A Time Traveler’s Guide To Judgment Day

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Since beginning my Spinraza journey over two years ago, I have been exposed to some pretty high-level scientific stuff. The Principles of Motor Neurons. Genetic Sequencing. Genetic Manipulation. And a whole bunch of really smart people geeking-out on how to turn cripply SMA people like me into X-Men.

People often ask me what it’s like, during this stage of my life, to describe what Spinraza has meant to me. What it has done for me. Most of the SMA patients out in the world are adolescents, children. Many are babies. After all, only a small portion of those with SMA make it into adulthood. So, those of us that are adults can give a perspective that children simply aren’t able to do. We have more life experience, and frankly, we’ve got the big-adult vocabulary to articulate what this is really like. We’ve got detailed analyses with really large words. SAT words. Oxford Dictionary words.

So, do you want to know what it’s really like?

You know the classic H.G. Wells novel, The Time Machine? The story that popularized the concept of time travel and launched an entire genre of science fiction? When Wells first published the book in 1895, it sparked the imagination of millions. Over a century later, the concept of time travel is still intoxicating.

Everyone (including you!) probably has a secret idea of what they’d do if they had the opportunity to travel in time. While most would do something selfish, like get winning numbers from a future Powerball drawing, some folks would do something more altruistic. Something that would benefit mankind… like killing Adolf Hitler or castrating Harvey Weinstein.

But, all these scenarios are fictional. Because time travel is impossible. Right?

Well it is… Unless you’re me.

If you really want to know what the Spinraza process has felt like to me— what is has meant to me— this is the way I describe it.

I am now a time traveler.

A time traveler that is revisiting a part of her life that she thought was gone forever.

Spinal Muscular Atrophy has always been a progressive condition. I was stronger at 5 than I was at 15. At 15, I was considerably stronger than I was at 35. And, by 55, there was a good chance that I would be dead.

But, with Spinraza, a crazy thing happened. The mad scientists at Stanford thrust me into their Interventional Radiology room— injected some liquid into my spinal fluid… and turned back time.

I began to live in own past. I could do things that I hadn’t been able to do in years. I was living in the past. Just like H.G. Wells wrote about 124 years ago. And, just like the novel, it’s been a wild, and frankly exhausting, ride.

It’s important to note that time travel isn’t free— and Spinraza is one of the most expensive drugs in the world. So, to continue to qualify, I must undergo thorough physical and respiratory evaluations every few months to measure my progress.

Given there aren’t many adults like me receiving the treatment, the data gained from our experiences is especially valuable. These measures and outcomes will hopefully offer the evidence needed to expand Spinraza access here in the US, and around the world. I want more time travelers with SMA. But, to do that, we’ve got to illustrate the benefits with cold, hard data.

No matter how you slice it, though, this added pressure is intense. While I’m constantly told not to be anxious about it— to simply do my best— I do worry about it. I fret about the messages I get from people with SMA around the world longing for treatment. I fear they won’t get to travel back to their past.

I feel guilty that I do.

Not all of us long to do something bold with a time machine. We don’t all want to be heroes that shoot Nazis. Some of us just want to travel to a time where we could talk a little louder… laugh a little harder… and pick our own boogers.

A few days ago, I had yet another full day of these assessments. It’s a day that I truly dread. Each time. It’s long, exhausting, and I usually always have at least one moment when I long to scream or curl into a corner and cry.

I care so much about these tests that it’s almost all-consuming. I do frequent physical therapy in preparation. I have even sought support from a counselor to work through the emotional challenges of this arduous process. These assessment exams are often all I can think about. Literally. All. I. Can. Think. About.

It’s like how Donald Trump must feel about Twitter.

I came into this assessment day— judgment day, frankly— feeling unsure. Feeling like perhaps I had plateaued. That I hadn’t noticed a change from the last time. I was resigned to this idea. I accepted it. It was okay (and expected) to have a plateau because SMA, by nature, is progressive. Stabilization is a win, too. Stabilization means more time available in the time machine.

But, I had a surprise. My respiratory measures showed additional small gains. My physical assessment was the most solid— yet.

The time machine was still working.

While I made it through this judgment day, in six months, I will have to do it all again. And again… and again. Because, in some way, time still manages to march on.

But, I’ll be waiting for it.

Looking at these stars suddenly dwarfed my own troubles and all the gravities of terrestrial life. I thought of their unfathomable distance, and the slow inevitable drift of their movements out of the unknown past into the unknown future.

