Category: Dealing With It

Bad Days

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I’m having a bad day.

Some days are fine, some days are normal, and some days it all just fucking gets to me.

I found out today that a dear friend has stage 4 cancer and was given 4 – 8 weeks. Maybe 9 months with chemo. And he and his wife are wonderful, amazing people and they don’t deserve this at all and just, just..

FUCK.

And I offered what assistance I can offer, what I’ve learned about the bureaucracy of dying, and just..fuck, man. It’s been weird and wonderful to watch the sudden outpouring of love on them, see the support network spring up ‘out of nowhere’ that I knew was there all along because I’m on the outside of this. Aching because I know the inside and it’s super shitty and they don’t deserve this. Angry, so fucking ANGRY that this is happening and I am powerless to stop it. And I know that panic, and that scramble, and that wait wait wait while you know time is ticking. I didn’t deserve this. They definitely do not deserve this.

No one does. No one ever deserves to be told they’ll be dead in a year. Or soon. The roadmap to life is complicated and strange, and it’s unexpectedly horrifying to see the end of that journey, and count the mile markers on that road. And sometimes you ride in the car and the scenery is pretty and you space out and things are okay. And sometimes, like today, there are potholes and horrific accidents and you just want to pull the fuck over and breathe for a minute, but you can’t. The car keeps driving. Time keeps ticking.

And so sometimes, like today, you lock yourself in the bathroom at work and cry for a little bit. About your friends, but about you, too. About everything. And then on the way home, you buy all of the junk food and sit in front of your computer and eat everything bad for you and play Skyrim and try to tune it out for awhile. Tomorrow will be better. But today is a bad day.

I think bad days are an evil gift, because they give you permission to fall apart for a while. It’s like a valve release, or some days like a punctured balloon. Permission, a reason, an excuse to just completely lose your shit and release all of the FUCK THIS SHIT IT SUCKS SO BAD FUCK EVERYTHING WHY THE FUCK IS IT HAPPENING THIS IS SO FUCKING UNFAIR and embrace the grief and face it down and acknowledge it, and then put your big girl panties back on and live your life. Tomorrow. Until the next time. And the bad days are cathartic and good, and yeah. Necessary, maybe. But it sucks to be having one, feeling like you’re in a nightmare and it’s going to get so much worse. Knowing I’ll feel better tomorrow does not help me tonight, as I eat birthday cake Oreos and cry in my now-practically empty office in a house I don’t get to stay in while my digital persona steals from random barrels and kills skeevers and dragons. Pretending that the world can stop for a bit, committing yourself to losing a night to escapism because it was a bad day. As though it somehow makes up for it when all it does is cost me more precious time.

Just..bad day. Tomorrow will resume my usual dealing-with-grace and optimism and humor. But tonight it all just sucks so much ass. And while it’s okay, normal, expected to have days like this, it feels unnatural and awful and I don’t like BEING sad and angry and pessimistic. It’s not me. I hate this. I hate being emo, I hate that people I love are going through trauma, I hate that I don’t always have the strength and grace to smile. I hate that I can’t always find humor in the dark. Especially when it’s darkness around people I love. I hate this.

I hate bad days.

“It’s a beastly, undignified business.”

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Terry Pratchett died yesterday. He was 66 and suffering from early onset Alzheimer’s disease. He was a brilliant mind, and the world is so much poorer for his absence.

In 2011, three years after his diagnosis, he made a film called Choosing to Die. He met with an extremely British man, Peter Smedley, who had motor neurone disease – known here in the States as ALS. Peter was about the same stage as I am when he chose to die, weakness in his legs that made it difficult to walk and get up out of chairs. He had a very bright mind, and saw clearly the end of his path. He didn’t want his story to end that way, so he went to Switzerland and wrote his own exit. His wife was immaculate and also extremely British and very “keep calm and carry on”. They both kept a very strong face through it all.

I did not expect to actually see the man die.

I am glad they filmed it. It was a very good and honest look at the mechanics of the assisted death. And even though it was hard to watch, I am grateful that he shared his story. It was surreal to see someone at the same stage as I, with the same mindset, take the steps. Earlier than I would ever have. So much earlier. But he knew where he was going and did not want that undignified end, and so he took the poison and his wife stroked his hand and he fell asleep and died.

And he had to go to Switzerland to do it.

I am so, so grateful, again, to live in a state where it’s legal. How anyone can deny someone the right to die comfortably in their own homes on their own terms is quite beyond me.

It is, indeed, a beastly, undignified business.

Clearing Out

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We had a huge moving/charity thingy sale last weekend. We could NOT have asked for better weather for it. It was warm, sunny, and beautiful. In the course of our three day sale, I learned some things:

1. People like slowly driving by sales and magically determining that your sale has nothing to offer. And sometimes even if they stop, they don’t bother turning the car off.
2. People will haggle over a $1 item, even at a charity sale.
3. If I had a dollar for everyone who inquired if my ladder were for sale, I could have bought a new one.
4. Dude who offered me “like, around twenny bux” for a $300 collectible KNOWS about Masterworks Replicas, man. He KNOWS.

Also, I was shown, yet again, that I have an amazing support network. Folks I haven’t seen in person in years showed up. People I’ve only known online showed up. Friends donated things to the sale AND bought stuff. After three days, we were exhausted and done and a little bit richer and a lot lighter in stuff.

In between the chaos and crowds, I watched things that used to belong to me become someone else’s. And rather than melancholy, it made me happy. It made me happy to see my Wishbone plushie go to a girl who knew who he was. It made me happy to watch a kid’s face light up when his mom said, yes, he can have that. To watch a woman buy a set of manga – in Japanese! – that I was sure no one else would want. At the end of each day, I looked at the garage, less full, and looked at my friend Danielle, running the show and doing ALL THE THINGS, and was so, so grateful.

The sale was born of grief and hardship. It is to offset the upcoming cost of a horrible thing, and to lighten my load for the move(s) to come. It was hard – SO HARD – to go through my things and decide if didn’t need that thing anymore, with the added implication of, “I don’t want someone to have to deal with this when I die so I’ll get rid of it now.” And I gave up some of my treasures because I knew they were useless treasures to me anymore, and they might become someone else’s. A new life instead of shoved in a box until my brother goes through my stuff when I’m dead. And so I let things go.

