Meena Has Momentum
For an expectant mother, the turbulence of pregnancy and the looming responsibilities of parenthood can be daunting. Navigating the razor-thin tightrope of taking care of yourself while preparing for an onslaught of diaper changes, midnight feedings and sleepless nights is no easy feat—now imagine doing all of that sitting down.
“When I became pregnant with my son Jamie after my injury, it was quite a shock for my husband and I—it was also a little bit frightening,” admitted Meena Dhanjal Outlaw, who sustained a spinal cord injury that left her paralyzed from the waist down. “It was hard to wrap my head around the fact that I was pregnant after all of that. My regular general practitioner had told me that there was a possibility that I might not be able to have this baby. I was being congratulated, but I was also being told that having a child might not be a possibility. There was kind of a numbness in me at that point.”
Outlaw recalls, with vivid clarity, the incident that would alter the course of her life—it happened on January 23, 2000, only three weeks after giving birth to her son, Miles. Stepping onto the balcony of her newly built home, she realized that she had been locked out of her house. Following several minutes of fruitlessly trying to communicate to her three-year-old daughter, Jasmine, how to unlock the door, Outlaw’s concern for the safety of her children took hold.
“All of a sudden, Jasmine looked back at me and there was fear in her eyes—she realized that something was wrong and mom can’t get in,” she recalled. “It was just this moment of reaction. I knew I had to get to my kids. Nothing else seemed to matter. After I had climbed down from the balcony, I realized that one of the posts was too thick to get across, and my body was three-weeks postpartum, so I was just weak and couldn’t pull myself back up. There was nowhere else to go and nothing else to do. I let go.”
Unbeknownst to her at the time, Outlaw’s fall shattered two vertebrae, T12 and L1. “I instantly had this surge of pain and I thought I had broken my legs, because I obviously couldn’t move them, but that wasn’t going to stop me—my mission was to get into the house, because I had two small children in there,” she said. “The paramedics were screaming at me to lay down and not move, because of the risk of the injury moving up, but at the time I didn’t know what they were talking about or why they were yelling at me.”
After Life Flight airlifted Outlaw to Memorial Hermann’s Texas Trauma Institute, where she stayed for a weeklong acute-care hospitalization, she was transferred to TIRR Memorial Hermann (The Institute for Rehabilitation and Research), where William Donovan, M.D., became her attending physician.
“My first day there was very frightening, because I understood for the first time that I was headed down a different path,” said Outlaw. “I thought they transferred me to TIRR Memorial Hermann so that I could learn to walk again, but instead they were teaching me how to be functional in a wheelchair. I knew it was the start of a journey of learning the ‘new me,’ so I gritted my teeth and moved forward. My son was only three weeks old when the accident occurred, so my kids were my motivation to get better and get home.”
When she re-married in 2006, the prospect of pregnancy was not on Outlaw’s radar. Following the unexpected realization that she was expecting, she saw an obstetrician who referred her to a high-risk maternal-fetal medicine specialist. “I went into the exam room thinking that being pregnant was a good thing, but left thinking as if it was a bad thing,” said Outlaw, who was 41 at the time. “Of course, my husband David was just in constant shock, because when we mar- ried he didn’t expect to have children with me, so he was just as content raising Miles and Jasmine as his own.”
Margaret Rogers, nurse coordinator in the department of urology at TIRR Memorial Hermann, referred Outlaw to obstetrician and gynecologist Hunter Hammill, M.D., at TIRR Memorial Hermann Outpatient Medical Clinic. “When we first met, it was like night and day,” reflected Outlaw. “The first thing he asked me was, ‘What have you heard about pregnancy and spinal cord injury?’ I went down my list of mostly cons—I was high risk, I couldn’t have a baby normally and would have to have a C-section. There was also mention of me not being able to have this baby at all. Then he told me to rid myself of all those thoughts and start thinking about having a baby. I left calm and relaxed, with the conviction that I could do it.”
“My most rewarding patients are always the spinal cord injury patients,” added Hammill. “They’re some of the ones that have the strongest bond with their children because it’s such an intense experience. Usually, these patients have survived a terrible, traumatic event in their life that left them with their injury and they’ve had to overcome a lot of struggles just to be alive and breathing. Being pregnant is a struggle for them at times, but it’s a struggle that they enter with a lot of optimism and hope.”
That sense of optimism and conviction in defying conventional wisdom paid off in spades—a natural birth, James (Jamie) Om Prakash Outlaw was born on June 29, 2011. After becoming a mother once more, Outlaw had to navigate an entirely different obstacle course, from the sheer lack of available resources to the seemingly simple task of buying a new crib. After being rebuffed at the store, where all of the cribs were too high to be accessible by a wheelchair, and finding nothing available online, Outlaw had to improvise.
