A Birthday Thought

Today I turn 36 years old and although I complain about my age, I really do enjoy growing old as I could've died 14 years ago.  On August 25, 2016, I celebrated 14 years of life, a rebirth into this person I am today.  Thinking back over the 14 years as an individual with paraplegia, there were so many battles in life that I had to face.  Many battles won and lost, but I'm currently winning the war.  I'm living life to the fullest that I know how.

This past year has been the best year because of the twins.  They are about to be 10 months old on September 9th and Linh and I are still SHOCKED THAT WE HAVE TWINS!  This is my favorite part of getting older, I get to see Elliot and Evelyn grow up.  I tell them not to grow so fast, but we can't control that.  They are now crawling, furniture walking, and climbing.  Pretty soon they will both be walking all over the house whether we like it or not.  I'm still learning how to be a father, that will be ongoing for the rest of my life, but it is the my most favorite life event so far.  

Another accomplishment I did this year was finish two triathlons.  I first wanted to do one last year for the Oakland Triathlon Festival in 2015, but Linh was pregnant and I wanted to focus on her.  This year, we had a weight loss challange at work and while joking around with some co-workers about doing a triathlon, we ended up committing to it and competing in the Oakland Triathlon Festival on July 31, 2016.  We only had about 6 weeks of preparation and training, but we all finished.  Then I decided to do another one in two weeks, this time it was the Tri Santa Cruz which hosted the Para-Triathlon Championship, where there were over 50 athletes with disabilities, and about 15 athletes that raced in my classification as a wheelchair user.  This was an amazing experience and I was able to see how I ranked against some of the best para-triathletes in the nation.

This 36th year means another year that I am alive and more opportunity for my heart to get full of love, as I watch the twins grow up.  The best gift for my birthday today is my life and everything I that I enjoy and love.

Dedication for my Mom, Ly Sou (aka Lisa Lau)

April 10, 2016 would have been my mother's 68th birthday.  If you were lucky enough to know my mom, she was the most generous, funny, loving, nurturing, and spunky person I know. To know my mom, you need to understand her history.  She was born in Cambodia and lived in a war torn country.  Khmer Rouge regime was the communist ruling party from 1975-1979 and their goal was to purify the country by targeting the Chinese, Vietnamese, mixed Cambodians, the educated (whom can opposed them), and all other non-pure Khmer (Cambodian) blood.  An estimated total of 2-2.5 million Cambodians were starved, tortured, and killed in the Cambodian Genocide to purify the country.

My mother was previously married and had two children.  I don't know the details but they are no longer alive.  My mother met and was arranged to marry my father as they tried to escape Phnom Penh and the Khmer Rouge in 1980.  My mother told me that she and my father fled in a rain storm and was knee deep with me in her womb as they escaped Cambodia and arrived in a refugee camp in the city of Mairut, Thailand.  This refugee camp is where I was born.  About 6-8 months later, we were sponsored by a family in Lansing, New York were we flew and stayed in a trailer on their farm.  On May 3, 1982, my sister was born in Ithica, New York.

She had endured losing her family and was forced to move out of the country into a world unknown to her.  She and my father worked hard in a self-employed janitorial service that cleaned houses, businesses and churches.  Eventually, they purchased a grocery store and at that point they had made their American Dream.  My parents worked VERY hard every day, all to provide for my sister and I.

Through all of this, she was able to be one of the most generous people I know.  We grew up poor and barely making it.  We lived with family, eventually in a studio apartment on E20th and 13th Ave in Oakland, CA, and when they saved enough they bought a house on MacArthur Blvd.  When we owned the store, she constantly gave away food to our regular customers that were on fixed incomes and sometimes were not able to pay.  She held a tab for others that were short one week but could pay the next.  She knew how tough it was to live marginally and she helped as many people as she could.  Many of our customers called her Mom because she took care of them and was a motherly influence on them.  At times she hated it, but I know she was happy inside knowing she can help others.