And I watched the teenager walk away, hugging Wishbone, and was content with my choices.

Vanitas Veritas

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Long before I was bestowed with the cosmic middle finger that is ALS, I was gifted with a genetic grab bag of fuckery called ectodermal dysplasia. (There’s GOT to be a cousin-marriage something or other back in my genealogy, because COME THE FUCK ON. My DNA is FUCKED. ) Anyway. I promise this is related to ALS, but I need to give you a bit of backstory.

Ectodermal Dysplasia, for those of you that can’t be bothered to google that shit, is a family of genetic disorders that causes defects in the hair, nails, sweat glands, and teeth. I have a VERY VERY mild case. Some people with these disorders are born with no sweat glands and have to wear cooling vests their whole lives, or have webbed fingers and toes, or no hair at all. I can sweat, I have some if not all of my teeth, I have hair at ALL, I’m ahead of the game. I am very fortunate that I was affected as little as I am.

But growing up with it as a kid?

Brutal.

My hair grew in transparent blonde and sparse, and only ever to about 2 inches long. Except on the sides of my head, that grew up to four in wispy little threads that flew away from my skull like feathery peachfuzz wings. When it got wet, it disappeared. My eyebrows were transparent blond, visible only when I got really angry and redfaced, so they stood out white on my face. My teeth grew in all kinds of crooked and brittle and some never grew in at all. My nails are these paper-thin shreds of nubbins. I was a very weird looking kid.

Fuck, man, you know how kids are little shitheads. I had the nickname Bald Eagle in my neighborhood. The older kids would see me coming and yell, “THE EAGLE HAS LANDED!” and run away. When I was in fourth grade, one of my girl classmates confided to me that one of the boys (that I happened to have a crush on) thought I *could* be cute – if I would just do SOMETHING to my hair, because it looked weird. I had a crooked, gappy smile that I hid behind my hand when I laughed. I had an expressionless face, because my eyebrows were THERE, they were just transparent. Even the adults joined in, unwittingly, mistaking me for a boy until puberty offered evidence to the contrary. I went to a flea market once, when I was about 8 or 9, and I was looking at this vendor’s pretty little necklaces and things, and the shopkeeper came over smiling, “Looking for something for your girlfriend, hmmm?” I was too embarrassed to correct him. When visiting my great grandmother, making the obligatory visit to her next door neighbor Mrs. Day (who always had Grandma Candy) I smiled and thanked her when she told me I was growing up to be such a big boy.

As you could imagine, I had a little bit of a gender issue growing up. It didn’t help that I have NEVER been good at “girl”; I really WANTED to be feminine and cute, but I felt like I was putting on an awkward costume that didn’t fit any time I tried. I was a social weirdo and never learned makeup or dressing girly, I felt awkward and weird, this androgynous thing that didn’t fit in anywhere. I was already Strange, my brain full of ideas that didn’t occur to most, a very intelligent and bored kid, standing out because I was a loner and never felt like I belonged to any of the little school cliques, not even the nerds. I was the weird kid in the back, and weird looking to boot. No seriously. Here’s me at 14, never having had a haircut in my life:

awkward14

My self confidence and ego never really had a chance.

Eventually I taught myself to embrace that weirdness and make it seem intentional – I dyed my hair strangely and scowled at everyone so they’d think that I MEANT to look that way. Androgyny was cool if you were a punk, man. Or something. I learned to hide it by being angry. I wore that anger as a shield, protecting the hurt and lonely little girl inside. The Bald Eagle is still a fucking RAPTOR man, and it will GOUGE YOUR EYES OUT AND FEAST ON YOUR LIVER. (Oh, poor, 16 year old me; I wish we could chat. How desperately you needed a hug.) But the anger just made me look weirder. My defiant, thrust out jaw just made my face square. My heavy lined eyes just made my invisible eyebrows more obvious. And I never smiled so no one would see my crooked teeth. And weird hair looks weird even if you try to make it look like you meant it.

Vasthi at 16

It took me a lot of years to work through that anger, slowly discovering and adding weapons to my arsenal in my Battle to Defeat Ectodermal Dysplaysia. Eventually I learned to draw on eyebrows to fix my expressionless face. To use false nails to hide and protect my little paperthin fingernails and have pretty, feminine hands at last (they were the one part of me I thought were pretty). I was introduced to hair extensions, after an unsuccessful flirting with wigs, and eventually I even came to revel in my ability to change my hair in a moment’s notice with them. Long hair today, short hair next week, long again the month after that. Through all of this, I let go of that angry teenager, who in turn stopped shielding the lonely and awkward little girl. I learned to allow myself to be a little bit feminine and dress like a girl sometimes, because I actually AM female, goddammit. And it looked cute on me.

And then I had good enough dental insurance to fix my crooked smile and have a beautiful smile for the first time in my life. That was a goddamned game changer. My brothers and I have all suffered the same over our crooked, missing, brittle teeth (I have the better teeth out of all three of us, but got totally ripped off in the hair department). All of us have dealt with being asked if we’ve ever used meth. By dentists. Having methmouth when you’ve never even so much as smoked pot or had an alcoholic drink makes you self-conscious as shit. And it’s cost all three of us countless opportunities. No one wants to hire a methhead. No one wants to date a weird looking girl with a wonky smile. So when I could afford to bridge the gap in my smile, to have straight teeth, I actually felt more normal and okay than I ever have in my life. I went from this:

to this:

And my world changed. And I felt like I finally won.

What does all of this have to do with ALS. I know. Relax, Sparky, I’m about to get there.

It was a slap in the face to be diagnosed with ALS RIGHT when I thought I had all my shit together. I had a really good job that I really like, I was financially stable. I had just bought a house like a Real Live Grownup. And at last? I was at a really good weight, my teeth were awesome, I knew how to do makeup sorta, my nails looked fantastic, and goddamnit I was PRETTY. FUCKING FINALLY. It took 38 motherfucking years, but I actually felt pretty, and smart, and stable. A Real Live Person Who Doesn’t Suck. I still had some shit to sort through, but I was doing pretty fucking good, all told.

