58 posts tagged “interview”

“The human spirit is more resilient than we think” – PatientsLikeMe member mmsan66 shares her journey with ALS

Posted January 29th, 2015 by

PatientsLikeMe member mmsan66 was diagnosed with ALS back in 2008, but she’s been fortunate to experience an unusually slow progression, which currently affects only her legs. As a college professor, financial planner and ALS advocate, she raises awareness through her work with the Massachusetts Chapter of the ALS Association. She even finds time to visit places like the Grand Canyon, and she shared all about her life in a PatientsLikeMe interview. Read below to learn about her personal journey. 

What was your diagnosis experience like? What were some of your initial symptoms?

I was diagnosed in 2008 at the age of 66 but, looking back, had definitely exhibited symptoms in 2007 or earlier. I had retired a few years prior, after a long career in Human Resource Management that included positions in the fields of health care, the Federal government, higher education (Northeastern University), and high technology (the former Digital Equipment Corporation).  But, rather than slow down and enjoy retirement, I started a second career in tax and financial planning. I became an IRS Enrolled Agent (EA), earned a Certificate in Financial Planning, and obtained my securities and insurance licenses.  I started my own business as a tax and financial advisor (Ames Hill Tax Services) and also began teaching undergraduate courses in Finance, Accounting, and Investments as an Adjunct Instructor at several local colleges and universities.

I definitely noticed a change in 2007, when I experienced a number of falls (for no apparent reason), culminating in a fall while on vacation in Florida in which I fractured my left wrist. Upon returning home, I scheduled appointments with several specialists to have my legs checked out and, after a series of neurological tests, received a diagnosis of ALS at the Lahey Clinic in July of 2008. I wasn’t completely stunned, as I had done a lot of internet research on diseases with symptoms similar to mine, but had gradually eliminated them one-by-one as each test result came back negative. However, like all PALS, I was hoping against hope that my suspicions would prove false. The one thing that kept going through my mind in the days following my diagnosis was that my life—— as I knew it—– would soon be over.

How has your ALS progressed over the past few years? 

In 2009, after learning that the average life span of a PALS was 3-5 years after diagnosis, my husband and I decided to sell our home of 36 years rather than modify it. Fortunately, they were in the process of building a luxury apartment complex on a hill in town, and we were able to move into a brand new handicapped-accessible apartment, complete with roll-in shower, and overlooking a pond complete with wildlife.

By 2010 I was no longer able to walk at all, and had to rely solely on a power/ manual wheelchair, as well as a scooter. Although confined to a wheelchair, I still maintain my active tax practice, preparing individual, corporate, and trust tax returns as well as representing my clients at IRS audits. When I realized it would be too difficult to travel to and from the various campuses at which I taught, I applied and was hired as an online instructor by the University of Phoenix, where I’ve been teaching Personal Financial Planning since 2010. At this point in time, after living with the disease for 8 years, still only my legs are affected. Thankfully, I still maintain my upper body strength, and my ability to speak, swallow, breathe, etc. remains completely normal. Somehow, I can’t help but feel that this slow progression might be due in part to the upbeat, positive outlook I continually strive to maintain, and the fact that I keep very busy with my family, clients, students, attending online CPE seminars (to maintain my professional licenses), and participating in ALS fundraising walks.

We read you like to travel – what are some things you’ve done to make traveling easier?

We’ve done some travelling since I’ve been unable to walk, but nothing extensive in the last couple of years. Our last long-distance trip was to Las Vegas, the Grand Canyon and several other National Parks such as Bryce and Zion. At the time, however, I was still able to transfer with my arms from my wheelchair into the passenger seat of our van. Now, since my legs are completely useless, a handicapped van is a necessity.  We will be going to Austin, Texas in October for a niece’s wedding. We’ve found travelling is a lot easier if you call ahead to lay everything on with the airlines. Reserving a wheelchair or a power chair at each destination makes things a lot easier. And, it’s of the utmost importance when making hotel reservations to specify a “wheelchair accessible” room, not just one that’s “handicapped accessible” (a motel that has a roll-in shower is the best!).  Also, contacting local ALS organizations in the areas you plan to visit well in advance can be very beneficial. They can direct you to rental agencies or, better yet, lend you the mobility equipment you will need while you’re there.

Can you tell us a little about your work and advocacy with the Massachusetts Chapter of the ALS Association?

A few years ago, I decided to become involved in ALS Advocacy with the Massachusetts Chapter of the ALS Association. I was invited to speak to groups of scientists at Biogen Idec in Cambridge, MA on the topic of living with ALS, and was interviewed by the Boston Globe and WBUR radio when Biogen discontinued the Dexpramipexole trials. I also attended the NEALS Consortium’s first Clinical Research Learning Institute held in Clearwater, FL in October 2011. There I was fortunate to personally meet many fellow PALS from around the US, as well as prominent researchers and clinicians engaged in the fight against ALS. (I also had the pleasure of meeting Emma Willey from PatientsLikeMe.)

In addition, I have spoken to groups at various other fundraising events sponsored by organizations such as ALSA, the ALS Therapy Development Institute (ALSTDI), etc. and have represented these organizations at ALS Awareness events at Fenway Park. Because of my visibility as a PALS, I was elected to the Board of Directors of the ALS Association’s Mass chapter, and currently serve in the capacity of Secretary. 

What have you learned about yourself that has surprised you and/or your loved ones? 

I think the first and foremost thing I learned, is that the human spirit is more resilient than we think. I would never have imagined that I could be diagnosed with such a terminal disease, and still continue on with my life as best I could, finding pleasure in simple daily activities. We had travelled extensively around the world in the early years of our 47-year marriage (lived in Hong Kong for 2 years) and planned to travel internationally once again once we retired and our daughter embarked on a career of her own. Now, I appreciate just being able to get into our handicapped van and take local day trips with my husband. Never mind viewing the Taj Mahal by moonlight, now an excursion to the grocery store or taking in a local college hockey game is a welcome diversion and takes some planning.

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“Strength will come, somehow, from somewhere” – PatientsLikeMe member Glow4life shares her journey with lung cancer

Posted January 26th, 2015 by

PatientsLikeMe member Glow4life was diagnosed with lung cancer (adenocarcinoma) this past June, and her story is a testament to never losing hope. She recently shared her experiences in an interview, and she spared no details in describing her challenges. Despite her terminal diagnosis, four rounds of chemotherapy and the sudden loss of her husband, Glow4life has remained positive, and she’s learned to take every day as it comes and live in the moment. Learn about her journey below and how she shares love and hope whenever she can.

How did you react after getting diagnosed with lung cancer in 2013? What was the diagnosis process like?

I had a routine X-ray in February 2013, after attending A & E with chest pains (which turned out to be nothing). A few days later I received a letter asking me to return in 6 weeks for a follow up X-ray, as there was a suspect area, probably scarring from a previous chest infection but best to check. My general practitioner reassured me it was unlikely to be sinister, if cancer was suspected I’d be looked into immediately. I thought no more about it and returned for the repeat X-ray as scheduled. The following day my GP rang me to tell me there was a tumor on my left lung that required further investigation, and gave me the number to ring for a scan, which took place within a couple of weeks. I asked if this was likely to be cancer, and he told me it almost certainly was. The scan did, in fact, reveal a cancerous tumor, and I was referred for a PET scan and bronchoscopy. On the 27th of June, I was seen by the specialist who gave me the news that adenocarcinoma was confirmed, and had spread to the other lung, and right adrenal gland, and was given an appointment with an oncologist, who would assess appropriate chemotherapy. It’s impossible to describe how this feels, but you know that your life has changed forever. I saw the oncologist on the 7th of July and was offered a course of cisplatin/premetrexed, a course of 4 to 6 treatments, every three weeks, in an attempt to shrink the tumors and prolong life.

I was told my prognosis was terminal, and that with successful chemo, 20 percent of patients survive a maximum of 12 months. If we were shocked before, nothing compared with this, it was like being hit by a wrecking ball. I started my chemo on the 23rd of July and had the fourth session in October, which was followed by a CT scan. This showed that the tumors had shrunk and no further chemo was necessary. A maintenance course of premetrexed was available but not recommended, as the chemo had made me very ill. Since then I have been on watch and wait, every three months, last time extended to four. I go for X-ray and blood tests before my appointment with Dr. Brown, my oncologist. My cancer is stable, though not cured, and my general health is good, as is my quality of life. I do tire very quickly, but then I’m getting on a bit!

