Annual Report 2016

Fifteen years is a long time to have MS, especially one day at a time.

Welcome to my annual post where I take a moment to consider what I’ve gained and lost in the past year, and what changes may await me in the coming one. As you know, I try to strike a balance. I don’t sugarcoat my condition, but neither do I focus only on the negative. And I reserve the right to inject humor no matter how serious the topic.

So, how did 2016 treat me? Could’ve been better. Could’ve been worse.

2016 Negatives:

  • Again this year, the negatives column is all about increased difficulty getting food and drink into my mouth, due to arm and hand weakness. If a year ago I needed assistance with 10% of my bites and sips, now it’s 50%.
  • After a sixteen-month personal trial with no benefits observed, I gave up on an experimental MS treatment—Biotin
  • Having some difficulty operating computer mouse and wheelchair controls.

2016 Positives:

  • Physical therapy continued to help me maintain the strength and flexibility in my arms and shoulders.
  • I made great progress on my book throughout the year. One of these days I’m going to have to call it finished. 
  • I voice-automated my home. 
  • Just a couple of days ago, I took delivery of a new, modern, power wheelchair. More on that in upcoming posts. 
  • DEKA, the iBot people, put my picture on the front page of their website
  • Down East Magazine printed an excerpt from my memoir.
  • Bangor Metro Magazine published a nice interview.
  • The Journal Nature mentioned me prominently in an article.
  • My daughter got married, and the wedding was beautiful.
  • Kim’s home business took off.
  • Another year above ground – still preferable to the alternative.
2017 Potential Losses (if my disease progression continues, this is what could happen next): 
  • More eating and personal grooming struggles.
  • More difficulty operating computer mouse and wheelchair controls
  • Eventually my bladder is going to stop working, and that will suck. This could be the year, but I’ve been saying that for a few years now.
  • Something I can’t even imagine (the devil I don’t know).
2017 Potential Gains: 
  • More writing success at the blog and elsewhere.
  • Find a publisher for my book or decide to self-publish.
  • Caribbean cruise in February, thanks to Kim’s home business.
  • New primary progressive MS drug called Ocrelizumab should be approved in 2017, and I will likely try it, although it’s another longshot for me.
  • A few positives I can’t even imagine.
I conduct this thorough review only once each year for a couple of reasons. First, it takes that long for me to determine if certain changes are the result of permanent disease progression or are merely the normal ups and downs from aging, seasonal affective disorder, or my body’s sympathetic response to the menstrual cycles of the various women in my life (apologies to my dedicated readers for recycling that joke from last year, but I couldn’t resist).

Second, I only do this once a year because it can be a harrowing process. As I contemplate my losses and gains, I tend to extrapolate – envision what my life will be like down the road if the disease progression continues at this rate. I am concerned for my future health and fearful for my future happiness. But, at this moment, Enjoying the Ride is more than just a clever blog name. It’s the truth.

An Excerpt from My Upcoming Memoir

In the picture to the right, I’m the little one, Tom is to the left, Andy is in the middle, and of course my mother…
I am still exploring options, so I don’t have a publication date yet, but here’s a snippet to tide you over. In this excerpt, I’m five years old and I’ve been told my mother slipped, fell, and will be in a wheelchair for the rest of her life. 
From Chapter 3 of Enjoying the Ride: Following in My Mother’s Tracks 
We scurried through the maze of hallways at Eastern Maine Medical Center, an hour’s drive from our house. A few weeks had passed since Mom’s accident, and my brothers and I were visiting her for the first time. Dad coached us as we walked.
“Don’t cry or look scared. It will upset your mother.”
I kept falling behind the three longer-legged Sturgeons.
“She’s going to look different, but don’t stare.”
I slipped farther back until Dad took pity, stopped my brothers, and waited for me.
“Does everyone understand what I’ve just said?” he asked, looking from boy to boy.
I peeked at my brothers. Yes. The answer was yes. Three heads bobbed up and down.
Dad took us into the room, one at a time. I went last. Everything shone bright white or shiny steel. The room smelled like our kitchen after Mom had mopped the floor, but with the faint odor of pee. The collection of high-tech equipment reminded me of TV shows about space ships. A person lay in the middle of it all, hands folded on belly.
Something wasn’t right. Dad had said we would be visiting Mom, but I didn’t see her anywhere.  She had long, beautiful black hair. This person’s head had been shaved, and two shiny steel rods were bolted to the top of the skull. Besides, Mom would be in a wheelchair. Andy had said so.
As if sneaking up on a frog in our backyard, I inched closer.

   The eyes… the nose… her mouth. These are familiar. It’s a woman.

   She wore bright red lipstick—a flowering rosebush in a snowstorm. When those lips broke into the smile I had enjoyed nearly every day of my life, I recognized my mother. 