H.G. Wells, The Time Machine

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Yes, We’re 20 Years Older Now

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The brain has the amazing ability to compartmentalize time in a way that can make us forget how much time has actually passed. For example, when I’m watching Netflix, my brain will ignore the fact that I’ve watched 3 hours of Grace & Frankie. My brain will swim in this blissful interlude until something cracks it— like the window that pops up on the Netflix app. You know the one I’m talking about. The Netflix window that asks if you are “still there” because so much time has passed since you began watching that it thinks you might be dead.

Personally, I hate this Netflix feature. My brain doesn’t want a reminder of how long I’ve been watching TV. I don’t want someone judging my life choices like that. After all, if I really wanted someone to judge me, the best way to do that is to give birth to a baby. Because then you can watch the entire world criticize every choice you make as a mother for the next 18 years.

Anyway, in addition to compartmentalizing time, the brain is also really good at making us forget how old we actually are. Recently, my high school class celebrated our 20th reunion at the amazing event venue, The Century, owned by our classmate, Erin. Once arriving at the reunion, the glamour of the surroundings was a blast of reality. While my brain understood that 20 years had passed, it hadn’t really understood that we were 20 years older until that very moment. The twinkling lights, the crisp table linens, and the fancy cheeseball shaped into the numbers ‘1999’ were glaringly grown-up. I suddenly realized we weren’t people that had a slice of pepperoni and a soda from Pizza Plus for lunch anymore. We were going to have caprese skewers with aged balsamic. We were going to eat an adult dinner using adult dishes at adult tables.

On the cocktail menu, I saw Gin Rickey. My newly-awakened brain recognized Gin as a very grown-up thing to drink. So, I ordered one. And then I proceeded to put a 14-inch red straw that I stole from a movie theatre into the drink (yes, I may be Adult Elizabette, but some things will never change). My cripply SMA ass will always need to use a straw in a drink. Even though my hands are a little stronger now with Spinraza, they will never be strong enough to lift a cocktail in fancy glassware handcrafted by some dude in Germany.

Another signal to my brain that time had passed? Suddenly most of the guys in my class weren’t recognizable. They were taller. They had facial hair. They had wives that made them wear pants that actually fit. It was very jarring.

My friends and I began to not-so-secretly flip through pages of the yearbooks on display like we were identifying suspects in a criminal lineup:

“Who is that guy over by the balsamic caprese skewers?”

“I don’t know.”

“His chin is bigger than the one in this picture.”

“Yeah— I don’t think he’s our man.”

But, it was when a big-smiled guy approached me with a hearty, “ELIZABETTE!” and a hug that I realized that I had an extra disadvantage in this game of high-school reunion Guess Who. I couldn’t recognize the guy hugging me. He looked nothing like anyone in my class. His chin wasn’t familiar. His pants were appropriately-sized.

But, he clearly knew me.

While being me has many perks (see HERE), one thing is very lacking— anonymity. It’s super obvious who I am. I was the only person in a wheelchair in my entire high school. In fact, I was the first person with a significant physical disability to graduate from Patterson High. So, I could literally have had a Caitlyn Jenner-style transition and they would still pick me out of the crowd.

It’s important to note that this lack of anonymity also makes it impossible for me to commit a serious crime. Don’t believe me? Imagine this:

Police Detective: “So, do you have any idea who may have committed this robbery?

Bank Teller: “Well, she was wearing a mask… but she was driving a fancy black electric wheelchair.

Police Detective: “And you say she was armed?

Bank Teller: “Yeah, but her hands were too weak to even point the gun at me. I felt kinda bad, so I gave her the money anyway.

This lack of anonymity did nothing to help me in this moment at my reunion, however. I was losing this round of Guess Who. As he pulled back from his hug, he said, “It’s me— Gilbert!”

“No-you-are-not!” This slipped out before I could help myself. Like when I cuss in front of small children or loudly burp after I eat cucumbers. It’s just not my fault when things like that happen.

My brain was not reconciling the evidence presented. This was Adult Gilbert twenty years in the future. Not little teenage Gilbert. It was as if, once again, my brain was desperately trying not to acknowledge how long I had been watching Netflix. It wanted to ignore the little pop-up window on the app insinuating that only a dead person would be watching TV for this long.