You’ve received treatment for your tumors – what’s it like being on a “watch and wait” plan?

Being on ‘watch and wait’ is like having the sword of Damocles hanging over your head, you never know when it might drop. But I try not to dwell on that, it would be wasting the extra time I have been given in pointless worry and speculation. I try to forget about it between visits, and for the most part I do, though I must admit to a certain amount of anxiety in the couple of weeks prior to the next appointment.

How has your day-to-day life changed since being diagnosed and treated for lung cancer? 

Well, I thought the worst possible thing had happened to me and things couldn’t possibly get worse. But I was about to find out different. It’s hard for me to answer this objectively, as 3 months after the diagnosis, and while I was in hospital having my 2nd chemo, my husband Tim was found dead at home, having suffered a cerebral occlusion. Tim was 11 years younger than me, and in perfect health, so the shock was profound, for all of us. I passed the next few months in a fog of chemo and grief, it was the hardest time imaginable, but the days passed and I got through it.

My life has changed beyond all description and I can say with all honesty that living without Tim is much harder than living with cancer. Loneliness is my biggest issue now, and wishing he was here to help me through this, which I know he would wish he was here to do. One thing I did learn was that having a terminal illness doesn’t make us closer to death than anyone else, and that life can be taken from any of us, at any time. So it’s important to take each day as it comes, and make each one count. When I die, nothing will be left unsaid, no actions regretted or opportunities missed.

I fear death much less than I did, while still embracing what life is left to me. We all have a time to leave this world and move on to whatever adventure lies beyond, and I know that the time is coming when Tim and I will be reunited in spirit. I will be sad to leave my beautiful family, but happy that I’ve been given this time in which we’ve all been able to prepare, and make the very most of the chance to let them know how much I love them. And we all have to leave sometime!

What have you learned from using the InstantMe feature on PatientsLikeMe?

What I’ve learned from PatientsLikeMe is that I’m not alone in this, so many of us are dealing with similar issues, and that while cancer is different to each individual, what is the same is that most of us are devastated by the effect it has on our loved ones. It’s so hard to see their sorrow, and know you are the cause and can do nothing to stop it. I’ve also learned that many people are much worse off than I am, having succumbed so much faster, while I am still here and comparatively well. Each time I go for a scan/bloods/chemo, or to oncology I see the waiting room full, and think, so many of us, all with similar fears and trepidation of what is coming our way.

We read that your motto is “Never give up, never give in” – along with that, what else would you say to someone who has been recently diagnosed with lung cancer?

What I would say to anyone recently diagnosed is this: You will wonder how you are ever going to find the strength to cope, how do people do it? But be assured that the strength will come, somehow, from somewhere, and you’ll find your way through. Take one day at a time, and make each one count. Prepare for every eventuality, but never lose hope. Follow good advice, not fads. Try not to look too far ahead and live in the day, or even the moment. Don’t think of yourself as dying from cancer, but as living with it. One of Tim’s favorite sayings, when the times were tough, was “Head up, son” I say that to myself every day.

And don’t Google! You’ll frighten yourself with out-of-date misinformation and meaningless statistics. Listen to the experts.

Finally, share love and hope wherever you can, while you can.

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“I continue to be inspired by those who share this fight with me” – PatientsLikeMe member Doug shares his journey with HP

Posted January 9th, 2015 by

Meet Doug. He’s part of the pulmonary fibrosis (PF) community on PatientsLikeMe and is living with a condition specifically known as chronic hypersensitivity pneumonitis (HP). It’s similar to other types of PF, but also has its differences. We caught up with Doug for an interview to help spread the knowledge about these two conditions, but learned so much more. He shared what it’s like to live with HP, how he uses PatientsLikeMe to learn more about his own health and how the community has helped him to stay inspired in his fight.

Can you share a bit about your chronic HP? Can you explain to our blog followers how it’s different than IPF?

I believe the major difference is that with hypersensitivity pneumonitis there is a cause. If I’m correct there are three forms: acute, subacute and chronic. All are caused by exposure to an antigen that may or may not be identified. In my case, I have chronic hypersensitivity pneumonitis (HP). My specialists have determined that it’s not necessary to identify the antigen since my condition is chronic and cannot be reversed.1

What was your diagnosis process like, and how was it different than what you’ve heard about getting diagnosed with IPF?

Of course I can’t compare how it ”feels” to have HP vs. IPF, and I’m no expert, but I will give you my version of the difference between HP and IPF. First, both are forms of pulmonary fibrosis. With HP, the fibrosis forms primarily higher up in the lungs, and IPF forms in the lower part of the lungs. Air trapping occurs in cHP but not in IPF. I have no idea how this impacts me as a patient, but I’ve included a comparison from Dr. Jeff Swigris.

Apparently another difference is that HP fibrosis is caused by inflammation, whereas IPF is caused by different forms of pro-fibrotic influences. Generally speaking, specialists recommend an anti-inflammatory drug (prednisone) and/or an immunosuppressive such as azathioprine, mycophenolate, cyclosporine, or cyclophosophamide. In my case, my doctor and I agreed on a course of mycophenolate. Initially, it had significant side effects, such as severe fatigue, poor sleep, weight gain and depression. I switched to Myfortic, which is a different brand of mycophenolate, and now the side effects are minimal. I have much more drive and I feel much better! It’s still too early to tell if it will help. My concern is that my pulmonary function test (PFT) results have dropped in the last four months, so I’m concerned that I’m deteriorating. At the moment, I function almost normally. I have a walking routine that includes a 7.5 K walk, which I can complete in an hour. I now require supplemental oxygen for long flights, but I still consider myself lucky!2

You frequently use the InstantMe and Quality of Life tools on PatientsLikeMe – why do you like to use these to donate your data?

I find it’s good to have a record of your health pattern. This can include how you feel daily as well as a record of the medications I’m on. I print out portions of this for my doctors’ appointments and it helps me be well prepared.

How have others in the HP and IPF communities on PatientsLikeMe helped support you on your journey?

My biggest concern is that HP is the “poor cousin” in the PF family! There are very few of us online and therefore it’s difficult to learn as much as I’d like to! Nevertheless, I have learned a lot about shared aspects of PF such as patient care, oxygen therapy and lifestyle issues. I continue to be inspired by those who share this fight with me and I’m always grateful when I’m able to learn something that will help me.

I’ve always told my wife I plan to die of old age! One of my strengths is that I have a great attitude. Participating in platforms like PatientsLikeMe helps me not only learn more, but it fortifies my attitude!

Many people may not know about rare conditions like HP and IPF. If there was one thing you thought someone who doesn’t have a clue should know about HP, what would it be?

That’s a tough question because there is so much more I need to learn before I feel I can address this question. I suppose the key with HP is that if you have developed acute or subacute forms of the disease you may be able to arrest the fibrosis before it progresses too far.

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1 http://nationaljewish.org/Participation-Program-for-Pulmonary-Fibrosis/Community/Blog/Participation-Program-for-Pulmonary-Fibrosis/November-2013/What-is-Chronic-Hypersensitivity-Pneumonitis

2 http://nationaljewish.org/Participation-Program-for-Pulmonary-Fibrosis/Community/Blog/Participation-Program-for-Pulmonary-Fibrosis/November-2013/Some-of-the-nuance-about-cHP


“…about 10,000 baby boomers are turning 65 every day…” – An interview with Dr. Sarika Aggarwal

Posted December 29th, 2014 by

Sarika Aggarwal, M.D. is Executive Vice President and Chief Medical Officer at Fallon Health, and it’s her job to make sure all plan members get appropriate, effective and high-quality care. We caught up with Dr. Aggarwal for an interview, and she talks about how she came to spend the last 26 years practicing medicine in Massachusetts, what the new partnership between Fallon Health and PatientsLikeMe means for members, and a bit about her work—especially her focus on helping seniors stay and get care in their own homes whenever possible.

A bit of background: Dr. Aggarwal graduated from Grant Medical College at Bombay University and then completed her residency at UMass Memorial in Worcester, Massachusetts. Before joining Fallon Health in 2012 as Vice President of NaviCare Clinical Programs, Dr. Aggarwal was Medical Director in the Office of Clinical Integration at UMass Memorial Medical Care and an Assistant Professor of Medicine at UMass Medical School.

