My First Time

shock

There are very few events in my life that I vividly remember: my wedding day, the day my son was born, and where I was when I first saw the images of the 9/11 attack that brilliant late summer morning in Connecticut, come to mind. They are all etched in my memory so clearly, that not only can I recall images of the occasion, but emotions, smells and things of that nature. Perhaps this is because they were so profoundly momentous and meaningful.

The day MS entered my life is also on that list. My first time, as I like to refer to it, occurred out of nowhere like an unexpected and unwanted bolt of lightning. Of course, I didn’t have a clue  what was going on at the time, or that it represented the beginning of a life-altering journey.  Be that as it may, the experience was so shocking, and the consequences so profound, how could I not remember it?

Ten years ago, I dragged my lazy ass downstairs into the cellar early one Tuesday evening, and stepped onto my treadmill for a long-overdue workout.  I had been in good shape for most of my life and, while not a fitness fanatic, worked out more often than not. For some reason, I had fallen into a rut and had not touched any exercise equipment for over a year, and was getting soft in a lot of places I didn’t like. For months I had vowed  to resume working out because, as a creature of habit, I knew all I had to do was get started and it would become part of a regular routine.

So I seized upon the thought to take that first step, ventured downstairs, strode onto the treadmill, and turned it on. Back in those days, my typical workout consisted of a ten minute warm up, followed by forty-five minutes of gradually increasing speed before concluding with five minutes of winding down at much slower speeds.

On that fateful evening, I didn’t make it past the first ten minutes. Shortly before the warm-up concluded, I felt a strange sensation in my right leg. At first, the leg felt heavy, as if a large weight was strapped to it. My reaction was to increase the treadmill speed, thinking it might work the kinks out. Bad move. In less than thirty seconds, the leg went from feeling heavy to being completely unresponsive.

The only way I can describe what I thought was going on in that moment, is that my leg simply stopped working. The knee wouldn’t bend, my foot wouldn’t lift, and I literally couldn’t control it. The limb felt as if someone had sucked the bone from it, and what remained was a limp, lifeless, piece of emptiness. Keep in mind this all occurred within a matter of seconds, and my mind didn’t have time to understand what was going on. All I knew is something was terribly wrong.

I also sensed that I needed to get off the treadmill immediately. I therefore grabbed onto the bar in front of the machine’s control panel, hopped to get my good leg planted on the side rail, swung my bad leg over by swiveling my hips as hard as I could in the direction of my good leg, and let go of the handrail, all one motion. I didn’t realize it at the time, but my balance was shot. I unintentionally lurched forward, tumbled off the machine, and onto a sofa that fortunately was within falling distance. Once my upper torso hit the sofa, I was able to brace the impact with my arms and roll onto my side. Whether I consciously knew what I was doing at the time is debatable. In hindsight, I think instinct took over and allowed me to assess my surroundings, and find a safe landing without really hurting myself.

As I sat upright on the sofa, the lifeless limb was bent at an odd angle, and I had to grab it at the knee and calf to place it in a normal position. My heart was meanwhile thumping in my chest and temples. I tried to curl my toes and move the foot in a circular motion at the ankle, but it would not budge. All I could think of was what the hell is happening to me?

I remember wondering if this was real or a bad dream, but not much else. After about fifteen minutes of sitting there doing nothing but ponder my fate, and I know this because I glanced at the wall clock, it occurred to me that the leg was working again. I could curl my toes, bend my knee, and stand up. All the strength and sensation had come back like magic. I strode back and forth across the room without any issues and sprinted in place, lifting my knees as high as they could go, like a sprinter warming up for a race.

Everything was normal, and I was confused as hell.

I turned off the treadmill, sat back on the sofa and one thought came to mind. “What the fuck was that?!” This was followed by, “what am I going to do?”, and “Who am I going to tell?”

The answer to those last two questions was nothing and nobody. Everything was back to normal, so I decided to ignore the event and pretend it didn’t happen. After all, what transpired was probably a complete fluke, and would never happen again.

Obviously that wasn’t the case. I tried the treadmill again two weeks later and the same thing occurred, only this time I was prepared for it, and stopped the machine once that strange sensation started coming back. Another difference was my foot started drooping and never fully recovered.  An attempt to mow my lawn a few weeks later forced me to accept the fact I could nor longer ignore whatever this was. Thus started the quest to find out what was wrong, which I will share in next week’s post.

Looking back at the event now, it seems so……innocent. I was so naive back then and felt bulletproof. Little did I know that my life would never be the same.

The Hardest Part of My Day

dressed

I love sliding into bed at night. By that time, my body is tired and stiff from having to carry itself on one good leg throughout the day. My hip is sore, my lower back is barking, my foot is dragging terribly because I can barely lift it, and my knee won’t bend without a significant effort. In fact, it is ramrod straight, and almost feels like it is hyper-extended, although it doesn’t hurt.

When I slide under those soft, warm covers,  I can feel my body exhale and melt into the mattress. It feels like I’m weightless, and this poor body, that has trudged and wobbled around all day, finally has a chance to lay prone and release the pressure that has coiled inside it.

The flip side of this is that I have to drag my ass out of its warm cocoon the following morning, which is often the most difficult accomplishment of the day.

First of all, it’s a struggle moving in bed, other than the periodic leg twitching. Turning onto my side is an endeavor, particularly when I turn to my left. The only way I can accomplish that is to reach across the mattress, grab onto its side with my right hand, and literally pull myself onto my side. Turning to my right is easier, but instead of grabbing the mattress, I have to tuck my right arm behind my back and flop over onto my side, like a fish out of water. I therefore have a tendency to sleep on my back all the time, which has forced me to sleep with a pillow under my knees to prevent my back from getting sorer and stiffer, which further complicates the turning process.

So by the time my alarm alerts me to the new day, my body is fully rested, but it also feels like it’s one hundred years old. You see, I can’t just sit upright from a prone position anymore, and as I have already mentioned, turning on my side isn’t as easy as it sounds. Getting out of the left side of the bed is almost impossible, so after I turn to my right, I literally have to shimmy my lower half to the side of the bed, push myself upright, then gently grab the bad leg and place it on the floor. The good leg easily follows.  That’s the simple part.

