart as a stock person, retail sales or a a vet then it is my job as a mother to make sure she reaches whatever her potential is.....a journey that I now have a different outlook on than I did 3 days ago! How many of us are walking around this world with a slight deletion or addition to one of our chromosomes? Dr. Lanpher says millions most likely...and they are just "quirky individuals"...

God is good indeed...and I thank God for putting me in a place that can help us give EK the best care and support to rebuild her confidence and self esteem. Whatever her potential is in this world, I am grateful that she is my child...and I was chosen to be her difficult and oftentimes overwhelming as it is for both us!


UPDATE:  6 1/2 years later...

What a wild ride the past 6 1/2 years have been for us!  Not long after starting work at my former job for CSFM, I had EK tested for an MTHFR mutation.  And low and behold she has a compound heterozygous MTHFR mutation.  Meaning she has a decreased ability to detox and she is unable to make the methylated form of folic acid and b12.  She was also tested for pylouria and elevated copper, and histamine levels..all three were abnormal.  That added another kink into our already complicated medical history!  Add that to the hormones of a teenager, the resistance to take any supplements at all and a peri-menopausal mom whose hormones are insane, while trying to learn a new career and then transitioning to her own practice...and you have the perfect cocktail for stress and explosive moments!   Her first 2 years of high school were not a pleasant experience for both us.  As we were at our wits end this spring with school and tutoring and the mentioning of quitting school and getting a GED, I learned of Renaissance High School.  A public school that takes kiddos like mine and basically nurtures them back to the self confident young adults they were meant to be.   

Tonight I cried as I sat in the back to school night for Renaissance High School in Franklin TN.  The high school that EK was accepted into after 10 years of struggling with her academics! I sat in silence tonight as I listened to the principle, Dr. Brian Bass explain how every child that is in that school (and there are only 42ish in each grade) was chosen and CHOSE to be there.  This is a school dedicated to educating the kids who "March to the beat of a different drummer" as he stated. Their mission is to  nurture them to not only survive but to THRIVE and find their passion in life.  As stated above, we have had nothing but failure in the school system dealing with EKs processing and learning style.  Tutor after tutor, IEP meeting after IEP meeting, parent/teacher meetings and the list goes on and on.  It wasn't until this Spring that my friend Stuart Tutler told me about Renaissance.  I sat tonight looking at the quirky, clearly uniquely dressed, artistic teenagers wondering how many of them had similar experiences as EK through the years.  I wondered how many of the parents there had cried, not understood, yelled, said harsh words to their kids during terribly high times of stress. I wondered how many kids wanted to just disappear and not be noticed in class and in life, how many shut down daily in classes they didn't understand.  I wondered how many broken families were sitting there tonight with me praying that this school and their dedication to teaching out of the box, nurturing our kids self esteem back to health is the answered prayer we had all been praying for?  EK and I have a second chance to heal and find the passion in learning that she has never had. What a gift from God that out of only 4-5 openings in the Junior class and 100's that applied...that sweet kid of mine was accepted!  

For the first time in 11 years of school, I am looking forward to seeing what this year brings for not only EK but for me as a mom...a single mother who has fought nonstop for this kid year after year in the school system.  I know her classes will be difficult, but her confidence will be preserved and self esteem nurtured back to health in an environment that is dedicated to making sure EVERY CHILD succeeds.  I drove home tonight listening to a kid talk nonstop about the kids in her new school.  The school is small, but the demand is HUGE!  Evident by the hundreds of kids that did not get in, that are on the wait list.  I cried tonight as I thought about the parents that were desperate to find a better way for their babes, a safe harbor in a broken educational system that is not equipped to educated the ones that are "marching to the beat of a different drummer".  I am humbled that my babe is given a second chance to spread her wings and find her passion, a love of learning and chance to thrive in an environment where everyone is a little quirky!  The English teacher told us that all the teacher there are a little quirky and relate to our kids quirkiness!  

She still has an MTHFR mutation, microdeletion of the short arm of the 16th chromosome, hearing loss (that she refuses to wear her hearing aid for :)), pylouria etc...won't take her supplements (even though I screamed out last week that "people travel from all over to come see me for help EK..why won't you listen to me and take your supplements"?....And I am closer to menopause than I was yesterday (meaning my fuse is short, and my sheets get changed several times a week due to catching on fire at night) and hormones are insane!!  BUT MY BABY HAS A SECOND CHANCE...AND THAT MAKES ME SMILE!  

Integrative Family Medicine