My mother always supported my sister and I through all of our interests, hobbies, sports, and education.  She ensured we were exposed to different things.  My mom would be at our swim practices, my sister's softball practices and be at some of my swim meets, tennis matches, football games, and hockey games.  She was always busy with work, but she made the effort to be there to support us.  As kids she sent us to Christian church camp every summer in the Sierra Mountains so that we can be more Americanized and assimilated.  We were exposed to the wilderness instead of our urban home and being away from home for a week with strangers that became strong friends after years of church camp.  Educationally, my mother wanted me to be a doctor like most Asian families.  I didn't have that desire and was not motivated in high school to get excellent grades, I only did well enough to meet GPA requirements for sports that I played.  My mom did see me graduate from Bishop O'Dowd High School and that was one of the proudest moments of her life.

In December 2000 when my mom passed away, I felt guilty for many years...even to this day.  I could't protect her like she protected me.  I didn't tell her I love her as much as I should.  She didn't see me after my spinal cord injury and how much strength and perseverance she gave me to survive and thrive with my disability.  She didn't get to meet my beautiful wife and I know my mom would love her.  The worst part of losing her so soon was that she never had the opportunity to see me grow into the man I am today.  Today I'm 35 years old and 15 years is a long time for me to evolve.  She gave me a foundation and helped shape my character.  She didn't get to see me marry the love of my wife; she didn't get a chance to love, cherish and spoil her twin grandchildren; and see how great of a father I am becoming.

If you are reading this, I want you to tell your mom that you love her, tell her how much you appreciate all she has done for you, spend more time with her and cherish every moment.  You don't know how much you will miss her and have regrets until she is gone.  I think of her every day and I know she is watching over me and my family, protecting me and loving me from a distance.

Proud father of twins

We have waited 4 years (of trying to conceive) and about 9 months since we began the IVF process and now we have two beautiful children, Evelyn and Elliot, born on November 9, 2015 at 5:01AM and 5:04AM.  They were born at 4lbs 11oz and 4lbs 3oz, respectively.  With a short one week stay in the NICU (neonatal intensive care unit) they were discharged home.  Linh recovered well and had some postpartum issues that were resolved after 3 weeks.

As a father of twins who use a wheelchair, I've had to figure out ways to adapt to provide care for my twins, how to support my wife, and how to be the best father I can be.  We share all areas of the child care.  I change diapers, feed, cuddle, put the twins to sleep, talk, sing, and read to them.  I built a changing table with my friend that is basically a small desk with a changing pad so that it is easier for me in my wheelchair.  When pushing around the house in my wheelchair, I cross my leg and place one of them in there and my leg cradles them safely.

At first the twins slept together in a co-sleeper at the foot of our bed.  If they are fussy and are awake I can scoot to them, pick them up and am able to take care of them from bed.  They also sleep in a rock and plays or a bouncer in the living room during the day.  When they were smaller I would pick them up with one hand.  I cradle their neck in my hand and support their body in my forearm and lift, luckily I haven't dropped them yet (hopefully never, but it's bound to happen when they get squirmy and I will have to adapt another way).  Now, I do the one handed pick up less often and I've started to grab them with two hands more often which is difficult without the use of my abs.  When they are in their sleepers, I just grab the sleeper and lift.  

Seeing the twins grow over the past five months have been amazing.  Each child is hitting their milestones faster than we have thought.  Both like to roll, laugh, chatter none-sense and in general are the happiest babies I know.  This week we thought Evie came down with her first cold, but we noticed she was sucking on her thumb more often so last night we checked and we figured out that Evie is now teething and has a tooth trying to poke through her gums.  Both babies have been sleeping through the night for about two months now and sleep from 7-10 hours.

Evie is our princess, she is the diva with a bit of an attitude...just like her mom.  She's beautiful, bubbly and happy.  Elliot is the go with the flow, quiet, observant, and chill...kinda like me.  We both have our own mini-mes and there's always some type of excitement.  I can't wait to see their personalities develop even more and how they continue to interact with each other and with us.

It's only been five months, but it seems to have gone by so fast.  Every time I wake them up for their morning feed and come home from work, I get a smile from both of them...a smile that melts my heart.  They are growing so fast and soon enough, they will be eighteen years old.

Our first Christmas together

Two Months old

4 Months Old

And our lil family last weekend at Tilden Park

Our Journey for Parenthood via IVF.