My leg is the weakest first thing in the morning, so I feel like a newborn colt when I stand for the first time every day. They are also unsteady and, like the colt, it looks as if I am learning to stand and walk for the first time. Compound that with poor balance, which is also at its worst first thing in the morning, and I’m sure I look like a staggering drunk as I make my way to the bathroom. I literally have my right hand on the wall from the time I get out of bed until I reach the bathroom, and there have been many times where that short distance from the bed to the wall almost ended in failure. It feels like gravity is doing it’s best to suck me down onto the floor, but it hasn’t happened yet.

I am a lot steadier when the morning bathroom routine is completed, but the limb is still very weak. The next mountain to climb is getting dressed. Getting my clothes on above the waist is a piece of cake, but not so much with the lower half. Underwear used to be an issue until I learned that the easiest way to get them on was to simply grab the bad leg by the ankle and place it where it needs to go. Same with the socks, but there are two complicating factors in play.

The first is that I am not flexible at all, and I don’t think any amount of stretching, which is hard to do in the first place, will change that. If you have ever strained your lower back, you how difficult it is to put any article of clothing on your legs or feet. That’s how it is for me, minus the searing back pain. Some mornings, the body is so stiff that it feels like the act of getting my leg high enough, and bending my body forward enough to get my socks on, will result in a hernia, a rupture, or a complete blowout of the lower back. Maybe all three.

Then there is the balance issue. Most people think that balance is an issue when one is standing, but it can also be a problem when you’re sitting. When I’m getting dressed, if my butt is to too close to the edge of the bed, and I’m leaning forward a little too far, gravity will take over and I’ll crumple to the floor. Falling is embarrassing enough when you’re upright, but falling when you are already sitting down would be the ultimate humiliation, even if nobody is there to see it. It hasn’t happened yet, but I have come close several times. Mostly when my mind is somewhere else.

So now the chore is almost complete. I am fully dressed and ready to take on the new day, but before that can occur, I have to take my first trip down the stairs. This is the most perilous thing I do all day, not only because of the unsteadiness, but also because I have my socks on, which tends to make the wooden stairs feel very slippery. Plus, it is dark, so I make sure to count every one of those fourteen steps until I reach the ground floor. One hand is firmly on the rail and the other is sliding along the wall when I make that trek, which helps not only maintain my balance, but will keep me upright if the foot slips or the knee doesn’t bend and I lurch forward unexpectedly. As you can tell, I fear falling down those stairs. I don’t think it will ever happen, but I believe that if I were to ever suffer a life-threatening MS related mishap, falling down those stairs would be the most likely scenario.

Once I’m downstairs, all I have to do is get my stuff together for the ride into work, followed by the final act of putting my shoes on and tying them, which often takes two or three attempts. You see, the AFO brace I wear is in that shoe.  I have to hold the leg by the calf and aim my toes into the shoe. Once they are in, I can lean forward, hold the back of the shoe with my fingers and slide the rest of my foot in, before I tie the strings. I’m sure this process looks very odd to someone who witnesses it for the first time.

Now I’m golden. The stiffness that existed twenty minutes earlier is gone, and my strength and balance is starting to come back, although it will take another hour or so to reach maximum capacity. I’m ready for the day and all that comes with it.

By day’s end, the body is once again tired, ragged and spent. I’m off my feet for most of the evening after dinner and the evening chores are done. My rocker recliner calls and welcomes me as I watch television with my wife. Once it is time to turn in, the legs protest having to carry my 190 plus pounds once again. It actually feels like a thousand pounds, but I shuffle up those stairs one last time to start the bedtime routine, then slide under those blessed covers and let the tension melt away. It has become my favorite time of the day.

I wish I could say the same thing about the next morning, but one has to look at the bright side. At least there is a next morning.

Tell Your Mind to Shut Up

scream

The brain is an amazing organ, a super computer that far exceeds anything technology can fathom, and hopefully never will. On the medical front, numerous clinicians have told me it is the final frontier, the one true mystery that remains to be solved, certainly not in my lifetime. Perhaps never.

The brain controls everything, and is also a focal point for those of us who suffer from MS. Some of us have lesions on the brain, some of us have demyelination of the spine, and some of us have both. Today’s focus however is not on the physical aspects of the brain and how it relates to us, but the mental aspect. If we let our imaginations run wild and generate fear and anxiety about our present and future, we aren’t doing ourselves any favors. Simply put, we have to tell our minds to shut up.

Easier said than done, admittedly. We can’t change our DNA, or how we are hard-wired. Some of us are more anxiety-ridden, or prone to bouts of it, than others, while some are better at letting things slide. But nobody who has a chronic illness is exempt from thinking about the implications of their reality. Even those  who are more kumbya and better at letting things slide struggle from time to time, and I am a textbook example of that.

I’ve stated a number of times that my attitude is not to dwell on the what-ifs or the why-me’s, and I stand by that. I try to keep my condition at arms-length, and lock it inside a secure vault somewhere in the recesses of my mind. However, there have been and continue to be times where the doubts, which I call Messi*, break free of the vault and run amok. I can feel the physical fallout when that happens, and the struggle is to corral Messi and drag her sorry ass, often kicking and screaming, back into the vault, and double the locks.

For instance, when the symptoms first started to appear and I wasn’t yet diagnosed, I didn’t have a clue what was going on, but I knew it wasn’t good. One train of thought was that I might have ALS, which really freaked me out. It was actually a relief when I learned it was “only” MS.

Every time there was a new twitch or strange sensation, Messi started speculating on what it meant, and it was never kind. As my progression slowed with the help of a good neurologist and the drug/apheresis routine he placed me on, I came to terms with my condition. I set it aside and worked hard to not let it rule my life.

Still, when something changes, I hear Messi growling. For instance, when the progression rose above the knee and made everything harder, it was hard to ignore. I started doing the math, which went something like this: I’ve had this for ten years, and for the first two the symptoms progressed quickly, stabilized, then progressed again this year to where it is now. So that either means I’ve got another ten before I really have to start worrying, or it means that I’m wheelchair bound in two to three. Therefore, I need to do a, b and c. But what if it happens more quickly? What happens if I can’t work, etc., etc., etc.

