I am still doin stuff, and I have things to tell you, but a total lack of the time to write it up. Man. Life is crazy but it’s good that I have the energy to keep up with it still. I still need to tell you about the lawyer, and other things.
This weekend, my bestest and mainest of babes is throwing a huge-ass garage sale to fund my crowdrise campaign. She’s been working incredibly hard on it and I can’t even tell you how much I love her.
Since I’m keeping record. I had another sorta-fall yesterday. I was just having a weak day, the walk to the bus took me a half hour and I was DRENCHED in sweat by the time I got there. The bus came at 12:18 and I did not stop sweating until like….1:30. It was a bit muggy, raining on and off, but man. It took SO MUCH EFFORT.
The bus did the kneeling thing, lowering to what would be curb level – but it was still a high step because that stop is on the street. I pulled myself up on the handrails and I just didn’t have the strength to make it up and I wound up kneeling myself. It took me a second to haul myself to my feet, and while I was paying my fare and showing the Honored Citizen ID that proved I qualified for the low fare, I thought, “Well I just kinda negated the need to show him the ID, he just got a demonstration.”
Another slight bruise on my knee, another slight bruise on my ego.
Soooooo in the days, months, years ahead, there’s gonna be a lot of uncomfortable stuff. Things you don’t talk about in polite company. But the point of this blog is to document EVERYTHING, and well, I know some people are curious about this sort of thing. SO let me educate you.
If talking about shark week, Vampire tea parties, communists in the funhouse, girl flu, a red light special downtown, a crime scene in your pants, or rebooting the ovarian operating system makes you feel uncomfortable or squicky? Then now’s your time to bail. Here’s a picture of kittens to wipe your mind clear.
Still with me? Okay.
While contemplating everything after my diagnosis, envisioning my future, thinking about all the practicalities, it occurred to me. What the hell am I going to do about my period? I imagine MOST people with ALS have already gone through menopause so it might not be a common question. But it’s just one more damned thing to deal with, that I am not going to be able to take care of myself. And some nurse dealing with that? Man, why. So I brought it up with Doctor Goslin, and she said when the time came, I could talk to my primary about options.
I decided the time had come.
I wanted to start the process now, when I could still deal with it under my own power and remain in complete control. And I wanted to give myself time to adjust to any side effects NOW, to allow enough time to go by to make sure that I had it under control before life was beyond my own control. I decided to go to Planned Parenthood instead of my primary, because they’d have all of the information about ALL of the methods. I wanted options and informed decisions. I did a lot of research on my own, and I really liked the idea of the implant, but that wasn’t a guaranteed stop to menstruation. So I went with an open mind.
It took me a little bit to find it, but it was made easier by the honest to god protest happening outside. Fetus posters and everything. They didn’t fuck with me though, they just stood across the street singing hymns. There was a sign in the upstairs window that said, “Hello protesters! Donors have agreed to give $37 for every one of you that shows up today! Thank you for coming!”
Heh.
Mannnnnnnnn it took FOREVER. I was half an hour early to my appointment and was taken back 45 minutes after my appointment time. I talked a little bit about it to the aide, she gave me some preliminary information, asked if I wanted AIDS and siphyllis/gonorrhea testing, was I being abused, had I ever been pressured into sex, did I feel safe at home? no, no, no and yes, thank you, I’m fine. She also reminded me it had been 4 years since I’ve had That Thing That Really Sucks and they recommend it every three. Would I like to take care of that today. BOOOOOOOOOOOOOOOkay FINE.
So the clinician came in and we had a long chat about all of the options. Half of them were out because I have a history of headaches and migraines which estrogen would exacerbate. The implant was not recommended because not only is it NOT a guaranteed end to menstruation, the effects vary wildly. Some women get heavier periods. Some women get spotting, some have irregular and unpredictable flows. So that was out. Which is a SHAME because I’d really like to only have to think about this once every three years, and the idea of a little plastic matchstick under my skin on my arm is creepycool.
We decided on depo-provera. It’s a shot in the arm, once every three months. It’s a hormone called progestin, a slow release that prevents ovulation. She told me that she has another woman who comes in regularly with her developmentally disabled daughter, and the daughter gets the shot as a matter of hygiene so it’s not at all an unheard of application. She had me take a routine pregnancy test first. Just cause. Even though it would be a second-in-history MIRACLE if I were. We did the Thing That Really Sucks, and then she stabbed me in the arm with a needle and I was sent on my way.
My arm’s a little sore. I was told I might gain weight, so maybe just be a little careful about what I eat, and depo CAN cause bone brittleness (yay?) so take calcium. I’ll see how this goes from here. When I left, the protesters were gone and it started raining BUCKETS as I walked to the train stop. A really amazingly nice woman shared her umbrella with me, because of course I didn’t have one. This is Portland man, we don’t believe in umbrellas (SPOILER: YES WE TOTALLY DO. It’s just that it doesn’t usually RAIN here, just this nagging persistent drizzle that only barely counts as rain and you don’t need an umbrella for that you sissy. But when a half block walk had me soaked to the skin? Yes, yes I WOULD like an umbrella. Thank you, lovely lady.)
We will see how this goes. I’ll keep you updated. And now you have an answer to a question you might have been afraid to ask, or didn’t occur to you. So when someone asks, what do women with ALS do about their periods? Now you totally know.
Caitlin Doughty is a mortician. I can go on about this woman, about her job, the relationship we as a society have with her job, buuuuut I won’t. Not yet anyway. BUT I agree with her views, she’s entertaining, and I love her a lot.
She has a video about how to deal with grief. Specifically, how to talk to someone who is grieving. It’s good advice when dealing with people going through terrible times in general.
