S-P/A Day

Unless you’re new to this blog, you know I’m an optimist. If you are new to this blog, welcome! Pull up a chair, have a look around. I hope you find something useful here. And oh, by the way, I’m an optimist. I can’t even tell you why that’s so, but I’ve always been. Even when things are absolutely shit, I still believe to the core of me in some way, somehow, things are going to be okay. Even if it’s a new definition of okay. I don’t think it really serves in purpose being pessimistic, because when you’re a pessimist and things go wrong, not only are things bad for you, but you’ve been miserable for a long time up to that point – because you’ve just been waiting for it turned to shit. “I told you so” is a cold comfort. Seeing it coming doesn’t necessarily make anything better. It makes you right, I guess, and if that makes you happy good on you. But the anticipation of misery just makes the lead-up miserable also. Besides, it really will be okay. I know it.

There are those of you out there who call yourself a realist. You’re not, really. You’re just a pessimist without imagination. If you are going to expect things to be bad, at least have some imagination on how you get there.

So, yeah, optimist. Even though the end of my path is set and dark, there’s still a lot of light here. More than I ever would’ve thought possible. I’ve waxed poetic elsewhere and I will again, and again, and again. Because it’s accurate. There is so much good in my life, more than ever thought I deserved, or possible, even. It’s here. I see it. It’sbright and glorious and why I continue to wake up every day.

But.

Sometimes.

Some days.

Some days it’s really fucking hard to see that light. Occasionally the darkness and the unfairness and the all-around bullshit and fuckery that is ALS creeps in the edges and obscures everything until it’s really hard to see anything good. Everything looks like a shit sammich and the world feels awful and hard. And when that happens, I take a spa day. Or rather, a S-P/A Day. A day to sit and think and allow myself to be sad. To dwell in self-pity and anger.

Because I mean, it’s really fucked up. I’m not such an optimist I can’t see how fucked my situation is. It sucks that this disease exists at all. It sucks that I have it. It sucks that I got it so young. I wasn’t even 40 years old yet. You’re not supposed to get this disease until your mid 60s. It sucks that it’s taking my hands, and my joys in life are all to do with using those hands to create. Create delicious things, create drawings, create these words that you’re reading right now. I’ll never make another wedding cake, or draw a pretty girl in a corset, or teach myself to knit, or pick back up calligraphy. No evenings whiled away on video games. No more dancing. I loved to dance. Eventually I won’t even have a voice with which to dictate these words. And alllllllll of that …sucks ass.

It sucks that I was diagnosed less than a year after I bought my house. My life was falling into place. I had a job I really loved, I was going back to school to further that career that I loved. I had signed up for driving lessons to easily get myself from my new house to the job that I loved. I had successfully dropped weight I didn’t want and was fitting in my cute clothes again. My plaid miniskirt was a wardrobe option again. I was wearing medium T-shirts and looking good in them. I was cooking healthy food for myself. I had my very own living room to dance in. I was dancing. I was mayyyyyyyyyyyyybe open for a new romantic possibility; my divorce was amicable and well in the rearview and there had been a few crushes. I was decorating my new home to be exactly the living space I had always wanted. I had a huge, gorgeous backyard just begging for a garden, and I had such plans for that garden.

It’s not. Fucking. Fair.

So yeah. Usually I can take it on the chin and keep smiling and find the good. Because there really is a lot of good. And it almost always outweighs the bad. But some days it doesn’t. It can’t. And on those days I sleep a lot, I take Ativan, I cry, and just generally wallow. I allow myself self-pity. I allow myself to get angry. And when the anger comes, I let it fill me and I feel it to the core and I rage. And I hate. And I keep crying. And then I sleep some more.