Here’s another example: I do a lot of keyboard work, and have always been able to type quickly and accurately. I never look at the keyboard. Once I got MS, I noticed a more typos, but dismissed it because they didn’t appear to be too many to dwell on, and thought I might be noticing what has always been there because of this new thing I was dealing with. Now, however, I can’t type a paragraph, and sometimes a sentence, without a typo of some kind. In fact, I’ve made four of them in this one sentence before I cleaned it up.  Does this mean the MS is beginning to progress into my hands, or is my keyboard getting old and decrepit? If I go down that particular progression path, I’ll be a basket case. So I deposited this concern in a separate compartment inside that vault, and will address it during my next neurologist appointment.

One last example: I participate in a number of message boards for people living with MS. I view myself as a MS veteran, and consider it important to give back and share my wisdom and experience, particularly to those who have just been diagnosed. Being part of these boards makes me feel useful, and also provides ideas for things to write about in future blog postings. Unfortunately, it also makes me realize how better off I am compared to what I read. There are so many people who suffer far worse than me, and are dealing with a lot heavier shit that I am in terms of family, relationships and other personal matters that I never considered. Messi feeds on that, and is begging to whisper “that’s going to be you” in my ear over and over again, trying to make me a believer. I know I have nothing to worry about on the family side of the equation, but the physical part? I already knew that everything they mention is part of the deal, potentially. But actually reading what people endure and what it does to their lives is more agonizing and makes it real. That could be me. Who the hell knows?

So it is a constant battle to keep Messi locked away and sedated, knowing full well one trigger event could occur that will unleash her, and perhaps make her impossible to contain. I don’t doubt the unleashing part of that scenario, but I would like to think that I will eventually be able to reel her in, somehow. Like I said, we are who we are, and I am a glass-half full, eternal optimist kind of guy. That will be my saving grace.

After all, we can’t change the cards we were dealt. Bemoaning our fate only shines a light on what we’ve lost, and can lead us down the slippery slope of what an uncertain future might bring. This train of thought only serves to add more stress that will stoke our anxieties and often raise hell with our symptoms. It’s fruitless and self destructive.

I saw a question posted on a message board recently that asked if we mourned the person we once were. I didn’t like what the question implied, because the me who didn’t have MS isn’t dead. I wasn’t body-snatched while everyone was asleep and replaced with a clone. I’m still the same guy, albeit one who limps like quasimodo seeking sanctuary, is in danger of falling every time he gets on his feet, is in danger of falling down the stairs if he isn’t careful (two more typos corrected), and has a hard time putting on and taking off his underwear, socks and shoes every day. I still have the same values, the same feelings, the stuff that made me the unique person I am. The only thing that has changed is my perspective. I’m not terminal, for God’s sake.

I’m fine with the premise that, in the words of a fellow blogger, it is okay to not be okay. https://msgracefulnot.com/2017/11/28/its-okay-not-to-be-okay/

And, I don’t see that changing, as long as my mind doesn’t provoke Messi.

 

 

*Messi is a play on words, combining the term MS with mess, which it does with my head. I refer to Messi as she because, in my opinion, females have the knack for pushing men’s buttons. I also believe while they are the more protective species in the animal kingdom, they are also more vicious.

The Auto-Immune Irony

illness

The symptoms were subtle when I was first diagnosed, but after a few years into my battle with MS, the progression became steadier, and I began to use a cane whenever I left the house. The interferons I was injecting myself with weren’t doing a damn thing, and I had become dissatisfied with my neurologist because he appeared unsure about how to proceed. In fact, he once called another neurologist to confirm a thought he had while I was in the office with him. This didn’t inspire a lot of confidence, so I decided to make a change .

I work for a large health system, and when I asked my boss if he knew anyone in the MS field I should consider, he deferred to the organization’s Medical Chief of Staff for a recommendation, and was given the name of a neurologist close to where I work, who was reputed to be one of the best clinicians in the state. I made the switch, and later learned that he was the guy my former neurologist had called that day.

During our first appointment, he declared I should change medications, which made me happy. I had come to hate injecting myself, particularly when I didn’t notice any improvement whatsoever on the progression front. In hindsight, I don’t know why I agreed to take them in the first place, because I knew they were designed more for the relapsing remitting (RRMS) kind, than the progressive kind I had. Tysabri wasn’t an option because the blood test he ordered when I scheduled the visit indicated I had the JC Virus. After listing the options available to me, he recommended I start monthly infusions of steroids and a chemo drug called cytoxan.  Shocked might be too strong a word to describe my initial reaction, but I was definitely surprised and confused. I mean, how in the world would a cancer drug help me. It seems silly now, but all I thought about at the time was getting sick and having my hair fall out, and asked him if I would have to deal with that.

He assured me the dose I would be getting wouldn’t cause those side effects, and I would be given an anti-nausea med just in case. When I asked why he believed this was the appropriate way to go, he explained that MS was an auto-immune disease and described what that meant. To paraphrase,  my immune system had run amok, and my body was cannibalizing itself in terms of the demyelination  that had occurred. The chemo would suppress the immune system so it would stop attacking my body, thus putting brakes on the progression. This explanation made sense, so I consented to the monthly routine.

This decision was made with a lot of trepidation that I didn’t share, because I didn’t want to sound like a wimp (I don’t have that issue anymore). Part of the anxiety evolved from the fact that I would be getting monthly blood tests to check my liver enzymes, because the chemo had the potential to fuck up my liver, which thrilled me. There were other things they would be checking to make sure the chemo wasn’t doing more harm than good, but that was the one that I latched onto.

My other fear was I would become susceptible to every germ known to mankind, because I would be shutting my immune system down. Consequently, I assumed I would be sick all the time, catching colds and any flu bug or any virus that was floating around. I thought the winters would become an especially miserable, unending chain of one illness after another. After all, wasn’t this a logical assumption, given that my front line of health defense was going to be taking a siesta? I was afraid that the devil I didn’t know would become worse than the one I did, but hoped that the reality would be different, and that the treatment would turn out to be the lesser of the two evils.

That was seven or eight years ago, and I look back at that time with amusement. Why? Because the weirdest and most ironic thing that has occurred since I’ve been getting these infusions, is that I’ve been remarkably healthy. Unusually healthy, in fact. Just mentioning it makes me wonder if I am jinxing myself for the upcoming cold and flu season, but I can’t deny the truth.