This is my journal for our IVF process.  I will not publish this until we are ready to, probably after the first trimester if Linh gets pregnant.  But I will date each entry so that I can put my thoughts down and you can follow my emotional roller coaster as it develops.  

3/28/2015 

My wife Linh and I began family planning since the beginning of our relationship in 2006.  Linh was still in school for her BS in Education and we decided it would be best to wait until she finished school and earned her teaching credential.  In 2007, I decided to go back to school, so we delayed conceiving until I graduated with my Master's in Social Work.  In January 2012, we actively were trying to get pregnant.  Due to my spinal cord injury, it was a difficult process.  Without going into too much detail, I am able to have intercourse and ejaculate. After about 6 months, we began to worry.  In July 2013, I had my first semen analysis the results were not favorable: low sperm count and low mobility.  I was devastated, my manhood and my ability to reproduce was facing an uphill battle.

We decided to meet with the Kaiser REI clinic in Fremont in the spring of 2014. The doctor suggested we go straight into IVF (in vitro fertilization - I'll explain more later).  However, she allowed us to try a few cycles of IUI (intrauterine insemination).  IUI is the process of taking my sperm, cleaning it, and injecting them into my wife's uterus to try to conceive.  My wife did one round unmedicated and one round medicated.  During the medicated round, she took oral pills to stimulate more follicles. After two attempts, we gave up.  It was emotionally taxing and we both agreed it was best to wait and do IVF.  With IUI and my low sperm count/mobility, we only had less than a 5% chance of conceiving.  We went in knowing this but wanted to try it.  Fortunately, my insurance covered the IUI and it was only an office copay of $25.  Normally the procedure can cost closer to $1,000 per cycle/attempt.  

Now the road to IVF.  Our Kaiser insurance did not cover IVF, so I changed my medical insurance to one that did have coverage...in fact they covered 90%!  IVF normally costs up to $15,000-20,000 with medication and ICSI (I'll explain further).  With my insurance our copay was just over $1000.  In Vitro Fertilization is an intervention to assist people with conceiving by removing eggs from the female, sperm from the male, place them into a petri dish and hope the sperm can find the egg.  My wife calls this the base model of IVF.  Well with me, my swimmers ain't swimming!  So the next step is actually taking a single sperm and injecting them directly into an egg, this process is called intra-cytoplasmic sperm injection (ICSI).

We originally planned to do our IVF cycle in May, but since I had a job opportunity coming, we moved it up. In March, we began the hormone injections to prepare my wife for the egg retrieval.  The goal of the hormones are to ensure we can retrieve up to 20 eggs.  She responded well and we were able to retrieve 15 eggs last week and 11 were injected with my sperm.  The next day we received the fertilization report from the doctor and only 3 embryos survived and she said they looked "perfect" for 1 day embryos.  This is abnormally low and we became concerned.  Ideally, we should have had 8 fertilized embryos. We would not get another report until Saturday (today).  The two days in between were torture.  Did the embryos survive?  Are they multiplying and dividing like they should?  Are we going to have kids?  The unknown is torture.

This morning we received a call with the updated fertilization report.  ALL THREE EMBRYOS SURVIVED and have divided into 8 cell 3rd day embryos.  They are growing normally and look great.  Our IVF transfer appointment was reschedule from today to Monday so that we can allow the embryos grow into the blastocyst stage (google it).  Basically, this allows us to determine which embryos will be the strongest and has the highest potential for becoming babies.  We hope to transfer 2 and freeze 1 for the future.  Yes, I said TWO EMBRYOS.  Due to the high stress, the cost, and the difficulty to conceive, we figured let's "buy one and get one free."  Our doctor thinks that with Linh's perfect health/labs/etc, transferring 2 embryos will give us an 80% chance of conceiving a singleton, and 60% chance of conceiving twins. YUP TWINS!  We are ok with having twins and are prepared for it if it happens  (how much can you really be prepared for twins?!?!  LOL).  

This is our journey so far.

