Margaritas & How To Stalk A Physical Therapist

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Earlier this week, I made the journey over to Stanford for my post-Spinraza-loading-doses evaluation. The neuromuscular team wanted to check my progress after beginning treatment. They are closely monitoring every aspect of my condition for their records— and to prove to insurance companies and other doctors around the world that, yes, Spinraza works on adults, too (not just kids). That way the insurance companies can stop being discriminatory, money-grubbing, ageist fuckheads so doctors can do their jobs and TREAT THEIR PATIENTS!

Whew, sorry. I got a little worked up there. Usually, I only get this riled up when Starbucks is out of caramel sauce… or I see motorcycles cutting people off between lanes in traffic… or I have to listen to Donald Trump speaking words together in clusters (i.e. sentences).

Anyway, at the beginning of the entire Spinraza process in February, I had an entire battery of tests. I saw physical therapists, respiratory therapists, occupational therapists— basically every kind of therapist that exists, except for the psychiatric kind. Which was unfortunate, because considering how drawn-out and stressful this whole thing would end up being, perhaps seeing a psychiatrist at the outset wouldn’t have been a bad idea. Maybe then I wouldn’t have needed as much Xanax, Netflix, or chocolate fudge ice cream.

They measured everything that could possibly be measured. The strength of my muscles and lungs. The flexibility of my joints and limbs. My fine motor skills. My ability to do long division. And if I knew the difference between their/they’re/there.

Okay, I might have made those last two up.

But, I think they should have tested that.

Anyway, this week, I had to repeat all those benchmarks again. As I am a high-achiever, obsessive-type, I had begun prepping for these tests at home. If there was going to be a test, I would get a good score. If there was a gold star or a happy face sticker to be earned, I wanted two of each. Maybe three. Yes, I am that person. That person in your high school class that always wanted to earn a higher score than you did.

In the days and weeks leading up to my follow-up evaluation, I did stretches at home, lifted small weights, exercised my hands with a squeeze ball, and did deep breathing. I was determined to score better than last time.

Upon arrival, I was weighed. I discovered that I had gain several pounds since February. While I’d like to think this was muscle weight gain, I suspect it’s more likely due to the extra chocolate fudge ice cream.

One of the last tasks in my first evaluation was to lift a pound weight from my lap to a table. I couldn’t complete the task last time. I couldn’t even move the weight at all. The cuff weight just sat in my lap like a useless lump as I poked at it with my tired fingers.

This failure haunted me. I’m sure Kim Jong Un feels the same way each time one of his rockets crashes into the sea.

So, I worked on this maneuver at home. I found a 16-ounce bag of dried split peas in the pantry and practiced lifting it from my lap to my desk. After a few days, I could do it quite easily. I was ecstatic. On the day of my recent evaluation, this was the test I was ready to tackle. I wanted to OWN it. And, in celebration, I promised myself I’d have a margarita on the rocks— with lime.

Unfortunately, I had to do nearly ALL the other tests first before this one. I showed off my slightly stronger biceps, triceps, my increased grip, and the wider range of motion in my hands. I was working muscles that hadn’t worked this well in a few years.

The downside to all this (you knew this was coming, right?), was that by the time we approached the lap-to-table weight test, I had begun to tire. I was able to lift the weight into the air (which I couldn’t do months ago)… but I didn’t have enough oomph to get it on the table.

I began to panic. I tried again. And again. And forced the physical therapist to stay longer in the exam room so I could try again. I could feel the gold star slipping through my fingertips. I did NOT want my damn rocket to self-destruct over the Sea of Japan. No, no, no.

I knew the physical therapist had other patients to get to and I could tell she was annoyed with my obsession with completing this one particular task. I was like a dog with a bone. I wouldn’t LET. IT. GO. I was like Donald Trump still obsessing over Hillary Clinton. I just couldn’t move on.

But, the physical therapist had had enough. When she left the exam room, I nonetheless shouted after her as the door closed, “If I can do this task on video will you give me the points for the task?!? Will you?!? Will you?!?

Yeah, I was that person.

It didn’t seem to matter that I went on to ace my pulmonary function test… that each measure of my respiratory ability had improved. I was still obsessing about the goddamn weight test. I wanted those points.

After a short rest, I had my friend start videoing me… I managed to lift a weight from my lap to the table in the exam room. Inside, I cheered… HELL, YEAH! I did it. I had proof. However, the physical therapist was gone by then.

But, if we’ve learned anything about me so far, it’s that I don’t give up easily. Upon leaving the neuromuscular department, the occupational therapist came over to chat. Before we parted ways, I burst out, “oh, and could you please tell Tina that I got a video of me putting the weight from my lap to the table?! Could you?!” I took a breath and added in a desperate rush, “I want those points!