When I first started the treatments, I may have encountered the occasional cold, sinus infection or flu. I can’t say for sure because I don’t remember those kinds of details from that long ago, but if they did occur, they were far and few in between. What I can say with absolute confidence, is the last cold I had was two or three years ago, and it was short-lived. I don’t remember the last time I was sick with the flu, had a stomach virus, or anything like that. Last year, everyone in my household had something, and had it on more than one occasion.  I also work in a large office, where everybody was sick at one time or another. Not me. I was the oasis of health in a sea of sickness at home and at work. I’m sure germs were floating all around me on a daily basis, yet I remained unscathed. It’s bizarre.

Is this pure coincidence? I think not. I believe that even though I’m trying to put my immune system to sleep, it remains overactive enough to shield me from the maladies that latch onto everyone else, yet not so active that the progression accelerates. I guess my neurologist knew what he was talking about.

This winter is going to test this theory, because I have switched to a new chemo agent that I will take every six months, instead of one Friday every month. You see, even though I didn’t get sick, I felt like I had the flu every Sunday that followed the Friday infusion, a parting gift from the chemo. This new drug will be administered twice a year and actually kills certain cells (T cells?).  I assume this means the drug is stronger, takes longer to get out of my system, which in turn means it takes longer for the cells that it kills to be replenished enough to give them another whack. My next scheduled infusion isn’t until March, so it will be interesting to see if I will enjoy another illness-free winter. Should that occur, how can I not conclude that my over-active immune system is like Pac-Man, gobbling up every germ seeking shelter before it can settle in my sinus or gut?

A definite plus, but I’d rather have two good legs.

 

Sunshine and Rainbows

rainbow

I was taking inventory and skimming through the last few blog entries and almost depressed myself. “What a downer,” I thought, and was not pleased at the subliminal tone I felt I was portraying.  Not because what I’ve written isn’t true or honest, but because the mood of these entries struck me as sad, bleak and foreboding.

That was never my intent, you see. I want to convey my reality honestly, and not pull any punches in describing how hard and frustrating dealing with a disability can be. However, there is a yang to every ying, so I also wanted to convey that there has been a healthy portion of good that has been served with the MS. I saw that I may have strayed from that the last several weeks. My bad.

Now you may think, what good could possibly come with dealing with a condition that has turned out to be a lifetime sentence?  The answer is plenty, but you have to look for it because they are often little things, and they are often fleeting.

What has come through loud and clear in the ten years I’ve dealt with this, is that most people are good, kind and caring. That may be hard to believe given the events that have taken place across the globe and in our country, and the general mean-spirited vibe you get from watching and reading the news, or surveying our political landscape. I don’t deny that exists, but I believe it masks the true nature of the human spirit that I have personally experienced and witnessed through frequent acts of kindness and empathy.

These shine through in small gestures, like people opening doors when they seem me coming, or offering to help carry things if they see I’m struggling. We live in a very impatient world, where we get annoyed if our computers don’t boot up immediately, or if something we are streaming takes a few extra seconds. But people I’ve encountered don’t seem to mind waiting at the door for as long as a minute to open it for me when they see me limping their way, or offering an open seat on a crowded subway when it becomes available, even through they may have been standing longer than I have. And these are complete strangers.

Colleagues have taken it upon themselves a number of times to stand in long buffet lines to gather a plate of food and walk it to my desk without being asked (probably because they know I won’t) so I would haven’t to negotiate that distance or balance a tray of food in one hand and my cane in the other.

There are more examples I could provide, but you get the point. These small acts of random kindness, which occur almost daily, have renewed my faith in people and re-emphasized what I have always believed: despite our differences, people are generally good and kind in spirit.

The ironic thing is that, in all likelihood, this type of activity has always existed within my orbit, but I was too engrossed in something else to care. Now that I have to be aware of everyone and everything around me, it is as obvious as the nose on my face.

It’s a pity it took something like MS for me to appreciate it.

 

 

Traveling With MS as My Companion

image

I love to travel.

While I have never traveled outside the US, I have visited most of our states, and most of our major cities. I enjoy getting away, seeing other parts of the country, and appreciating how vast and beautiful our land is. When I am on a plane, I love looking out of the window seat at the vast expanse passing underneath on a clear sunny day, or witnessing the spectacle of flying over a city at night, taking in the lit landscape like a young boy gazing at a glorious Christmas tree. As an experienced air traveler, I have learned a lot about what not to do in terms of booking, connection times, how long it might take to get through security, and things of that nature.

Over the last few years the amount of traveling I have done has reduced significantly, not because of my MS, but because the opportunities aren’t as great. The only accommodation I made because of the MS was to arrive at the airport earlier and to give myself more time between connections, because rushing though the airport to make the connecting flight is impossible. Aside from those two changes, my game plan when it came to negotiating the airport, and general attitude regarding air travel, had not changed, until today.

Subconsciously, I knew that when the symptoms slithered into my knee, it was a game changer. After all, I have documented that it is harder to walk, and that my balance is significantly worse in previous posts. I was curious how or if it would change my airport experience in the days leading up to this morning’s excursion from Connecticut to Nashville, Tennessee. In my self proclaimed state of denial and stubbornness to plow ahead and not worry about the consequences, I vowed not to change a thing regarding my airport game plan in advance of this trip. Then, my wife asked this question, although it was really more of a statement: “You’re getting wheelchair assistance this time, aren’t you?”

When I booked the flight months ago, I declined that option, perfectly content to muddle my way through security, and be the first on the plane. But she wouldn’t let it go, so I thought about it and decided, why not? But honestly, I only relented because of the two braces that span my toes to upper thigh, and the hassle they might present going through security. So screw it! If it makes getting through security easier, I could temporarily swallow my pride.

I am so glad I listened to her, for a number of different reasons.

The first thing you need to know about our airport, Bradley International, is that it is not huge. Early morning, which is when I arrived, is the worst time to be there because of all the business travelers getting out on the first flights of the day. And this morning’s crowd was no exception. In fact, it was probably the busiest I have seen it in years. Lots of people, and lots of long lines.

But when I entered the airport today, I knew something was different. Pulling the rolling suitcase behind me was infinitely harder because I had to zig zag through the mass of people, and with my balance, I don’t zig zag very well anymore. After I gingerly made my way to check my bags and drag them to the X-ray machine, I parked myself on a chair, and gratefully waited for the wheelchair attendant to arrive.