Man, I can’t even tell you how busy – STUPID busy – I’ve been. Sorry. I should have posted this one ages ago (last week) because it’s a quick check in.
I had another check-in with Doctor Goslin last Wednesday. It was a strength check, a meds adjustment check, and a general well-being lookover. I’d messaged her earlier with some concerns about my energy levels and OH MY GOD that became a whole thing because my insurance decided to be awful.
So, my energy levels have been in the toilet. Seriously in the toilet. Friday nights I was going to bed around 11, my usual bedtime. And sleeping until 2 in the afternoon. And then taking a nap at 5 until 8. And then back to bed at midnight. During the six hours I was awake, I accomplished nothing. Not even ‘played a video game’ “nothing”, just…stared at the internet and/or watched tv shows I’ve seen a million times and know by heart “nothing”. I like sleep, don’t get me wrong, and I’ve historically spent entire weekends sleeping a whooooole lot. But it’s not something I’m doing for enjoyment anymore. I sleep because I’m THAT freakin’ tired. Unfortunately I’m not really in a position to be able to waste time.
So as I posted before, she called me that evening and we set things up to get me a scrip for adderall. It’s a controlled substance – because let’s be honest, it’s legal meth – so I had to wait for a physical prescription could be mailed to me. We also started me on a low dose of Celexa to supplement the Wellbutrin I’m already taking for depression, because Celexa has better anti-anxiety properties and my fatigue COULD be caused or at least exasperated by depression. I got the scrip, took it in to the local Frederick Meyers..
…and was told Cigna wouldn’t pay for the adderall because they don’t approve of its use in people over 19 years old.
Thus began the Dance of the Morons, where we appealed, they said no, Dr. Goslin tried to clever her way around the restriction, and was shut down again because they do not cover adderall as a treatment for fatigue in ALS patients. But they WILL cover it for MS patients.
MS IS A FREAKIN SISTER DISEASE YOU JERKS. THEY ARE VERY SIMILAR.
Only mine is a guaranteed death sentence, but whatever.
SO they said no every possible way they could in response to every single way we tried to weasel through it. In defeat, during our checkup appointment I was given samples (a lot of samples) of a drug called Nuvigil, which is for sleep apnea, narcolepsy, and shift work disorder.
…I didn’t know there was such a thing as Shift Work Disorder either.
It’s diagnosed for people who work widely varied shifts, like nurses, to stay awake when they are working crappy hours. Just like it says on the tin. Anyway. Yeah. She gave me samples of that. We also doubled my Celexa dose, to be slowly ramped up over two weeks.
We also checked my strength, and she saw no change at all since I saw her two months ago. This is AWESOME. Super slow progression FTW. As she put it, she’d very likely be seeing me for years and years to come. Yayyyyyyy <3
During the visit we also chatted a little bit about assisted suicide, but that...that is its own post. That's been brought up a lot lately, and I want to talk about that. Later though. Later.
So in the end of the appointment, she was really happy about how well I'm maintaining my strength, and she saw no reason to see me for another three months (but I'm welcome to email her with questions or concerns of course). I had been scheduled for a clinic day soon, but she canceled that because I don't need it.
I started the Nuvigil the next day, and it seemed like I was a little more awake. Friday, a little better. Saurday? I slept until 9AM, screwed around on the internet for awhile, wrote that last emotionally draining post, and then took a nap from noon to two - because I WANTED to. And then I went through my closet and got rid of two bags of clothes, cleaned all the catboxes, tidied my room, went through some things in my office....SUPER productive day. I felt pretty normal. So, Nuvigil is awesome. I'm not sure what we're going to do about that in the long run. We'll figure things out. She always does.
So that's the haps, man. I'm doing good. Meds are helping me retain a normal level of activity, my strength remains unchanged, and life is pretty freakin' great.
I saw Zoë Keating in concert last night. She’s an amazing musician who makes sublime music with a cello and some looping software.
Do me a favor. In another tab, open this link. Listen to it as you read this. The piece you are hopefully listening to is called Escape Artist. It’s my favorite. I love the places it takes me, the way I feel, and the calm it brings.
My other favorite is a piece called Optimist, and it’s always been One Of Those Songs. You know. You hear it and it hits you and it’s like, “FUCK, man, this is my song. This is me. This is everything I’ve been trying to SAY.” And while Escape Artist is my favorite because of the emotional and mental places it takes me, Optimist was My Song. It was an embodiment of what I am to my core, the thing I’ve always wanted to be, who and what I am when I take off the mask. My philosophy, my purpose, my soul, conveyed in cello and software. Artistry and technology.
Optimism has been high this week, but it’s been put through the paces. It’s been a week of The ALS Show. The whole weekend was about the Walk, which gave me a boost of love and support. At the end, though, the whole day was a reminder of my disease, and a display of it’s various stages, a glimpse into my future with it. Monday my carpool was traveling so I walked to the bus and I was tired from it all day. Tuesday I had all kinds of job stress because I’ve turned into our purchasing/finance person and it was the end of the quarter. Wednesday I had the appointment with Dr. Goslin. Thursday I had a meeting with the Elder Care attorney and faced a lot of important but terrible decisions. And then a meeting with my amazing realtor and talked frankly about the practicalities of buying a house when I know I’m not going to stay there forever because eventually I am GOING to have to live in a nursing facility until the end. Friday, work was harsh, there was physical labor and stressy conversations, and then the concert. Finally. The concert.
I sat in a dark room, with strangers, listening to my soul resonating. And out of nowhere, I had the thought:
This is what I want to hear as I die.
