illness

Strength

What is strength? That is a question that has weighed on my mind as of late and after mulling it over I believe I know the answer.

Strength is not measured by muscle. How much you can bench press and the size of your biceps does not make you strong. Is it a person’s high position of power? I think not. No matter how many people follow your lead and heed your command it does not truly equate power. Not in my opinion.

Strength is found in the quiet ones. The ones who prevail despite circumstances, the ones who forgive, the ones who face their personal battles despite their fear or weakness. Strength is found in the child who readies themselves for school alone while their parent has already gone to work. Strength is in the mourner who visits the grave of the loved one they lost. Strength is in the person who daily searches for work. Strength is in the nurse who care for the dying. Strength is in the unwell who fight daily despite the pain. Strength is in the person down on their luck that asks for help. Strength is in the smile given despite the challenges. Strength is in faith of better times to come. Strength is in finding the positives despite the bad.

Some of the strongest people I have ever met have been those that would not garner much attention. They are not famous, rich, accomplishing feats or breaking records. Every day I see individuals living their lives and trying their best. Not giving up is strength. Fortitude and love is the greatest example of human strength. We should all be so strong and never forget to try as hard as we can.  ~Love to you all.


 

“If you can’t fly then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do you have to keep moving forward.”

Martin Luther King, Jr.

Illness & Hate?

Anna Akhmatova
“I seem to myself, as in a dream,
An accidental guest in this dreadful body.”
Anna Akhmatova, The Complete Poems of Anna Akhmatova

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Today sequestered in my bed at home I unfortunately find that I am alone with myself. My family is here and they are in no way ignoring me. Yet I am internally alone with my thoughts and feelings, in my bed my awareness of all the things my body is going through is screamingly apparent. I am generally not one to have a pity-party and I tell myself that I sure as hell am not going to start having one now. Yes, I have been better. I remind myself that I certainly have been far worse. The problem is when a person is alone with their internal discord of thoughts and feelings they can become somewhat pessimistic. Given enough time your thoughts will boil down to…this sucks & I hate this.
I hate the disease.
I hate the fatigue.
I hate the need for assistance because my body is uncooperative.
I hate the looks of helplessness I see in the faces of those who care.
I hate the uncertainty.
I hate the burning cold heaviness in my legs.
I hate the bouts of cognitive soup.
I hate the headaches.
I hate missing out.
I hate letting people down.
I hate the worry I cause.
I hate the pain.
Hate is a awful word. It is a word I rarely use. Hate is such a strong expression of detestation and loathing that there is few things in my life I can honestly attribute it to. It is when I am at my weakest that I feel free to apply it to things. When that happens I must stop myself-refocus, breath, take stock, and have faith.
If I were honest right now I must amend the fore stated list.
I wish there was no disease.
I accept the fatigue.
I love that I have people to help me.
I appreciate that people care enough to be concerned.
I understand that I do not know what will happen.
I adapt with layers to keep warm.
I laugh at my tendency to lose my track of thoughts.
I believe my headaches are temporary.
I enjoy what others can do.
I acknowledge that others will worry.
I undertake the pain, knowing that despite it I will not relent.

thomas bernard
“Whatever condition we are in, we must always do what we want to do, and if we want to go on a journey, then we must do so and not worry about our condition, even if it’s the worst possible condition, because, if it is, we’re finished anyway, whether we go on the journey or not, and it’s better to die having made the journey we’re been longing for than to be stifled by our longing.”
Thomas Bernhard, Concrete

Rx, Insurance & the M.S. Struggle

When a person has a preexisting condition the battle for insurance coverage and then the ensuing insurance cooperation is often nothing short of an endeavor. Over the years my experience has been a trial of patience and expression of ire. Multiple sclerosis ranks right up there with cancer in the eyes of the insurance industry. It is seen as a exorbitant never ending cost to their bottom line. Now I am only talking about health coverage because luckily I can get that through my husbands employer, but as for life insurance that I cannot attain. Too big and obvious risk for those companies.

Here is the fact- M.S. has no cure. M.S. has a variety of drugs now available to try to speed the recovery of attacks and to slow down the progression of the disease. These disease modifying drugs are far from cheap. The drug that I am currently on is Gilenya, it is a once daily pill. For a one month supply it costs $5,500.00. That is right people, $183.00 per pill.

The drug manufacturers do have programs to help fray the cost to the patients. That is determined by insurance coverage, income requirements, etc. This all works out wonderfully when properly set up but it can be a horrible stress trying to get it to that point, especially when your health insurance provider is changed as ours did this year.