And then when it is over, when I’ve given it a whole day, I can put it aside again. I allow it one day of my life, and then the rage and sadness get shunted aside in favor of the day-to-day living that must happen. It gets overshadowed by the joy that still here. My anger serves its purpose and then it’s done. Until the next time. I try not to let mourning for who I could have been – and who I was becoming – overrule the happiness I could still grasp if only I allow myself to look for it. It’s not all doom and gloom, but sometimes it has to be. Just for a little while. So it can fill me, and pass through me, and keep me in touch with my own grief.

Every now and again it’s important to give those emotions their own time, so that I can put them away and get on with the day-to-day living that’s necessary, and to fully appreciate all of the fucking amazing things that are still very much a part of my life.

Five

Five years ago today, my life was split in two. My life B.C. (Before Crisis) and A.D. (After Diagnosis)

Five years ago I was told I was going to die. Pretty horribly. My prognosis wasn’t great. ALS typically kills you in 3 to 5 years. I had a feeling I had a few years – my progression was pretty slow. Six months after exhibiting any symptoms, I was still on my feet with no assistance, no degradation in my hands, breathing was excellent, swallowing and speech still perfect.

Only ten percent of people with ALS live longer than 10 years. I optimistically vowed to be among them. (….as if I have any control.)

It’s five years later, and I’m still doing pretty well, all things considered. I may make ten years yet, though I don’t think so, honestly. I’m definitely showing signs of wear. I can no longer stand, let alone walk, without assistance. When I try REAL hard, I can still sliiiiightly move the big toe of my left foot sometimes. My hands are near useless garbage meat noodles,
my posture like a T.Rex . I can curl my fingers in but not flex them out, the only digits I still have some control over is my thumbs. I type with the knuckles of my index fingers. Bladder control is completely a thing of the past. My breathing is getting shitty, but it’s nothing I need assistance with, yet.

This last month, I’ve started to exhibit bulbar symptoms. Mannnnnnnnnnnnnn it’s hard to admit that. I’ve been biting my tongue in my sleep, but luckily I already had a night guard so it’s not a problem. No choking or drooling or slurring yet, but my tongue sometimes gets a little tired if I’m eating something really chewy or hard.

It’s not the end of me, but I’m starting to think I can see it from here.

Not sure I’ve got another five years, but I’m going to try like hell. I’m pretty confident I won’t make it to fifty years old. (..This disease sucks, man, don’t get it.)

BUT.

BUT!!!

I have outlived the average. Some folks don’t even get one year. I’ve gotten FIVE. So far. It’s been such a rare privilege to make friends with my own death, to know what’s coming and have a chance to plan for it. My employer had amazing benefits and was completely understanding. My friends, my circle, they have my back in ways I never would have dared to expect. I was already death positive and prepared to think about my own demise in very real ways. I am doing SO WELL, all things considered. I was positioned to handle this with some grace and lots of support.

This sucks, but it could have been so. much. worse.

Tonight, instead of mourning my life that won’t be, I can celebrate the life I’ve had so far. Old school – I’m throwing a freaking pizza party to mark beating the typical prognosis. It’s going to be great to be with my planets, to eat and have some laughs and be grateful for five years of life so far. A very full life containing an amazing cast, fantastic sets, a very interesting plot. I will have hopefully been a source of light for someone, a sliver of kindness, maybe a laugh or two. I have cool tattoos and cute cats and enough stickers to have my own boutique. I am eating delicious things with the best people.

When people ask how I’m doing, I tell them “so far, so good”.

And I really, truly mean it. My life, she don’t suck, you know?

Here’s to another five years. Let’s see where this road leads.

Clinical Anxiety

Clinic was Monday! Let’s break down how it went, shall we?

PT/OT: My hands now no longer register ANYTHING on the strength test. Fuck. My arms are still plenty strong, though. My biceps are a force to be reckoned with from essentially doing push-ups on my walker every day. I have an appointment to follow-up with Deb the Awesome to reimagine my spider hand braces, since my wrists droop badly enough now they’re not helping much. It doesn’t do a lot of good to keep my fingers propped up if my hands as a whole are curling under. My finger joints are doing great though, still a lot of flexibility in them so I’m not going to be clawhands any time soon. Yay!