Yeah, I was that person.

Despite that emotional hiccup, everything else went well. And I was happy with how things had unfolded. The whole evaluation took nearly three hours, though, so I was exhausted by the time we loaded up in the car.

But, on the entire 2+ hour drive home, I thought about the celebratory margarita I’d have later that evening. I had moved that weight from my lap to the table. I had video proof of it, even though it may not have counted. And that’s all that matters, right? That margarita would be mine.

I think I deserved it.

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Hurricanes, Pregnant Pandas & Kardashians

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It’s been an intense 9 months. Between qualifying for the nusinersen treatments, waiting to get the ‘greenlight’ to begin injections, and then enduring the hectic schedule of getting my first four loading doses, it’s been a crazy ride. While Hurricane Spinraza was slow to arrive, it gained speed at the end and has packed quite a wallop. A positive, encouraging wallop… but, a wallop just the same.

Perhaps it’s too soon after Harvey, Irma, and Maria to make hurricane metaphors— but, I’m going to do it, anyway. If President Trump can pitch paper towels into a crowd of desperate Puerto Ricans like a carnie at a state fair, I guess anything goes.

Physically, receiving these injections isn’t easy. There’s discomfort, soreness, — and yes, sometimes pain— from the actual treatments themselves. There’s the exhaustion from the long traffic-ridden drives to and from Stanford. It’s a physical challenge. Surprisingly, though, an additional improvement that I noticed after beginning my injections? My residual soreness/pain resolved itself more quickly with each and every treatment. My body felt just a little tougher each time.

Despite the physical challenges, very few people discuss the emotional challenges of this Spinraza journey… especially for those of us that have lived with spinal muscular atrophy all of our lives. So much energy, especially by medical professionals, is focused on our physical health, that our emotional health can be neglected. But, these needs are just as important. The last nine months have taught me that.

Those of us with SMA are expert jugglers. We balance many things in our lives… work/school, family obligations, friends and the management of our care needs— all while keeping track of the pregnant Kardashians. Which is seriously hard work. I keep waiting for one of the reality stars to put up a live pregnancy camera in their house. You know like the zoos do when they have a pregnant female panda? And everyone livestreams the zoo camera online in the days leading up to the birth in the hopes of catching a glimpse of the pink squirming glob that comes out of her panda uterus?

Yeah… that.

(Think of the ratings, Kris Jenner… just think about it.)

Anyway, we SMAers can handle a lot. It’s challenging to juggle our usual tasks— but, we do it. Because we have to. But, when you add in the giant, heavy ball that is Spinraza, it’s impossible for us to keep all the other stuff in the air without dropping some shit on the floor. This is unfortunate because I literally can’t pick up any of the shit I drop on the floor. I have to wait until someone comes and picks it up for me.

After my last loading dose, I physically and emotionally crashed. I went into hibernation— like one of those mama bears that Sarah Palin rattles on about. For about a week and half, I didn’t want to do ANYTHING. I wanted to drop all my juggling balls and sit in the corner and watch episode after episode of the Gilmore Girls. Because if anyone could fix my problems, it was Lorelei Gilmore.

So, I wallowed. And stewed. And fretted. And took some Xanax.

This went on for a while. But, then it started to fade away. I felt the muscles quivering in my arms— reminding me that I had $500,000 swirling in my spinal fluid. It was time to get to work. I had fucked around for long enough.

I started exercising my arms, wrists and hands— with stretches and small weights. I began lifting things more easily than I had done in a while. While in the car, I held a water bottle to my mouth and drank (without a straw!). I lifted a one-pound bag of dried split peas from my lap to my desk— something I hadn’t been able to do at my physical evaluation at Stanford in February.

Things were happening.

So, now I’m trying to make these things part of my routine. I sit at my laptop (while I’m watching Netflix), and do my weird exercises. I’ve discovered that music isn’t my motivator… but, good o’ streaming TV does the trick!

Just maybe not a live Kardashian cam…

There’s only so much a person can handle.

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xoxo

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Fully Loaded

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My Spinraza journey has been one of highs and lows. I’ve had laughter and joy— but, also some tears and anxiety. It’s been a whirlwind of emotion that has frankly surprised me. If my journey were a story, I’d say that each injection introduced a new plot twist. You know, a plot twist like a long-lost, evil twin brother in a really good telenovela? Or, a sudden beheading on Game of Thrones? Or the content of a press conference at Trump’s White House? Because, in all those examples, where you think the plot is headed is never where it ends up.

Earlier this week, I had my fourth, and final, loading dose of Spinraza. After these initial doses, I will just have to return to Stanford four times a year for a single dose to maintain the level of drug in my body. Like topping off a tank of gas. Only this gas is worth more per ounce than plutonium. Just don’t tell Kim Jong-un about this stuff. Knowing him, he’d probably try to fling a vial of it at Japan.