3/30/2015 9:00AM

Linh received a phone call from our doctor.  She stated that all three embryos are growing and two are graded: 5AA and 2BB.  The last one we do not know the grade.  Basically 5AA the embryo is in the blastocyst stage of development and is very ideal.  The 2BB embryo is still developing into a blastocyst.  We have a 12:45 appointment and we have decided to transfer the two stronger embryos.  The last one will remain in the incubator to allow it to develop further so that it can be viable for cryogenic freezing for future use.

3/30/2015 9:37PM
It's just surreal.  We went into the IVF transfer room and I was full of excitement.  The nurse comes in and preps Linh for the transfer, we sign some paperwork, and she hands us a picture of our embryos.  Yes!  Pictures of our potential baby or babies!  As stated earlier, our doctor expects an 80% chance that we have a singleton and 60% chance for twins since we are using two embryos for the transfer.

Our babies!  Well at this stage 5AA and 2BB embryos.


3/31/2015
My wife informs me that our doctor left a message stating that the last embryo was able to grow into a 5AA and was viable for freezing.  Amazing news!  We have one opportunity for another transfer in the future if we decide to have another baby.

4/2/2015
My wife said I wasn't very supportive over the past two days.  We had a small argument and she was very emotional.  I explained to her yesterday that I didn't have the opportunity to adjust to her emotional mood swings caused by the hormones and the embryos being transferred into her body.  Of course I want to be there to support, love, protect, and be her security blanket.  We have had communication problems through out our relationship but we have always been able to communicate well enough to resolve the issue at hand.  I told her last night that I will give it my all to ensure she feels safe and can be emotional with me.  She is technically carrying my child (children) and I have to support her the best I can.  If you are reading this...I LOVE YOU!

Regarding the embryos, I'm keep researching and reading blogs and articles about IVF and pregnancy.  When will the embryos attach to the uterine lining?  How many cells are each embryo now?  The unknown is very dark for me and it scares the living sh*t out of me.  Not knowing if we are actually pregnant, not knowing how many embryos attached, am I going to be a dad?  All of this is frightening and we just don't know until my wife takes the pregnancy test that is scheduled on April 8, 2015.  I do my best not to think of it, but It's a constant irritant in the back of my head.

4/8/2015 - The Results Are In!
I've been anxious about this day.  Over the past week, Linh has complained about sore and full breasts, one of the many symptoms of pregnancy.  For the past few days I've been looking up anything I can find about parenting from a wheelchair with very little results.  I think this blog will have a large section about parenting from a wheelchair for others to learn from me and my mistakes and accomplishments.

Today Linh went to give a blood sample to test if we are pregnant or not.  Her appointment was at 9:00AM and was told we should have a phone call after 1:00PM with the results.  Our doctor calls Linh with great news, we are pregnant.  Linh calls me right away and tells me the good news, I couldn't believe it and asked her if she was f-ing with me.  Her HCG numbers are pretty high so we might have a chance of having twins.  Linh has an appointment for a 2nd confirming blood test on Friday 4/10/2015 and then a sonogram in two weeks to confirm if we have a singleton or twins.  Either way, I'M GOING TO BE A DAD!!!

4/22/2015 - Our first ultrasound
What an amazing experience!  At this ultrasound we found out if we are having a singleton or twins...well it's TWINS!  We are so excited and can't wait to find out the sexes!  We also were able to hear the heartbeats of each of our baby.  Both heartbeats were strong at 170-180 bps.

5/6/2015 - Last ultrasound @ Reproductive Science Center
Today was our last visit at RSC as we "graduate" from our infertility doctor to an OB/GYN.  During the ultra sound we saw our children dancing...they look like dancing jelly beans!  I watch this video often and shared it with our immediate family and a handful of friends.  It's amazing to see life growing inside my wife.

Fast forward.  Today is June 3, 2015 and last night Linh allowed me to announce our great news on social media and now I'm adding my new post to my blog.  What an amazing journey so far and the twins are not even born yet!  We started to try to conceive in January 2012...3.5 years ago.  After two failed IUI attempts, switching insurances, then rushing to start the IVF because of a job change, we ended up pregnant with twins!  December 15, 2015 is the official due date, however, since we are expecting twins, it will be about 4 weeks earlier.