It just came as a true statement, and I could clearly imagine this sublime music playing as I slipped away, and everything would be calm and perfect. I started crying, and it was a comforting, profound moment of perfect acceptance. I am going to die. And it is still going to be okay. I cried as I sat in the theater and listened to her pouring her heart out through her cello, and I knew for a fact that it was going to be alright. No one noticed that I was crying, it was just the music and I, and it was perfect and calm and connected. With astounding clarity, the universe reached out and touched my shoulder through her music, and whispered to me of comfort and love and understanding.
I keep this blog, and it helps me put order to chaos. I have a job, and it keeps me grounded. I have a fantastic, amazing support group, and they give me strength and hope to survive every day. I have music to keep me sane.
I am, at my heart, an optimist. I’m going to be okay. Somehow. Even if I die, that will be okay, too. It’s going to work out, and on days like this, in moments like this, I am in perfect peace and acceptance.
And now you should listen to Optimist. It would be a perfect end, for this to be the last thing I ever hear. And so I leave it here for you, with love and acceptance and faith that it really IS going to be okay.
I’ve gone on and on before about how grateful I am for the support I’ve gotten, how much I appreciate the support I’ve been given, how blown away at the love I’ve been shown. It’s probably become a little bit tiresome.
Well, suck it. There’s a lot more coming.
I admit I totally got press-ganged into doing the Walk in the first place. The Veterans Resource Group had a table in the cafe at work. I stopped by to chat, and met another person who ALSO had ALS for the first time. (I’ve met a fair few since then. We’re a small crew, but we run – or hobble or ride – in the same circles.) Part of the table’s purpose, besides awareness, was to recruit people for the Walk to Defeat ALS. “You should form a team,” I was told. “I bet you’d get a lot of support.”
I was of two opinions on that. On the one hand, it’s asking for something. I’m not good at that. On the other hand, a tiny irrational fear, ‘what if I form a team and no one shows up?’ While I was debating this in my head, a coworker walked up to the table to see what I was up to.
“Vashti’s making a walk team, do you want to join her?”
He looked at me, “You are?”
“I…uh. Apparently!”
And that’s how it started. I put up a poster outside my cube, I wore the red wristband, I talked openly and honestly about the diagnosis when I was asked, but I felt really weird about asking my friends to come over in support of me. I caved and asked my friends to help me name the team at least. We had a lot of really good suggestions, but in the end, The Godzilla Squad won out. On the 16th, I posted my team link.
On the 17th of August – the next DAY, for those of you playing at home – I was at 17 members and over $1000 raised.
To say I was overwhelmed is a gross understatement. So, fun fact! I’d never cried for joy before. I always thought it would be kind of cool if something like that happened to me, but I am not sentimental in the right ways, I guess, so it never happened. Until then.
The Ice Bucket Challenge gained serious momentum, and so did my team. On the 26th, I was at $3k and 26 people. A dear friend of mine in Sacramento also started a team in my name, Team Dinsdale. We met online waaaaaaaaaayyyyyyyy back in the day, before the Internet was a thing, when you had to dial directly in to someone’s computer and leave messages on a digital bulletin board. In the BBS days, my first handle was Dinsdale.
Life continued its usual frantic pace, there was a lot happening, and before I knew it, it was the final weekend. I had four people staying at my house to attend, and one flew in from Sacramento to be here for me. I was spoiled absolutely ROTTEN that weekend, with homemade Ethiopian food of amazingness, fancyface ice cream and donuts for dessert, and the best company a girl could ever ask for.
And then, Walk Day. This is my team:
Because ALS isn’t going to stomp itself out.
Amazing people, every one.
We gathered in a spot that was strategic and awesome until the live band started playing. Right. Bloody. There. But we were VERY easily distinguishable in the crowd with the hoodies (OMG SO AMAZING LEENDAH I LOVE YOU) and Danielle, my main babe, had printed out the kitten-vs-Godzilla picture I’d been using for my Walk page, and attached them to an umbrella. And Matt. Oh my golly Matt. He had commissioned a mighty cape of DOOM and a head cover for his staff:
IS THAT NOT AWESOME.
Yes of course it is, don’t even bother answering.
There were a LOT of people there. Oh my god so many. I’m really glad I had my team around me so I was constantly distracted by OH MY GOD HI I HAVEN’T SEEN YOU IN FOREVER instead of ..holy crap I am in the biggest of big crowds and this sucks. We borrowed wheelchairs,Danielle and I, because I can walk a mile, but it sucks, and I think three is out of the question. Danielle had to borrow one because her foot is borked and it hurts her a lot to be on her feet at ALL and walking three miles is similarly out of the question.
It was a FANTASTIC walk. Well. Roll. I got pushed. The chair was surprisingly easy to wheel myself around in, but I had a lot of people willing to help me out. There’d been cold and rain suddenly, but it cleared up in time to be LOVELY for the walk day. Even a little too warm to wear the hoodies all day, for they were made of fleece and are SO COMFY AND WARM but maybe not the best when standing for a while in direct sunlight. Megan was the smart one, she held the umbrella. Some surprise faces showed up – I didn’t expect my older brother there, he told me he had to work but then didn’t have to! – and met a couple new friend-of-friend faces and did not at ALL have time to introduce everybody to everybody. We walked a really pleasant stroll along the waterfront, and groups connected and drifted as we walked.
We finished, exultant, and some of us stayed for a picnic, and some of us had to get back on the road.
I am so. so. so incredibly grateful. I am grateful to everyone who came. Everyone who couldn’t come but donated. Everyone who couldn’t come OR donate, but thought about me.
In the end, my team was 49 members strong, more than 35 of whom showed up to walk, and $5460 raised.
I’ve always strived to be the kind of person someone would care deeply about, and like having around. I …I guess I managed that, if the support and love I’ve been shown is ANY kind of indicator.
I love you all. You’re amazing and the world is lucky to have you in it.
