Decisions

I am 31 years old.

I started my first job as a nanny when I was 18 years old, and ever since then I've worked with children, whether as a nanny full time or part time, caregiver to a child in my home, or my job now, working in a church nursery.

I've been married for seven years next month. My daughter turned four in November. I have a job and a mortgage and two cars and a privacy fence. I'm a grown-up, right?

My mother passed away four years ago in May, when Ally was six months old. We were very close and she fought a very long battle against cancer. Losing her was, without question, the most difficult thing I had ever experienced, and in spite of the hundreds of times I was told it would get easier with time, I'm finding that not to be the case, because I am just a big baby. I am a momma's girl, and whenever things are hard or whenever they're good, whenever Ally does something really smart or says something funny or has a really, really bad checkup that leads to open heart surgery, my head is always screaming "I WANT MY MOMMY!"

So being a grown-up means that the decisions are on me. In this case, of course, I have a shared burden with my husband. When it comes to decisions about Ally, the buck stops here. We're the final word.

For someone who is constantly in a mental temper tantrum over being motherless, it maybe should be cause for concern that I have so much authority. Did I mention that making decisions has never, ever been my forte? Just ask my mom.

So the diagnosis comes down the pike and all the brainiac doctors reach the same conclusion: Ally needs surgery, and she needs it soon. We need to go in and make it so her heart can function a little easier, a little more like it's supposed to, and we also need to install an electronic device so that if her heart doesn't do what it's supposed to and stops, it can save her.

Now, the big question: WHERE?

There are three places in North America with cardiologists who specialize in HCM. If Ally were 16 or 25 or 50 and needed this surgery, we'd be packing it up and driving to Cleveland to have her heart operated on. The adult CV Surgeon at the Cleveland Clinic is arguably one of the best in the world for dealing with this very same problem. It would almost be a no-brainer.

The problem is that Ally is four, and her heart is much, much smaller than an adult's. The surgery is much more complicated because of that, and that muddies the water quite a bit on who might be absolutely 100% the best to do her surgery. We're blessed to have UAB so close, with so many smart people, but the decision about where to take her is just not black and white at all.

Aforementioned genius HCM surgeon would be in the operating room with the pediatric surgeon if we chose Cleveland... that's an appealing level of expertise.

But there's a list a mile and three quarters long of upsides for UAB, too. Just to name a few:

• It's close to home. She has surgery and is in the hospital for a week, we get in the car and we're home in 90 minutes, versus 12 hours from Cleveland.

• My family and friends, with a handful of (important!) exceptions, are in or near Birmingham. It's where I grew up. Never underestimate the value of your support system, although you might because your support system is just not as good as mine. Sorry, it's the truth.

• Insurance is something not to be toyed with. Finding out if Dr. Zahka in Cleveland was covered for us to see him for a second opinion was a nightmare for me. Getting every single doctor she might come in contact with cleared through our insurance is not something I want to be focusing on under the circumstances. The money may not matter in the big picture, but this is not a nose job we're talking about. I would much rather know what's coming at me financially than just hope for the best.

• Dr. Kirklin is the surgeon at UAB. If you live in Birmingham, you will recognize this name. Half the city is named after his father. There's a reason for that, and a reason he's the head of the department.

It's such a tremendous burden to make the right decision when you could certainly consider it life or death for your child. We have some truly amazing people in our lives who we know, without a doubt, are there to support us, offer us advice if we ask for it and an ear if we just need to talk. Personally I would not have a shred of sanity left if it weren't for these people, but it ripples out so much farther than just people we are in immediate contact with. I've been sending out email updates since this whole thing started, and I get messages forwarded back to me by my family and friends, notes from people I don't even know saying that they are praying for us and for Ally, and I can't even tell you how much that means to me.

Why? Because I can't make this decision on my own. I'm just a child myself sometimes. I'm not capable of handling this on my own.



It's easier said than done... even though I can hear her voice in my head, I'm not Mom. But I am trying, and the prayers of all these people, the ones I know and the ones I don't, make a big difference. When I asked for prayers for wisdom so that we could make the best decision possible for Ally, people have been responding in spades.

Maybe there isn't a clear cut sign, flashing neon billboards with arrows pointing at the right choice. No message from God written plain as day in the clouds. Really, how great would that be? But that's not exactly how God operates. He speaks to your heart.

Right now, my heart is telling me we need to stay close to home for this. Maybe the overwhelming personal, selfish need I feel to have the people I love within easy reach if something goes wrong, or even if nothing goes wrong, is God's flashing neon sign. Maybe it's not weakness, but the message in the clouds.

Thursday morning, we're meeting with Dr. Lau again to get questions answered hopefully to the extent that both our hearts are at peace with the decision to stay in Birmingham, and from there, we move forward.