…And then just when I think I have shit solid and good, ALS fucks it all up. I’m not going to be able to do my awesome job that I like, working with people I love, eventually. I have to sell the house I am in love with and didn’t even get to finish decorating because I can’t deal with stairs for much longer. I gained a fuckton of weight back because of my good friend Stress Eating. Hey, did you know there’s a German word for the weight you gain from emotional eating? Kummerspeck. It literally translates to “grief bacon”. Isn’t that the most AWESOME THING EVER. I mean, the weight gain sucked, but there’s a WORD FOR IT. And then being told by doctors DO NOT LOSE WEIGHT, you’re going to need it later, and people with extra pounds just tend to do better with ALS anyway. So here is your medical prescription to EAT WHATEVER YOU WANT. Don’t go all apeshit, I mean, we don’t want to have to fit you for a bariatric wheelchair, but you’re dying, fuck it, eat those nachos. Sucks about the not fitting into your clothes anymore though, yeah? Don’t worry, eventually you won’t be able to eat except through a tube and you’ll fit into all that again. So it all works out, yeah?

Where was I.

Right. Early on, it hit me, something stupid and vain – eventually I’m not going to be able to draw my fucking eyebrows on anymore. And I think I’ve just TOLD you why, that bothered the ever loving fuck out of me. I could rely on people to get me dressed, and probably put makeup on my face, but there were going to be days when none of us could be bothered to do that shit. And it really fucking bothered me to be reduced back to my 14 year old self. I had just CONQUERED that, I am not HER anymore. But I’m not going to be able to put on this Armor of Normal Seeming (+1 to appearance and +3 to charisma) forever. Towards the end of days, I’m going to be this emotionless husk, and I’m not even going to have any fucking eyebrows.

And it’s expensive, and vain, and fuck you I don’t care. I got permanent cosmetic tattooing done on Wednesday. I paid a stranger $395 to tattoo eyebrows on my face. And it looks fucking awesome.

And I can’t quite articulate the sense of..relief? Success? Booyah? Even though it was expensive and there are SO MANY better uses for the money, there’s a weight off of me with the knowledge that I can’t go back to 14 year old me anymore. I’m permanently done with her. My teeth are permanently okay, even if I DO still have a baby tooth on the bottom and not all of them ever grew in, they look like normal people teeth when I smile. And now my face is permanently okay, because I don’t have to draw on expression every day. What was already there has been highlighted, so when my hands no longer work, I can still quirk my eyebrow when you say something stupid. For awhile. And then I won’t be able to move my face at all, but my eyebrow game will still be fucking strong, yo. And I’ll never be that expressionless, angry little girl again. I’ve graduated, the tattoos on my face a diploma from Fuck That Shit University, signifying a degree in Being Just Fine, Thanks for Asking.

I am gonna go down, ALS is eventually going to kick my ass, but Ectodermal Dysplasia can fuck off forever. I beat it. I win.

The Eagle has fucking flown.

Beautiful Kitten Fish, Sleep Baby Sleep

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I have a very romantic weekend planned. While everyone is eating expensive dinners and watching 50 Shades of Sexual Assault this Valentine’s Day, I will be having my second sleep study. We’re going to try me on CPAP as I’ve said before, and it’s likely I’ll get one of my very own. It’s better than chocolates and roses any day!

…I should note that Valentine’s Day means nothing to me at all. Lest you think I’m actually bitter.

I will call the pulmonologist and make an appointment today, they’ll want to know the results of the study before we get started with equipment and everything. I’m hoping it all helps with the exhaustion and whatnot, I’ve been having a REALLY hard time waking up this last week or so. It might be the med change; we’ve upped the dose of Adderall from 10mg to 20. I don’t know that it’s doing a better job than the Nuvigil did, honestly. But we’ll see.

Sleep’s been kind of elusive these days, but that can be written ENTIRELY off to stress. I’m packing for real, now, and going through things to give up for the garage sale. It’s three times as difficult as it should be – I have to fight my inherent laziness, the high cost of physical exertion that ALS brings, and it’s just..SAD. It’s depressing as hell to go through my things with this air of finality. It’s moreso than the usual “Meh, I don’t need this” when you move, it’s “I will probably never have another use for this at ALL and I don’t want someone else to have to deal with it when I’m dead.” So it makes me tired and maudlin and my brain won’t stop even if I’m physically tired. I have a ton of people on standby who will help me pack if I ask, but they can’t go through my things for me. That’s my sad and lonely duty.

Also, I’ll be honest, the thing with the news article about my work and ALS has stressed me right the fuck out. And that conversation continues on my work’s internal news site.

Work stress, too, was about ALS recently.

Life seems entirely about the stupid disease lately, and it’s all stressful, and it’s really hard sometimes to not just curl up and sleep and avoid it all for awhile. I just don’t have the time to indulge in that. It hasn’t beaten me, not by a long shot, I still know everything’s going to be just FINE, goddammit, but it’s harder right now. It’ll calm down and be okay in a bit, but all I see for awhile is deadlines and packing and expenses and pressure. And while I’d like to just sidestep all that, and play Skyrim instead, I know I can’t, and it will be so much worse for me if I even try.

And so I will continue to work, and pack, and sort, and not sleep very well, and spend too long in the mornings lying in bed and snuzzling my cats instead of getting up and getting dressed for work. For now. For awhile. Not forever. There will eventually be an end to the work, and most of this stress, and I’ll be allowed to properly sleep.

Bloop bloop bloop bleep bleep.

Learning New Can’ts.

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Every day is a voyage of discovery.

I have recently discovered that I can no longer stand up from a seated position without either swinging my arms wildly in front of me for counterbalance, or using my hands to lift my butt off the seat and pitch forward. I have also discovered that I can’t go in to my backyard when it’s muddy anymore, not even to close the shed door because it’s raining hard and the floor inside is getting soaked, because I WILL fall in the mud and bend my umbrella and muddy the hell out of my hands and knees AND lose the freaking key for the shed lock somewhere in the grass. I have also discovered that I can’t step over the threshold of my house without pulling myself up on the door frame or something. Stairs are becoming akin to mountain climbing.