Here is our announcement photo.  We are huge Oakland A's fans, we are season ticket holders and had our first "non-date" at an A's game in 2006.

Samuel Merritt University: SCI Education for PT Students

For the past few years, I have been invited to help teach a class on spinal cord injuries to second year physical therapy students at Samuel Merritt University in Oakland.  This is my fourth (maybe 5th) year helping this class.  Individuals with SCI are invited to share our stories of our spinal cord injury, sit in an open forum for discussion, and then we become the guinea pigs for the students to do the ASIA (American Spinal Injury Association) exam to test our sensory and functional levels.  We were not allowed to reveal our level of injuries until after the students complete their assessments and report their findings.

It's amazing to see the passion and enthusiasm that these students have in learning from us.  We are able to provide our insight and perspective of our SCI.  Each year I tell the students that it is them, the physical therapist, that builds a foundation of knowledge and skills that we, the wheelchair users, use for the rest of our lives.  I reveal to them the relationship I have with Kelly R., my PT during my rehabilitation.  He is one of the main reasons why I have been so active after my SCI.  He taught me the wheelchair skills, increased my self-esteem, and gave me confidence to conquer all the obstacles I would face in the world built for able-body individuals.   I find it very important to educate these students on how important their job is when working with individuals with SCI and other disabilities. Once again, it was another great class of students and I am confident they will become great physical therapists.

I had a discussion after class with both of the instructors about doing a presentation or lecture to educate the class even further about the psycho-social implications of a SCI for newly injured individuals.  In this lecture I would discuss: 1) why it is important for the students to understand the psychological and sociological changes that these patients are experiencing 2) how to build rapport to foster a safe environment and provide necessary motivation for each patient to be successful in acute rehabilitation.  Of course, this presentation/lecture would be effective as an in-service to all disciplines (PT, OT, SLP, RT, MD, and MSW) who are involved in the acute and outpatient rehabilitation setting.  I hope I have an opportunity to do so and will discuss it further with the instructors and my department when I begin working at Summit.  This is going to be amazing!

Noah's Little League Game

One of my hobbies (whenever I have spare time, which is very little)...photography.  Here are some pictures from my nephew's little league game today.  My brother-in-law, is the team manager.  My 2 y.o. niece Olivia is in the last picture.  I used my Canon 6D with my friend's Canon 70-200/F2.8 USMII lens.  I need to buy this lens one day!

So much going on in 2015

2015 has been a great year for me so far in my personal, athletic, and professional life.  So what's going on?  First, lets talk about work.  My former physical therapist and friend Kelly suggested I email my resume to his manager regarding a Medical Social Worker position that is opening up at Alta Bates Summit Medical Center in Oakland for the Acute Rehabilitation department.  With overwhelming support from people I knew through referrals and recommendations, and of course "blowing them out of the water" in my interview, I was offered the job.  This is as close as it can get for me for a dream job, the only way it can be better if I worked with pediatrics in acute rehab.  When I went back to school to be a medical social worker, I had a goal to work with others with disability and to work for a rehabilitation unit.  Well, at Summit I will be able to work with individuals with spinal cord injuries, traumatic brain injuries, stroke, and other diagnosis in a rehab setting...PERFECT!  I only graduated from San Jose State University in May 2013 and did not expect to land this type of position for at least 5-10 years.  What's even better than working with this population?  The HUGE raise and free medical benefits...AWESOME.  I start this job in mid April.

Athletically I have a new challenged that I wanted to do.  This year I turn 35 and I was considering what I can do to improve my health even more than the usual sports I am doing...triathlons!  I contacted the Oakland Triathlon Club and got a great response from the president of the club.  With his support and the teams support I am training to complete my first para-triathlon this summer.  Most events will have a 1/2 mile swim, about 13 mile bike ride, and a 3.1 mile run.  This is going to be an amazing journey.  This is my version of a mid-life crisis, HAHA!  Being healthy is the main goal but depending on how well I can do, this might be my new sport/lifestyle.

Personally, we have decided to move onward with the IVF process.  Due to my spinal cord injury, I am not able to conceive naturally so we will need assistance.  Details will come in the near future as I agreed with my wife that I would not publish anything until later.