A little later that evening as I began eating my fancy dinner of chicken in a mushroom cream sauce, I started to think that the being-20-years-older-thing has its perks, too. We are more mature. Our clothing choices are better. And, the food is definitely more sophisticated than back in 1999. And, while it could have been the gin fueling those thoughts (which is possible), I still suddenly couldn’t wait to see what the next reunion would bring.

And at least there’s one thing for certain: I still won’t have to worry about not being recognized…

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84 Minutes… and Counting

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I recently got a letter from the Social Security Administration asking me to participate in the National Beneficiary Survey (NBS) for those on Social Security Disability. The supposed goal of the survey is to improve programs that Social Security offers and to see how existing services are being utilized. I was “randomly selected” to participate in the anonymous survey. I think this is meant to make me feel special. As if I’ve won some kind of prize— like a free donut.

According to the letter, the policy research company tasked with facilitating the NBS offers a $30 gift card to participants who complete the phone survey. This line caught my attention because I like gift cards. And the fact they were going to give me a gift card for giving my opinion was very enticing. I am a person with many opinions. Further, giving suggestions and feedback is one of my favorite things to do— even when my opinion isn’t wanted, needed, or welcome. So, the fact that they wanted me to give my opinion made this a Win/Win situation for me.

So, I gave them a call. After waiting on hold for a few minutes, I was informed that the survey would take around 50 minutes. That’s a lot of time. And it’s especially a lot of time when you’re a disabled person like me that takes nearly 2 hours to get up, showered, and dressed each morning. But, I did have opinions to share. Lots of them.

I told Lucy, the survey company employee, to proceed. She began by asking me about my disabling condition, which then resulted in me having to spell out Spinal Muscular Atrophy because no one knows what the hell it is. Then, she asked:

“When did you first get a disability that inhibited your ability to work?”

“During the Reagan Administration.”

“Pardon?”

“I mean, I suppose it wasn’t Ronald Reagan’s fault, directly, but I born and diagnosed with SMA while he was president.”

As the questions proceeded, it was very clear that the survey wasn’t written with people like me in mind. This is odd because I’m über-disabled. If you had to give an alien from outer space a stereotypical example of a disabled person, I’d be your girl. But, this doesn’t mean that Social Security sees it that way.

“When do you believe that your disability will improve enough for you to get off of SSDI?”

“Not even the Vatican can make something like that happen.”

“How about in 2 years?”

I launched into a detailed genetic description of SMA, not fully satisfied until I could hear her nails clicking speedily on the computer keyboard in the background. I was determined to make my survey answers the most thorough and detailed she had ever encountered– like damn Tolstoy’s epic War and Peace. I wanted every word I said entered in the record. I was going to earn that $30 gift card.

“What could we do to help you return to work full-time? Job training?”

“I don’t need job training. I have a university degree. I graduated with honors. The main problem here is that Medicare & Social Security Disability Insurance need to cover home-based personal care attendants. The barrier of inadequate home-based care is what prevents many of us with the skills and abilities to work from doing so. How can we work if we don’t have someone to help us get dressed? How can we work if we don’t have someone reliable to drive us there? The faulty poverty-driven Medicaid system inhibits us from bettering ourselves by punishing us for even small advances we make by stripping away the meager benefits we receive. This needs to change. You want more disabled people to work? Make home-care coverage part of the Medicare program. I guarantee you’ll see results from that investment.”

“So, would a job coach help you return to work?”

I began to feel a headache nag at the corner of my temple. I began to seriously regret doing this survey. Just like a woman always regrets getting bangs. While at the salon you think it’s great, you’ll inevitably realize that those bangs will never resemble the rest of the hair on your head. This survey was turning out just like that.

Then, Lucy began asking me about my physical abilities and other aspects of my life. And that’s when the survey became more interesting.

“Can you climb a flight of stairs?”

“I assume you mean without Inspector Gadget’s help.”

 

“Can you stand and bear weight?”

“Nope.”

“When was the last time you could stand and bear weight?”

“Please don’t make me bring up Ronald Reagan again.”

 

“Have you served in the Military?”

“HAHAHA! Wait— is that a serious question??”

 

“Have you participated in the Ticket to Work Program?”

“No. But, I want to talk about the military thing some more.”

“Umm— okay.”

“Can you imagine if I went into a military recruiter’s office and tried to enlist? They would freak the hell out.”

*The sound of Lucy’s typing ceases and she begins chuckling.*

“I should do it. I’m really good at driving my power wheelchair— which is operated by joystick. Therefore, I could pilot a military drone airplane without a problem. So, that means that I could kill innocent civilians just as easily as an able-bodied person… maybe better.”