I am on this particular drug because of problems taking many of the others available for treating this disease. Prior to finding a usable treatment I was having regular attacks, so regular that every six months my MRI’s showed more and more damage to my brain and spinal cord. I was using my wheelchair and walker predominantly and was having a shadow of the life I wanted with my husband and then 2 small children. I was put on Gilenya two years ago and it has done very well in keeping my illness in a kind of homeostasis. Rarely now do I need to use my cane, a night and day difference.

This medicine is essential for me. So when our insurance provider changed I contacted my neurologist and the new insurance company to make sure that getting my meds would be a non issue. HA! This drug must come from a specialty pharmacy through the insurance companies due to the expense and nature of it. One specialty pharmacy from one insurance company is, I have found, unwilling to work with the other. Over the last two weeks I have logged over 6 hours on the phone trying to get my medicine.

I am not saying that I have not had any help, in fact I had a wonderful woman from the current insurance company spend nearly the entire day on trying to get this figured out. Unfortunately she is an anomaly. She played go between for the two companies and the neurologist’s office and after hours managed to get the prescription to the current insurance company’s specialty pharmacy. She even managed to get it classified as a urgent order.

The specialty pharmacy said they would call the next day to arrange delivery. The next day comes and no call. The saga continued but from that point I no longer had that wonderful woman from before as my advocate and go between.

I truly miss her.

I called to see how things were progressing with my prescription order. Every day I have had a different person on the phone, each time I’d have to recall what I was calling about and what had already happened. Each time the person on the phone would read through all of the noted made on my account and then put me on hold. Then they would take me off of hold to ask if they could put me on hold so they could transfer me to another department. Finally after a number of holds and transfers I would end up at what should have been the last link in the chain, the area that should have my medicine and should be able to say ‘yes we have it and its on its way’.

Nope.

The procession would lead nearly to the end of the chain with an individual who was more or less apathetic to the fact that my health is deteriorating without this med. These end of the chain individuals would merely inform me that they have it, it is in cue, and it is in the verifying script process. Basically I have spent an excessive amount of time wondering and waiting on whether or not i will get my very much needed meds.

As I write this today I am more or less confined to my bed. It has been two weeks without this rx and my multiple sclerosis is reliving it hay-day in much of it’s horrible glory. My legs have become heavy blocks of icy stone, I am weak and fatigued, and I have all the balance of a drunken three legged cow on a unicycle. My husband and boys have to aid me about the house to keep me from falling. All of this indignity because of a medicine and a company desperately trying to avoid it’s own responsibilities.

I would never wish this or any disease on anyone. But I am getting to the point where I wish the heads of the insurance industries could spend one day in the body of those who are infirmed by something more uncomfortable than a sore bottom from sitting on fat wallets. Perhaps then the care for individuals, no matter the infliction, would not be so easily disreguarded.

M.S. Diagnosis

It was on the morning of February 20th 2004 when I woke up with some numbness in my left arm and leg.  I decided to write it off as I slept wrong or maybe had a pinched nerve. I got myself, my toddler and the baby ready for the day.  My husband Tony had already gone to work a couple of hours earlier and the boys needed to be taken to Nana’s so I could get to class at the community college I was attending.  After dropping them off, while I was driving to school the numbness was worsening and my left side started feeling heavy.  I figured there was no harm in calling the local hospital’s ‘Ask-a-Nurse’.

I spoke to a wonderful lady at the hospital, telling her all of my symptoms.  It wasn’t long into the conversation that her tone changed a bit and I became a bit more concerned.  I parked the car and continued the conversation which ended with her advising me to get to the ER.  The nurse believed my symptoms sounded like I was having a stroke, possibly in part due to my birth control.

So turned around and headed to the hospital, calling Tony on the way.  He immediately went looking for his boss in the factory to let them know he needed to leave.  Upon arriving at the hospital I told them all that was happening and they rushed me back and hooked me up to an EKG.  My heart was fine.  By then Tony was there and the hospital staff was sending me for a CT scan.  That came back fine as well.  Next they had me do an MRI.  While sitting in the impossibly cold room waiting to hear about this final test I prayed…

“GOD please have them find whatever this is, I know this is not all in my head, give us answers and we will deal with them as we need to”.

You see for years, even as far back as high school, I have had these odd things come and go.  Pains, numbness, severe fatigue, and a whole myriad of other little things.  Physicians had on more than one occasion said ‘yes you have these things but we see no underlying cause’ alluding to it may be all mental.  Sitting there I was terrified that I was going to be told it was all in my head again.