Dr. Aggarwal, we know a little bit about your background in India. What made you decide to come to the United States?

My husband had been studying in the U.S. for about six years and went back to India to visit his parents. [That’s when we met, and] … I came to the United States three days after we got married. I finished my fourth year medical school clerkships here before starting my residency program.

What drew you to Fallon Health? How have things been going since you took over the role of Chief Medical Officer?

I was Medical Director of Clinical Integration of an academic health system on the provider side during my last job. I realized with the advent of the accountable care organizations (ACOs) that the providers needed to learn to manage risk and develop health plan capabilities, such as utilization management and population health management capabilities—things that the health plans had mastered for many years.

As Medical Director, I was working closely with Fallon on one of its programs for seniors called NaviCare. When I learned of a position to lead the program, it was the opportunity I was waiting for.

The role of Chief Medical Officer has been challenging but exhilarating. It is a work in progress, building new programs to improve member heath, looking for opportunities to reduce waste in the system, and building a culture of continuous process improvement.

How are you bringing your experience with nursing home alternatives for seniors to your new role?

NaviCare was a good training ground for learning about taking care of seniors with multiple chronic diseases. Since about 10,000 baby boomers are turning 65 every day, and a large number of them have more than one chronic disease, we spend a lot of time working on ways to give this population the best care, in the right place, at the right time. A lot of my work in NaviCare involved transition of care models to keep the patients independent at home, and out of the hospitals and nursing homes. We are now using some of these successful care management best practices with our other populations.

What’s your favorite success story during your time at Fallon?

In 2013 we started a pilot with a government provider-payer program. This program involves helping the providers with care coordination for the members we share together, efficient sharing of data and successful embedding of case managers and navigators in the provider sites. We have grown membership in this program, and our care team now participates in the provider team office meetings. We have had a lot of member success stories in this program, which shows what collaboration between the different healthcare entities can achieve.

We’re very excited to be partnering with you and bringing PatientsLikeMe to Fallon members as a free online resource. How do you think your members will benefit from an online community and health-tracking site like PatientsLikeMe?

I think when patients are diagnosed with a new medical condition, whether it is rare or common, they need more than clinical care from their provider. In this complex medical environment, they need support and knowledge from a reliable source. PatientsLikeMe is a great tool that can provide a family of support beyond your own family – a family of support that “gets it.”

Even as a provider, it is hard for me to completely understand all the ramifications of an illness in a patient’s life, since I myself do not live with this illness. PatientsLikeMe is a group of people, a forum where you can meet people to talk to, who understand you and who are just like you. In addition, you can track your progress and learn more about your condition from a reliable source, all in partnership with your providers. It is a win-win situation for all in the healthcare system.


“In my own words” – PatientsLikeMe member Vickie shares about her experiences with lung cancer

Posted November 20th, 2014 by

Meet Vickie, a PatientsLikeMe member who has survived cancer not once, but twice. She’s sharing her story, from diagnosis to survivorship, during Lung Cancer Awareness Month. She spoke about her reaction to getting diagnosed, the anxiety filled months leading up to surgery and what recovery was like post-operation. Learn about her journey below.

The journey
Occasionally I received cards in the mail offering discount lung or heart screenings. I think most people do now and then. I always throw them in the trash. In May 2012, I received one. For some reason I didn’t throw that one away. I called and scheduled an appointment for the heart and lung scan. Was told I’d get a letter in two weeks letting me know the results.

Imagine my surprise when 4 days later I received a voice mail asking me to call the hospital back as soon as possible. With feelings of dread and fear, I returned the call. Was told they were concerned about 2 places in my left lung. Was cautioned to not jump to any conclusions. They could be any number of things. I needed to have testing done. Was scheduled for MRI and PET Scan. Those results were enough to call for a biopsy.

Had the needle biopsy. My lung collapsed immediately. Very scary. Spent 1 night in the hospital. Sent home with instructions. Two days later began having problems breathing. Drove myself back to hospital and found out lung had collapsed again. This time was hospitalized 4 days.

While I was on a gurney in the ER, a pulmonologist from the hospital cancer center (didn’t know he came from cancer center at the time) came to see me. He asked me if I had been told the results of the biopsy. I told him no. He told me it was positive for cancer. Told me not to worry about it, they were going to take care of me. I remember lying there and I just nodded my head. I thought about it for about a minute then blocked it out.

The hope was to do surgery while I was in the hospital for the second lung collapse. The surgery, a lobectomy and wedge resection, would remove my upper left lobe and a portion of my lower lobe. Unfortunately the original scans showed calcium build up in an area of my heart. It was decided I needed to have the heart issue taken care of before the cancer surgery.

Had a heart stent put in. Had to be on a blood thinner for at least two months to make sure blood clots didn’t form on the stent. I then had to be off the blood thinner for a period of time. I have been seeing my oncologist every three months. Get CT scans every six months. Also see pulmonologist every three months.

The surgery
It was three months between time of diagnosis and my surgery. Seemed much longer. I was very worried the cancer would spread. When the time came for me to stop the blood thinner and no call came from doctor I was on edge. I felt they were forgetting about me. I made a call now and then to the lung cancer nurse navigator to remind them about me. I wasn’t that way all the time but I did have extreme anxiety at times. Earlier my family doctor had offered me something to help with my anxiety. I turned it down. Eventually my anxiety did reach a point where I did tell my PCP I needed some help.

Finally, the day of my surgery arrived. September 24, 2012. My parents had driven in from Colorado. Took me to the hospital. Other family would be joining them. At about 0730, the preparation began. I had no idea what kind of a journey was coming my way. I woke up October 8, 2012.

Nothing had gone as planned. What I know of that time is what I have been told by family and what I have read from my medical records. I was on a vent. I was combative and had to be restrained. I tried to pull vent out several times. I had lost enough blood I became anemic. Three days after the surgery I suffered respiratory failure. I developed an infection.

After waking up, I was very confused. I had and still have memory problems. I had to work on my penmanship. Didn’t have enough hand control to write. That has since returned. Couldn’t speak above a whisper due to a paralyzed right vocal cord from the vent. ENT told me there was a good possibility it would never come back. Ended up spending 6 months in a nursing home undergoing speech, physical and respiratory therapy.

Surviving and sharing
I find PatientsLikeMe to be a source of comfort. It is nice to know I can share my feelings and thoughts with those who have been or are going through similar experiences. It makes me stop and think about how I am doing. It is helpful to look at where I have been and see where I am and think about where I am headed.

Diagnosed June 2012 with lung cancer. Diagnosed April 2013 with uterine cancer. At last week’s checkup with pulmonologist, was shown something on my most recent scan. November 19, 2014 will be having bronchoscopy.

It has not been an easy journey. But when all is said and done, I am still alive.

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“I just kind of went on with life.” – PatientsLikeMe member Fred shares his experiences with MS

Posted November 19th, 2014 by

We’ve interviewed a lot of members on the blog over the years, and each has a different perspective on life with MS. Fred1118 has taken sharing about his life with MS to a whole new level, documenting his life in a personal photoblog and posting the pictures with the world online. Fred shared all about his experiences in a recent interview, everything from his handicap-accessible house to how physical therapy helps him stay mobile. Read his story below.

What went through your mind when you were diagnosed with RRMS back in 1994?

I didn’t really know too much about MS at the time. I’m not sure if I had even heard of it, so didn’t know what to think. The diagnosing neurologist said, “you have a mild case of MS.” I was young and carefree at the time and didn’t really worry about it too much. I kind of just went on with life.

It looks like you’ve done a lot of work on your house to make it handicap accessible. What are some tips and tricks you can share with the community?

I would say that everyone’s needs are different. It’s a good idea to have an occupational therapist that is experienced in doing home safety and accessibility evaluations come work with you in your home to see what your abilities and limitations are so he or she can make proper recommendations. I advise that people not wait until modifications are absolutely necessary before making them. I’ve been guilty of that in many regards, including waiting too long to get a power wheelchair. I should have gotten one sooner. It would have expanded my ability to go places and do things.

We saw some pictures on your photoblog of you in physical therapy – is that a daily routine? How does it help you manage your symptoms?

