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Finding Freedom

Living Forgiven and Free

I Remember

My brain thinks my body can move. It remembers hugging, drying my hair, and standing on a rock in Lake Tahoe. In a heartless way, it remembers scratching an itch. I recall doing life activities myself, like showering or eating, while someone else does it for me. Weird, right?

I wonder if my brain remembers because I’ll regain movement one day. I daydream about learning to walk again. I put forth extraordinary effort in physical therapy sessions that are simultaneously exhausting and exhilarating.

This dream delivers hope.

Hope springs from a stem cell treatment that is crawling through the FDA pipeline. Social media posts depict people with ALS lifting weights and running again after receiving the treatment. Other participants report their disease progression has significantly slowed or stopped. Thousands of other people with ALS will die waiting for FDA Approval. A life saving treatment exists but you can’t access it — that’s more heartless than an itch you can’t scratch.

Hope isn’t a strategy, but a fuel to keep living.

I’m Forgiven and Free, fueled by hope.

It’s Different This Time

My disease progression continues, but this time it’s different. I can live without the use of my legs; I can live without the use of my arms. It’s not easy, but doable. But now, my progression is reaching the point of life or death. I can’t live without eating or breathing. Thankfully I’m not there yet, but I’ve made the turn.

First, is an esophageal motility test to determine if I need a feeding tube. I can still eat but often choke when saliva hits my vocal chords. Aspiration is the concern. Pasta doesn’t belong in my lungs.

I already have a Trilogy ventilator that breaths for me when I sleep. Love it. I will eventually need it 24/7. I also use a cough assist and suction machine to make up for my compromised respiratory function. All this, combined with an atrophied tongue, compromise my speech. I can still be understood in a quiet environment, but I will eventually lose my ability to speak. That’s a bummer because I love to talk.

So it’s different this time because this function loss is terrifying and requires life or death decisions. My world is shrinking and I’m reluctant to embrace the new normal. I will eventually, but I’m not there yet. A crystal ball would come in very handy right about now.

Where do I go from here? I could stay in bed and wait it out. I’m not a fan of that option. Instead, I will work through this and return to gratitude asap. How will that happen? I’m not sure, but this is what I’ve done so far:

  1. Been sad
  2. Been afraid
  3. Questioned everything
  4. Made a doctor appointment
  5. Been depressed and withdrawn
  6. Been frustrated
  7. Cried, sobbed, and yelled
  8. Had a pity party
  9. Went to support group
  10. Felt better

Here’s what I’ll do next:

  1. Finish writing this blog post
  2. Stick close to family and friends
  3. Take the esophageal motility test
  4. Decide what, if any, surgery to have
  5. Grieve when needed
  6. Stay present and grounded in my faith
  7. Enjoy time with family and friends
  8. Kiss my grandkids
  9. Redirect negative thoughts and return to gratitude
  10. Repeat

That’s my ten-step process to moving past recent losses and adjusting to a new normal. What about you? I don’t corner the market on difficult times, how do you walk through yours?

I’m Forgiven and Free and adjusting to a new normal

 

Living Your Best Life

My life isn’t what I expected. Who would have thought my arms and legs would be merely ornamental? I’m not going to lie, being a quadriplegic isn’t easy. Wow. I need a minute to let that sink in, my arms and legs are no longer functional. It’s not the end of the world. I can still live my best life, regardless.

You can read here how I mourned the loss of being the cookie making grandma I thought I’d be — but I’m done mourning.  With the support of my family and friends, I’ve adapted to a new normal. Check out the picture, I’m playing with my 3½ month old grandson. I’m not able to hold him so Grandpa put baby’s bouncer over my legs. Voila! Twenty minutes of nursery rhythms and giggles. Pure joy.

What does living my best life look like?

  • I write a work of fiction celebrating the power of sisterhood.
  • I participate and advocate whenever I can to find an effective treatment or cure. 
  • I celebrate that I’m at year six with a two to five year prognosis.
  • I surrender to the fact that I need help with everything except breathing and talking. ALS hasn’t taken those yet. But if it does, I’ll adapt to that too.
  • I process frustration and grief when they come, then I punch them in the face.
  • I surround myself with positive people, my tribe.  
  • I practice mindful meditation to stay present and grateful in this beautiful gift of life.  
  • I remember God has a divine purpose for my life — that is to encourage and pour love and acceptance into every person I meet. I’m not there yet, I’m a work in progress.

Are you going through the motions of this life, waiting for your best life to begin when _______? Fill in the blank. Stop waiting. Start now. What does living your best life look like? Don’t compare yourself to others. Don’t listen to what society says. Live YOUR best life. Drop the excuses. Find your tribe who will support you and get busy living your best life, regardless of circumstance.

What does  living your best life look like? Comment so I can learn from you.

I’m forgiven and free and living my best life, regardless.

 

Powerful Medicine

I believe in the good things coming — Nahko

The music of Nahko and Medicine for the People has profoundly influenced my journey. I adopted their chorus, I believe in the good things coming, as a motto to sustain me during my difficult days living with ALS. Nahko sings of peace and finding joy and gratitude, a message that is medicine for my soul.