Speaking of cards!! You may remember a conversation I had with my dear friend Megan about playing the “I’m dying” card, and she decided to needed to make me actual cards with various demands.
GUESS WHAT.
SHE MADE ME THE CARDS.
I can play this card whenever I want!
She and her fantastic husband Colin actually made me the cards. They are a physical thing. They are sparkly embossed and amazing. They ALSO gave me the Jack Skellington and Oogie Boogie figurines you see (and I heart them SO HARD) and the black heart decoration which does not at ALL show up in this picture. But it is soft and awesome.
Megan is one of the most thoughtful people I know. She once made me a little box of lip cutouts that she’d kissed with lipstick on, for when I need smooches and she is not there to give them. I can’t tell you how amazing she is. Her husband Colin, who I’ve known just as long, is also amazing and full of love. He is the perfect partner in crime for her and I love them more than I can ever possibly tell you.
And THIS, THIS is how I survive with a smile. I am orbited by planets of awesome, and the pull of their gravity keeps me from collapsing in on myself.
I love these cards and I am looking forward to the looks on people’s faces when I actually use them. I love the people who made them. I love the people who gave suggestions for them. I love that I have such amazing people in my life. I love that my diagnosis has shown me exactly how loved I am, and how completely I am surrounded by the brightest and best people in the universe.
OK kids, quick diversion. This is something I wanted to do for a little while now and I finally got my act together to make it happen.
*squee*
I have calling cards now! I’ve had a lot of occasions where I’m talking to someone about my blog, and it’s not QUITE got enough Google Juice to find by ALSFTS, so I wanted something proper to hand over. “Yeah, I actually wrote all about how I came to the diagnosis and what my symptoms are. It’s at my blog which is..oh hell. Here’s the info.” And then hand over the card like a pro.
Of course I wanted a cheap option, and there are all kinds of sites out there that do the “250 cards! Free!” and then charge you for everything. “Oh, did you want INK on those? Well that’s $5. Gloss? That’s $5. Shipping? Fifteen dollars.” Pffffft. I wound up at Printastic because I found they had the best templates and I’m NOT about to design my own shizz yet, I just wanted something quick. They had the usual free 250 cards thing, but only like two bucks for gloss and then I think 7 for shipping, so it’s not bad at all. I didn’t expect much, something better than a Post-It.
But they actually look really COOL (even if I do say so myself!) and are decent quality, not flimsy or anything. So hooray! Here’s what they look like!
Madam, my card.
Now if you will excuse me, I’m going to go hand these things out like a BOSS.
Longer post to come. But I am so, so grateful to everyone that came out to show me love and support today. So grateful to those that could not but wanted to. So grateful to everyone everywhere who ever gave a shit about another human being. I am so glad to be alive and in such excellent company.
I was introduced this week to a comic called Spinnerette. You can read it here. It’s a pretty fun send-up of superhero comics and usually pretty goofy – a fun romp of a comic. I’m not finished with the archives yet, so I can’t give you a complete opinion, but it’s well drawn and occasionally funny.
The reason it was recommended to me, though, is that one of the main characters has ALS. She built a robot suit so that she can use what time she has left to fight crime, Iron Man style. I halfway expected to be vaguely insulted by how they treated the disease, but she’s actually pretty matter-of-fact about it, and the reactions of people around her are pretty faithful. She’s not her disease, that’s not the point of her character. It’s her motivation, but not her reason to exist. I like that a lot.
Similarly pretty accurate is the reaction when she tells the plucky heroine that ALS is degenerative, and she only has a few years to live.
http://www.spinnyverse.com/index.php?id=87
And you can just..feel her frustration. The main character is more sensitive about this woman’s ethnicity than she is about her disease.
This is exactly how not to react when someone tells you they have ALS. Or any other disease for that matter. Please don’t do this. It is REALLY REALLY frustrating. You think you’re being all chipper and optimistic, but you’re really just sticking your fingers in your ears and going LA LA LA LA LA. You’re in denial and it’s really hard to be around you. You’re telling us that we can’t be honest with you when we’re having a bad time. You are obligating me to put a happy face on my hurt for your comfort, and fuck you for that.
ALS isn’t all shit, all the time, but sometimes it really is awful and we should be allowed to be up front about it. Allow us to break the news that YES, this is FATAL. And then let us be okay with that, and help you come to accept it, too. And when you accept how horrible it is, you can truly appreciate how marvelous the rest of it is, most of the time.
The Ice Bucket Challenge was amazing in bringing awareness about ALS to the general public. It’s gotten to the point now where when I say ALS, there might be a reaction, and I don’t have to continue, “..Lou Gehrig’s?” People are starting to know what ALS is. And that’s WONDERFUL.
But we’ve still got a way to go.
I am looking forward to a time when someone asks what’s wrong, I say ALS, and there is complete understanding. Not just “oh that’s pretty bad, isn’t it?” but “Oh, this is terminal, I’m so sorry.” It would spare me so many awkward conversations about treatment prospects and recovery times. There’s no gentle way to say, “There is no treatment. This is a death sentence.” It’s hard to drop that on someone and tell them that you’re okay, honestly, in the next breath. “I’m going to die. But it’s okay.”
It would be so much easier if they understood the implications already so that I can be spared giving people tidings of death with every conversation about my disease. Not just the mortality part, but the whole gradually becoming stuck in a meat shell until I suffocate part. It would spare so much awkwardness. I can’t even imagine someone having one of these superficial conversations with me, learning I have ALS, and then Googling it later and HOLY SWEET MOTHER OF GOD THIS IS AWFUL IF I HAD KNOWN I WOULD HAVE BEEN SO MUCH MORE SYMPATHETIC OH GOD SHE PROBABLY THINKS I’M THE MOST UNFEELING PERSON EVER. (I don’t. I promise.) But the alternative is unlimited conversations like this:
“Hi, how are you?”
