The Magic Little Bottle

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I never imagined that one tiny glass vial could ever consume so much of my time, my thoughts… my efforts. My quest for this magic little bottle—this miracle drug— has been months in the making. But, on a recent July day— a resplendent blue-skied morning— it finally happened.

Spinraza is now real.

For those of you that haven’t been following my journey, you can read my past writings on this topic HERE. But, if you’re one of those people that used Cliff Notes or Spark Notes in school and are actually too lazy to go and read these posts, here’s a recap…

Right before Christmas, the FDA approved the very first treatment for my rare genetic condition— Spinal Muscular Atrophy (SMA). This progressive neuromuscular disease is the #1 genetic killer of children under two years of age— but there’s a small segment of us that manage to survive into adulthood. There is no cure. Due to a missing gene on my 5th chromosome, I am not able to produce a vital protein for muscle growth and maintenance. Instead, I must rely on alternate genes in my DNA to produce this protein. But, these alternate genes aren’t very reliable or productive— just like dial-up internet, a really stoned teenager, or the entire US Congress.

This revolutionary new medication tweaks my alternate genes, allowing them to produce more protein than before— like when Peter Parker was bit by that weird spider that changed his DNA and turned him into superhero. Don’t worry, though, I won’t be climbing walls or spewing webs from my wrists like Spider-Man. This is a treatment, not a cure. But, gaining just a little strength would make a big difference in my life.

In all honesty, I never thought I’d live to see the day when there was a real treatment for my disability. Just like I never thought I’d live to see an orange-tinted, reality television star become President of the United States.

So, yeah, I guess anything can happen.

Since the FDA approval in December, I’ve been laboring to get this treatment, having to surmount many obstacles. For example, there were tests of all varieties— physical and pulmonary exams, blood tests, genetic screenings, a polygraph test, and a breathalyzer.

Okay, I might have made those last two up.

I also had to contend with the insurance hurdles to get this very-expensive medication covered. At $125,000 per injection, Spinraza is an orphan drug— which means that it is so incredibly specialized that only the few of us with SMA can actually use it. Drugs like these are years in the making, so if only a small number of people can use them, each dose has to be very pricey to recuperate the costs.

Last month, the excellent team at Stanford Neuroscience called that I had been given the “green light” to begin treatment. It was one of the happiest days of my life. Just like the first time I drank a pumpkin spice latte and the day I first got an iPhone.

So, this week, we headed over to Palo Alto for my first lumbar spinal injection of Spinraza. The sky was blue with promise and there was anticipation crackling in the air. It took over an hour for two doctors to carefully maneuver the tiny needle into my spinal fluid— dodging the complexities of my scoliosis (the side effect of my SMA) as they went. But, with the help of live x-ray guidance, they did it.

When the nurse brought out the magic little bottle of Spinraza, I felt tears of joy, not pain, rush into my eyes. And when she finished injecting the vial into my spinal fluid, she said, “Elizabette— it’s in.

Even though I had gone through a lot to get to this moment, I knew in an instant that my journey was really just beginning.

So, stay tuned, folks.

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xoxo

(To follow my progress, please subscribe to my blog…)

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That 70’s Show

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I’ve heard it said that fashion is cyclical. What was once in style is sure to become fashionable again— if you just wait long enough. While I’m not sure if that’s always the case, I think the cliché is more true than not.

I’ve noticed that over the last few years that the color palette of the 1970s seems to be creeping back in vogue. While I wasn’t alive during that decade, I’ve seen enough of my parents’ Technicolor photographs to verify this as accurate. You know those little square Kodak photos with rounded edges featuring your relatives with well-coiffed hair and bright floral outfits?

Yeah, those things.

I’ve been seeing lots of clothes and decor with those colors recently. And in places where, frankly, I’d prefer they weren’t. For example, a couple of years ago, I lamented a paint job that had been completed at my doctor’s office here in Patterson. When I told my doctor that the color of his building resembled the shade you’d find inside a baby’s diaper, he told me that he had no part in selecting that particular color palette. While this reassured me of his decision-making ability, that hasn’t stopped me from having to look at those colors each time I go for a flu shot.

I regret to say that this 1970s color invasion has claimed another victim. Today, I had a few errands, so I had to stop by the bank. I hadn’t been inside the bank in quite some time, so I was too busy saying hello to the nice ladies that work there to notice that the interior had undergone a redecoration. Once I was in line for the teller, I looked up and felt my nose instantly wrinkle in dislike.