I’ve had two proper falls since the last Amtrak one. I fell on a wet inclined driveway with mulch while getting out of a car. That didn’t hurt too badly except for very nearly ripping my middle fingernail off. That really sucked. And then I had a fall in my driveway while carrying things inside the house. It was my own fault, I was carrying things with both hands and I have recently discovered that well, I should not be doing that. The fall wasn’t horrible, I didn’t break anything, just skinned the hell out of my elbow and landed on my foot wrong enough that my big toe was a solid bruise for a few days.

Lessons learned.

On the plus side? My arms are fucking BUFF now.

I had my follow up appointment with Doctor Goslin last Wednesday. We mostly talked about meds, new insurance, and stupid administrative crap. She checked my strength in my thighs and hands and arms and was satisfied with the rate of decline – there wasn’t any. My calves, though, are basically devoid of useful muscle now and my feet are done. When I don’t wear shoes in the house, my feet just drop on the floor with each step – I call it froggy feet. I don’t walk down the stairs so much as clomp.

The last time I saw her, she recommended a sleep study to see if maybe my exhaustion was in part because I don’t sleep well. The sleep study found mild sleep apnea – no surprise, it runs heavily in my family – but nothing to explain the lack of energy. I’ve got a follow up study on Valentines Day, how romantic! And I’ve been referred to a pulmonologist to see if they have any recommendations about that, but I’ll probably be getting a CPAP machine. It will help with keeping my lungs strong, if nothing else, she said. I can see that. I have no idea how the cats are going to handle it. It doesn’t make so much noise once it’s on your face, but still.

Today, we start the voyage of discovery that is med changes. I was out of Nuvigil about a week before I had my appointment with her, and OH MY GOD the difference. I went straight back to sleeping 18 hours on the weekends and nearly falling asleep at my desk all the time. I went home from work and crawled in to bed with my laptop and passed out at like 9, those nights. Because this is a new year, new insurance, she tried to prescribe me adderall again, and gave me samples of Nuvigil just in case.

Insurance denied the adderall. But not a blanket denial! Just..she had prescribed one to two a day, and they only covered one. It’s the second to lowest dose of it, and I was only ever going to take one anyway, but it took a couple of days to sort it out. And by couple of days, I mean I just got it yesterday. Today’s the first day, we’ll see what happens.

It’s a world of flux and change, even if I have the answers. I know I’m going to lose my ability to walk, but it’s a question of when, and discovering daily the new can’ts. I discovered that I can’t function without some sort of energy med. I don’t have an answer why not, yet, but it’s a new can’t.

But sometimes can’ts are not a bad thing. I can’t do this on my own, because I have people who love me and won’t LET me. I can’t stop moving forward, even through all of the can’ts, because I have so many people carrying me.

I can’t stop believing things are okay, because I know they will be. They’re gonna SUCK and be full of more can’ts than I could ever imagine, but somehow, it’ll be alright. Things will work out.

It can’t happen any other way.

“Privileges”

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I joke a lot about “membership has its privileges” when I get some special attention over my disease. Closer parking spaces. People holding the door for you longer than they normally would. Things like that. I definitely notice I’m getting special treatment, the more debilitated I get, and “privileges” is becoming kind of a tired joke, but I’m learning daily how differently people get treated when they’re “less than perfect”.

I went through Security Theater this morning, to get on a plane to come to New Orleans for a vacation. (Hello from New Orleans!) Megan and Colin were my partners on this venture, and Colin did a fantastic job of running interference for me. We researched what was needed for someone to go through security with a cane and braces, and Colin was marvelous at stepping up and informing the various security peeps of what was expected.

Sidenote: Post 9/11, this was the most pleasant TSA experience I’ve had.

I didn’t have to remove my braces, they swapped my metal cane with a wooden one so I could walk through the metal detector, and then had me (try to) stand in the imaging machine – not backscatter, it turned out, some other technology. Megan’s going to research that. I wobbled. They patted me down a lot and swabbed my hands and shoes for explosives, and then a really nice TSA officer collected my things for me and led me to a chair to wait for the other two.

My cane and braces got us in the fast track through security. My cane and braces got us boarded first. Pre-boarding, bitches! My cane and braces get me more attention and consideration than I’ve ever had. It is just weird to me still, to be granted privilege and special status because my body is betraying me. “Here, you have less time, literally, than the rest of us. To the front of the line, please.” I’m grateful for the consideration, it sincerely does make my life easier. But it feels weird and alien still, because there’s that edge of “I don’t deserve special treatment” and “I don’t NEED special treatment” and on either side of that chasm is a yawning abyss of “Shut up, yes you do.”

I’m not sure what the point of this is. I guess part of me is a little appalled that it takes something like a terminal disease for people to notice and be nice to you. And I’m just as guilty of it. I’m far more likely to smile at a total stranger with some sort of affliction, like – hey, you’re okay, man, you’re cool. I’m on the other side of that now and… it’s not insulting at all, but it’s a little sad. Like, why wouldn’t you hold the doors for that dude but you’ll hold them for me?

And I joke about “membership has its privileges” but..really, it seems only fair that the universe dishes out SOME gentle allowances to soften the blows. Even if it’s only in letting me on the plane 20 minutes before everyone else. For every fall, there’s someone to help me back up. I’m happy to be in New Orleans on someone else’s dime, and I honestly couldn’t ask for two more considerate and compassionate travel companions who are on point and looking out for ways to make my life easier. (They were always there, though. ALS didn’t do SHIT for me on that front.) So I guess, if the universe is saying “Sorry bout your terminal disease, have everyone letting you on the plane first as a consolation” isn’t that bad. At least it comes with something. And I am grateful for those little mercies. They really do soften the blows, and make things just a bit easier.

I’m privileged to have those small mercies.

Bathroom Bitching

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I promise this isn’t really TMI, but I’m gonna talk about the politics of bathroom stalls. And a personality defect of mine, it turns out.

I’m getting weaker; even if DocGos says she doesn’t notice any difference. When we first met, I used to be able to walk up the stairs with two hands full. Now I can’t; I have to have one hand free for the rail, and on no-spoon days I need both. When we first met, I could stand up on my own from sitting in a chair. I really can’t anymore.