   She couldn’t turn to look at me. The rods kept her head aimed straight up at the ceiling. “Come here, Mitchy. I won’t bite. How do you like kindergarten?” Mom spoke in her usual, cheerful way. Her eyes soothed; her voice comforted.


Dad must have told her not to cry, too.

Standing Up to MS

The rule of thumb is that full-time users get a new wheelchair every five years. Let me do some quick math…holy shit, it’s time!

Think about your level of excitement when you buy a new car, then multiply that by a factor of 100. Now you have some idea how I feel about getting a new, top-of-the-line, power wheelchair.

Here’s the chair my insurance company just approved:

It’s the Permobil F5 VS, and yes, it is a standing wheelchair. Standing provides not only a functional benefit, but a therapeutic one. The Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) lists these advantages of a standing chair:

  • Improve functional reach and access to enable participation in Activities of Daily Living (ADLs) (e.g. grooming/hygiene, cooking, toileting, reaching medication)
  • Improve mobility and lower limb function in those with preserved muscle strength in lower limbs
  • Improve range of motion and reduce the risk of contractures
  • Promote vital organ capacity including pulmonary, bowel and bladder function
  • Promote bone health
  • Improve circulation
  • Reduce abnormal muscle tone and spasticity
  • Reduce the occurrence of pressure ulcers
  • Reduce the occurrence of skeletal deformities
  • Provide numerous psychosocial and quality of life benefits
These are not insignificant benefits. In addition to the standing function, I’ll get full recline to a sleeping position, and a 14 inch rise so that I can sit at high-top tables and reach the top shelves at home. In this case, size matters (I only have 8 inches rise now). There are too many other features for me to list here. In the wheelchair world, technology leaps forward over any five-year period.

This doesn’t mean I’ve given up on the next generation of iBot wheelchair. I’m still very interested in where that product goes, but I don’t have enough information to wait at this point. Speaking of the iBot, though, if you go to the front page of the new DEKA website, you might see a guy you know modeling his iBot.

I have so many people to thank for helping me secure this new wheelchair. I’ll do that in a future blog post. If all goes well, I should get my Permobil by Christmas or soon afterward. What a present!

Neighborhood Watch

 

As a full-time
wheelchair user, and someone who no longer works, I spend the better part of
each day indoors, by myself. It’s not so bad, however, because I live
in a glass house.

Two sides of my living
room are nothing but windows—an observatory of sorts. When my eyes are not glued to my computer screen writing,
reading, corresponding, researching, or watching Netflix, I’m gazing out my
windows, and I love what I see.

Wildlife

A couple of days ago, a flock of small, genetically
identical, dark brown birds with white spots descended upon my lawn. Probably
200 of them. I suppose half were male and the other half female, but they all
looked the same to me (is that racism, sexism, speciesism?). I didn’t recognize
their classification, and I couldn’t find it on the internet. They
moved about independently, randomly, at a frantic pace, feeding on invisible
morsels between my blades of grass. Everything in their world occurred at hyper-speeds,
a blur to our human senses.

Each time one bird violated the personal space of another, a
brief confrontation ensued. Wings flapped, and some unknowable set of rules
determined the winner. The victor held his ground while the vanquished was excommunicated to another part of the lawn.

Every so often, however, some outside force, something they
saw or something they heard, caused every member of the flock to abandon their self-interests.
They stopped feeding and squabbling, oriented themselves all in the same
direction, and took flight like mindless cogs in a larger machine. They so
loved the morsels in my grass, however, that after
a few minutes they flittering back
and once again filled the space with a buzz of random, independent activity, until the next common danger united
them in flight. 

There are few analogues for this behavior in the human world. Once people start acting
independently, we are loath to come together for the common good without first
engaging in considerable debate, arm-twisting, and deal making. Yet here we sit at the top of the food chain…for now.

But I digress.

People Watching

Sitting in my
wheelchair, peering out my windows, I’m also treated to some top-notch people
watching. My neighbors Sue, Susan, and Kri walk their dogs (Jake, Rocko, and
Sadie) several times a day. It’s not only dog walkers, though. All sorts of
people wander down our street. Sometimes
I recognize them from the larger neighborhood. Most of the time I don’t. They
come in all sizes and shapes: young and pretty, old and weathered, athletic,
disabled, and everything in between. Why this parade by my window? There’s an
attraction at the end of my street—the Atlantic Ocean.

Scenery

Animals and people are
fascinating, but unreliable. The scenery
outside my house—it never disappoints. The six-foot-tall window immediately to
the right of my computer screen may as well be a work of art, a painting. The lower two feet of this
masterpiece depicts my front yard, the street, and my neighbor’s front yard. This is where the strange flock of birds did their
thing. This is where my neighbors walk
their dogs and take their constitutionals. This
is where the snow piles up.