The first thing I noticed after I requested wheelchair assistance was that my boarding pass was marked TSA pre-checked, which allowed me to bypass those long lines. As we weaved our way through the throng, I was happy that I didn’t have to get caught up in that mosh pit of humanity.

Going through security was easier for a couple of reasons. The first was that even though they had to wand me, given my leg was encased in metal, I didn’t have to fret over my wallet, watch, and other items being left unattended, because my wheelchair escort grabbed them for me while the TSA agent was doing their thing. The other reason was that, in my opinion, the TSA rep was, well, nicer. He did his job quickly, and got me out of there faster than the previous times I went through the process without the wheelchair. Maybe it was my imagination, but I felt a lot of empathy.

I didn’t really need the chair to get to my gate after I was through security, but I have to admit it was nice not having to walk that distance. This was further illustrated when I got to O’Hare, and walked to my connecting gate. I wasn’t in a hurry, and I could have waited for the wheelchair to arrive, but I chose not to. The trek took a very long time and I felt something I never experienced in an airport before: vulnerability.

You see, people inside an airport are clueless. They wander around, either looking at their phones, looking for their gates, looking for something to eat, somewhere to sit, or rushing through the crowd like a running back picking a hole to run through, and they are all oblivious to who or what is in front of them, in back of them, or around them. That is not a good feeling for someone with balance issues, so I simply steered to one side of the terminal and stopped or slowed down when someone threatened to invade my orbit, using my cane to secure my space if necessary. It felt like walking through a mine field.

Fortunately, the agent at my connecting gate told me a wheelchair would be waiting for me in Nashville, so I knew I wouldn’t be tempted to hoof it on my own when I arrived. It was a good thing too because while there were nowhere near as many people as there was at O’Hare, the walk was just as long, had more inclines, and the floor was carpeted, which tends to grab my foot more.

By the way, is it me or does it seem that the airport wheelchair attendants tend to be older, or smaller of stature? While I am average concerning height and weight, I am certainly not a lightweight, and felt bad for the two that got me because they had to strain a few times to get me where I needed to do.

Another thing that was different is that getting in and out from the window seat for a bathroom break during the flight was much harder, having to grab and hold onto the head rests on the seats in front of me to stay upright. Maybe I am going to have to get aisle seats from now on. And once I got to the aisle, the journey to the bathroom felt a lot more wobbly than it ever used to, and the aisle felt narrower. My hands were always on the seats on each side of the aisle because if we hit unexpected turbulence, I know I would have fallen across someone’s lap. I never felt that way before.

Getting on and off the bus that served as the shuttle to my hotel was harder, and as we approached the Opryland Resort, the bus driver described it as 57 acres under one roof and instead of thinking that was really cool, it seemed like another obstacle to contend with.

The fact is, it has been a year since my last trip, and everything is harder. When I was at the same meeting in Vegas last year, everything was just as spread out as it is here, and there was as much if not more walking inside the facility. But the difference between this year and last, is that last year I viewed that reality with a “no problem” attitude. This year’s attitude is more like “oh shit!”

I will never get on an escalator again with luggage in tow because I have one hand on the cane, another of the luggage handle and, unfortunately, no third hand to grab onto the escalator rail. Not a smart move for someone with balance issues. Nothing bad happened, but I would be lying if I said I wasn’t nervous. Why I didn’t look for an elevator is beyond me. That won’t happen again.

Now that I am here, I am sure I will enjoy my time in Nashville, but I know there be a lot of walking and standing, and I suspect that will take more effort than it used to. Then I will have to endure the return trip home. When I reflect on this trip once I am home, I doubt it will squelch my desire to travel again, but perhaps I will have to be more selective regarding where I travel to, or when my flight departs.

The one thing that I do know is that MS has definitely invaded the ease in which I used to travel, and that with time this will become harder. Perhaps a point in time it will come where traveling will become impossible.

And that would be a very sad day.

Balance

Balance

 

If you look up the word balance in the dictionary, you will find a variety of definitions and meanings, but there two in particular that interest me the most.

The first one, which applies to me specifically (and perhaps many of you), concerns physical equilibrium: an even distribution of weight enabling someone or something to remain upright and steady.

Of all the difficulties MS has presented, this one has been with me like a shadow from the beginning. At first, the shadow was small and barely noticeable. Now it is large and long, like those that  trail you when the sun is low in the sky towards the end of the day. This has also provided the biggest challenge I’ve had to deal with over the last ten years because, slowly but steadily, my balance has become more tenuous.

In what seems like a lifetime ago, I was a member of my college’s modern dance company. My motive for joining this group during my freshman year was to become more flexible and stay in shape for the upcoming baseball season (and to meet girls, I must confess), but I learned to enjoy the movement and creative aspect of the art, and stayed with the group through my senior year. During this period, I learned a lot about body mechanics, and this knowledge has become invaluable as my balance has eroded. One thing it did, although I didn’t realize it at the time, was teach me how to fall and roll without hurting myself. Needless to say, that has become a very useful skill. I also learned the secret to staying upright.

Marcy Plavin, our company’s director, always urged us to “find our center,” primarily because it provided a better form on stage and made our movements crisp and clean. Now, staying grounded in my center is what allows me to avoid crashing to the ground when my delicate balance is disrupted.

In general terms, my “center” is that spot just above the middle of the pubic bone, and I try to always keep my weight focused on that single spot. This isn’t an issue when I’m on flat terrain, because my body isn’t tilting in any specific direction, and my weight naturally settles there. It’s a different story, however, when I’m on terrain that is sloped, slanted, or flat but bumpy.

First of all, if my foot catches something, regardless of the terrain, it’s a recipe for disaster if I’m not aware of where my center is. Should I lurch forward, I can, with the help of my cane, quickly reorient myself and reestablish my center. As a result, my cane, which was once something I used occasionally, is always in my hand outside of the house. Otherwise, gravity will take over in these situations. I also need to be constantly aware of how my body is positioned, and instinctively react the moment my balance is compromised.

What is weird and infuriating, is what sometimes happens when I’m not moving.

If I’m on flat terrain and allow my mind to wander, I can sometimes stagger sideways if I unconsciously lean to my right. I’m sure this looks bizarre to anyone who witnesses it. They’d probably think I was hopelessly drunk or on something. While this rarely occurs, it does happen.

Most of the dangers that await me are outside of my home, and my yard is a prime example.