When the doctor returned his face was concerned looking and he sat down on a stool and slowly began to tell us their findings from the MRI.  The physician said it looked like I had M.S. (multiple sclerosis) and that he wanted to send me to a neurologist as soon as possible.  I looked at my husband he looked like he just saw a terrible injustice; he looked at me with strong devotion and sympathy.  I wasn’t sad, scared, or even upset.  The sick thing is I was relieved.  It was ‘real’ and it had a name.  Granted I didn’t know anything about this disease at the time and I am sure I was exhausted from the hours of tests, but at that moment I was numb mentally as well as physically.

When we were finally allowed to leave the hospital we were both spent. Tony assisted me to car because by then I could not walk without aid. I didn’t want to tell anyone until I understood more but as it was we had to get our kids from Nana’s.  So there was no choice in telling them or not.  It was strange seeing the faces of my grandparents as Tony explained for me what all had happened.

Papa sat very still and listened but the old man’s brow was furrowed as if he was working on some sort of difficult task. Then there sat Nana in her chair, she looked helpless.  This woman is a rock, never did she put up with anyone’s guff, and she could do anything she wanted to put her mind to.  I didn’t comprehend this until years later when she told me what was going through her mind.

“I felt like the universe betrayed me, you are my first grand-baby and you were never have anything bad happen to you.  I was always going to make sure of that.”

There was certainly some humor that night though.  My mother has always been ‘special’ in her comprehension and certainty in her knowledge.  She began to tear up and pace about the room while Tony was explaining all of the events and results of the hospital trip.  I don’t know why but the whole scene for me was like I was outside of it all.  Watching the people in that comfortable, if not overly furnished room, as though it could have been on the television. Granted I was right there in the middle of it sitting in the chair by the fireplace holding a wiggly toddler on my lap.

That is about when my mother said,
“I am so, so sorry. You must have caught it from me and your father.  Something in our genes must be faulty.  It’s just not fair that my only child is one of Jerry’s kids!”

That’s when I snapped back into reality.  One of Jerry’s kids?  This struck me oddly funny seeing as I used to watch the MD Telethons and I knew at least this much, Multiple Sclerosis is definitely not Muscular Dystrophy.  So tired as I was and mildly irritated for reasons I’m still not sure I responded with a bit of biting yet giddy tone,

“MS not MD! GOD bless them but I’m not a telethon kid! “

The rest of the evening must have been unremarkable, seeing as I recall little about it. Tony got me home and put me to bed.  It would be one more long and uncertain day before I would see the neurologist.  The next day I saw my new neurologist, a Dr. Bekavac.  I had to have more MRIs done, with and without an injection of contrast to show active lesions.  I learned lesions are scars where the immune system is attacking the protective covers on your nerves.  Fun, huh?  That was followed by a spinal tap, not enjoyable but if you have ever had an epidural it is a similar process.  Instead of putting stuff in they are taking fluid out- gives you a wicked headache afterwards.  The diagnosis was a definitive MS.  The doctor wanted me to get on a disease modifying drug to treat my newly discovered disease.

The next morning Tony again stayed home to care for me and the boys, he also made phone calls to his mom in Manchester IA and my dad in West Bend WI.  The news was met with mixed feelings of denial and disbelief.  It was a lot to take in for everyone. Between the things the doctor said and all of the informational booklets about this disease I started to feel overwhelmed…and scared.

The drug treatments turned into a couple of month ordeal.  A nurse practitioner would come to the house and teach me and my husband on how to do the injections.  She was a wonderful woman who took her time and did her best to make us feel comfortable with the process.  On the third day of the drug Rebif the nurse noticed I was developing a reaction, a bad reaction, my tongue started to swell. She shot me with and EpiPen and called my doctor to let them know I could no longer be on that drug.  So a week later they switch my treatment drug to Copaxone.  I broke out in blistery hives. Same as last time I got shot with and EpiPen to stop the allergic reaction.  It was a few weeks after that that they had me try Betaseron.  Also a no go.

My symptoms progressed during that time. On top of the left arm and leg issues my right leg was starting to go numb from the knee down and the fatigue was unbearable. My neurologist started me on a run of IV steroids followed up with oral ones.  It would be years and a few trips to Mayo Clinic before I would be able to level out. During that time I went from using walkers, wheel chairs and canes interchangeably with periodic bouts of near normalcy with a smattering of steroids in the mix.

Through the days, months and years I ran a gambit of feelings-anger, fear, mourning, depression, detachment and finally acceptance.  Every day is it’s own day.  One day I may be absolutely fine and the next day find my limbs unresponsive.  But I did learn one thing and it is so desperately important…

….you can get through more than you ever thought you could and still see there is beauty and joy even in the little things all around you.

msbutterfly