“I’m going to die horribly, thanks, but otherwise grand. How are you?”
Yeah. Awkward.
Okay, so: story time!
I ran into a coworker in the hall a little bit ago. He’s not with my group, but he works on my floor so I see him a lot. Really nice guy, though we got off to a rough start – we met in an argument over who had booked a conference room (I did! And I proved it!) and he was really bitter and snarky at us even though I GAVE him the room and we just found another one. But he had the good grace to make a point of finding me later to apologize and explain that he was really frustrated with getting kicked out of rooms a lot that day because I guess his admin sucked and didn’t actually reserve ANYTHING. But he was sorry he took it out on me. And we’ve been happy acquaintances since.
…Anyway. He stopped me in the hallway and asked me how I was doing. It was a genuine, “How are you?”, instead of the generic “How are you” that you pray to God the other person will just superficially say “Fine! You?” and you both can go about your day. He was actually concerned, and I was a little confused because we hadn’t talked about my disease before – had he seen the spot on the news?
“I’m good,” I answered him honestly. “Doing alright.”
He voiced that he had seen my walking kind of deteriorating and was wondering if I was okay.
“Ah, that. Well, I have ALS.”
There was a little bit of recognition there, and he sympathetically told me, “I’m sorry to hear that.”
“Thank you. But I’m doing okay.”
“So it’s a progressive thing?”
“Yep, someday I’ll be in a wheelchair.” I shrugged.
“Oh. Is it hereditary?”
“Sometimes. Not with me, but 10% of cases. Usually it just comes out of the blue.”
He was sympathetic, nodding.
“But nothing hurts,” I continued. “I’m doing okay. I’ll be working as long as I can.”
We’d reached the end of the hallway where our paths split. He gave me a warm smile and said, “Please let me know if I can help you in any way.” And he meant it.
I was touched. “..Thank you, I will.”
He turned to go, and said in farewell. “Well, I hope you feel better.”
So I opened the floor to questions, and I got a couple. I hope you guys know you can always ask me questions and I’ll try to answer them as honestly as I can. The usual disclaimers apply – I speak for myself, not for everyone with ALS, your mileage may vary. Hit me up in comments (anonymously if you like) if you can think of anything else you’d like answers to.
Q. How does progression work? Random parts or a clear path with variable timeframe?
Everyone’s experience with ALS is different. Though according to Dr. Goslin, the rate of progression tends to be steady. If it’s a fast progression now, you can expect a rapid decline until the end. If it’s slow and steady (as mine is) it will remain that way. ALS doesn’t go in fits and starts, apparently – it’s a constant rate. I’m losing the ability to walk, but it’s not as though one day I’m going to wake up and my legs just don’t work. They’re going to fizzle out slowly.
Some people start with the speaking/swallowing difficulties, some people’s starts in the hands, some peoples’ start in the hands and feet at the same time. Some people die within months of learning something’s wrong, some people go for years before being diagnosed because they just figure they’re clumsy or getting old. This is the main reason I can’t speak for everyone with ALS. Our feelings and how we deal with the disease are incredibly varied, but nothing so varied as how the disease manifests in the first place. It’s entirely unpredictable except in how the story ends.
Q. Does it hurt? Not trying to do things but just in general?
The disease itself doesn’t hurt at all. That’s one of the things I was actually lamenting during my diagnosis – nothing hurt, so I couldn’t point to any one thing as the problem. The only pain that ever came as a result of ALS were the occasional muscle cramps in my legs, but they’re rare now that I’m taking neurontin to calm the twitches. Kneeling now hurts because there’s no longer that cushion of muscle protecting me – so my bones are pretty much pinching my skin against the floor. ow. But no, nothing hurts as a direct result of the disease. I don’t feel the neurons burning out. My only clue that it’s happening are the random fasciculations and the progressing weakness.
Q. I know you’re Christian – how does that affect your thoughts? Does it give you something to hold onto or is your faith shaken?
H’oboy. Well. I’ve always considered myself Christian in that I believe in the teachings of Christ. It boils down to – Be Kind. Take care of those who can’t take care of themselves. Believe that you, too, will be cared for. Every major religion has some variant of the Golden Rule. I was raised hardcore Evangelical Christian, and I still hold a lot of the same faith, but I don’t believe in the Bible as a literal record of events, and ..yeah. It’s complicated, and changing. I believe in God, but I don’t believe He’s necessarily involved in the minutiae of our lives. I really don’t believe He cares who we’re having sex with. I believe it is in us to be kind and rise above our animal nature, and that brings us closer to Christ, closer to being like God.
My faith (or whatever it is you want to call this) is unshaken, because I don’t think God was necessarily involved any more than God is involved in the changing of the leaves in Fall. I don’t believe that God will fix this except through the minds of brilliant scientists who will figure out a cure. I think things happen for a reason, but sometimes that reason is that you’re stupid and have made terrible life choices. And sometimes that reason is that your DNA is twisted and you were doomed from the get-go. I have ALS for a reason, and that reason is ..whatever it is that causes ALS. I don’t think I was given this disease as a challenge of faith or a chance to show grace, I think it just happened because sometimes people get ALS. We’ll figure out why some day. I’m not going to wake up magically free of ALS, and that’s okay. It’s not God’s fault. It’s not anyone’s. It’s just how the universe manifests itself.
Though I admit, I WAS cursing the universe a bit when I got shingles on top of all of this. Just a little. Cause…dang, man. Really?