Dietician: (Hi, Kelly!) My weight remains stable, so I’m to keep doing what I am doing. I need to keep mindful of feeding myself while I’m at home, now, since I don’t have the routine of work to set that schedule for me. My mom doesn’t know to bring me food unless I ask her because she’s old as hell and eats like, a tic-tac a day and calls it a meal. (Hi, Mom, love you!)

Nurse: I forgot to ask her what my chair weighs. Dangit. It’s written down somewhere in my chart and I’m curious what that thing weighs without me in it. Combined, we are 627 pounds of geddafuggoutmaway. She arranged my appointment with Deb, and I didn’t otherwise have much for her. I rarely do. That’s a good thing.

Social Worker: Have I waxed poetic lately about how amazing the ALS Association is? Because damn. Single-handedly saving my sanity more than once, and saving my ass multiple times. We arranged for them to pick up equipment that I’ve borrowed (FOR FREE) that I no longer need because my disease has progressed beyond their use. We then spoke about some other situations that are stressing me out, like the lack of social services for my elderly disabled mother, and she promised to dig up what resources she could for my mom in our area. She sent me an email not even a day later with a bunch of places to check out. THAT is how amazing ALSA is. My mom’s not even on their roster, but because helping her would help ME, they were totally on it. I LOVE THE ALS ASSOCIATION.

Neurologist: Usually I’d be seeing Dr. Goslin, but today I met with her new partner. I’d seen him talk at the ALS Research Symposium, and I’d been given his bio before when I was asked to write something up for him explaining why the ALS Multidisciplinary Clinic was such an awesome thing. It was nice to meet him, and the dude has one of those old-school doctor bags that J wanted to steal. Plus for geek. It was a general get-to-know-you kinda appointment.

Speech: These appointments always go fast because I’ve got no symptoms at all yet. Puff up cheeks, move your tongue, eat this dry-ass graham cracker so I can watch you swallow. NBD, nothing to report.

Respiratory: Yeeeeeah this is always my absolute least favorite, not least of all is because it’s actually HARD. I’ve actually been noticing decline here, and since this is the part of ALS that actually IS going to kill me, I don’t like having a concrete measurement of how shitty my disease is. And yet. I want that measurement, so that I know, so that I can plan, and manage expectations. I came to this appointment knowing my breathing has gotten a bit worse lately; it’s taking a bit longer to recover when I exert myself, and there’s been a few times I wake up in the night because my breath is a little short. I also had to report that my CPAP machine (which I am now supposed to use every night) is busted, doesn’t power on at ALL. We are going to get me a new machine, called an AVAPS and I have no idea what the difference is because I keep forgetting to look it up.

Hang on.

“Noninvasive mechanical ventilation with average volume assured pressure support”

That tells me nothing. 2 secs.

…Oh. It’s…basically a non-invasive respirator. So it’s hardcore. OK then. That’s…intimidating. But I had the choice between getting my CPAP replaced or getting this new hotness, and since I still have Cadillac Intel Insurance for another year, I really want to get the expensive stuff now.

With that out of the way, we did all the usual tests. First they stick a rigid plastic thing in my mouth and I exhale as hard as I can to make these little indicators move; it measures cough strength. Cough strength is still normal; it was down ten points from last visit but she wasn’t worried about that at all. The next test involves a soft plastic mask over my nose and mouth and inhaling sharply; I always ace that one by going beyond what it measures; I guess I’m really good at..sucking…? Monday was no exception. The last test is the worst. Both in what it portends, and the work it takes to perform. My dudes, it is HARD. It blew goats even when my lungs were as strong as ten oxen. It involves inhaling deeply, plugging your nose, and then blowing out as hard as you can, for as long as you can, while getting encouragement shouted at you to GO GO GO MORE MORE MORE MORE and then when you can’t possibly exhale anything else and you feel like you’re going to pass out, another sharp, fast inhale.