My dose last month went incredibly smoothly, as I documented here. I had a confident, gladiator doctor that had the needle in the target zone so quickly that I thought he was joking. After all, it ain’t easy to negotiate the long lumbar needle through my spinal rods, even with the live x-ray guidance. So, this time, I figured that world-record speed would be hard to beat.

But, I was wrong. Upon arriving to the radiology department at the Neuroscience Center, I was informed that the A-Team was going to do my injection that morning. I felt a jolt of excitement. I get the same feeling when I get a coupon for 25% off at Bath & Body Works.

When I met the doctor, it wasn’t Mr. Gladiator… Rather, it was like if Dr. Meredith Grey had suddenly developed an undetermined-European accent and appeared at my bedside. Her friendly smile and slightly wavy dark blonde hair were straight from one of my favorite TV shows.

She was calm, capable and prepared. And she had the needle inserted so quickly that I didn’t even feel one damn thing. Like nothing. Not a twinge. Not a zing. Like Robert Redford was to Horse Whisperers, she was to lumbar punctures. She was the Lumbar Whisperer. I think she should put that on her business card…

Doctor. Neuroradiologist. Lumbar Whisperer.

It has a nice ring to it.

It wasn’t long before I was ushered to the recovery area. Feeling so relieved to have the injection complete, I quickly guzzled some water and an entire caffeinated Mountain Dew to ward off any potential spinal headache. (Spinal headaches are a very common side effect of this procedure— and caffeine and hydration can help prevent it.)

It was all going swimmingly… until the nurse returned to take my blood pressure and the numbers too closely resembled the final score of a record-breaking NBA basketball game. The excitement and caffeine had hit my bloodstream like a locomotive— and my blood pressure proved it.

They told me to relax, which is the one thing that is impossible to do when you’re a hypochondriac like me. If you tell me to relax, the exact opposite thing is going to happen— I’m going to panic.

My palms began to get sweaty and I became convinced that I was going to have a stroke and die— taking my expensive plutonium-loaded spinal fluid with me to the grave.

They observed me for over 45 minutes, waiting for the blood pressure to reduce. Which, of course, it didn’t. How could it when I had 4 sets of eyes watching me and telling me to calm down?

It’s no surprise that I began to cry. All the stress from the last few months— the waiting for the Spinraza, qualifying to get it, all the insurance hurdles, going through the discomfort of getting the injections… all of it… it hit me like a wave, pulling me under. I bet Trump gets the same feeling each morning when he wakes up and realizes he’s still president.

Soon after that, the nurse took pity on me and let me go home. My relief was enormous. I don’t remember much of the drive back home to Patterson— I was in a daze of relief, exhaustion and, yes, joy, too.

For you see, I had done it. I had survived my loading doses. I wouldn’t have to do another injection again for 4 months. It seemed like bliss.

Stay tuned, though, for more updates on my progress… I will be chronicling everything here (lucky you!). Most of all, thank you for your support on this journey… it has meant so much.

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Spinraza, Turkey Burgers And The Voices In My Head

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I had my 2nd injection of Spinraza earlier this week, so I’m pleased to report that I’m now worth a cumulative quarter million dollars. The little cells and neurons in my spinal fluid are so high-class that I fear that soon they’ll be too cool to spend time with me anymore. What if they forget their humble origins and do something snobbish— like adopt a British accent or befriend a Kardashian?!

The second injection was a little more painful than the first. Getting a needle through the labyrinth of my spine is no easy task— I’ve got metal rods in there to help with my scoliosis, some bony fusions and twisty vertebra. So, the doctor must slowly and carefully insert the needle, making microscopic adjustments and realignments as he/she goes. It’s like playing the classic board game Operation— one wrong move and the buzzer goes off. But, instead of a buzzer, they’ll hear me yell, “Argh! What the $&@#!

So, yeah, it’s kinda fun.

But, the excellent neuroscience team hit the bulls-eye— even though it took a little longer than I would have liked. I lay on the table, on my left side, for over an hour as they worked their magic. I stared at the wall and tried to ignore the pain in my shoulder from maintaining the position they require for the injection. I tried thinking of things that would distract me— what food I’d order at the restaurant later on… why I seemed to be drooling so much on my hospital-issue pillow… and when would the pumpkin spice lattes finally return to Starbucks this autumn?

As I was approaching the end of my tether, I felt the tears slide in and I began to cry. Not the cute kind of crying, of course, but the wet, snuffly kind. The kind reserved for Hallmark commercials and cheesy movies like The Notebook and Rambo.