My beloved bank had been painted a shade of yellow that, if seen in a toilet bowl, Dr. Oz warns us is a sure sign of dehydration.

I mulled on this revelation for a few minutes— looking around the walls as if expecting to feel differently about the color. Once it was my turn at the teller, I nearly asked her about it, but I stopped myself because I didn’t want to make the staff feel bad for having to work at a place that resembled a urinary tract infection.

However, since they are probably reading this column right now, it’s too late for me to worry about that at this point.

In conclusion, I’d like to add the following: I am not the most fashionable person. My sense of style is highly circumspect— just like my ability to walk, which is decidedly nonexistent. So, I’d take my fashion opinions with a hefty grain of salt— just as you would all the things that come out of Donald Trump’s mouth.

I’m sure these buildings and these 1970s colors are super chic— and I’m sure real, honest-to-goodness designers made the color choice. I’m also quite sure that many people must like them.

BIMG_4228ut, definitely not me.

Messy Drawers, Cassette Tapes & Vladimir Putin

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There’s no right or wrong time to clean out a messy drawer, or that one cabinet that hasn’t been touched since audio cassette tapes were still a thing that people actually used. Don’t mistake this as a diss on cassettes— nothing could be further than the truth. I used to love to rock out to Michael Jackson’s Thriller album on my mint green boom box. In fact, I eventually wore the cassette tape out and had to use some of my piggy bank money to buy a fresh copy at the mall. This was a time when you had to actually drive to the store to buy music— so it was a serious commitment. You had to really want something if you were willing to make your mom drive you 40 minutes to the Vintage Faire Mall to get it. After all, in the 1980’s, the only thing you could download from a Cloud was some rain.

Cleaning out an old drawer or shelf can be a therapeutic experience. I know I always feel better, lighter, and calmer when I can de-clutter something. That’s a fact. Unloading possessions is deeply cathartic. While I know that some people get the same feeling from yoga and meditation, I suspect Vladimir Putin gets a similar zing of excitement when he invades Ukraine and polishes his knife collection.

Sorting through old stuff can yield surprising results, too. Once I found a $20 bill in a nylon fanny pack at the bottom of my dresser. Remember fanny packs? Yeah, I wish I didn’t, either. Aside from being horrified that I actually wore the damn thing, I instantly felt like I had won a prize by discovering the twenty bucks inside. It didn’t seem to matter that it was actually my own money, I was still a Powerball winner in my mind.

A few days ago, I cleaned out an old drawer in my bathroom. Inside, next to a crusty bottle of Johnson & Johnson Baby Powder, and in front of a curling iron that hadn’t been used in over a decade, I found a little box. Inside? My high school class ring! I hadn’t seen the ring in years, in fact, I had forgotten all about it. But, alas, here it was in my hand, smelling slightly of old talc, yet none the worse for wear. It was like finding a $20 bill, only way better. Vladimir Putin probably gets the same feeling when he imprisons dissidents and runs around the Kremlin naked.

So, the moral of the story is this: don’t wait to clean out that one messy drawer in your house. While you may only find old buttons, some matchbooks, and a few dried-up pens, there’s a chance you could discover something awesome. Like a $20 bill, your high school class ring, or— if you’re Vladimir Putin—your secret stash of Soviet-era nuclear weapons.

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If only everyone could be so lucky.

My Christine

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Everyone has that one cool older cousin— the one that just makes you think, “Wow, she’s so rad! I want to grow to be just as cool as she is!” The kind of girl that listens to alternative rock or smooth jazz and wears giant clunky Doc Marten boots heavier than a WWII German Panzer tank.

But, this chick wasn’t so cool that she scoffed at the letters her little cousin wrote to her on bright pink Hello Kitty stationary. No, she wrote back diligently, even though, at the time, the little 12-year-old me was about as cultured and interesting as a really bad episode of Full House (The original one… with the damn Olsen Twins!)

But, it didn’t seem to matter to her. She loved me just the same.

That was my Christine.

Given the age difference between us (8 years), as I grew, so did our relationship. I stopped being the annoying little cousin that talked about Legos and glitter pens. I became a grown-up person that talked about grown-up things. Like why the hell did she think that a kalimotxo was preferable to a 7/7? And even before the ATV wreck that messed up her hand, why on Earth did her handwriting still have to be so awful?

We’d talk current events, books, and how to roast the perfect leg of lamb. We’d strategize ways to castrate our least-favorite politicians while gleefully eating our Aitas’ homemade tripota.