Which means I need the handicapped stall now – I need the bars. Well, it’s like the cane – I could probably manage without? For awhile longer? But it’s so much easier with, and why make my life harder just to prove to myself that I can, that I’m still an independent woman who don’t need no man. erm. Bars. Yes. Bars. That’s what I was talking about.

And because I need the bars, I am trying really really hard to not be bitchy about it when someone who clearly does NOT need that stall is in it.

Okay – confession. I have *always* gotten a bit internally bitchy about people using the stalls when they don’t need to. It’s a serious character flaw of mine – I get bent out of shape when people don’t follow The Rules. I get irritated when someone cuts someone else off in traffic. Even if the person cut-off doesn’t even notice. I get irritated when people cut in line, even if I’m not in that line. I get mad when people at work leave their dishes in the bathroom when the stinkin’ break room is LITERALLY ten feet away. I get SO MAD when people don’t break down their fucking cardboard boxes and just leave them in the hallway. It’s because I tend to get really mad on behalf of other people, whether they even realize they’ve been wronged or not. By cutting that guy off, by sneaking in line, by not taking your dishes in, by not breaking down your cardboard and putting it in the recycle area, you are making someone else’s life more difficult because you are a selfish ASSHOLE. Even if it’s just a minor inconvenience, there was still no need for that inconvenience to exist, you just created it because you are a LAZY SELFISH DICK. And so I get mad. Because you are not following The Rules.

…Bitch.

ANYWAY. At work, we have a huge wheelchair stall, and the normal sized one next to it has bars, so it’s awesome and I use that one, because I don’t need the space, just the help up. But consistently – CONSISTENTLY – the wheelchair stall is taken up. By tiny, tiny women. Like, a regular stall would feel large to them, WHY do they need the extra extra space? It’s always been a phenomenon that made me scratch my head, but there’s actually been a couple of times that it’s made me wait. And I try not to get irritated, but seriously.

YOU ARE FIVE FEET TALL AND 80 POUNDS SOAKING WET WHY DO YOU NEED A TEN SQUARE FOOT BATHROOM STALL.

Answer: YOU DON’T.

So when I go in there, and both stalls are taken, I have a choice between using one of the other ones, and then using the freakin’ toilet paper dispenser to pull myself up and hope to GOD it doesn’t come off the wall, or wait. And if I don’t have my cane with me at the moment, then they look at me weird for waiting. But if I DO have my cane, sometimes they have the good grace to look abashed. Usually not – they’re oblivious, because people at my work are very self-involved. See: previous posts about trying to not get knocked the fuck over in the cafe and halls because they’re not paying attention.

I wonder if, when I’m in a chair, I’ll be any more irritated. Maybe I’ll do the passive aggressive thing and put a note on the door: “THERE IS SOMEONE IN THIS BUILDING WHO ACTUALLY NEEDS THIS STALL – DO YOU?!”

In Comic Sans, natch.

Realistically, I probably won’t. I’m really good at ignoring those breaking The Rules when it’s me getting shafted. Though, I did get really irritated this weekend about it – I went to Bingo at an American Legion lodge (looong story) and wound up waiting for ten minutes for the one handicapped stall. The other two were simply too wide, I wouldn’t have been able to brace myself on the walls to stand, they were just too far apart. There was a line, and I as time went by I started to say kinda loudly every time someone asked if I was in line, “Go ahead, I have to wait for the handicapped stall, I need the bars.”

Man, I dunno WHAT she was doing in there. She took her shoes off at one point. I thought she was changing her clothes, but she came out with nothing but herself. And flushed a HOJILLION times and used up most of the toilet paper. I just…man. Yeah. She was old, there’s all kinds of stuff happening there that I don’t even know. Probably best that I don’t know. I just know I had to wait ten minutes to pee and she totally could have used the other stalls.

This is all the beginning of the inconvenience, the social stage of decline, and it will be really interesting to see how I adapt to it when it gets worse. Maybe I really WILL become the Bathroom Stall Avenger. Maybe I’ll just pull an Elsa and let it go. It will be telling, either way. Just as I’m discovering the true character of those around me, I’m discovering what I’m made of, too. I have kindness and patience I didn’t know I possessed, and intolerances I didn’t know I had in me.

I’m building my character even as my body unbuilds itself.

Two quick things…

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Before we return to our regularly scheduled sweary shenanigans and inappropriate morbid humor, I want to say two further things about assisted suicide, and then we’ll move on.

1) This is not gonna happen for me for a long long time. So don’t go writing any eulogies or shit, cause I’m still here. I’ll give y’all lots of warning if/when that happens, but for now, you fuckers are stuck with me. Swearing ALL the swears.

2) It is BEYOND fucking RIDICULOUS that the criteria to qualify for DwD does NOT include dementia. FOR FUCKS SAKE. It is patently UNFAIR that these reasoning people can’t choose their end when they start to lose their reason. The body may not be in decline, but their LIFE certainly is. They are dying. Their bodies are just going to take a bit to catch up. Let them check out with class, for fucks sake.

Assistance

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(Okay, sorry, it’s been a long time but I knew this post needed to be next and it was really hard to think clearly about. For reasons that will become very clear. This post won’t be a happy one, I wager.)

There’s a chair, a table. The table has three prescription bottles on it. The chair is draped with colorful striped fabric. She enters the screen, sits calmly, and smiles warmly at the camera. She picks up one of the bottles.

“I got my prescription today, to end my life when I see fit.”

She says it with a little difficulty, but it’s ALS, not emotion, that makes it hard to talk. She’s calm. Confident that she’s made the right choice. Beautiful. She explains she’s not going to take it, not today, because life is still too good. She thanks everyone for supporting her decision to choose. She has bulbar onset ALS and while she’s lost the ability to swallow anything, she can still speak; which is good, she says, because she has a lot to say. She puts the bottle on the table, and she tells her viewers how much she loves them all.

She glances at the prescription bottle on the table, almost lovingly, and faces the camera. Her warm smile brightens her face again, she is serene. “It’s a good life,” she says. “Live it.”