I glanced at the clock. I had been on the phone for 84 minutes—and counting. The questions went on for a few moments longer, but my attention started to fade until the very last question:

“Is there anything else you’d like to add?”

“Yes, actually. And I want you to write this down. Are you writing this down?”

“Yes.”

“There’s a bill in Congress right now that could address some of the issues I’ve raised in this interview. It’s called the Disability Integration Act. H.R. 555. Those of us with disabilities want to live productive and independent lives. Please help us make that happen.”

She thanked me for participating in the interview, and wished me all the best. Then, she asked me if I wanted the $30 gift card mailed to me, or someone else. Someone else?? I actually had to have her repeat the question because it was so insane.

Does anyone spend 84 minutes on a survey and then give the only good part about the entire experience away to someone else? No. Definitely not. I may be disabled, but I’m not a communist.

Ronald Reagan would be so pleased.

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Lizard Brains & Toffee Nut Lattes

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I’m nearly two years into my Spinraza journey, so you’d think I’d be relaxed about the entire process. That I would have a ‘been-there-done-that’ attitude about the spinal injections, and the subsequent physical and respiratory evaluations that follow. That I’d be that chill kid that doesn’t get emotionally twisted into knots at the sight of the familiar 500g weight… or the large plastic mouthpiece that gets shoved under their lips to test their pulmonary capacities. That my vast experience would allow me to stay cool under these pressures. You know, like Robert Mueller when faced with a nation that can’t seem to read a 448 page document that they forced him to write in the first place?

But, no, I’m decidedly not that unshakable.

I had my 9th Spinraza injection several weeks ago, after recovering from a nasty bout of influenza. This illness took its toll, and I was worried about the effect it could have on the physical and respiratory assessment results to follow. So, in the days leading up to my assessment, I began to physically and emotionally prepare for the grueling day of tests. I doubled-up on my physical therapy. I increased my protein intake. And, most importantly, I talked to my counselor about breathing exercises to try to keep me from slipping into ‘lizard brain’ during the stressful moments of the day.

If you aren’t familiar with ‘lizard brain,’ please know that I’m not making this concept up. It’s not about a colony of salamanders on Animal Planet. Rather, the term refers to a frenzied state of mind that can occur when extreme stress causes all reasonable thought to vanish— and you are left with the instinctual urge to fight, or run away. This part of our brains is very elemental. Prehistoric. And it traces back into the beginnings of life. The ‘lizard brain’ hibernates inside all of us— but, if you are Donald Trump, it’s activated 87% of the time.

I am a naturally competitive person. As I’ve discussed on this blog, I often push myself to my limit. I want the A on the test. I want the gold star. I want to be able to say that I tried my damned best. When my ‘lizard brain’ is activated, my instinct is to fight. Generally speaking, this drive is a good thing. On these physical and respiratory assessments, it means that I give a lot of effort. If my brain calculates that there’s a 51% chance that I can lift that 500g weight, I have a hard time letting that task go. I want those points. I want to see them write it down on their damn little clipboard. My lizard brain can go from ‘off’ to ‘on’ in that exact moment. And it won’t back down until I’m red-faced, shaking— forcing the physical therapist to pry the 500g weight from my sweaty fingertips.

This isn’t necessarily a good thing. A reasonable, normal brain would realize that I shouldn’t waste energy that I will need for the rest of the assessment. But, ‘lizard brain’ makes unwise decisions. It does stuff that’s just not rational. This is why someone needs to remove the Twitter app from the president’s phone.

At Stanford this week, I really tried to keep that part of my brain contained. I came into evaluation day prepared. I was going to be focused. Methodical. I was energized— and ready. The lizard was going to be On. A. Leash.

I ate a good breakfast. My friend, Edith, brought me a Toffee Nut Latte from Starbucks to sip on the drive over to Stanford. It was a size grande. This is an important detail because I generally only order a size tall at Starbucks because my naturally high-strung personality can only handle so many shots of espresso. (This fact will become important as this story moves forward).

About halfway to Stanford Neuroscience, I got the sudden urge to listen to rap music. I never, ever listen to rap music because my taste in music tends to be more similar to a 92-year-old Jewish man than the Millennial hipster that I actually am. But, it felt like I needed to hear that music in that moment. As I started belting out the lyrics to Petey Pablo’s Freek-A-Leek, Edith grew concerned:

“How much of that latte have you drank?”