When my mom was diagnosed with the brain cancer, glioblastoma multiforme, she was there each step of the way until the end— hugging, and squeezing me, with a remarkable amount of restraint so that she wouldn’t crush my cripply ribs. If you knew Christine, you knew it was nearly impossible for her to hug with anything less than Superhuman strength. But, for me, she managed.

That was my Christine.

As we were both only children, we shared an extra-special bond. We understood the joys, and sometimes burdens, of such a thing, while relishing in the stories of our Aitas— which we told with great vigor and our very best Basque accents. We commiserated together when our parents wouldn’t let us dye our hair purple, but secretly rejoiced when Christine and her badass-self went out and got her lauburu tattoo.

On that September afternoon, 12-years-ago, when she called me to tell me that the pathology report had come back from her surgery, her voice was strong and steady, like a soldier ready for battle. “It’s malignant. Stage 4.” My heart stopped and then began to pound in a beat that nearly drowned out the sound of her next words… “It’s glioblastoma multiforme.

I knew in that moment what her eventual fate would be. But, I waited to cry until we got off the phone. And I cried. And I cried. And I said a prayer, “Please let her live long enough to see her little boy become a young man. Let her fight it off until then.” And, the fucking lioness that she was, so she did.

Her loss is great, but the life she lived was even greater. She loved fully and deeply— and that gift lives on in all of us. I know there will come a day, very soon, when I’ll reach for my phone to tell her something, but she won’t be there. And my heart will break just a little, once more. But, I’ll hear her voice in my head, “Don’t be sad, caca. It’s going to be okay.

That was my Christine.

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The Waiting Game

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I’m sure some of you may be wondering how my quest for Spinraza— the first treatment for Spinal Muscular Atrophy (SMA)— is faring. Obtaining this treatment isn’t for the faint of heart, it takes will, perseverance and just a little desperation— like climbing Mt. Everest, running a marathon, or taking a job in the Trump Administration.

As I’ve documented here, I’ve been examined by several Stanford doctors, I’ve had DNA tests, and I was approved and prescribed Spinraza… two and a half months ago.

But, I’m still waiting to receive the treatment. If I was a female chipmunk, I could have already given birth to nearly three litters of babies in the amount of time I’ve already been waiting. That’s a lot of chipmunks.

Insurance companies around the country have a wide range of policies on Spinraza. While the FDA approved the medication for all ages and types of SMA, at $750,000 for the first year of injections, it is in the insurance companies’ financial interest to limit access to the treatment. So, they have come up with a wide variety of parameters that they are using to approve/deny payment for the drug. Some insurances say you have to be over 15 years old, other insurances say you have to have less than 3 copies of the SMN2 gene, while some say you have to have over two copies of SMN2. Odder still, some are saying that that they won’t pay for those who already use a wheelchair… or a ventilator… or have a last name that ends with “r.”

I have Medicare, so my insurance situation is even stranger. Medicare is requiring something called “Buy & Bill.” Administering hospitals must purchase Spinraza themselves and then Medicare, in theory, will reimburse it. However, under this current set-up, the financial responsibility/burden is on the hospital. And most hospitals are understandably hesitant to assume that risk because they know there is a chance that Medicare will not reimburse 100% of Spinraza’s cost.

Would you fork out nearly a million dollars for a medication if you weren’t sure you’d get paid back for it? Uhm, HELL no. And no one wants to be the bad guy that sends on that kind of bill to the poor cripples in the wheelchair. I may not be in marketing, but even I know that’s not good PR. So, because of this policy, those of us with Medicare are in limbo. We’ve got prescriptions, but no way to get the drug— it’s like having a ticket to the moon, only NASA is broke and all the space shuttles are in museums.

I’ve been told by folks at Biogen (the distributor of Spinraza), and at Stanford, that talks are happening behind the scenes to figure this out. But, as time goes by, all of us with SMA get weaker.

Being patient is difficult, especially for someone like me that doesn’t have a lot of patience from the start. After all, I can barely wait for a grilled cheese to come out of the pan before I take a bite. I hover over the stove like a drone— and I burn the roof of my mouth EVERY. DAMN. TIME. Who can wait for that melty cheesiness? I know I can’t. You’d think that the resulting soreness in my mouth would deter me from doing it again the next time, but I’m just not that smart.

I’m sure some of you reading this are aghast at the price tag associated with Spinraza— and are thinking that there is no need for the treatment to be that expensive. But, please don’t descend upon the makers of this drug with torches and pitchforks on my behalf.

