FROM THE FRONT LINE Confronting Disabilities.

Many of my patients have learned to confront medical disabilities-in themselves or family members-with courage and determination. Here is a story of two such patients.

Several years ago in this column I related a story about Judy, a public health nurse who had been very anxious and dependent during her pregnancy. She was one of those patients who called at least once a week with seemingly trivial complaints. I wondered at the time how she would be able to deal with a labor and delivery, even of moderate intensity, and if she would have the required ingredients to raise a child comfortably.

When her baby was born with extrophy of the bladder, I felt heartsick.

Despite my dire predictions, Judy has turned out to be a model parent. Her daughter has required several operations and Judy has dealt with this admirably. Judy has to constantly monitor her third grade daughter's hygiene to help prevent urinary tract infections, which could eventually affect her renal function. In fact, she has become somewhat of an expert on extrophy of the bladder and now leads support groups for parents with children who are similarly afflicted.

Now comes chapter two of this uplifting tale. The other day, Louise, Judy's close friend, came into my office for her annual examination.

I was not surprised to see Louise limping into my office wearing a leg brace. She has had multiple sclerosis for years, and every year when she presents herself for her Pap smear she exhibits at least one more disability.

Last year she informed me that her bladder was no longer functional and that she could urinate only with self-catheterizatifon. She still experiences intermittent abdominal pain secondary to adhesions that developed after her third cesarean section. Louise is always upbeat, though.