“Uhm, only like a third of it so far. But, I feel really good about how this day is going to go.”

The music continued. As we approached the bridge into Palo Alto, I started counting overpriced Tesla cars that I’d see on the freeway. They were easy to spot with the pretentious ‘T’ on their trunk. I briefly pondered if the company’s founder Elon Musk liked rap music. Then, I remembered that I needed to worry about my lizard brain, so I did a few breathing exercises and counted fourteen more Teslas. Then, I felt a hot flush run through me:

“Ooo, can you open the window? I want to feel the bay’s cool air on my face on the bridge.”

“Did you finish your drink?”

“Nope. Only half so far. But, it’s really yummy. The Toffee Nut Latte is almost as good as the Chestnut Praline Latte. You know, it’s probably not as good because instead of two nuts in it, it only has one nut. Like Lance Armstrong.”

We parked in the garage, and as the cool air hit my skin, I realized that, for some reason, I was already sweating.

“Fuck, I’m sweating.”

“I should have got you a decaf.”

“Look, my undershirt is stuck to me.”

After checking in to the reception area and drinking some water to hydrate, I waved at my doctor’s nurse practitioner across the foyer. When she came over and hugged me hello, I hoped she couldn’t smell my sweaty and toffee-nutted body.

I was taken back into the exam room and my vitals were taken. When my blood pressure was within the normal range, I was shocked. Seriously surprised. So, my lizard brain decided that it was a good idea for me to drink the rest of my latte.

The respiratory therapist came in a did a full pulmonary function test. Right away, I could tell that all my hard work during my influenza recovery, and afterward, was paying off. The Spinraza was doing its job. The numbers with each respiratory test were coming in higher than before. I was on a respiratory and caffeine high. My lizard brain was secretly tweeting:

“This is the most huge thing ever. I’m the best pulmonary test-taker in history.”

After I caught my breath from those tests, I finished my latte. As my straw was slurping the last toffee bits on the bottom of the cup, the physical therapist came in for the physical assessment tests. With the caffeine pumping in my blood, I felt especially focused. All the world fell away until it was just me and that test. I watched her hand making notations on her clipboard. I started to mentally tabulate points like a card-counter at a blackjack table in Vegas. I was going to bust the dealer. She was the dealer. I would not be stupid enough to take the bust card.

“If I lift this cup this way, will I get more points?”

“No.”

Five minutes later.

“I know I only get three tries to do the task successfully and get my points. But, if I don’t set the item down, it still counts as one try, right?”

I don’t know if the caffeine was doing it, or all the preparation I had done, but I felt a zing of excitement as, one by one, the tasks came easier than I had expected. My mental tally was telling me that my score was higher than last assessment. And the therapist agreed:

“You’re doing really well. I think you’re ready to try an additional task we haven’t done before: putting you on the end of a table to see if you can sit upright all on your own. Without any support.”

“Will I get more points for that?”

“Yes.”

“Then let’s do it!”

I’d like to report that I did get those points. I did sit on the edge of that table all on my own. First, I did it bracing on my own hands. Then, I did it without the support of my hands for even more extra bonus points. It was an amazing moment. Edith even cried a little because it’s a task we’d never thought I’d be able to do.

I’d like to say that this achievement was emotional for me in that moment, too. That this milestone was the culmination of two years of treatment that paid off in a tearful crescendo.

But, it didn’t happen in that way. And you know why it didn’t? Because my lizard brain was too busy shouting:

“GIVE ME ALL THE POINTS!”

It was still all worth it, though.

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Red Tape, Duct Tape & The Wheelchair Vortex

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When you’ve got a rare and complex disability like Spinal Muscular Atrophy, time can be a very precious commodity— like diamonds, Labradoodle puppies, or a really good Wi-Fi signal. Since many everyday tasks can take us longer to complete (like showering, eating, and getting dressed), we tend to budget the rest of our time wisely and carefully. It’s an important skill to cultivate when you have a disability— otherwise you’d never get that term paper done, never balance your checkbook, and never have time to buy laundry detergent at the store.

Along with these everyday tasks, life with a complex disability comes with a lot of hidden bureaucratic demands that take up time. Between filling out on-going forms for Social Security and state services, to coordinating between various caregivers, doctors and therapists, to following up on medications and equipment, it’s a vortex of bureaucracy that keeps our lives in motion.