But, then, I heard a voice in my head… a teasing, yet urgent voice that was surprisingly insistent, “Come on now… NO PAIN, NO GAIN!” I recognized the booming voice instantly as my late uncle, John. It was comforting to hear his voice and it helped me push through that moment. I’m not a person that generally hears voices (I may have many other medical issues, but that ain’t one of them)… yet, that gravely, stubborn encouragement was just what I needed.

The end result makes all the pain and discomfort worth it, though. At the beginning of my journey, my neurologist told me that our goal was stabilization— to halt the progression of my Spinal Muscular Atrophy. That would be a victory. That would add years to my life. Any gains, even minuscule ones, would be icing on the metaphorical cake (if that cake cost $125,000 a slice).

As I mentioned in my last blog post, I began to see improvements very quickly after my first treatment. In the days since my second, I’ve felt tightening in the muscles of my back, legs and shoulders. I also managed to pick up a hefty turkey burger (something I couldn’t do easily before) and shove it in my mouth like a starving Chris Christie. I was so proud of myself. It didn’t seem to matter that I got meat juice and condiments all over myself— that wasn’t the point. The point is, I ate it without using a fork and a knife. I OWNED that turkey burger. That burger was my bitch. It was awesome. I bet Donald Trump felt the same way about Chris Christie during the election, too.

IMG_4299Anyway, soon I’ll be headed back to Stanford for Dose #3… stay tuned for more Spinraza fun!

xoxo

Two Weeks Later…

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It’s amazing how much can change in two weeks. Wars have been fought and won in a shorter span of time and, if you are a believer, than the entire world was created by the Almighty in a mere 7 days— including, Adam, Eve, snakes, assorted shrubberies, and the Fuji apples you can buy at Savemart for $1.29 a pound.

And if all that wasn’t enough excitement, I also made the front page of the estimable Patterson Irrigator newspaper― instead of my column’s usual spot on page 5, or 7. So, yeah, a lot can change very fast.

Two weeks ago, I had my first injection of Spinraza. (For those of you that haven’t been following my journey, you can read my past writings on this topic HERE.) It wasn’t long after that initial treatment that I first began to feel that magical little $125,000 serum at my work in my spinal fluid— like busy Oompa Loompas toiling at Willy Wonka’s factory over a steaming vat of marshmallow cream.

The night following the injection, I woke up at 2am absolutely starving— like I hadn’t eaten anything for days. If you know me at all, you’d know this is an impossibility. There are few things in this life I love more than food. And if I could think of what those things actually are, I would write them right here.

I spent the next 3 days basically eating everything that wasn’t nailed down— especially things with protein. I was like a mama grizzly bear that hadn’t seen food since she went into hibernation last December. A real grizzly― not the fake ones that Sarah Palin seems to find everywhere she goes.

To give you an example, after already consuming breakfast, lunch and three snacks, one afternoon around 4pm I got hungry again and began casting my eyes around my kitchen. My radar settled upon a pouch of cashew nuts on the counter. For a few minutes, I attempted to open the reusable zippered fastener on the pouch. But, I quickly grew impatient and annoyed when my not-strong-enough fingers couldn’t open the lip. Undeterred, I grabbed my purple Crayola kid scissors (the only kind that I can use without hurting myself) and proceeded to desecrate the thick pouch until I had wormed a two-inch hole into the plastic. As the soothing scent of roasted cashews wafted up to my nose, I knew that victory was at-hand. THE CASHEWS WERE MINE!

This inexplicable hunger, this rabid feeding frenzy, culminated in a fluttering feeling in the muscles of my neck, my upper arms and my right hand. I began to notice that things were just a touch easier to do. My Sonicare toothbrush felt lighter. I was typing faster on my computer. I was able to grab my water bottle just a bit more smoothly. My voice sounded stronger. My respiratory numbers were up. I could text jokes about Mr. Trump to my friends even more swiftly than I had two weeks ago.

Things were happening.

It’s difficult to fathom that the little vial of muscle juice was already working. But, while a great deal of things are “all in my head,” I guarantee than this definitely wasn’t. Just because I could convince 11-year-old me that Santa was real, despite all the evidence to the contrary, this doesn’t mean that I’m imagining that the Spinraza was already helping. While my imagination is incredibly well-honed, it’s not that good.

This week, I head back to Stanford for Dose #2. I never thought I’d be this excited to get another shot into my spine. Never. Just as I thought I’d never live to every meteorologist IN THE WORLD go apeshit over an upcoming solar eclipse.

Seriously, though, this hype is way too much— just like the Twilight movies. Once the solar eclipse is actually done, everyone is going to forget all about it… just like they forgot how they once found Robert Pattinson brooding and charming.

Anyway, please wish me luck for Dose #2.

Who knows what the next two weeks will bring?

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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

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