______________________________________________________________________

Assisted suicide. Death with Dignity. Voluntary Euthanasia. It’s an extraordinarily controversial topic. It’s something I’ve had strong opinions on ever since I heard of Dr. Kevorkian. It’s something I’ve thought about a lot since ALS became a possibility for me, and it’s been on my mind almost every day lately thanks to Brittany Maynard.

If you’re not familiar, congratulations, you’re probably one of the five people who’ve escaped this story. You can read it here. The short version is, she was diagnosed at 29 with terminal brain cancer, was told she had months to live and an excruciating death waiting for her. So she chose to end her life under her own terms. She openly talked about how she would do it, and knew exactly when. November 1st, she took her medication and died.

It’s polarized the world it seems. Everyone has an opinion. She had the right, she did not. She was choosing to die with grace, she was a coward committing suicide. She was strong and brave, she was thwarting God’s plan for her. Opinions were very strong, debates were very heated, and theoretical relatives were killed daily in debate, by agonized suffering or suicide, and everyone thinks they know what is best. And everyone – EVERYONE – had something to say about it.

And maybe some day someone close to you will need to decide on this option. Maybe an aunt with cancer. A father who gets into a terrible accident with injuries incompatible with life. Or God help them, someone with ALS. If they live in a select handful of places, they will have this option to choose. They will have this conversation several times with a medical professional. And if they choose to die, they will pay an obscene amount of money for a prescription to die, because it is OH MY GOD EXPENSIVE and insurance will not cover it. (Which is stupid, really, you’d think the insurance company would pay YOU to stop costing them so much.) But they get the prescription, and maybe they take it, maybe they don’t. Whatever side of the fence you’re on, whatever opinion you have on the subject, allow me to make one thing abundantly clear for you.

YOU GET NO FUCKING SAY IN THIS DECISION.

Absolutely NONE.

There is no debate. You get to sit the fuck down and shut your face when that person makes that decision. If they ask you how you feel, fine, but know that you do not get ANY fucking say in what they decide. You can have all the arguments in your head that you want. But if someone makes the choice to die, and their doctor agrees? Then it’s done. You have no right to interfere with it. At all. Keep your opinions. Honor their decision. If you disagree, fine, but know that it makes LITERALLY NO DIFFERENCE.

Comfort them in their last hours, support them until their final days, and keep your goddamned opinions to yourself.

_______________________________________________________________________

I was 24 when Jack Kevorkian came into the public’s eye, when he was arrested and then later sentenced for murder because he’d helped terminally ill people to die. “Voluntary euthanasia” they called it then, in all of the court reports and news articles. Now it’s more bluntly called “assisted suicide”. They mean the same thing, but ‘assisted suicide’ has more of an accusatory feel to it and so that’s what people call it now – because Society Does Not Approve.

“It goes against God’s plan,” is the most used argument against it. “This happened for a reason and you are giving up.”

“It’s Death with Dignity,” is the most used argument for it. “It’s a humane close to an inevitable ending.”

And even then, as these two sides yelled at each other and called each other “murderer” and “sadist”, my 24 year old self thought about it with a calm heart and careful deliberation. “If I were ever in great pain and going to die eventually,” I decided, “I would want to kill myself. I think people should have the right to die on their own terms.”

And my 38 year old self thought about it with the same calm and deliberation. “If this turns out to be ALS,” I decided, “I want that option available to me.”

And my ten-days-away-from-being-39 year old self stared at the carpet for a moment, letting the diagnosis wash over me, and I thought about it with calm and deliberation. ” I’m really, really happy that I live in a state where it’s legal. I need to figure out what is my breaking point so that I can get the process started before it’s too late.”

________________________________________________________________________________________________________

Spoiler Alert: I’m going to get that prescription. I am very probably going to take it.

And you know what? There’s not a MOTHERFUCKING THING you get to say to me about it. This is MY choice. This is a step *I* will take if I want to. I know what’s best for me. I know how much I can handle. You don’t. And you don’t get to dictate to me when I can die.

I already know how my story ends. I’ve seen the last chapter, and it’s terrible. I want to be able to close the book before it gets that far. It’s a shitty close to a pretty good story, otherwise. “Died happily, surrounded by loved ones” is a much more kickass end chapter than “died slowly, suffocating and starving, languishing in agony at not being able to interact with those she loves while watching them steadily stop coming by and trying to talk to her because it was sad and awkward”.

You DO have the right to think and feel anything that comes your way. Even if it’s the bullshit idea that “this is God’s plan” which I will NEVER, EVER ACCEPT. If it’s in God’s plan that I should die like this, then God is a jerk. I don’t believe God hates me this much; I just believe that shit happens. And this sucks. And it’s no one’s fault. And that’s okay. There doesn’t need to be a plan or a reason for this. But if you feel there’s some proper reason for this, that’s fine.

I would never dictate to you how you should feel. It’s not my right, and not my place. Your opinions and your feelings are as important to you as mine are to me. Even if you disagree with me, it is entirely your right. I might debate you on logic, but I can’t and I won’t debate you on feelings. I respect your right to disagree with my choice, but that does not give you the right to interfere with it.

I would never presume to tell you how to feel, because I can’t know. But I will tell you not to presume to know, because you can’t feel.

You’re even welcome to share your thoughts and feelings with me. Just know that it’s going to make absolutely NO fucking impact on my choice.

I don’t know what my breaking point will be. It sort of shifts around, some days I think I can live with things that I can’t fathom, other days. And it may well turn out that I don’t think it’s really all that bad, even at the end. It’s amazing what you can get used to, if the change is gradual. I may think that spending my entire life having ten minute conversations that consist of three words is okay, that being an active brain in a meat shell completely at the mercy of everyone around me is a perfectly decent way to live.

I currently think I probably want to die before it gets that far. The last thing I want to leave is an impression of being a burden. Even if it’s not true, I know that I will start to feel like people are resenting me for being useless, that they’re tired of me taking so fucking long to get anything across with my stupid little eyegaze tablet. Even if I know it’s not true – and I do, I know that I’m loved and people would happily shoulder me for as long as I need them to – I know I will feel that way. Because I know me better than anyone. And that might be harder to bear than the humiliation of having my diapers changed. That WILL be harder to bear.