I was getting in home PT 3 days a week for a few months after suffering a seizure that prevented me from driving for several months. The PT is of course not a cure for MS, but it does provide exercises and strength training options that can help you maintain some abilities. When you’re sitting in a wheelchair all day, I think you can lose some function not just from the MS, but also from being sedentary, so it’s important to exercise.

Can you tell us about your daily meal set-up? 

I have a pretty simple daily meal routine. I often eat the same things day after day. For breakfast I eat some yogurt, a multigrain type bar and a banana. That rarely changes. Lunch is almost always a sandwich (some kind of meat and cheese along with some mayo) and a piece of fruit, maybe an apple, pear or peach. Dinner varies a little. A friend who lives here with me often makes a pretty bountiful garden salad that includes lettuce, spinach, beets, carrots, broccoli, cauliflower and more. Sounds good huh! In addition I’ll eat something else like canned soup, a bowl of cereal, maybe a pre-made Indian dinner that I like. Almost all meals are eaten on my wheelchair tray.

Your photoblog takes viewers through a day in your life – what inspired you to give back to others and raise awareness for MS?

I’ve been a long time volunteer with both the National MS Society and the Myelin Repair Foundation. I had never really done much volunteer work prior to my MS diagnosis. After I stopped working full time I didn’t really do much of anything productive with my time. It was actually a girlfriend who suggested contacting the MS Society to see if they had volunteer work I could do. They did, and I caught the volunteerism bug. I would recommend it to anyone. I often say that doing volunteer work is as beneficial and rewarding to the volunteer as it hopefully is to the people you’re volunteering to help.

Not everyone is as open about their personal experiences living with MS as you. What was it like working with the photographer and putting yourself out there?

I guess I’m kind of an open guy. After meeting Ted (the photographer) I felt comfortable with him and trusted him. I decided pretty much right away that I was going to be all in on this project. I figured if you’re going to do something, do it right. We hoped to have an impact with the photo essay, and only being half in so to speak wouldn’t do the job. I didn’t really do anything other than let someone take pictures of me doing things I normally do. I know Ted was amazed at how open I was. I didn’t really feel like I was doing anything all that amazing.

Photos courtesy of TGoldmanPhotography.com

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“Perseverance, patience and acceptance” – PatientsLikeMe member Steve shares what it’s like to live with MND

Posted November 14th, 2014 by

Those three words describe how PatientsLikeMe member Steve says he has adapted to life with motor neuron disease (MND). He was diagnosed with MND (also known as ALS) in 2007, and technology has helped Steve navigate the challenges of living with ALS while raising three children. He’s also made a video about his journey, called “Motor Neuron Disease Made Easier.” Steve spoke with us about the decisions that come with a MND diagnosis, the inspiration for his film and “how adaptable one can be in the face of adversity.” Read more about Steve’s story below and head to his blog to watch his film.

Looking back over the last 7 years since your diagnosis with ALS/MND, is there anything you’d like to have known sooner that has helped you along your journey?

I think I was fairly pragmatic about researching the condition from the outset, so there haven’t been many surprises apart from the fact that I am still here 7 years later (and I just realized it’s actually 7 years to the hour as I write). One of the difficulties with the disease is the uncertainty of the rate or nature of its progression. There is so much equipment, mostly hideously expensive, that you will need if you want to mitigate the effects of the disease – wheelchairs, hoists, adapted vehicles, communication aids, modifications to your home, the list goes on. But if you don’t know how long, for instance, you will be able to use a standing hoist, you can’t assess whether it’s worth spending the £2000 (about $3,000USD) on one. I know there’s a degree of uncertainty with the prognosis of many illnesses but I can’t think of another which comes close to the complexity of MND.

You’ve documented your experiences in your film “My Motor Neuron Disease Made Easier” – can you share a little about your inspiration for the project?

The thought of having MND without the internet is terrifying. The amount of information available regarding equipment and solutions to our multitude of challenges is staggering. However there aren’t many websites, which bring everything together. And many have information without presenting it in a real world context. So I thought that a video demonstrating most of the equipment I use would be a simple and quick way for fellow sufferers to see what’s available, but more importantly seeing it being used. Furthermore, I have realized that for many issues there simply isn’t an off the shelf solution. And in my experience many of the healthcare professionals just aren’t very creative, so I wanted to share my ideas like the chin support, heel pressure reliever and hoisting techniques to others. Having made the video, the filmmaker, Bernard, wanted to expand the idea to how MND impacts on a family. Then finally I wanted a sixty seconds version, which could be potentially used as a hard-hitting awareness campaign. The 3000-word narrative took several days to type using eye movements, but I am proud of the results.

How has technology helped you cope with the impact of ALS/MND? Is there anything you can recommend for PALS who might not be as comfortable with technology?

Technology has undoubtedly made coping with the disease far easier. Having had over 20 years experience in IT, I appreciate that I am better equipped than most to adapt to new technology. But you really don’t need any technical ability to use an eyegaze system for communication purposes, which is the most important benefit it offers. Actually, initially I only used it for this purpose. It was only after I got more confident with eye control that I ventured out of the easy environment of The Grid 2 software and started using Windows directly. I am now able to do anything anyone else could do with a computer. It also allows me to participate with family life as I am able to control all the computers and network devices in the house, which means I can sort all the problems out. I am even in the process of buying a house using my eyes.

I arranged all the viewings, negotiated the price, organized quotes for adaptations, dealt with solicitors, scanned necessary documents, bought hoists and other equipment on Ebay, arranged dropped kerbs for wheelchair access with the council and will hopefully move before Christmas. The only thing my wife had to do was choose the sofa! So almost anything is still possible.

Your blog is testament to your incredibly busy family life! Being a father of three boys, what impact has ALS/MND had on your approach to parenting and family life?

I have to say that the impact of MND on my abilities as a father has been the hardest thing about this disease. My triplet sons were 6 years old when I was diagnosed and I was confined to a wheelchair by the time they were 8, and when they were 9 I could no longer talk to them. They are now nearly 14 and I am grateful that I am still here but we have missed out on so much, both physically and through communication.

The most obvious impact are the physical restrictions. Almost every activity that a parent enjoys with their kids has been denied to me, from kicking a ball around in a park to giving them a hug. But maybe a more important loss is that of communication.

Eyegaze is undeniably an incredible means of communication but it’s certainly not conducive to flowing conversations. Ten-year-old boys aren’t very interested in waiting around while you laboriously construct a sentence, especially if they think it’s finally going to read “no xbox for a week”! Trying to teach something using eyegaze or trying to discipline using eyegaze is at best frustrating and ineffective respectively. That’s not to say I don’t try but these are two of the most important roles of a parent, which for me have been severely compromised. However I am still able to contribute in other ways. Being able to control all the computers in the house means I can help out with IT related stuff. I have setup Minecraft servers for them and helped install mods, I have installed and monitored parental control software and setup backup facilities and  I have fixed virus problems.

When I could still drive my wheelchair independently and didn’t require a full time carer, we were still able to go out to places as a family regularly. But as the logistics of getting out got more complex, the family activities decreased, although this is equally contributable to the troglodyte tendencies of teenage boys.

What has been the most unexpected thing you have learned during your journey with ALS/MND? 

I guess it would be how adaptable one can be in the face of adversity. In one of my videos I mention remembering when I learnt about Stephen Hawking and thinking how can anyone live like that. It seemed so horrific. But I am living like that, and whilst I disagree with some PALS who say there are positive aspects to our situation, you do adapt to it if you develop these three key attributes – perseverance, patience and most importantly, ACCEPTANCE. I won’t say these are responsible for my longevity (that’s just down to good fortune), but they have made the last seven years bearable.

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“Hope won’t make it happen” – PatientsLikeMe member Phil shares about her experiences with lung cancer

Posted October 22nd, 2014 by

That’s Phil’s (PhillyH) personal motto in life – “hope won’t make it happen.” She’s a PatientsLikeMe member who hails from Northampton in the United Kingdom and was diagnosed with lung cancer in 2012. Ever since then, she’s been learning to live with the ups and downs of her condition. She recently shared her experiences in an interview with us, everything from the reaction she had after her blunt diagnosis to her treatment decisions and son’s new tattoo. Phil also shared her thoughts on what every person who has just been diagnosed with lung cancer should know. As she says, “If you don’t know, you can’t do” – read below to learn about her lung cancer journey.

When you were diagnosed with lung cancer in 2012, what was going
through your mind?