My house sits on a hill, and the downward slope has become increasingly difficult to navigate. Part of it because my foot drop has become so bad, that my foot is constantly getting stuck in tufts of grass. As a result I’m literally taking one step at a time, like an inch worm, when I’m out there. But I’ve also had occasions where I’m standing still, not moving at all, and still almost keel over. This used to happen only when the downward slope was on my weak side (the right), but I learned to manage this by transferring the cane to that side to have something to hold me up if I felt myself tipping in that direction.

Recently, going up a particularly steep grade has become treacherous. I have to force myself to lean forward when the slope is behind me because if I don’t, I can sometimes tilt backwards. Should this occur, it is the one and only scenario where I can’t recapture my center. This has occurred a few times, particularly around our pool that sits on a mound that has a short but steep pitch. When I’ve felt myself losing my center while standing on that slope, panic instantly sets in for the briefest of moments because I know that if I reach that point of no return, I will tip backwards, I won’t be able to brace my fall or protect myself, and could really wind up getting hurt. Fortunately, that hasn’t happened yet.

And this is during the summer, when the ground is warm and dry. I hate to wonder what the winter will be like.

To illustrate how silly this has become, even the act of correcting my posture, particularly if the motion is quick, sharp and I’m not holding onto a cane, or aren’t near a wall I can brace myself against, can cause me to stagger backwards.

The bottom line is that MS has stolen my physical balance, and has made it something I constantly have to battle to achieve a stalemate. It is the reason why negotiating stairs requires my full attention and concentration. It’s also the reason why the simple act of walking and standing has become a competitive sport.

The second meaning, which applies to us all, concerns mental and emotional steadiness: a condition in which the competing elements of our life are in equal or correct proportion.

This type of balance is the most difficult for me. Specifically, where is the line between being smart and taking care of myself, and giving in or giving up? Where is the line between between being cool and rationale about the disease and its future implications, and focusing too much on them and panicking? Is it better to stick your head in the sand and not worry about the what-ifs until you’re forced to, or to always think about them and plan for their eventuality. Do I need to concern myself with the prospect that all the drugs I’m taking could potentially shorten my lifespan, or is it better not to think about that at all, to focus instead on the quality of life, and how things are in this current moment?

I have my own answers to these questions and navigate according to that compass. I think I do a good job of maintaining an even emotional keel, and not get too high or too low. One could argue that I don’t take my condition seriously enough, but that’s how I roll.

What I  struggle with the most is the proper balance between sharing the fears I do occasionally have with my family and loves ones, and keeping them  to myself, which is my typical MO. After all, there isn’t a thing they can do to improve my condition, and sharing too much might unnecessarily worry them more than they already are.

But is that being selfish? Is it better to let them in on the secret that I am sometimes afraid of  where all this might lead? That I’m terrified of potentially living in a body held prisoner by this relentless beast, and of having to become completely dependent on them for everything? The thought that one day I might need help getting dressed, eating, bathing or going to the bathroom is my skeleton in the closet. Honestly, that isn’t living, it’s existing, and I don’t want any part of that. That, and the possibility that my condition will become a financial sinkhole that will destroy our financial security, is a cross I don’t want to bear.

I don’t obsess about these things, but they exist. I don’t dwell on them because doing so would destroy that emotional scale, tilting it heavily in the wrong direction. Maybe that’s why I try to keep them at arm’s length, in a blissful state of denial. I own this and keep it to myself because emotional balance is a very delicate thread. One unfortunate tug could unravel everything.

And that doesn’t help anyone.

 

For those of you who follow the blog, I will be away on a business trip next week and may not be able to submit what up to now have been weekly posts. Expect the next post to appear in two weeks

 

Is it Me?

pexels-photo-356079[1]

It is me, or do people you don’t know very well say “I’m sorry” if they ask what is wrong with (fill in the blank – with me it is my leg) and you tell them you have MS?

Is it me, or do the “I’m sorry” people end the conversation immediately, and try to discreetly move away as quickly as possible?

Is is me, or do you find all that annoying?

Is it me, or are more non disabled people using the handicapped toilets in public restrooms? Boy, does that piss me off (no pun intended). And when did being a large person become a disability?

And speaking of bathrooms, is it me, or does it seem like you are as far away as possible from the nearest bathroom when you need one and are at work or in a public place?

Is it me, or do more non-disabled people park in handicapped parking spaces than before? Either that or I happen to notice it more because when it does happen, the next available spot is a long walk from where I need to go.

Is it me, or do you hate the term “handicapped”?

Is is me, or do you have a greater awareness of other people who have a disability of some kind? I sure hope it isn’t because there are more of us than ever before.

And speaking of awareness, is it me, or are you more aware of your surroundings since you were diagnosed? I have to be, especially when there are a lot of people around, because one mistimed bump or stray cord laying across a floor might create an embarrassing fall.

Is it me, or do you find people going out of their way to open a door for you in a public place?

Is it me, or does that annoy you? Listen, I appreciate the motivation behind the gesture, and there are times, like when my hands are full, that I am happy for the help. But I’m not an invalid, and like to fend for myself most of the time. Is that being overly sensitive?

Is it me, or are you paying a lot more attention to healthcare politics than ever before?

Is it me, or are you more aware of your insurance benefits, and all the rules and regulations regarding getting services approved for payment, than before you were diagnosed? (Confession: this is a cheat question because in my line of work I have to know all this stuff. But I need to fill the page, and thought it was an appropriate question.)

Is it me, or do your parents (if they are still alive, or were alive after you were diagnosed) treat you like a little kid because of your disability?

It is me, or has your diet become a lot more important than it used to?

It is me, or does your body ache more when you get out of bed in the morning than it did when you went to sleep the previous night?

Is it me, or has the amount of medication you’re taking increased exponentially since you were diagnosed?

Is it me, or do you not bother to read all the literature that comes with those drugs? I typically don’t, and never have, because reading it can make you think the stuff you are about to take will cause something a lot worse than what you have. Aren’t lawyers wonderful?

Is it me, or do you not fully understand why some of the stuff you are taking is supposed to work?

Is it me, or do you discover that the stuff you are taking actually does work, but only after you stop taking it?

Is it me, or does it seem that most, if not all, of the options available to ease your symptoms involve pharmaceuticals?

Is it me, or do you appreciate friends and family more since you were diagnosed?