“I eventually got a cheap pine crib and had my next door neighbor adapt the crib based on my design,” she said. “We added hinges so that it would open up like a door. That’s the crib that Jamie still sleeps in, but that’s how far I had to go.”
Embracing her new path, Outlaw refused to allow her disability to place limits on her as a mother. “The joy of watching Jamie grow up is watching him adapt to me, and it’s just amazing,” she said. “He never learned to walk with a regular walker—he actually learned to walk pushing my wheelchair, because the wheelchair fascinated him. The joy is watching him progress, and it hasn’t affected him, or his siblings, in any way. They’ve just adapted. By the time Miles was four years old, he was able to break down my entire wheelchair and put it in the trunk of my car. It’s a very cool thing, it really is. I’m just ‘mom’ to them. There’s no difference.”
Realizing how her vast amount of independent research, innovative thinking and continuous connection to the support structure of TIRR Memorial Hermann had allowed her to carry, give birth, and continue to raise a child with ease (despite the occasional hiccup), Outlaw felt compelled to share her experiences with others. “I’ve definitely made a conscious effort to bring it all together,” she said. “I try to put myself out there on a very personal level, but I don’t think that there’s any other way to do it in this situation. I’ve been working on compiling a directory of everything that’s out there for someone with a disability, especially for people who want children—whether it’s through adoption or a natural birth. It’s about ensuring that they know what’s around them and where they can go for further assistance.”
This past year, Outlaw competed for Ms. Wheelchair Texas 2014, becoming the first runner up and promoting a platform that reflects her experiences: “Inclusive Parenting.” She continues to ensure that all the resources that were available to her are easily accessible to other disabled persons wishing to have families of their own, working to dissolve the perception that spinal cord injury and pregnancy are somehow incompatible.
“This is one of those instances where, after decades of spinal cord injury patients resigning themselves that nothing’s available to help them have children, we’ve sort of accepted that,” said Hammill. “With each individual pregnancy, we try and do individual interventions and hopefully there will become a coalition of providers—physical therapists and adaptive technology manufacturers—who will come together. I’m lobbying to develop adaptive technology for mothers with spinal cord injuries that helps them change diapers and take care of their child. These are all things that you can overcome.”
Outlaw is now a published author, spurred by that same sense of obligation to help others to benefit from her journey. Her first book, “A Moment in Time,” was published in 2005 and chronicles her experience following her spinal cord injury. Frustrated by the lack of relatable children’s books to read to her two young children after her paralysis, Outlaw decided to write one of her own. “Mattie Has Wheels,” her burgeoning children’s series, provides a window of insight into the life of Mattie, a young girl who uses a wheelchair without letting it inhibit her from being a normal kid. “When I would go outside and saw parents and their kids react to my wheelchair, I wished they would just ask me questions,” she said. “I wanted to make them understand that this is not anything but a device that helps
me get around. I decided that the best way to speak to people, even adults, was through children’s books. Mattie is my way of saying to everybody, ‘Here I am! If you’ve ever wondered what it’s like to be in a wheelchair, I’m going to tell you.’” In May 2012, Outlaw was awarded a college diploma in writing for children and teenagers from The Institute of Children’s Literature, and is working on the continuation of the Mattie series. Her newest release, “Mattie Has Wheels: Traveling on a Plane,” will be out later this year.
Compelled to use her struggles and successes as a platform to educate others, Outlaw serves as a lead co-coordinator for a Spinal Cord Peer Group, an outreach program of the National Spinal Cord Injury Association of Houston that strives to bridge the interpersonal gulf that can arise in the wake of a traumatic injury. “We already have over 100 mentors alone on our list for anyone with a spinal cord injury, but we’re also expanding to other areas like muscular dystrophy or multiple sclerosis,” explained Outlaw. “That way, you always have someone—I didn’t want anybody to feel alone, because I felt really alone after my injury. I lost my husband, his family and my friends. Nobody wanted to know me. I was no longer Meena, and I had to fight my way through to make people realize that you can’t shut me away just because I had this injury. Now, it’s become this amazing, beautiful chain reaction that keeps everyone connected.”
Outlaw continues to foster those connections—as an ambassador for Ms. Wheelchair Texas, she recently hosted Houston Fashion Week’s Couture Fashion Show at the JW Marriott Houston in the Galleria.
“I may be in this chair, but I will always look good in this chair,” said Outlaw. “When people look at me, I can see that they’re thinking, ‘Wow! She looks really good, and she happens to be in a chair.’ It has to be about mind over matter. One of my therapists at TIRR said, ‘It’s all about focusing on the positive,’ and I knew that I was supposed to let go of everything that was going to hold me back, and hang onto the good things so that I could continue to grow.”