Q. Are there really neat treatments upcoming that hold out some hope?
Stem cell research is going to be the key. If we fix this at all, it’s going to be through stem cell research. It’s what shows the most promise. Recent tests have allowed some early-stage ALS patients to recover a little bit of strength. And while some of that is controversial (spoiler alert: not all stem cell research involves embryos), I also believe that if the naysayers were diagnosed with ALS tomorrow, they’d probably be willing to inject fetuses straight into their spinal column if they thought it would keep them alive.
I don’t think we’ll find a cure in my lifetime – no, that’s not entirely true. We might find a cure in my lifetime, but it will never get through the FDA rigmarole in time to reach me before I die. My only hope is through participating in clinical trials, which will carry some risk, but even if that kills me, it provides a data point. Which is precious. And I really do believe we’ll figure this out. Some day ALS won’t be a death sentence, but I don’t think there’s any chance of that happening with me. And that’s okay. We’re working on it, it’s getting attention.
Q. What are your happy thoughts?
I am loved. Seriously. I am so fucking loved. It’s amazing. I would NEVER have thought in my whole life that I had this many people who cared so deeply for me. Any time this stuff gets to me, I can make myself calm down with the knowledge that there are people who would do anything to help me.
It’s a powerful thing, to know you’re not alone. And I know there are going to be days when that knowledge saves my life.
So, I hope it’s pretty clear by now that you can ask me anything and I’ll do my best to answer. But I wonder, do any of you have any questions for me? You can post them here anonymously if you want. If I get any, I’ll answer them in another post.
I went out to get the mail yesterday after work, and waited for traffic to cross the street. My street’s the only one in the neighborhood that goes all the way through from one major road to another, so it’s busy. Coast is clear, I step off the curb, but here comes a truck. He’s waiting for me, how nice! But the other side is not clear, and it looks like there’s a few cars, so I don’t want the truck to wait for no reason. I think that I will signal to the truck driver that I intend to wait for traffic by stepping back on to the curb.
Except that doesn’t go so well.
Instead, I don’t have the strength in my legs to make that step back, and so I wind up on my ass on the curb in some very crunchy grass. My neighbors don’t water their lawn any more than I do. I’m not hurt at all, just embarrassed, and I laugh nervously, shake my head, and flash the truck driver a thumbs up. Like, hooray for that! ha ha ha I just fell that’s so funny. But I’m okay! He laughs, and drives away.
I wait for traffic to clear to try to stand up. It takes me a try or two.
And I’m not going to lie, when I got back in to the house, I cried. And felt an irrational anger at the truck driver, even though I know if he had understood why I just fell, he wouldn’t think it was funny at all. And I was laughing, too, and he has no idea that it’s a nervous habit I’ve had all my life. When I’m angry, I laugh, and then I cry. When I’m hurt, I laugh. When I’m being insulted, I smile. Until I’m alone. And then I cry. But still I’m a little angry that he didn’t understand it wasn’t my fault I fell. It wasn’t clumsiness. It wasn’t. fucking. funny.
This is the fourth fall. It’s not the worst. The worst one, thankfully, didn’t have any witnesses and was just scraped up palms. It was the day of my diagnosis and my mind was elsewhere so it’s hardly surprising I didn’t quite make the curb. They’ve all been the result of trying to step up and not quite making it, and then not having the strength to correct my balance. So I just kind of sit down. Or kneel. I’ve never been actually hurt, they’re gentle falls.
But they’re a precursor of things to come. A sign that things are going to get worse. Hateful little reminders that my time on my own two feet is limited. The fall itself is frustrating, of course, and humiliating, but they echo of disability and impending loss. There’s no outward injury, just a cringing inside and fear and future loss.
There will be more. Worse ones, too, I wager. And in public, I’ll fall with grace and good humor, and joke about it, and feel like dying just a little, and never let on that I’m not actually okay.
“Nothing bruised but my ego,” I joke. But that bruise hurts like hell.
One of my very favorite, most used bits of gallows humor is the idea that the world somehow owes me something because of my disease. I call this the “Fuck It, I’m Dying” defense.
…Of course I don’t actually BELIEVE that, that would be stupid. Even though I know there are some terminal patients who do think that way, it makes absolutely no sense and that’s a ridiculous way to think. I present you my very very favorite poem ever:
A Man Said to the Universe
BY STEPHEN CRANE
A man said to the universe:
“Sir, I exist!”
“However,” replied the universe,
“The fact has not created in me
A sense of obligation.”
POW. The world don’t owe you JACK SHIT, my friend, if you’re dying today or tomorrow or a hundred years from now. But it’s funny to think so.
Any time I think I might get in a little trouble at work, like I forgot to submit my monthly status report (OH MY GOD I TOTALLY FORGOT TO SUBMIT MY MONTHLY STATUS REPORT! SHIT!) my friend and coworker asks, “What are they going to do, fire a dying woman?” When we don’t choose where I wanted to go to eat, “Demand it anyway. You’re dying. OVERRULED. We’re gonna go get Mexican, bitches.”
I was talking tonight with my dearest Megan (who is awesome and you should BE so lucky to know her) about traveling for business, and sourpuss coworkers who just want to go to the hotel after work and not explore the city. Especially if you’re in another country! COME ON MAN, LET’S GO HAVE AN ADVENTURE. Megan agreed, “Yay, adventure! Demand adventure. Play the I’M DYING YOU HAVE TO TAKE ME ON AN ADVENTURE card.” I told her, “I LOVE that card!”
And then she said, “Okay, now I want to make you cards. Two-sided, business card, or maybe a little bigger, like an old fashioned calling card…One side: I’M DYING. Other side: miscellaneous demands.”
I’M DYING…
I DEMAND CAKE.
I DEMAND SEX.
I DEMAND KITTENS.