My first reaction was defense. Somehow I had to deflect the enormity of what I had been told. I was so disappointed, I had been prepared for pneumonia. After all I felt well, wasn’t sick, wasn’t losing weight, still doing everything I had always done. I was so very angry about the way the doctor gave me the news. Before I had even sat down she bluntly announced “well it’s not good news.” I’m not really sure I heard much after that (if she had said the biopsy shows… then I know that’s fact, not her opinion).

It was so brutal. I asked what my life expectancy was and whether chemotherapy would help me. The response was “it might give you a few extra months.” All I wanted to do was run, hide, escape. The reality was that I had to be strong for both myself and my husband who pretty much fell apart at the news.

We had a brief meeting with a Macmillan nurse who was very sympathetic but not very helpful. There was no treatment plan, I could not have new lungs, I could not have resection, all that I could have was palliative care. Telling our immediate family and friends was hard. It was very emotional in the beginning. The care and kindness shown by friends was overwhelming and amazing. And still is.

My experience confirms to me that you should always have someone with you even if they can’t help much. It deflects some of the isolation, the why me feelings.

That diagnosis was given on 31st July 2012. I was in a very dark place after this as I had no control. I was powerless. It felt like my husband had seen me die there and then. Then I heard nothing from anyone. I was expecting to get some news of what happens next. And waited, and waited and waited. That was scary. I contacted my GP who chased the hospital and eventually on 19th August I had a treatment plan. I also was better informed about the cancer and told it was very slow growing. But incurable. The treatment would hopefully provide some control over the disease and keep it at bay.

Targeted therapy, 1 x 250 g IRESSA tablet (Gefitnib) daily. And blood tests and oncology appointments every four weeks. CT chest and liver scans every 3 months. I felt that was good result.

How has your daily life changed since your diagnosis?

From August 2012 through to July 2014 it really didn’t change that much. I still maintained my full time job as a professional development trainer. I went on holiday, I did gardening, I did write a bucket list and have fulfilled much of it, even going to Chicago. The one thing I didn’t do was a hot air balloon ride. Fear held me back, I wasn’t sure I would be able to breathe properly.

I have lost stamina, and strength in the last two years. I can’t do heavy stuff like digging, and putting up cupboards. I can paint walls and order people about to get things done (in a nice way of course).

I retired in May 2014 for a number of reasons. Firstly my relationship with my boss was not productive and was increasingly frustrating. I was finding full time harder and harder. I could work from home but I don’t possess the discipline to do this long term. Financially, it meant I lost a portion of my pension but I would rather have peace and calm in my life. I can’t be doing with office politics. Never mind the fact that I worked in public service and it is a very challenging and yet fragile environment to work.

The pivotal change came in July when my oncologist told me stop taking the IRESSA tablets. My cancer had become resistant to it. The scan showed an 8mm increase in size over a three month period. I was bereft, alarmed, panicked. It was like my protective cloak had been taken from me. I still have a supply but have stopped taking them as instructed. The latest scan showed a similar increase over three months. So it seems to be growing a 3mm a month. My oncologist still recommends observation so I return again in December.

Most of the time I feel good. I do get tired and some days are better than others. Sweating/flushing especially around waking time and morning nausea don’t last too long. A piece of dry toast usually stabilizes me.

Had a flu jab Tuesday and have felt rough all week. This is compounded by Sciatica, which sneaked up on me about 12 days ago. It’s beginning to ease now. Just have stonking headache now. Probably due to a busy few days. It went something like this. Monday 29th September right leg is painful, when sitting or getting up from a sitting position. Tuesday 30th speak with a friend who suggests sciatica. It’s okay once I’m mobile so put it to the back of my mind. Thursday 2nd Oct drove 180 miles to South Wales to see my son and his family. Sunday weather warnings make me cut short my visit and I leave around 4pm that day. Leg has been hurting more, so take painkillers. Monday see GP who announces immediately that I [have] sciatica. He knows this from the way I stagger into his room. Feel such an idiot when I get up in waiting room full of people and can’t get my limbs in action. Any way he prescribes painkillers but regularly not just when the pain kicks in. Tuesday blood test in readiness for oncology appt. Nurse offers flu jab so I take it. Tell her I have a bit of a sore throat and that’s okay. If you get flu it’s because it’s already there. Wednesday arm is sore as is throat but otherwise okay. Thursday oncology scan shows slight progression again, she’s not unduly worried. She arranges for pelvis and spine xrays because of the sciatica. Thursday have the xrays and they do not show anything. If I’m still in pain on Tuesday/Wednesday next week contact them. They will arrange CT/MRI scans. So alert to my situation. Discussed concerns re chemotherapy as aware it can poison my system. Shared thoughts on alternative meds such as Phoenix Tears. She cannot comment but does say not to mix supplements.

Friday had my nails done, they are beautiful, my new ring looks even better. Not expensive and life’s little pleasures are important to me.

Reading books on fighting cancer and will adjust diet to build immune system and fight cells. Would love to use my mini trampoline but husband would have a fit. He is a born pessimist, and well you must know that I am the opposite.

The other day my son Carter texted me asking what are you favorite flowers in the whole wide world. I tell him carnations, yellow and white. Thinking that a big bouquet is coming my way, big smile on my face. He then sends a txt pic of his upper arm with a carnation tattooed on it! I still smiled. That’s who he is. He wanted a permanent reminder and told me the flower won’t die. Through tears I still smile.

Sometimes I think I’m in denial, but I know that I’m not. I get up every day thankful I’m still here, still loved, still wanting to live till I’m a hundred.

You recently joined PatientsLikeMe – what have you found useful so far? And what do you hope to learn from your fellow community members?

It has been really helpful to read how other people are doing, what meds they are [on] and compare their treatment regimes to mine. This informs me so that I can ask better questions of my oncologist and Macmillan team. I learn something every time I go onto the site, how people feel, how they are coping or not, what their lives are like. It’s very comforting to be able to dip in and out without any expectations on either side.

Can you share how you’ve gone about making treatment decisions?

My biggest decision so far is not to undertake intravenous chemotherapy. The option offered requires weekly vitamin b12 injections, folic acid 5 days before chemo (a combination of cisplatin and premextred) with anti sickness tablets for the following 2 days, and I know chemo will kill good as well as cancer cells. It won’t ‘cure’ me. It won’t get rid of the cancer. So each time I see my oncologist I discuss my health and make my decision. It doesn’t hurt although I feel a pressure sensation in the left lung on my back. (Imagination?)

If you could share one thing with someone who’s been recently diagnosed
with lung cancer, what would it be?

Take time to absorb the information. If there are words, expressions that you don’t understand ask for clarity. Get in terms that you do understand. Join a site like this. Do be wary of internet information and check out the site’s reputation, reliability and responsiveness to you and your questions.

If it is at all possible ask if the diagnosis meeting can be recorded. That way when you feel more adjusted you can listen in the privacy of home. You’ll pick things up that you missed first time round. It will help you prepare a list of questions to take to your next appointment.

If you don’t know you can’t do.

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“I was just doing my job” – PatientsLikeMe member Lucas talks about his experiences with PTSD after serving in the Marines

Posted October 21st, 2014 by

PatientsLikeMe member Lucas (Freedom666420), or Sarge, as his friends and fellow soldiers call him, served in the Marines during two tours in Iraq and was injured while literally hoisting his entire squad up and over a wall to take cover from enemy fire. He recently spoke with Sarah, a PatientsLikeMe community moderator, and shared about his experiences in an interview. Lucas talked about his recurring insomnia and nightmares, and how quitting alcohol and speaking with fellow veterans has helped him cope with his PTSD. Read what he had to say below.

Will you tell us a little about your story?
I enlisted in the military right before I turned 18, graduated basic training about a week after I turned 18. I was in the Marine Corps for about three years total after all the paper work was done. I was discharged medically- honorable retirement discharge because I was injured.

I was on my second tour, about half way through when we were taking air fire and I was trying to get everybody over the wall and I looked back, after I got the last person over, I looked back to make sure everything was clear and that’s when I saw an RPG coming at us and I pushed the last guy over the way and I was blown up. I was hit by shrapnel and the explosion blew me about 61 feet past the wall and when I landed I shattered my right heel and I had shrapnel across my face and shrapnel in my right hip. I walked back to base.