A specialized medication of this caliber is years in the making. There are many costs that go into creating something like this. So, they need to recuperate what they have invested in it. Further, this isn’t a medication for diabetes or high cholesterol— only a very limited number of people can use Spinraza. So, each dose has to be expensive to make it worth their time. If there is no financial incentive to research rare conditions, like Spinal Muscular Atrophy, then no one would bother doing it. That’s a fact. Kindness and altruism doesn’t make the world go around— money does.

In the meantime, today I received this Spinraza welcome packet from Biogen in the mail. It’s a treatment organizer— like the planner I had in high school that I rarely used. This organizer also came with a decidedly cheap pen— emblazoned the Spinraza logo.

spinrazapicNo offense, Biogen, but it’s 2017. Who writes with an actual pen, anymore? And who carries a planner? No one.

And I’m going to be frank… Don’t be like Clark Griswold’s cheap boss that bought him that crappy gift in National Lampoon’s Christmas Vacation. At $125,000 an injection, you could buy me an iPad, instead.

I’ll be waiting. You know where to find me.

Netflix, Stones & Scones

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When I get bored, or if I’m a little sad, I like watching documentaries on my laptop about old, historical things— like English castles, Russian tsars and evil Nazis dickheads. It’s calming and therapeutic… yet, cheaper than Xanax.

Today, I stumbled upon a documentary about Westminster Abbey on Netflix. You know that big, old Gothic church that Prince William and his wife, Kate, got married a few years ago? Yeah, that building. It’s been around for nearly a thousand years… and it’s THE place to get buried if you are super cool and accomplished. There are kings, queens, princes, dukes and even scientists— like Sir Isaac Newton and Charles Darwin. There are scads of writers, too, including Aphra Behn— who, in the mid-1600s was the first woman to make a living as a novelist, playwright and poet. #oldtimeygirlpower

Westminster Abbey is also the place where the kings and queens of England are crowned. During the ceremony, the monarch sits on this really old wooden chair that was built in 1296. The chair still exists today. It’s survived generations of termites, vandals, and the really fat ass of King George IV, who in the mid-1800s spent most of his time eating large amounts of food and shagging women— all while being addicted to opium. He was a real winner. #momoneymoproblems

The chair was designed to house a special slab of stone beneath the seat. This slab is called the Stone of Scone. It’s important to note that the name has nothing to do with actual breakfast scones, much to George IV’s utter disappointment. Rather, the stone was the seat upon which hundreds of years of Scottish kings were crowned a really long time ago. In 1296, though, King Edward I of England took the stone from the Scots so that it could become the coronation seat for his many future, royal, and sometimes tubby, descendants.

As you may guess, this did not sit well with the Scottish. It didn’t take much to inflame their ire during this time, but stealing their favorite old rock was an easy way to do it. In between eating haggis, playing bagpipes, and drinking whiskey, the Scots stewed about this horrendous act for hundreds of years— even after the two nations joined together under one monarch. The English refused their many requests to have the stone returned— unwilling to compromise with the plaid-wearin’, brogue-talkin’ heathens to the north.

Fast forward 700 years. (I didn’t promise this would be a short story.) On Christmas Day in 1950, four Scottish students broke into Westminster Abbey with a crowbar and snatched the Stone of Scone from beneath the seat of the coronation chair. Okay, snatched might not be the best word for something that weighs 336 pounds. Rather, they dragged the stone out of the Abbey on an old winter coat and managed to secret the slab of rock across the border to an eager, and joyous Scotland.

British police vigorously searched for the stone for three months before the Scots finally relinquished the stone in time for Queen Elizabeth II’s coronation months later. The boys that took the stone were pardoned and details of the investigation were plastered all over the newspapers. Yet, each side still claimed ownership of the Stone of Scone and its history. Eventually a deal was reached so that Scotland could keep the stone for most of the time, except during coronations… every other Christmas, and the 2nd Tuesday of the month. Like a divorced couple’s joint custody arrangement of their 336 pound baby. It was all very complicated.

Strike that. No… no, it wasn’t complicated. It’s actually very simple. England and Scotland, two very advanced nations and pioneers in the development of representative democracy, were fighting over a FUCKING ROCK. A piece of goddamn stone that you can find in any riverbed, on any hillside… hell, even in someone’s weedy backyard.

See, this is why history is so awesome. And this is why I watch historical documentaries to make myself feel better. Because even if I’m having a bad day, a sad day, or I’m depressed about what’s on the 5 o’clock news, I know that we humans have done stupid stuff all throughout our history. The dates and years on the calendar may change, but our stupidity does not.

IMG_3927And there is definitely something comforting in that.

Don’t you think?