I DEMAND ADVENTURE.
I DEMAND FREE STUFF
YOU HAVE TO FORFEIT THIS ARGUMENT
TELL ME I’M PRETTY
BUY ME SOMETHING
CARRY MY SHIT
CARRY ME
I’m sure you all can help me think of other good ones. Let’s hear them.
I gush a lot about Dr. Goslin. BECAUSE SHE IS AMAZING. But, I’m also prone to hyperbole. I get it. You might think I’m exaggerating. But here’s this thing that happened.
Lately, I’ve been having a few more rougher days than usual. Some depression is absolutely expected with a terminal diagnosis. Duh. And I was on antidepressants before I was even diagnosed, because broken brains run in my family and I am no exception. But this last couple of weeks I’ve been more prone to let things get to me, like the Ice Bucket Challenge haters, and slight arguments turn into self-hate sessions, and I am just having a hard time with things right now. In addition to this, things are harder to do, physically. They’re taking a lot more energy than I would think. I’m tired all of the time. And I don’t know if I’m tired because I’m depressed, or if I’m depressed because I’m tired? But everything seems so much harder than it feels like it should be. Friends and family have noticed, and my little brother has mentioned several times joking-but-not that I should ask my doctor for some Adderall. Maybe I’d have the energy to get things done and cleaning won’t be a herculean task that wipes me out for the entire next day.
Monday was a holiday, and a classic Depression Day with lots of sleeping and moping. It carried over to the next morning, which is unusual. I’m typically over it the next day. So I got fed up with being a mopey, tired lump and that afternoon I sent Dr. Goslin an email:
We have an appointment to meet in a month, but I wanted to let you know that when we do meet, I’d like to talk about medication adjustments. I’m not sure the wellbutrin’s doing anything anymore, and I’ve been completely devoid of energy. I know some tiredness is to be expected of course, but for example, yesterday I slept from midnight to noon, ate some lunch, then slept from 2 to 7. And back to bed at 11. It’s to the point my brother told me I should talk to you about adderall or get a speed habit or something. hehe. So when we meet, can we talk about this?
I was expecting maybe an email in a couple of days to acknowledge the question, a quick “Yes, we can discuss your medications when we meet.”
Instead she called me after work. We talked for about about my symptoms, where I was at, and where I thought I should be. She asked what I’d like to do. Do I want to attack the depression, the fatigue, both? I told her I didn’t know, because, (as I said up in that second paragraph) I wasn’t sure if they were separate issues, or if the one was feeding into the other. She gave me many options, made sure I was seeing a therapist regularly, and told me about different drugs, what they did, what their side effects were; she usually prescribes another antidepressant that deals more on the anxiety side, that is a nice compliment to the Wellbutrin, would I like to try it? Additionally we COULD try some energy-producing meds, if I thought that was something I would like to try. She carefully explained all of my options, made her suggestions, and ultimately left it up to me to decide which route I wanted to take.
I didn’t even have an appointment. She won’t get paid for that time, probably. But she made the effort, she called me outside of her office hours, to talk to me and see that I was taken care of. Because she didn’t want me suffering for another month if we could start to do something about it NOW. And this is why I tell people she is amazing. And why I love her. She is one of the most powerful players in my support team and I really don’t know what I’d do without her.
So, without hyperbole and in all seriousness, Dr. Kim Goslin is the mutha-f**kin BOMB.
There are things that are more difficult to do now. This is hardly a surprise, it’s a lovely happenstance when your motor neurons burn themselves out and your muscles atrophy. But there are some things it never would have occurred to me would be harder.
Like putting my shoes on. I have no strength in my toes at all, so when I put shoes on, they just kinda curl under when I shove them in. I can’t flex them so set it right, so I have to push on the tops and sides of my shoes once they’re on to get my toes to try to uncurl so I’m not walking on them.
Scrubbing floors is harder, not necessarily because my energy pool is lower, but because I have no muscles in my lower legs anymore so kneeling on the wooden floors hurts. There’s no real padding, so it’s like I’m knocking my bones right on the wood. And then once I’m done with that section of floor, getting up to shift a few feet away is hard because I don’t have the strength to push myself up from a squat, so I crawl on my knees, knock knock knock, and ow. Sucks.
Same for standing a long time. It’s not that my legs don’t have the strength to hold me up as much as it’s the lack of muscles in my feet so I have no padding to protect me. It’s like standing on concrete, even in spongy shoes. After about an hour or so, it’s not that I’m muscle fatigued from walking around, I have to stop because my freakin’ FEET hurt.
I’m also finding it hard to stop short, when walking. My toes have no strength to balance me out. So when I walk up to the elevators, I have to make a lot of little cha-cha steps when I stop in order to not fall over. It’s easier now with the cane, but it’s still weird.
Maneuvering in the hallways at Intel has always been hard. There are a TON of very…..self-involved engineers here. There are the ones looking at their phones walking on a direct collision course with you. There are the ones gathering in clusters right around the corner so you crash into them when you turn. There are the groups of them walking three people across down the halls, leaving you LITERALLY no way to walk around them, so you wind up just standing there, waiting for them to either physically crash into you, or notice you and pull the cluster a little tighter to squeeze by you as you’re hugging the wall.
Walking through work now is like dancing in a minefield. I have to be vigilant at all times because if I get bumped into, I’m going down. I can’t quickly sidestep someone turning the corner too sharply. In the cafe, when someone stops short, I can’t avoid crashing in to them. So I advance cautiously, looking for potential problems, and keep a two person length in front of me at all times. I have become the granny driver of walking in the cafe.