Is it me, or are there a lot of things you used to fret over that are no longer important?

Is it me, or did you begin thinking about your mortality much sooner than you could have imagined?

Is it me, or did going to the bathroom become a much bigger production than you thought possible?

Is it me, or did going down the stairs become potentially life-threatening?

Is is me, or does the same thing apply to taking a shower?

And since we are on the subject of hygiene, is it me, or can you no longer wash the bottom of your feet?

And, is it me, or do you not even think about taking a bath anymore because you won’t be able to get out by yourself? Or because of what the heat of the warm water might do to your symptoms?

Is it me, or is condo-living starting to sound pretty good?

Is it me, or has walking on a snow covered sidewalk, driveway, or parking lot, become like walking on a tight-rope, or in a minefield?

Is it me, or do you only fall when you aren’t paying attention?

Is it me, or do you want to crawl into a hole and disappear when this happens in public?

Is it me, or can you gain weight more easily than you used to?

Is it me, or do steroids make you ravenous?

Is it me, or do you bleed more easily from all the drugs you take?

Is it me, or were you resistant in the beginning to accept help because of the misguided notion that you would be giving up your independence?

Is it me, or has that shit stopped?

Is it me, or do you think that your spouse and kids were somehow cheated because of your disability?

Is it me, or do you feel profoundly guilty that you can’t do as much around the house as you used to, and your spouse/family have to pick up your slack?

Is it me, or are you doing more than you probably should because you try to minimize the slack they have to pick up?

Is it me, or has daily life become a lot more expensive since you were diagnosed?

Is it me, or do hallways seem overcrowded when another person enters your space?

Is it me or do you no longer walk in the middle of a hallway? I’m always off to the right side, hopefully with a handrail or a wall within easy reach.

Is it me, or are airports a lot more intimidating?

Is it me, or does it take you longer than thirty seconds to get into a vehicle?

Is it me, or do you avoid support groups. I think I don’t go to them because I don’t believe I’m that bad off, and seeing others who are would scare the hell out of me. It’s that denial thing I keep talking about. Who knows, maybe I’d be pleasantly surprised.

Is it me, or did you become a expert on all matters related to MS within a very short period of time?

Is it me, or isn’t a lot or this really comical?

Is it me, or doesn’t a lot of this really, REALLY suck?!

 

FYI: One of my readers, whose mother has progressive MS, started a company, in part to  help her mom stay independent and as safe as she possibly could, with help, of course. She sent me a link ( http://www.helpmedicaldevices.com ) to the company. I checked it out. While it lists a lot of stuff that might be better suited for frail seniors, there is also a lot on the site that people with MS-related mobility issues could find helpful, so I thought I would pass it along.

 

 

 

MS Gear, and What I Most Dread

gear

As a person whose symptoms impact my mobility, I’ve accumulated  some gear over last decade.  They are placed side by side in the accompanying photo, in the order in which I obtained them.

My first noticeable symptom was a droopy foot, which tended to drag across the floor when I walked. An AFO brace solved this dilemma. It gave my foot a permanent lift, which helped prevent me from stubbing my toe on the floor or having it get stuck in the carpet, which could result in a fall. I still use this today, although  the Velcro straps and padding have to be replaced occasionally.

As my foot and ankle became weaker, I purchased a cane. At first, I only used it when I was outdoors, because that was where I ran the greatest risk of spraining an ankle or stumbling over something that might cause me to lose my balance. Now my balance is shot, and I use it all the time when I am not in my house. I can walk without it as long as I am on a flat surface, although it is a struggle over long distances, but I use the cane more as a way of keeping my body from listing to the left, and also to help take some of the pressure off my back and hip. I have three that I use now.

By the way, if you need one, and want something with more fashion and style than the shiny metal variety with the grey plastic handles, you can’t beat the selection offered by The Fashionable Canes web site.

Next, after a lengthy battle with my insurance company to get the purchase approved, came something called The Walk Aide, which is a device that I strapped onto my leg below the knee. The Walk Aide sends electrical impulses down the leg, which lifts the foot.  This was a godsend when I first started using it. I didn’t need the foot brace or the cane, and I could literally jog with it. Unfortunately, once the progression reached my knee, it rendered the Walk Aide useless because my entire leg was screwed up, not just the foot and ankle.

Once the symptoms reached my knee, and made the joint feel like a hinge without any screws to hold it together, I obtained a knee brace brace. When I first strapped that beast on, it felt bulky and unnatural, but this changed after a few weeks, and I hardly notice it now. When I am at work, or am going to be in public for any length of time, I wear both the AFO and knee brace.

It takes about ten minutes to get both of these on or off, and is a bit of a production. The most maddening thing in the beginning was that both items had Velcro straps, which kept getting stuck together. I didn’t know which one belonged to the AFO or the knee brace, and wound up mistakenly taking some of the straps completely off the knee brace. Unfortunately, I never bothered to see how they were attached in the first place, so it took a lot of trial and error getting Humpty Dumpty back together again, stretching my patience thin. It was a good thing no sharp objects were within reach.

When I am in full battle regalia, my right leg is covered or supported by something from my toes to just below my crotch, and I have a cane in my left hand. Maybe I’ll wear a full suit of armor some day. Wouldn’t that be a sight for sore eyes.

I know the odds are not in my favor on this, but what I am trying to avoid is having to add the dreaded wheelchair to this list. Or as least defer it for twenty years or so.

Why do I find the prospect of wheelchair so alarming? Realistically, it would make getting around much easier, provided the environment I’m in is wheelchair friendly. Not having to walk so clumsily might also be easier on the back and hips, which constantly bark at me. Maybe I’d find it more palatable if I only needed or used it some of the time, where it was an option instead of a requirement.

Does what the wheelchair symbolizes bother me the most? A little piece of me dies every time the symptoms progress, because the functionality that is lost doesn’t come back. I know that. But there is something about walking on your own two feet that gives you a sense of independence you don’t realize is there until it becomes threatened. Will having to  rely on a wheelchair signify that I have lost the battle, that MS has gotten the best of me, and that the me who used to golf, go for walks, ride a bike, mow the lawn, and take care of all of the yard work, is dead?