Do that three times.

It actually makes J a little uncomfortable to watch, because it’s so obviously hard. It’s intense, it feels like hell, and at the end you have a number that represents your average lung capacity. When I started going to clinic, my scores were over a hundred percent – a very strong set of lungs. Over the last year, I’ve watched that number go down. She wasn’t concerned, really, even 80% was still really good! and she had no recommendations for me except to continue with the breath stacking exercises, which is where you inhale as much as you can and then use a balloon and tube to squuuuueeeeeeeeeeeeeze more air in. and hold. and release. And when you’re no longer light-headed, do it again. And again. I often describe it as reverse drowning, because that’s what it feels like. I do that, but not as often as I should. Six months ago at Clinic I hit 70% and she was a little less cavalier about me not doing them every day. 3 months ago on Clinic day, the machine was busted so I was spared. She wasn’t worried about it though, as my other tests were about the same as last time and she expected the same for this test, too.

I knew it wasn’t going to be the same. I feel a difference. When I eat too much food, I can feel that it’s harder to breathe – not that I’m short of breath, exactly, but I feel that when my lungs don’t have proper room to expand, there’s less strength in my diaphragm to bully the rest of my guts out of the way, maybe. It’s not harder to breathe, exactly, but I notice that I am breathing. And I was keenly aware that the breathing test this time was the hardest it’s ever been. I could feel veins on my forehead. She told me the result.

60%.

I’ve gone down 10% in six months.

I am now to do breath stacking twice a day, and sleep with the AVAPS every night, once it arrives. Next Clinic maybe we’ll do the respiratory early; having it be the very last thing in the day might have fudged my numbers a bit since I’d be tired. But somehow, I didn’t think that will matter. I didn’t take it well at all, and was in a shitty mood the rest of the night, and spent pretty much all day Tuesday crying or sleeping. I feel better now, hence why I have it in me to post tonight, but it kiiiiinda cemented something I’ve been thinking the last few months, something that I haven’t said out loud or posted or anything because I don’t want panic, either from myself or from any of you.

I am pretty goddamned sure I don’t have another 4 years.

I mean, it would be nice? But I’m not going to live to 50. I know that. I’ve been really fucking lucky to make it 4 years, and still be able to be on my feet awhile and wipe my own ass and everything. Some people with ALS don’t make it through ONE, and I’ve already had four, officially diagnosed, and probably closer to six since symptoms first appeared. I’m so, so fucking lucky. I get to see my death coming and plan for it. It was just rude as fuck to see that imaginary timeline become somewhat ..truncated, from what I was telling myself. But now, the part of ALS that will kill me has officially begun to kill me and I don’t have as much time as I thought.

You know what though?

That’s okay.

It really is. This is how ALS goes. This is normal. It’s okay. I’m alright.

Tonight, I am sanguine. There will be more freaking out; count on it. (See you at 3am, stupid brain) At this exact moment though? I have a clarity most people will never, ever experience. I see a world in 5 years without me in it, and it’s a good world and those I love are doing fine, in that long-term place. There’s a delicious release that comes with knowing so far in the future is officially Not My Fucking Problem. Today though, I am making many short-term plans. Hangouts with friends. An art show opening. The Walk to Defeat ALS on Sunday. A zoo trip with family. Neil DeGrasse Tyson – TWICE – in November. I still have a future to plan. It may be abbreviated, but goddammit I have SOME time. I get to make plans. It’s a fucking privilege to tell someone I’ll come to an event in April and know I can. After that. Who knows. My timeline is finite, truncated, and not guaranteed, but I have one. I can see what’s coming and make peace with it before it happens. I get the rare and amazing privilege to become friends with my own death.

And that is fucking awesome.










Without Music, I’d Be Lost.

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.