I didn’t foresee any of this. When they tell you that you’re going to lose strength in your legs, you think “walking is going to be harder, going up stairs will be nearly impossible.” You don’t think “I can’t squat down to tie my shoes ever again”. Or any of the things above. It’s a bizarre safari of self discovery, and it’s not even upsetting, not really, not OH WHY ME I CAN’T KNEEL ON THE FLOORS TO SCRUB UP CAT PUKE ANYMORE”, it’s just been, “Huh. Okay. So that doesn’t work anymore.” and working out what to do instead.
Milk crates. Milk crates are what you do instead. Milk crates are my friend. You just park your butt on it, and lean over for scrubbing the floor, or sifting the litterbox, or tying your boots. Milk crates are awesome. They used to be book shelves, then moving boxes, now they’re butt support. Universal problem solvers.
Eventually I won’t have to worry about any of this stuff. I’ll be in a chair, and I’ll just run over the engineers who get in my way. There won’t be a balancing act when stopping short, just brakes. I’ll be sitting when doing the cooking. And the floors…well, someone else will probably have to deal with that. Problem solved for ME, either way. But it’s interesting, finding out these little things that no longer work.
I had the second talk today, for Intel employees. I mentioned the talks briefly before, but lemme recap.
The leader of the Veterans’ Resource Group here where I work contacted me to see if I’d be willing to help. Veterans are twice as likely to get ALS and we don’t know why yet, so they’ve dedicated this quarter to raising awareness. Part of that awareness campaign was two scheduled events where they brought out the technology available to assist ALS patients, tried to drum up support for the Walk to Defeat ALS, and talked about ALS in general. He asked if I’d be willing to just give a short talk about my diagnosis, how it came to be, and how technology has come into play. I came to his attention because of the news story on voice banking, and he thought that was a wonderful way to introduce ALS to Intel folks – apparently I am the only Intel employee currently working, who has ALS. He asked if I’d share my story. Of course I said yes, no big deal.
I thought a lot about what to say. I didn’t want to just stand up there and talk about my diagnosis. I didn’t even really want to talk about myself much, except to say, this is what ALS is, and if you have any questions at all about what it’s like, or how you get diagnosed, or anything, please ask, because I want people to know this stuff. There’s a lot of misinformation out there, and most of the information that is correct is cold and clinical, hard to put a face on. And I didn’t want to be a Sally Struthers pity party campaign of DON’T YOU FEEL AWFUL LOOK AT THIS HORRIBLE STUFF YOU SHOULD GIVE US MONEY AND FEEL BAD.
And so instead I talked about the tech. Both times, I didn’t manage to stay on script, but this is more or less what I said. And I wanted to share it here, because it’s valid and important to me.
After a 6 month chase including MRIs, a spinal tap, a biopsy, and several impressions of an electric voodoo doll, I was finally diagnosed with ALS. (As it was stated) ALS is also called Lou Gehrig’s disease, after a then-famous baseball player gave a speech telling America that he considered himself the luckiest man alive.
That April 1st, as I sat in the neurologists office and tried to process the news, the first thought in my head was not that I felt particularly lucky. The first thought was actually, “I have to wait until tomorrow to tell people, because NO ONE is going to believe me when I call them on April Fools’ Day to tell them I have a terminal disease.” And my second thought was, “Ok, now what.”
Some people interpret this as courage; I think it’s actually closer to pragmatism. If anything, working here has honed my natural ability to deal with crises with grace. I *can’t* panic; I’ve suddenly lost the luxury of time, and in less than a year I went from perfectly healthy to planning advance directives and making decisions about feeding tubes and ventilators. And it’s become a full time job figuring out how the heck am I going to AFFORD all of this. Dying of ALS is a very expensive endeavor in the States. There’s all of the mobility equipment I’m going to eventually need, there’s the two story house I had bought a handful of months before I was diagnosed that now has to be sold because stairs are becoming impossible. There’s going to be hospice care, and figuring out who I can rely on to get me to medical appointments.
And even more stressful that figuring out money, I have to tell a lot of people about my diagnosis. When a coworker asks if I’m limping because I’ve hurt myself, I have to tell them why I’m limping, and I find more often than not that it usually entails an explanation of what ALS even IS. When I told people of my diagnosis, while their first reaction is always “I’m sorry” – which feels lame to you? But it helps, it really, truly does – the SECOND thing out of everyone’s mouth is always some variant of: “What can I do to help.” I have never realized how many amazing people are in my life. When I was diagnosed, I knew I’d need someone to lead my care team when I couldn’t, and when I looked up, my best friend had her bags already packed and checklists in hand. When I realized that it’s become so much more difficult to do the simplest things like go to the store, I have a plethora of people offering to take me. My little brother moved his entire family from California to be here for me. Casual acquaintances have become friends. And my coworkers have become my invaluable allies.
I have the very good fortune to be working here at Intel. Our benefits are actually really good, especially when you compare them to the nightmare that is Medicaid. And most importantly? The people I work with are an incredible asset. You have two things we really need if we’re going to defeat this stupid disease. First? I’ll be honest, …we need your money. Research takes money to fund, and did I mention how expensive having ALS is? But second, and probably most importantly, you have intelligence and innovation. If you look at the tech available to make living with ALS easier, and compare it to what is POSSIBLE, you’ll see an almost comical shortfall. Eye gaze tech allows ALS patients to use a computer after their ability to move has gone, but it costs thousands and thousands of dollars, and the best stuff isn’t covered under insurance. There is good technology available, and there’s AMAZING technology POSSIBLE. And you’re just the people to help us push this tech to the next generation and make it available to everyone that needs it, not just those that can afford it.
Ever since that April diagnosis I have been shown time and again that I am completely surrounded by people who are willing and able to make this disease suck less – for myself and every other person with ALS.
And because of that, I realize that I am actually very, very lucky.