You want to make sure, whenever you’re a squad leader, you want to make sure everyone is safe before you are.

How many people did you get over the wall that day?
I got 22 people over the wall that day.

Wow, you’re such a hero.
I don’t say I’m a hero, I was just doing my job.  I like to be recognized for some things but I served in the military, I was just doing my job.

What are your experiences living with PTSD?
I have nightmares. Basically I have insomnia because I don’t sleep. Every time I do sleep, all I think about are my brothers that didn’t get to go home to their families. And the men that I served with all the way through basic SOI (School of Infantry) training and all my other training, there were several that I went with and I actually went to their families and gave them all the information they needed to know. I wanted them to know personally what happened and how everything went. Because most families never get closure from the military, they just get a statement saying your son (or daughter) has been KIA (killed in action) and they never give a reason of how they went. I wanted everyone’s family in my platoon to know how they went. I know my family would want closure if I were killed.

Are you currently treating your PTSD?
It’s something that I don’t know that I’m ever going to get past. There are things that are drilled into my mind right now that I don’t know that I’m ever going to get past.

That’s why the VA wanted to send me to a counselor and I told them I’m not going to go talk to someone who’s never been there before. There are people that I’ll talk to about some stuff, and there are people I won’t talk to.

It’s one of those things where you have to be very comfortable with the person you’re talking to. I had a horrible experience when I was younger with a counselor, so I don’t like counselors. I’ve been through ten of them.

I think I’m just better off going to the VFW (Veterans of Foreign Wars) because there’s one right in my town. I quit drinking so I go and drink a non-alcoholic beer or soda and I talk to them. I quit drinking a couple years after the military because for the first two and a half years there wasn’t a day I went sober. I drank constantly. There were days when people worried about me because I was always drinking. But I was able to sleep. I needed to be able to sleep, so I slept. I’ve been sober for going on 4 ½ years now, but I just wish I could close my eyes and not see faces.

What helps you cope?
Mostly I talk to another Vietnam vet. It just seems like talking about it makes it a lot better. It’s very helpful when you talk to somebody about it. I feel like you have to talk to somebody else that’s been through something similar. If you find an older man who maybe fought in Vietnam, they give you great input on everything.

It’s better to connect with somebody who you can open up to because you’re able to speak about it and try to get some relief for yourself because if you keep it all bottled up inside, it just gets worse from there. You know before I started talking to the Vietnam veteran who I’m talking to, there were plenty of times that I thought about killing myself. But after talking to him for the past two years now, I’ve honestly begun to feel like I don’t want to anymore. I’ve started a family and things are going better for me, I just still have nightmares and flashbacks, but things get better when you actually talk to somebody that has been through something similar.

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Every three minutes

Posted September 29th, 2014 by

That’s how often a person is diagnosed with blood cancer in the United States, according to the Leukemia and Lymphoma Society (LLS). This means that 156,420 Americans will be diagnosed in 2014, and hundreds of thousands more worldwide.

But that’s just the start of what everyone can learn during National Blood Cancer Awareness Month. Check out the Lymphoma Research Foundation’s (LRF) video below:

Did you know there are actually three main types of blood cancer? Each affects a different kind of cell in your body and can vary greatly:1

Leukemia is found in your actual blood and bone marrow, and it causes abnormal white blood cells to form and disrupt the normal immune system.

Lymphoma affects your lymph nodes and lymphatic organs, which are the parts of the immune system that remove excess fluid from the body and produce special white blood cells.

Myeloma is the cancer that is limited to plasma cells, which are cells in your blood that help produce antibodies and fight disease.

There are many subtypes of these three categories, including conditions like chronic lymphocytic leukemia, non-Hodgkin’s lymphoma and multiple myeloma, to name a few common ones. This month, get involved by participating in a Lymphomaton (a fundraising and awareness walk), finding a LRF chapter or even posting awareness flyers and posters on Facebook and other social media outlets.

 

Don’t forget to check out Bob’s blog interview – he’s a PatientsLikeMe member who shared about his life after being diagnosed with multiple myeloma and how he’s learned to manage his condition.

 

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1 http://www.hematology.org/Patients/Cancers/


“Bang for the buck.” PatientsLikeMe member Steve shares about his experiences with ALS and the IceBucketChallenge

Posted September 19th, 2014 by

Ice + water + video camera = a viral ALS awareness campaign that has spread over social media and the news like wildfire. Millions of dollars has been raised for ALS research while more and more, people are learning about this neurological condition. Recently, PatientsLikeMe member Steve (who has been living with ALS since 2009) took on the challenge, and we caught up with him to find out why. Steve shared about his own diagnosis experience, what he thinks about the ALS community on PatientsLikeMe and what he hopes to see come out of the IceBucketChallenge. Don’t forget to follow Steve on his own blog, too. He calls it Bachblog. 

Can you tell us a little about yourself and your diagnosis with ALS?

I first noticed an odd cramping in my left hand sometime during the summer of 2009 when I was 49 years old. That fall, I realized I no longer had the strength to use fingernail clippers with my left hand. At the time, I was playing pickup basketball two or three days a week. I began to notice that after one hour of basketball I was “wiped out” and that I was having difficulty taking longer shots.

In January 2010 I saw a doctor for a sports hernia related to basketball. At my wife’s insistence, I brought up the cramping in my hand. He took one look at me (I was shirtless) and noted that I had fairly significant atrophy of the left arm. He referred me for an EMG, which I had a few days later.

Within a couple of months I got my neurologist to reluctantly admit that she believed I probably had ALS. She referred me to the University of Minnesota ALS clinic and, about a year later in February of 2011, I was given a definitive diagnosis.

Because I am a U.S. Navy veteran and the VA treats ALS as a “presumed service-related condition,” I am very well taken care of by the government. I am very fortunate in this respect and I wish all PALs had a similar level of support.

I retired in August 2011 as a computer programmer/analyst and UNIX systems administrator. My wife and I (with, at times, other members of my family including two daughters) have traveled quite a bit since my diagnosis: Hawaii, Belize, the Dominican Republic, Costa Rica and a Baltic cruise. I feel fortunate to have enjoyed years of relatively good health. However, I have declined to the point where any significant future travel would be very difficult.

Closer to home, I continue to enjoy family, reading, writing, online and (occasionally, with help) club and tournament Scrabble, trivia competitions, birding, and the Minnesota Timberwolves and Lynx. In the past two years I have created crossword puzzles that I have shared on my blog. I have been very happy to walk both of my daughters “down the aisle” in the past year and to welcome two great guys to our family.

You called the IceBucketChallenge a “seemingly ridiculous internet meme” in your video. Why did you decide to take on the challenge?

At first I thought that it was a curious way to spread ALS awareness and not much more. Many of the videos I had seen barely mentioned ALS and few included appeals for donations. But that soon changed, and I began to read of the astounding amount of money being raised.

My team had raised around $7000 in two previous ALSA walks, but I was not planning to participate this year for a variety of reasons. I decided that I would use the ALSIceBucketChallenge to make a contribution this year.

There are a bunch of ALS organizations people can donate to. Why did you choose to call out ALS TDI in your video?

I believe that the ALSA, while not perfect, does a lot of good work on behalf of our community. But I know that only about 27 percent of money donated to the organization is dedicated to research. There are justifiable reasons for this figure, but in the spirit of this challenge I wanted to raise money specifically for research. I have been very impressed by the work and commitment of ALS TDI. I believe they offer a lot of “bang for the buck” and that their commitment to openly sharing what they learn is absolutely essential to the overall effort of finding a cure for ALS.

You’ve been part of the PatientsLikeMe community for more than 3 years! How has connecting and sharing with others living with ALS helped you?

I cannot begin to enumerate all that I have learned from the site. The experiences of PALs who have lived with this disease for longer than I have – and, sadly, those who have died – provide such a wealth of experience and advice. Every patient has a different experience with this disease, but there is nothing I have gone through or will go through that someone else has not faced. PatientsLikeMe has been and will continue to be a valuable resource as I struggle to meet each new challenge.

It looks like you update your Functional Rating Scale on PatientsLikeMe a lot. Why do you donate your health data? What does donating your health data mean to you and to research?

I try to update my FRS every time I have an appointment and am evaluated on the scale by healthcare professionals. If I had to do this over, I might have chosen to do it consistently every month.