The time it can take to attend to this red tape is daunting. You know the hours it can take to prep and cook an entire Thanksgiving dinner? That’s a LOT of time, right? Imagine having to do that several times a month— even when you’re tired, sick, or just want to lay in bed and watch people get decapitated on Game of Thrones. That’s what it is often like for us. Plus, we don’t even get any leftover turkey out of the deal (which is totally lame because I love leftovers!).

Recently, I’ve had an extra bundle of fun (can you sense my sarcasm?) added to my usual list of bureaucracy. This task is at the top of my list of The Most Dreaded Of All Tasks. In fact, I daresay it is the veritable Mount Everest of tasks a cripple like me must climb. And I don’t say this lightly because I literally can’t climb anything at all.

It’s the Trying-To-Get-A-New-Power-Wheelchair-Vortex-Of-Hell.

Sure, it might sound exciting to get a new custom power wheelchair— to get a bright shiny new model with fancy features and leather upholstery that smells like a pretentious Italian shoe. But, a new wheelchair ain’t a Prius (even though it can cost nearly as much). They are also not so interchangeable as to be simply a matter of budget, taste and style.

As I’ve written on this blog before, these wheelchairs are built to our specific measurements and our medical need. They are designed to maximize independence and health. They are the very tool of life. And, when you have a complex disability like SMA, a small change in a wheelchair design or an error in a measurement for the seating can mean the difference between sitting comfortably to having a pressure sore on your buttocks. It can mean the difference between being able to drink a glass of water independently to not being able to reach the table at all. So, a lot can ride on these devices and making sure they are fit appropriately.

That’s a lot of stress— and a lot to add to our already-busy plate. So, it’s not surprising that we’re often not eager to get a new wheelchair when we’ve still got one that works well. But, as time goes on, it can become difficult to get parts and do repairs. Plus, I can’t speak for every disabled person, but I’d rather not go too long with a decrepit wheelchair that’s only held together by loose wiring, duct tape, and human stubbornness. (I think we’ve got enough of that in the White House).

So, every 7 or 8 years, I begin this process anew. Given the price tags on these custom wheelchairs, insurance companies don’t make it easy to qualify for coverage. There are many hoops that a person must jump through to get a power wheelchair. This is ironic because most of us that need these devices literally can’t jump at all.

First, my doctor must reestablish my need for a power wheelchair and reverify my disability. This is despite the fact that I’ve been this way for 37 years. It’s as if they fear that my genetic condition is going to suddenly disappear into thin air— like Lori Loughlin’s career.

Second, I must be seen by a special neuro physical therapist that will do a head-to-toe functional assessment— which must corroborate my doctor’s findings and include an analysis of whether my mental state is good enough to operate a wheelchair without driving myself off a cliff.

(Even though this process makes that very, very tempting.)

After that, my doctor has to verify the special neuro-physical therapist’s evaluation and that it’s in full agreement with his recommendations. He then sends it all to the DME company, which is in charge of fitting me for the new wheelchair and making sure it’s functional.

I’m fortunate that I have a long and positive relationship with my local DME (durable medical equipment) provider, Alan. He has been very accommodating and helpful to me over the years. He’s put up with my tears of frustration, my harassing phone calls, and my complaints about how ugly all their wheelchair paint color options actually are.

Insurance companies don’t make this process easy for DME providers, either. To be frank, they make it a giant pain in the ass, which has driven many DME companies out of business, which in turn makes it hard for disabled folks like me to get our rickety wheelchairs repaired or replaced.

It’s the red tape nightmare that just keeps on giving— like a bad case of shingles.

Anyway, Alan came over a few days ago and we came up with an initial plan for my new wheelchair. This plan basically consisted of me pleading desperately:

“Alan, make the new chair exactly the same as this chair. Seriously. Like not even a centimeter difference. Okay? You know the old fable, ‘The Princess & The Pea?’ I am the Princess. Trust me, I will know if there’s a pea under the mattress…..Umm, why are you laughing? I’m not kidding. I am the Princess. There will be no PEA in this WHEELCHAIR!

Realizing I sounded slightly deranged, I coughed, and added:

“By the way, would you like a cup of coffee? Perhaps you might need it now.”

And that’s basically how that initial consult went.

It’s now up to Alan and his team to gather all his notes, the paperwork from my doctor, the assessment from physical therapist, and to combine it all together to submit for insurance approval. Every “T” must be crossed, and every “i” must be dotted. If it isn’t, I will have to begin the process again— the idea of which makes me want to cry.