No, that’s silly, because the truth is that I can’t do most of that stuff now, and haven’t been able to for years. But, my mind tells me the potential is still there, because I still have the use of my legs. In fact, I still do some outdoor work, and shovel snow. I can still vacuum the house, and clean bathrooms, although not very well. I’m running errands all the time. I push myself to do these things, in part to prove to myself that I still can, but to also feel useful.  If a wheelchair entered the picture, will all of that be gone?  I know the only way I will sit in one of those fucking things is because I have no other choice. How useful will I be then?

I hate being less than whole, and I hate being dependent. It’s one thing to have that happen when you’re really young or really old, but I’m neither. I should be at the stage of my life where I should eagerly plan for retirement, and look forward to the options that come with those years, instead of worrying about becoming a burden to those I love, and drain my finances in the process. All of these certainly impact why I find the idea of a wheelchair so abhorrent, but one reason stands above all.

I mentioned in a previous piece that I keep the fact that I have MS at arm’s length. I know it’s there, but have conned myself into thinking it isn’t that big a deal. I know it can get worse, and am aware of the other nasty symptoms I could come down with. I have blinders on when it comes to all that however, because the fact is none of it currently applies.

The reality of a wheelchair would burst that bubble, and shred my comfy cocoon of denial. I’d wake up one morning and realize, “Holy Shit! I’ve have MS!” Plus, it would make daily living much more complicated, and I have enough complications in my life.

I’m the stubborn sort though, so what will happen is there will be a period of grieving, then I’ll make lemonade out of the lemons dumped in my lap. My glass is always half full, you see, so something positive will come out of it. Maybe I’ll enter wheelchair races to…….well, just because.

I’ll figure something out. Resiliency is important when MS is your constant companion. I’m sure as hell not going to be someone who is miserable to be around.

I just hope that I don’t have to worry about it any time soon.

 

POST SCRIPT TO THE ACCESS TO HEALTHCARE PIECE: Congress is as it again. It is very possible that the latest proposal, which is to eliminate the Affordable Care Act and replace it with block grants to the states, will come to a vote next week. The only way that will occur is if the votes are there to pass it by a simple majority vote. If passed, this in all likelihood will allow insurers to have pre-exhisting condition clauses, effectively excluding us from the market. If that doesn’t scare you it should. If you don’t like this development, please make sure you let your Senator know ASAP, particularly if he or she is a Republican.

 

MS and Access to Healthcare

medications-money-cure-tablets-47327

I normally avoid writing anything that can be considered remotely political, but I’m making an exception in this case because living with a chronic condition, and having unfettered access to healthcare, is not a political issue. It’s a moral and ethical issue.

When efforts to “improve” the Affordable Care Act captured the spotlight earlier in the year, I could not believe Congress was seriously considering giving insurers the option of waiving the requirement that forced them to provide coverage for people with pre-existing conditions.

Don’t they know that treatment for something like MS can make the difference between living a productive life versus becoming dependent on Medicare disability or even Medicaid, which would cost taxpayers more long term?

Don’t they know that nobody chooses to be in this position, and how vulnerable we are to their political whims?

Don’t they know that even with good health insurance, the out of pocket costs for many of us can be daunting?

Don’t they know that one of the leading causes of personal bankruptcies are overwhelming healthcare bills?

Don’t they know that nobody, save for perhaps the very wealthy, can foot the bill for the treatment we need to halt or slow the progression of our condition?

Are they that blind? Even worse, are they that ignorant or mean-spirited?

Listen, I’m all for reigning in healthcare costs and government waste. I know there are a lot of people who feel government should not be intruding into people’s lives and dictate what they or businesses should or shouldn’t do. But I don’t think it is a stretch to say that anyone who feels that way would change their tune if they were in our position.

Quite frankly, if our elected officials in Washington all had chronic health conditions like MS, access to healthcare would not have strings attached. It would probably become law in a heartbeat.

Our treatments can be very expensive. Without health insurance, there is no way in the world I could get the care I’ve received over the last decade. Seriously, having to pay for one month of treatment would be disheartening. As it is, my yearly out of pocket medical expenses are significant, but what choice is there? Is it right to put someone in a position to make a choice between eating and getting the healthcare they need?

Health insurers will say otherwise, but their primary goal is to make the largest possible profit. They want their premiums, but they also want to pay as few claims as is legally possible. I admit to being biased about this, because I have worked in the healthcare revenue cycle arena for over thirty years. But I do know what I am talking about.

It’s complicated enough to get approval for treatment, and getting the bills paid. Insurers play games all the time, trying to avoid paying a claim or denying treatment that should be covered, often putting patients in the middle and causing undo stress in their lives. If you have doubts, someone who once worked for a large health insurance company, and was responsible for processing and paying medical claims, told me (he was out of the industry by then) he had a monthly denial quota to meet. In other words, his unit had to deny claims, regardless of whether the denial was valid, to hit his number.

I’ve endured a few of these games myself, and it took weeks of persistence on my part to get them to overturn a decision that was wrong to begin with. Fortunately, I had the knowledge to cut through the bullshit and run-around I was getting. And if that didn’t work, I knew who to contact in the state to intercede on my behalf. I can only imagine what it would have been like had that not been the case.

Healthcare is big business, and everyone wants their piece of the pie. The discussion over pre-existing conditions pissed me off because regardless of the rhetoric, this entire debate was about greed, not common sense.

This is not meant to be a commentary about how expensive healthcare is. I think everyone would agree the costs are insane. It is not a critique on what is wrong with the system (a lot), or who should pay for what. Nor is it a recommendation that everyone should be required to have healthcare coverage, although I do have a strong opinion about that. I am not advocating anyone should get a free ride either, because I don’t think we are entitled to anything.

What I am saying, is that if you give health insurers the choice of deciding who or is not eligible for coverage, and/or give them the option of pricing the coverage for those with chronic conditions, they will not do the right thing. Instead, they will either say you can’t be covered, or set their rates so high that nobody could afford them. So don’t put us in that position. The only thing we are entitled to is to have the same access to coverage, and the same financial obligations, as those who aren’t living with something like MS.

Fortunately, it appears that this storm has passed, but I don’t think the issue is dead. Each and every one of you should stay on top of it, and e-mail your senator and congressperson, letting them know how you feel on matters as they develop.

You voice could make a difference between getting access to the care you need, or be shit out of luck, unable to afford what you need, and left hoping your MS will be merciful and leave you alone.

I think we all know how that would work out.