During my participation in the dexpramipexole drug trial, my FRS scores should have been particularly helpful for researchers and PALS interested in the drug. I continue to contribute my numbers as I do not know how and when an aggregate comparison of participants’ scores may be useful.

We’re all working to find a cure for ALS, but what research advancements do you hope to see in the short term?

I believe, as do such brilliant PALs and advocates as Steve Saling, Steve Gleason and Eric Valor, that until a cure or effective treatments for the disease are found, technology IS the cure. I hope to see continuing refinements of the high-tech solutions to many of the challenges presented by this disease.

Support for research into assistive technologies and for sophisticated but expensive ALS residences is important.

As more and more people learn about ALS through the IceBucketChallenge, what’s something you think they might not understand about the condition that you’d like to share?

I know that PALs who have lost the ability to communicate or who communicate with much difficulty are often assumed to be somehow compromised mentally. They are talked down to or assumed to be deaf as well as mute. In most cases, nothing could be further from the truth. I have not experienced much of this yet, but the assumption or even the appearance of the assumption that we are unable to think, feel, make decisions and speak (even if technologically assisted) for ourselves is profoundly discouraging.

Were you part of the PALS/CALS group that sent the letter urging the ALSA to donate their funds to ALS TDI? If so, can you explain a little about the letter and why the group felt it was so important to send to ASLA?

I did not contribute to the creation of this letter but I did sign it. I think it is important for the ALSA to honor the wishes of the vast majority of contributors to this campaign and spend this money on research.

Having said that, I do not believe that it is necessarily a good idea to spend it all immediately. This windfall will not happen again. It is important that any research efforts funded by this money are sustainable. A research effort that spends a large amount of funds upfront without a realistic prospect of continuing support is a dead end. I would like to see the ALSA commit to long-term support for a few of the best and brightest independent research efforts. To researchers who are open and committed to sharing their efforts. Big pharma need not apply. To give these independent researchers assurance that their support will not dry up next year or the year after that is critically important. Therefore, not all of this money need be spent this year. It does need to be committed to research and invested wisely. This will be a challenge, but it is very important. More than ever before, ALSA needs to be transparent and responsive to its constituents in this matter.


“Speak up!” PatientsLikeMe member Dee speaks about her journey with ALS

Posted September 15th, 2014 by

 

There’s been a lot of awareness going on for ALS with the IceBucketChallenge, and to help keep the momentum going, PatientsLikeMe member Dee (redrockmama) shared her personal experiences with the neurological condition. She made the decision to install a feeding tube early in her journey, and now she is managing her weight through overnight supplements. Read on to learn more about her ALS story and why she thinks every person living with ALS should become their own best advocate.

 

Tell us a little about yourself and how you are doing, Dee.

I am 62, married and a mother and grandmother. I have bulbar onset of ALS. I have always been very active and independent to a fault. I was raised horseback riding and still have a horse. I am told my disease is progressing slowly but of course to me it doesn’t feel that way.

Many people in the community talk about how finding an official diagnosis isn’t easy – what was your experience like? 

I actually found out fairly quickly. My symptoms started in April 2013. First doctor thought it was a stroke, second told me it was stress and of course they did MRI’s and blood tests, basic neurological exam and a stress test. Third doctor did an EMG. That was June 2013. Finally hearing someone say it out loud was initially a relief. That feeling didn’t last long.

In the ALS forum, you wrote about your decision to get a feeding tube in February. How has the operation changed your everyday life?

My first doctor told me I had to lose 15 % of my weight for him to order a feeding tube put in. Now understand, my first symptom was slurred speech and within days, difficultly swallowing. We had several issues with this doctor and clinic so we changed doctors. This was January 2014. He asked me several key questions, like; how difficult eating was, did I enjoy my meals or were they a chore, how did food taste, how often did I choke? He said his experience was that doing the feeding tube surgery earlier had better results. The stronger I was the better. We did it within two weeks of that appointment (February 10th). As of the end of May, I am no longer able to eat solid food at all. I have lost about 10 pounds but am currently maintaining well by having my supplement given to me overnight through a Kangaroo pump.

How has being a registered nurse shaped your perspective?

I’m not really sure except that I felt confident I knew what I had before any doctor was willing to diagnose it, and knowing what was ahead of me was frightening. It has made me good at being my own advocate. By being my own advocate, I mean when how I feel doesn’t coincide with what “the professional” is telling me, I speak up and or look for someone who will listen. We all know our bodies better than anyone else and every case of ALS is unique in some way. We have different symptoms, different rates of progression and some have pain, some don’t. Make sure you’re not being categorized. If what they say just isn’t what your gut tells you; speak up! Advocate for what you think is best for you and the way you want to deal with your disease. If you don’t speak on your own behalf who will?

What is one thing you have learned on your journey that you didn’t expect?

I have come to realize that our lives revolve around meals. We are all social beings, and we come together over food and drink. Not being able to do that is really a challenge and even makes the ones around you uncomfortable. Food is comforting and even though I have never been a big eater and I’m not ever hungry, I really miss the tastes and experience.

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Nola’s new bathroom

Posted September 11th, 2014 by

It’s rare that we’re surprised by the power of connection in the PatientsLikeMe community—we see members connect everyday and transform their lives through the exchange of information. This story extends beyond shared knowledge, though; it displays the powerful bonds of internet friends who offered truly life-changing support from opposite coasts. Below, listen to them tell their amazing story to our community moderators Sarah and Jeanette. Click to learn how Gary helped Nola regain her independence, her ability to clean herself, and most importantly, her dignity.

Nola (6.02x10e23) lives with progressive MS in California. In the past ten years, she’s gone from walking to slightly limping, to using a cane and then a walker. Now, she’s in a wheelchair and cannot use her right arm.

“I had to keep adjusting slowly how I did any little thing. How could I write a check? How could I make something to eat? Or get something to drink? Or just get to the bathroom and back? It’s constant change and you have to accept the change and learn how to adapt and try to still be able to get things done that you want done. You’re going to have do it in some very different ways that might be uncomfortable or absolutely undignified. But you have to do what you have to do.”

As her MS progressed, Nola discovered that the 6-inch lip at the bottom of her shower was an impossible barrier. She could get one leg up over it, but she could no longer pull the other leg in, which prevented her from being able to get into the shower to fully bathe herself.

She hired a contractor to build her a handicap-accessible bathroom, and paid half of the money up front:

“He started the project, but he got ill. He lost his regular job and eventually lost his home. I had paid him ahead of time half of the amount, but then when all of these terrible things happened to him, I went ahead and paid him for the rest of the job, even though he had hardly started. He really needed the money. He’d come every once in a while and do a little work. As he got more ill, it just became impossible for him.

It ended up that I still didn’t have a bathroom and I had lost quite a bit of money. I did not have the money to hire somebody else to do this. I wanted to be able to stay in my home, but it was getting to the point where I couldn’t even take care of personal hygiene.”

Nola went 6 years without a shower, until:

“Members of PatientsLikeMe that are in this one particular group with me, we’ve all become close friends over about maybe the past 5 or 6 years. We’ve always relied on each other for moral support. It was my place to complain a little bit. Everyone knew the story and they’d all been rooting for me and hoping that I could get this bathroom done. It had been over a period of 2 years of waiting and waiting.

Gary, here, who works at a Home Deport, 3,000 miles away, on the other side of the country, got this idea. Home Depot sometimes does these charity projects. He suggested that I find out if they might help me.

Gary (1955chevy) did indeed help Nola from his home in North Carolina. Check out the photos on Pinterest below!

We told Nola we’d share some tips and tricks she learned from her PatientsLikeMe community for others to learn from. With a number of different products and limited resources, it’s hard to know what to invest in. Visit this thread to see some of the suggestions Nola has for you and to add your own.

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“Treat the person, not the disease.” An interview with nurse practitioner Phyllis Zimmer

Posted September 8th, 2014 by

Family Nurse Practitioner Phyllis Zimmer has a Master’s degree in Nursing and is a Fellow at both the American Academy of Nursing and the American Association of Nurse Practitioners. It sounds like Phyllis always knew she wanted to be a nurse, but truth be told, Phyllis wasn’t sure what her career path would be until she decided where to apply to college. Then it all came together.

Read on as she describes her passion for nursing, her own experiences as a patient, and some of the important questions patients should ask their doctors and nurses.