Some days I think that my mind is active enough, I’m solitary enough, that I’d probably be okay to be so isolated, as long as I have a sliver of communication.

Some days I think, when I’m no longer able to eat.

Some days I think, when I can no longer breathe on my own.

Some days I don’t think about it at all.

I just know that I need to do it, if I’m going to, before I’m no longer able to do it on my own. You have to do it yourself. And even if it’s someone putting the meds in a feeding tube and putting your hand over the syringe so the weight of your hand pushes the meds into your stomach, it has to be you. Which is right and proper, because I could never ever ask someone, “Will you help kill me?” Even if I have people who love me enough to be willing to go that far to help, I would never ever ask someone to carry that burden. It has to be under my own power.

And it could very well be that I’ll get that prescription and never use it. I’ve been told that many more people get it than use it. And that’s okay. But I want the choice to be mine. And I want that option. I want that right, and that power. That decision belongs to me.

And when I die, be it by time or by chemical, you guys can do whatever you want to celebrate or mourn me; throw a party, get drunk, burn my sticker collection. My funeral will be for you – but my death is all about ME. You can decide to celebrate or curse me however you like when I’m gone, it makes no difference because I’ll be absent. And you can celebrate or curse my choice, and it makes no difference, because you’ll be absent. It’s the last and most intimate experience anyone ever has on this earth, and it’s personal and private. Sacred. No one can encroach on that space. No one should ever think they somehow get the right to think they can tell me how to die.

You only get to decide for yourself whether you take my decision on death with dignity.

Talking to Strangers

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I was on vacation in Leavenworth this weekend. It was partly to celebrate Danielle’s birthday (which is tomorrow, November 4th) and partly because we’ve been itching for a road trip awhile and a birthday was a good excuse. My weakness reined us in, for sure, but it’s a small town so we didn’t have to compromise much. There were three instances in which I told a total stranger about having ALS, the first being the woman who checked us in to the hotel apologetic as hell because our room was on the third floor when she saw I was using a cane. She asked what happened, had I broken my leg? She was very sympathetic when I told her of my diagnosis, and a little bit baffled because I was so young. She knew about ALS because of the Ice Bucket Challenge (I FUCKING LOVE THE ICE BUCKET CHALLENGE); she was very willing to be as accommodating as she could to help my stay be as easy as possible.

And the other two were on opposite sides of the spectrum.

++++++

One:

Danielle’s dropped me off at a shop to wait for her to park, because she has to park kind of far. (She wound up actually just parking at our hotel and walking the four blocks) I sat on a bench in front of the spice and tea shop we’re going to check out, and after a little while, an older woman with a walker approached. I asked if she’d like to sit, and scootched over to make room for her. I had been in the middle of adjusting my braces, because I’d left some velcro exposed (still haven’t made my straps, dammit) and it was catching on my socks. She asked what they were for, did I hurt myself? I told her that I had ALS, clarifying Lou Gehrig’s when her face was blanked.

“Oh. I’m so, so sorry,” she told me, with genuine sympathy.

“Thank you,” I told her sincerely. “I’m doing very well, though. It’s going to be okay.”

She was silent for awhile. “To tell you the truth,” she says quietly, “I wish to God it was me instead of you. You’re too young.”

I looked over at her and realized then that she was very near to crying. Her eyes were brimming with tears and she had a faraway look. “Oh, sweetie, I’m okay, I PROMISE,” I told her quickly. “My progression is so slow. Nothing hurts. I’m okay, it’s alright.”

She asked how old I was, and repeated “too young” when I told her. We introduced ourselves to each other, her name was Sheila. She asked a little bit about my progression, my symptoms, what my support structure was like. She agreed in the end that I was in the best possible situation and seemed mollified, but still upset. Danielle showed up then, and we said goodbye.

Once we were in the store, I said quietly, sheepishly, “I just made a total stranger cry.”

Two:

We stopped on the way home, randomly, in Goldendale, Washington. Because we needed a pee break and we’d never been there before. We discovered an honest to god observatory, saw some deer in a graveyard, and then Danielle saw a bookshop and wanted to go in. The book store turned out to be an Everything Store – the guy had literally everything. Books, jewelry, games, toys, fishing gear, light bulbs, office supplies, plumbing gaskets, literally everything. The shopkeep was named Dan, and came out when he heard us come in.

“Good morning,” he said cheerfully. “How are you today?”

“Fantastic,” I told him, “you?”

“Wellllll I was GONNA say ‘hobbling along’, but saw your cane and thought better not.”

I laughed and told him it would have been alright. He told me to have a look around and tell him if I needed help finding anything, he probably has it. After looking around a bit, I conceded, “You really DO have a little bit of everything.”

I stood at the counter while Danielle looked around. He looked over to me. “If you don’t mind me asking, what happened? Is it an injury? Something you were born with?”

“ALS,” I told him, “Lou Gehrig’s – recently diagnosed.”

“Oh, I’m sorry,” he said.

I gave him what is now my standard, “Thank you. I’m doing really well, though.”

And after awhile he smiled and said, “You know, I can tell. You’re going to be okay, you’re handling this great. You have a very bright spirit. You’re handling this with the right attitude; you’re gonna be fine. Nothing’s gonna get you down.”

I grinned and told him he was absolutely right. I have the slowest progression, the best support network, and the most amazing friend in Danielle. “That’s the right way to be about it,” he said.

We introduced ourselves, and had a little chat about the origin of my name, he told Danielle and I about the apartment he had in the basement of the store for his kid (“I didn’t want him living at home”) that his son never moved in to, his other property in a town of 93 people, the work he does on it. We chatted about a whole lot of little things while Danielle figured out what she wanted to buy. I bought some Topps stickers – because I’d been on vacation 3 days and hadn’t bought ANY – and instead of selling me five packs for $10, he asked if I’d like to buy the whole box for $15. I said heck yes. We said our goodbyes with a promise to stop in again if we were in the neighborhood. He repeated his complete confidence that I was going to handle this just fine.

We left the shop, and I was in a great mood.

++++++

Both reactions were sincere, neither was an incorrect way to behave. Your reactions are entirely your own. The only ways you could possibly screw it up when I tell you about my disease is to a) gasp and tell me it’s SUCH an awful disease and it’s going to get so much worse, or b) tell me it’s my own fault somehow for a life of sin or something. Or laugh. That would be pretty bizarre and awful of you.