Here’s hoping the duct tape will hold out until then, though.

Wish me luck — And stay tuned for updates!

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Icebergs, Firefights & Winning #9

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Getting sick when you have SMA is not a fun experience, as I’ve discussed previously on numerous occasions. The tiniest cold can turn our lungs into a swamp of mucus, and recovering from, even such a minor illness, can take longer than a steamship voyage across the Atlantic. And that’s assuming there are no icebergs lurking in the water that could sink the ship— or, worse, yet, send us to the hospital for IV antibiotics. It’s a dangerous ocean out there, even without German U-Boat torpedoes.

So, it’s easy to imagine that if the illness is more than a cold— things can become serious very quickly. Recently, I was threatened with such an iceberg. A Titanic-sinking hunk of Influenza— the most dreaded of respiratory viruses. The little bastard that attacks during the night, overwhelms your defenses, and turns Leonardo DiCaprio into a blue icicle.

As soon as it hit, I knew exactly what it was— and the danger it posed to me. I had prepared for this moment, and didn’t take it lightly. Keeping my lungs clear was my top priority. I would sacrifice sleep and rest (the two things most needed when you are ill), just to keep those airways pliable and open. I would do anything to get the mucus out. Literally anything.

So, I leapt into action. I pulled out all my respiratory devices. CoughAssist. BiPAP. Nebulizer. And I started my emergency influenza protocols. Tamiflu. Zithromax. Prednisone. Albuterol. I had trained well for this moment. I was like those Paris firefighters that protected the Notre-Dame Cathedral. I was not going to let the whole structure fall apart.  Sure, I knew my roof was made of really old wood covered in medieval pigeon shit. That just meant I was going to have to work extra hard to save the good bits of the building. But, it was definitely worth saving. If cranky French revolutionaries couldn’t defeat me in 1789, I wasn’t going to let a fire do it. Mon Dieu!

The following days passed in an exhausting whirlwind of respiratory care. Given the complexity of SMA, we can most often receive better care at home than in the hospital. You might find this surprising, but most local medical professionals have little to zero experience with a patient with a rare neuromuscular disability, like SMA. So, hospitals can be very dangerous for us. We have learned this the hard way. So, we have to become our own advocates and our own resources. And our doctors become our partners and colleagues… we teach them sometimes more than they can teach us.

It wasn’t long before my bedroom began to resemble a respiratory care unit. And I personally resembled the little green Mucinex monster from the commercials on TV. I was green, gross and contagious. Frankly, I was my own worst nightmare.

And, I was exhausted. Coughing and keeping my lungs clear became a full-time job. The kind of job with lots of overtime and no weekends off. The really, really sucky kind. In fact, I was so exhausted that I took to blending my food so that I wouldn’t have to waste energy eating and chewing. Every ounce of my strength was devoted to respiratory care and I needed to maintain the nutrition and calories to do it. Yes, I really was that committed. And, yes, blended food actually tastes exactly the same as non-blended food. For example, a blended Chile Relleno still tastes exactly like a non-blended Chile Relleno. (Unfortunately, it does look like baby poop, though.)

As my efforts slowly yielded positive results, this didn’t stop the mental toll from weighing heavily on me. The anguishing rotating schedule of BiPAP, CoughAssist and Nebulizer— in between drinking my meals and trying to rest— was relentless. There wasn’t even much time for Netflix, which says a lot because I can always find time for Netflix.

Emotionally, I struggled. I cried, even (which wasn’t wise because it made me even more snotty and gross). I had nightmares about really scary things. Like going to the hospital… being put on a breathing tracheotomy that took away my ability to speak… and, worst of all, Donald Trump tweeting even more than he already does.

After two weeks, I began to see the light. I could go stretches of time without coughing. My doctor noted that my lungs were improving. I was eating solid food again. I stopped dreaming that Robert Mueller was kidnapped by Boris and Natasha.

Things were looking up.

And then, last week, I made it to Stanford to receive my 9th injection of Spinraza. It was just the boost that I needed. A physical boost, but perhaps even more importantly, an emotional win.

In the days since, I feel my strength slowly returning. It will take time for me to get back to my pre-iceberg self, but I just need to be patient.

Wish me luck!

(PS: If you need to find me, I’ll probably be watching Netflix.)

influenzalife