You seem passionate about nursing. Why did you become a nurse in the first place?

The short answer? I don’t know. Maybe it has something to do with my years as a Girl Scout, and always wanting to make a difference in my life.

When I was in high school, trying to decide on a college, I told my parents that I wanted to be a nurse, but I had no idea where that came from. Years later, I found out that my paternal grandmother, great aunt and her sister were all nurses. My family has a wonderful photo of the three nurses wearing long, floor-length pinafores, watches around their necks, and winged nursing caps.

Then when I was an undergrad, I saw nurses in action and thought, “I want to do that!” So I became a nurse, then a nurse practitioner and have practiced as a nurse practitioner ever since.

Tell us about what it means to be a nurse practitioner.

As a nurse practitioner, you have a huge responsibility to provide quality care, but also an amazing entrée to patients’ personal lives. People trust you. They’ll tell you things about themselves that you’d never dream you would learn about another person.

I feel so honored when people are comfortable enough to share both the joys of their lives – the births, the experience of being a new parent, as well as the difficult parts of their lives – something they’re afraid of, a new symptom or disease they are coping with, a sexual problem. People talk about intimate personal issues: domestic violence, concerns about alcohol use or fears about death or dying. They trust me to listen and to help.

The nurse practitioner role blends what I love best about nursing – the advocacy for people, patient teaching, and patient-centeredness of my profession – and what I love about medicine: making the diagnosis (solving the puzzle of what the symptom or problem is), the clinical decision-making, providing treatment that is medicine.

I also like the level of autonomy nurse practitioners enjoy. I’m accountable and responsible for my own practice.

Do nurse practitioners specialize?

Yes. Nurse practitioner programs are offered in specific specialty areas – family medicine, pediatrics, adult/geriatrics, acute care, psych/mental health, and so on. The broadest scope of practice is the Family Nurse Practitioner, who sees patients for health and illness concerns across the age span. The Pediatric Nurse Practitioner, in contrast, sees only children.

Your specialty determines the scope of your practice. Nurses choose their nurse practitioner specialty based on where they are most comfortable and have the most interest. The data says that nurse practitioners do a great job, and offer high quality care regardless of specialty.

I began as an adult nurse practitioner, and when the masters program became available I went back for my master’s degree and chose family medicine because I enjoyed seeing both adults and children, and wanted the broadest scope of practice possible.

Can you tell us about an experience that really affected you?

Definitely. One of the most impactful experiences I’ve had was as a brand new grad. I’d only been practicing for a short time, and I was given a referral to see a woman who had been diagnosed with lung cancer.

After she was sent home from the hospital, I was assigned to do her discharge and follow-up care. The family decided that she was not to be told she was terminally ill. She’d been doing well, and she was able to care for herself and get around for a while. I visited about once a month to check on her.

As she got sicker, I did home visits more often. From monthly visits, I moved to every three weeks, then every two weeks, every week, then every day, and finally several times a day. We became close. The family wanted to provide her care themselves, so we moved a hospital bed into her home, she went on oxygen, and I worked with the family to support them in caring for her.

It was a slow, gradual, downhill course. I still remember the day when she and I were in her bedroom, talking. She asked me why her family wouldn’t talk to her.

I asked what she meant, and she said, “I know I’m dying.”

As a nurse, I was treading on delicate ground. I had specific instructions from the family—I couldn’t confirm or deny anything. So I tried to listen, and tried to be a coach for her and help her feel comfortable raising the question to her family directly.

It was hard for her to talk with her family. There were a lot of tears. But then, it got so much easier. Feelings of fear, sadness, anxiety, all were shared. They had opened the door to communication, and each family member had an opportunity to share their thoughts with my patient. These were important final conversations. I realized then that this is how end-of-life care should be.

I understand you had surgery. Why? What happened?

I found a mass. It turned out to be benign, but it was big and needed to come out.

Actually, I found it in the middle of the night, and I was shocked. My husband’s a doctor, but I waited until morning to tell him and then went in for tests to find out what it was.

I was just like some of my patients – I didn’t want to deal with it!

School was restarting. I had a million things to do, with teaching and practicing. I thought maybe I could manage the problem medically for a while. That lasted a few months, and then I had a period of time where I had more pain than I’ve ever had in my life. So, two days after school got out, I had surgery.

I was scared to death.

I imagined not waking up from anesthesia. So I talked with the surgeon and the anesthesiologist and asked if there was any way to avoid being intubated and having general anesthesia. They said they might agree to do just an epidural instead of general anesthesia.

For me, that was the lesser of two evils. The choice was being intubed and having a longer recovery versus having an epidural (an injection into the spinal area), with a shorter recovery but being awake during surgery. I got the anesthesiologist and the surgeon to agree to the epidural. The biggest advantage of the epidural was that I had an incredibly speedy recovery, and I felt more in control. I also conned my hubby to be in surgery with me – and we talked during the procedure, which I found very comforting.

But there were definitely moments when I felt I had no control- and I was afraid. And the entire procedure of having surgery is tough. You feel a loss of privacy, you feel embarrassed. The gown is open at the back, and so you feel exposed, even though everyone tries hard to keep your modesty intact. You may need an IV or a catheter, or some other procedure to “prep” for the surgery, and you have to deal with it. In my case, everyone tried hard to be respectful and explain things, which taught me how much we, as patients, need that kind of support.

The only really negative part was that they asked me in admitting if I wanted to be an organ donor. I don’t think you should ask someone that on the day they’re having surgery!

Do you think your nursing background helped prepare you to be a patient?

All of my nursing experience is in outpatient care, and the hospital environment is very different. But, yes – it made the difference in helping all the parts come together. I knew a lot of what to expect from admission, to the surgery, and after. When you’re the patient and you have monitors beeping and IVs in your arm and you feel very vulnerable. But being in nursing helps you feel a little more in control. For example, I knew my discharge plan. I felt ok and not weak and dizzy, and I could do some things on my own. I knew what I couldn’t do when I got home. I had clear written instructions and knew who to call if I had a problem. I went home in 24 hours instead of in several days. My nurses made sure I could go to the bathroom, could walk and not fall over, and was able to eat and drink.

What were your nurses like?

I had three different nurses caring for me, and each had a distinct style. One was an older, really experienced nurse with a very “cut and dried” approach, and she was great. She got things done. One was younger, newer to the profession, sweet, very kind and caring. The third was a wonderful Irish nurse with a darling brogue. She was a blend of the other two, and she had a great sense of humor. Each of my nurses brought something different to my care. They all were competent and inspired trust.

And, my Mom came and sat in the room with me and read a book or knitted or whatever. She wasn’t talking with me much, but as a patient, it was hugely reassuring to have my Mom there. It made me think: As a nurse, do I welcome a family member, help them know what they can and can’t do?

How did your own experience change your practice, if at all?

My nursing career began as a public health nurse, and that background makes you think about care in the broadest sense- public health nurses look at community and family variables as well as the issues for the individual patient. I’ve always had that “holistic” mindset. But being the patient yourself, experiencing the fears, the questions, the difficulties of doing what you are supposed to do when you don’t feel well, makes you practice differently. I think it makes you more understanding, more empathic.

When I think about all the things I’ve learned as a nurse, and my experience as a patient, the most important lesson for me is to treat the person, not the disease. And remember that each person has people in their lives, family, friends, partners, etc., who are concerned about them. The patient needs care, but so do those who love that patient. They need attention as much as the patient does. My experience made me even more aware of how valuable nursing can be – the truly important role that nurses play in patients’ lives each and every day.

What advice would you give patients, from a nurse’s point of view?

I’d tell them, “Ask questions and make sure you understand all your options.”

If you’re given only one option, it’s not enough. Ask what the full range of possibilities are, and what are the pros and cons of each approach.

Personally, I’d ask: What is your best advice for me as a person, and why do you say that?  In other words, the best for me, not someone else. If I were your sister or mother or wife or friend, what would you advise?

The more you know, the better. Don’t be afraid to ask questions. If they use a word or name a med you don’t recognize, you absolutely have a right to know. It’s your body, your life, and these are your decisions, not our decisions.

My job is to support your choice. I don’t always have to agree with my patients, but I think I do owe them information about why I don’t agree. As a patient, you trust your health and well being to our care. It’s my goal to always be worthy of that trust.

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