Both reactions sincerely touched me. One left me troubled, one left me buoyant. Neither of my reactions are the responsibility of the person invoking them. I have a hard time accepting the inverse, though. When I tell someone about the diagnosis, and it predictably troubles them, I feel guilty and responsible for bringing them down. It’s not my fault. And it’s not her fault that her deep sadness troubled me so much. It was not his job to cheer me up. And it’s not my responsibility to sugar coat or put a smiley face on a terrible situation.

It is not my responsibility, but it is my nature. And I could tell it was his, too. He and I are of the same “Fuck it, it’s gonna be alright” mentality.

And sometimes, I’m of her mindset, too. This is terrible, I feel helpless, I wish I could change it.

Both reactions are correct and useful, in their own turn. And I’m happy to have met both of them, this weekend. It’s put words to perspective, and both of them were very sweet people and I’m glad they spoke the words they did. It means the world to me, to know I’m not alone when I’m sad, and to know there are cheerleaders who have got my back when things look awesome.

Even when – especially when – that support is from complete strangers.

Legal

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Man, real life is just NOT going to give me a break lately! Sorry! But it’s also awesome that I’m still able to DO so much and keep up with what I’m being asked to do. So I will take this all optimistically.

Anyway. The lawyer.

First of all, we used the Crowdrise funds to pay for it, which I felt weird about, but that’s precisely what that fund is for. So it was $650 NOT out of my pocket. Yay! Thank you everyone who donated to that. I love you. For reals. I’ve put off this legal appointment for a long time because I simply couldn’t afford it.

We were recommended to use a particular elder care lawyer, who had a lot of dealings with ALS patients. For lack of knowing what the hell we were doing anyway, we went with him. He had the stereotypical swanky corner office with floor to ceiling windows, nice couches. I was completely intimidated, I won’t lie. Everything about the place said “You can’t afford this.”

We explained what my situation was. Dying of ALS, need to get my affairs in order. We explained what we wanted. Answers on particular laws and financial advice. I’d filled out a questionnaire (why does that word have two Ns? Millionaire doesn’t. Weird.) that detailed my pathetic assets. Which basically amounted to the life insurance policy through my employer and a little bit of 401k, and my house. Which I still owe almost everything on because I’ve only lived there a year.

(Goddammit. One fucking year. FUCK!)

I told him I was planning to sell the house and buy something single-story. He looked at me like I was on drugs and told me he would absolutely not advise buying another house. I’m not going to get any financial benefit out of it, he told me. It’s going to be nothing but a money sink. Consider renting. There are laws that say landlords HAVE to let you remodel to be ADA compliant. There’s subsidized disabled housing, too, but the wait list is like 2 years and I’m not even actually disabled yet so I can’t even START that process. So why he brought it up I don’t know.

Danielle (my bestie and primary caregiver to be) and Gecko (my brother and finance manager when I die) were with me, and both had a lot of very good questions. Danielle asked about Medicare and Medicaid, what they would cover, how would we/what will be appropriate procedures to move me to assisted care living, ten fifteen twenty years down the road when I need it?

He looked genuinely surprised. “Ten years? Did the doctor give you that long?”

Um. “I have an extremely slow progression,” I told him. “Two years since I noticed a problem and I’m still walking.”

“OH. Oh okay. Okay. Buying another house is NOT so far fetched,” he told me. “Usually when people come to me, they have a small handful of years left. Three maybe. Buying a house you’re only going to have for three years is not advised, but you’ll get benefit out of it if you live there for ten.”

We talked about in-home care vs assisted living. How much worth you have and how much you have to use up before Medicaid kicks in. Living on SSI and how much money you get to keep (hint: HARDLY ANYTHING). In assisted living? It was like $20. That’s all you get. They take care of your housing and food and medical care, sure, but entertainment? Clothes? Toiletries? if you have a cat? You’d better figure it out because $20 is all you get. If you live at home you get to keep more of it, but of course you have to deal with mortgage and bills and food on your own. It’s REALLY not a lot.

So, hope you’re independently wealthy! Cause otherwise your life is going to be small and hollow. Sorry your disease sucks, but let’s make it worse by bogging you down with money woes and bureaucracy and complicated decisions! What can you afford? Nothing! A small bed in the corner of a nursing home somewhere where we’ll tuck you away there until you die.

We talked about executors of estate, who I want to have as my finance controller, who I want to be in charge of medical decisions. He gathered information and after the appointment he mailed me papers to certify all of that. He told me to get my living will in order and spread copies of that to everyone. He also said we need to draw up my will to state who gets what portion of what assets I’ll have, and I can attach a sheet later dividing up physical goods.

I kind of froze. Who gets what? I don’t fucking know. I threw out some percentiles, and Danielle insisted she did not need to be figured in there anywhere but if anyone deserves ANYTHING when I die then holy fucking SHIT is it Danielle. My brother Justin a close second. Gecko third, for being willing to deal with all my debts and shit when I’m dead.

Though I DID find out that when I die, Gecko will NOT be responsible for dealing with my debts. With very small exceptions (that I do not have), those debts get written off when I die. “I’m not suggesting you go run up your credit cards,” he cautioned with a shrug. “But.”

When we left, my brain was full of doom and money and gloom and responsibility and numbers, so many fucking numbers. What’s fair. What’s right. What’s necessary. Next steps. Long term, but not long long term because you never know. I was keenly aware of my situation. How little resources I have. How much money it’s going to take to keep me alive. How little time I have to save any of it.

I was completely overwhelmed, and really wishing I drank at all.

It’s a fucking complicated thing, dying. And it seriously is unfair that this diagnosis does not come with a lawyer, an administrative assistant, and a kitten.

TMI : The Bleedies

tragerstreit1 Comment

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.

Without Music, I’d Be Lost.

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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 promise.

We Still Have a Way to Go.

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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.”

…

…….

Yeah, awareness has a long way to go.

Answers!

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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.

Falling with Grace

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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.

When I say Amazing, I mean Amazing.

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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.

Difficulty Level: Beginner

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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.