I had the most amazing experience at a concert a few days ago. Nahko came out into the audience and I found him standing next to me. He held my hand and sang my favorite song, Love Letters to God. My heart nearly exploded. I felt his energy pour into me as he sang, I’ve never experienced anything like it. I was overwhelmed with a feeling of abundance and joy that could not be contained.  My heart expanded and I am compelled to be a conduit for the love and acceptance shown to me. Truly, he gave me his medicine.

Speaking of medicine, I was fortunate to start in a phase I, open label extension of an experimental drug trial. That means I get to take a new drug everyday for 11 months, with no placebo. I’m super hopeful that this novel molecule could stop my progression. I’ve lost the use of my arms and legs, but I can still talk, breathe, and eat — three things I’d like to hold onto.

So friends, what do we make of this? Two things: Medicine and healing can come in different forms and we can let peace, love, and joy flow through us in abundance. There is no shortage of these.

I’m Forgiven and Free and living life abundantly

Brain Damage to Gratitude

I’ve recently turned the scariest corner of my ALS journey — bulbar symptoms. I’ve lived in denial for five years, thinking I would never get there. But, here I am, experiencing loss of pulmonary function, choking, excess saliva, and slow speech. It’s devastating. Those who know me, know I have a LOT to say. The thought of losing my voice is terrifying. The thought of not being able to breathe on my own is harrowing.  

By the numbers, my Forced Vital Capacity (FVC) is 75% of normal. That’s still a manageable number, but it’s when symptoms begin to appear. You’ll have a hard time hearing me in a noisy restaurant and I’ll get exhausted trying to be heard. Being proactive against this beast, my physician ordered a trilogy ventilator. I will spend some time getting used to the bi-pap function that will give my diaphragm a rest at night and provide symptom relief during the day. This is typical progression and treatment. It’s not the end of the world, but it’s the beginning of my respiratory issues.

I quit taking my big vitamins after a few choking scares. But, my waistline will attest that I don’t have any trouble eating yet. You can see that my grandkids can still feed me breakfast in bed. Archer says, “A bite for Gramma, and a bite for me!”

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My voice is beginning to slow as I sometimes have to deliberately move my tongue when talking. It’s quite noticeable after a glass of wine. My speech pathologist predicts that my voice has about a year left. We’ll see how it goes.

I did have one surprise — Pseudobulbar Affect (PBA). It’s a treatable, secondary neurological condition that presents as uncontrollable, exaggerated, or inappropriate laughing or crying. People with Parkinson’s or ALS or people who have suffered a stroke or traumatic brain injury may develop PBA. I’d been crying much more than usual and thought I was experiencing typical depression symptoms. I decided to talk to my doctor about it after one particular episode.

Steve and I were at a restaurant called the Lazy Dog. I pointed out to Steve that the beer tap behind the bar was a red fire hydrant. How cute is that? I thought it was so cute, I started bawling. I wasn’t eager to admit I had brain damage, but I knew then it was PBA. I talked to my doctor and asked to try Neudexta, the medication to treat PBA, and to meet with a therapist to learn some new coping strategies. I’m happy to report that the medication managed all of my PBA symptoms within a week and the therapist is teaching me mindful meditation techniques to add to my toolbox.

I share all of this with you as part of my grief processing. By the time I am able to write about it, I’ve grieved, adapted, and accepted the situation as my new normal. I also write in hopes that you learn with me and ultimately live in gratitude, regardless of circumstance.

I’m Forgiven and Free and grateful you all are on this journey with me.

An Open Letter to the ALS Community

I’ve lived past my expiration date and I’ve still got questions.

This month marks five years since my ALS diagnosis with a 2-5 year prognosis. I’ve crammed a lifetime of living, loving, learning, and advocating into those few years and I’ve still got questions.

I’ve met hundreds of patients and their families, caregivers, advocates, medical practitioners, researchers, drug developers, regulators, and legislators and I’ve still got questions.

Last week, I was reminded at a meeting of people with ALS and FDA regulators that we are all one ALS community. I would agree that we all have a common goal of finding an effective treatment or cure. However, I would argue that we look at the problem though distinct lenses. We champion our own point of view and often dismiss, distrust, or disparage community members who view it through a different lens. We disagree on how to reach the goal at best and cannibalize at worst. I’ve got some questions about that.

This problem is not new nor unique to the ALS community. But for now, my life and the lives of tens of thousands of other people currently living with ALS depend upon an immediate solution.

The National ALS Association led an effort to create an FDA guidance document to facilitate the clinical trial and drug approval process. It was presented as a collaborative effort, inclusive of all parts of the community. The voice of the conservative neurological science community dominated the conversation and document. Looking through their lens, it was a big win. Looking through my lens, it tragically meant we support the 12+ year, $2.5 billion, status quo drug approval process. That means the research community keeps their version of perfect science while patients like me are guaranteed to die waiting. I understand their position, they are desperately searching for an effective treatment and are unwilling to change because they want a scientifically proven treatment. They truly believe that is what’s best for patients. Drug developers are looking for an effective treatment as well and their lens includes dollar signs and a highly regulatory environment. The FDA would be thrilled to approve a treatment that has been proven effective by passing the gold standard of trial design. I want access to potential treatments now. My lens is urgency and access, period.

Can someone please draw a cartoon of this conundrum?

Here’s the deal. I, along with many others, have tried to gain traction on pressing for bold changes to this process. Today, I was asked by Sandy, a newly diagnosed woman, “Why isn’t something being done? What can I do to create change now?” My heart sank. If I knew what to tell her, I’d be doing it myself. She is one of the lucky ones — participating in a stem cell clinical trial. But, dear God, the study protocols are nothing short of barbaric. Sandy is voluntarily being denied access to currently approved medication for three months to see if she declines rapidly enough to be included in the study. If she progresses enough, she still has a 50% chance of a placebo being surgically injected into her spine. Here’s the real kicker: If Sandy gets the stem cells and shows improvement, she will not have access to future treatments for years. Barbaric.

They’ve got their conservative science that looks promising. Sandy is a desperate, dying woman. She feels it’s her responsibility to endure this trial to benefit patients in the future. Can someone please explain to Sandy’s family how this is okay? A promising treatment exists but your wife and mother is a lab rat and can’t have access to the treatment outside of a barbaric clinical trial.

Nothing is going to change until the patient community demands it. We have to find a solution that creates a win for those of us living with ALS. Let’s take an honest look through each other’s lenses and find a compelling solution. We need a Manhattan project, funding the brain power and advocacy to make it a reality.

Here are my questions:

Who has the leadership, resources, and influence to create a win-win for the entire community?

What barriers are preventing this from happening now?

I’m sitting in my hospital bed, typing with my eyes. Yet, I believe I can make a difference. What if those with resources and influence acted as though their lives depended upon finding a solution now? The answer is out there. Please help me find it.   

The Surreal Gift

My bed gently rolls me from my side to my back. The familiar hum of the bed rouses me. You know that place, you’re half awake and half asleep? I open one eye, just a sliver, to see if the sun is up. Yes! Time to get up. In my mind, I sit up and swing my legs off the bed. “Steve, you won’t believe the dream I had. I was paralyzed and completely dependent on you for everything. It was crazy!”

My attempt to sit up met with resistance. I’m reminded of the reality, this is not a dream. I feel perfectly fine, not sick, like a dying person is supposed to feel. Yet, I can’t move because ALS is killing off my motor neurons. Surreal.

The Gift

Psalm 46:10 says, “Be still and know that I am God.” I read that and think, be present, let go of results, don’t worry about what tomorrow will bring. Then, I remember Matthew 26, “Do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes?” Each faith tradition speaks to being present and at peace. That’s the gift. Let’s practice gratitude and peace, regardless of circumstance.

What’s stopping you? Root it out, let it go. No buts, be still.

I’m Forgiven and Free and still 😉

Top Ten List

I’m not dying anymore. I’ve outlived my 2 to 5 year ALS prognosis and I’m done being sick. I’ll continue to advocate and irritate until we have an effective treatment, but until then, I’m choosing to LIVE without death hanging over my head. I know a band of heroes and sheroes who are showing me how it’s done.

You’ve read my laments; I anticipate mourning losses to come. My life is different than I expected, but it is what it is. I once said in an interview, “There aren’t many people I’d trade places with in this life. I’ve got it pretty good.”

Here’s the top ten list of the upsides of my less physical, more cerebral life. In other words, the benefits of holding still:

10 — Plenty of quiet time
9 — Rarely need an alarm clock
8 — No housework
7 — Preferred parking
6 — No expensive gym membership
5 — Manicure stays perfect
4 — Feet stay callous free
3 — Only need to tan my front side
2 — I’ll never need a knee or hip replacement
1 — Did I mention no housework?

There’s always a bright side. I have my top ten list, the most supportive family and friends, and my faith.

What’s on your top ten list?

Guest Post: Patient Voices Matter

I’m grateful the National ALS Association gave me a platform to be heard.

The Official Blog of The ALS Association

This guest post is from Shelly Hoover, EdD, a member of the Patient & Caregiver Advisory Committee, and does not necessarily reflect the opinions of the Association staff, its Board of Trustees, or its chapters.

By guest blogger Shelly Hoover

Patient voices matter, yet the collective ALS patient community has been too patient and too quiet for too long.

The ALS Association led an unprecedented effort to develop an FDA Guidance Document for Industry. Here’s a quote from the introduction:

“In February of 2015, The ALS Association launched this effort to develop the first-ever community-driven drug development guidance for ALS with funding from the ALS Ice Bucket Challenge, bringing together over 100 participants including people living with ALS, caregivers, researchers, clinicians, and industry experts from across the world to contribute their expertise and experience. In parallel with this effort, a committee was formed to update the ALS clinical trial…

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