If I raise my head
just slightly, I take in the next foot or so of this artwork—the ocean at the
end of my street. Our corner of the Atlantic is a shallow cove, so much so that at
low tide it empties and becomes a mud flat, which has a certain appeal, but it’s not as visually pleasing as the cove at
high tide. Something about a basin full of water, it calls to me. When I know visitors are coming to my house, I hope for a
higher than average tide. I’m pleased
with the result about half the time.

Still higher in the
portrait, the next foot captures the opposite shore of the cove. A
well-maintained walking/biking path runs along that piece of coastline. As I
watch folks make their way along this Greenbelt, I am quite certain that nobody
is using it because they must, but rather because they choose to. People follow this
path for the journey itself, not because they need to be anywhere in particular
along its route.

And finally, the upper
two feet of my window painting is filled with sky. It’s almost never the same
day-to-day or minute-to-minute. I face east, so I’m treated to sunrises and
often moon rises. Even though the sun sets on the opposite side of my
property, it blankets my view with a soothing glow on most evenings.

So yes, I am stuck in
the house, especially in the winter, but I have plenty to watch in my
neighborhood, and for this I am grateful. Everyone
should be so lucky.

Have I Betrayed My Childhood Self?

I can still remember the questions I pondered as a child:

  • What will my job be when I grow up?
  • Who will I marry? (Will she be hot?)
  • Where will I live?
  • How many kids will I have?
  • Will I grow old?  How old?

I also recall some of the promises I made to myself as a child:

  • I will become rich.
  • I will become famous.
  • Nobody will ever tell me what to do.

I didn’t keep any of those promises.

Until I left the rat race a few years ago, I sometimes felt guilty about coming up short. Today I understand that I am not beholden to my childhood self. These
dreams served a developmental purpose (in order to become an
adult, one must first envision it), but I shouldn’t have considered them a blueprint for life. Our childhood ambitions are misguided because young people cannot grasp life’s complexities, and don’t appreciate its subtleties. The
degree of wisdom necessary to do so is acquired later in life, if ever.



In retrospect, these are the questions I should have pondered as a child:

  • Will I be lucky enough to find real love? (I was)
  • Will I have my health? (I did for the first 38 years)
  • Will I lead a happy and contented life? (I have)
  • Will I have a fulfilling career? (not really, but it paid the bills)
  • Will I be a good person? (with some exceptions, I think I have been)

And these are the promises I should have made to myself when I was a kid:

  • I will not presume that life owes me anything; any positive experiences beyond
    being born are simply frosting on the cake.
  • I will be a lifelong learner, a rational and open-minded thinker, and a
    candid, yet polite, communicator.
  • I will not waste precious resources on jealousy, hatred, or revenge.
  • I will try to do my small part to improve the human condition.
  • I will not blindly adhere to hollow societal norms.   
  • I will live each day as if it will be my last.
  • I will be true to my family and friends.
  • I will be reliable and humble.
  • I will have fun, lots of it.  
  • Even when life becomes difficult, I will endeavor to persevere.
If I had made these promises to myself as a child, could I have kept them? Let’s just say that at 53 years of age, I’m still a work in progress.

If young Mitch could have peered into the future, I’m quite certain he would have been disappointed with what
he saw. But young Mitch wasn’t smart enough to discern what a good life
looks like. How could he have? He was just a kid.

Bangor Metro Magazine Features Story on Kim and Me

At the risk of over-tooting my own horn, I wanted to share with you another awesome piece of news. Bangor Metro Magazine, which services mid-coast, eastern, and northern Maine, recently contacted Kim and me for an interview. Click here to read the piece.

At one point I recount how 17 years ago my family doctor said I “probably have a good 20 years left.” That was a misunderstanding which I explain in some detail in the upcoming book, so don’t do the math and think that I only have 3 years left to live!

Many thanks to journalist Joy Hollowell for a wonderful article.

Click here to read.

Down East Magazine Publishes an Excerpt From My Memoir

I’ve always been a huge fan of Down East Magazine, widely considered the best magazine about life in Maine. No matter how bookish you may be, no matter how learned in the written word, it’s the stunning photography that draws you into the magazine. Only after you find a comfortable spot to delve into the articles do you come to appreciate the quality of the writing. That’s what brings you back month after month.

In June of this year, I took a couple chapters from my as yet unpublished memoir, blended them into a single essay, and chopped it down to meet their word limit. I submitted the essay in late June, then I pretty much forgot about it.

Two months later I heard back. They wanted to publish the piece in their November edition. Given that I had written about deer hunting with my father, the timing was perfect. They even paid me a modest sum. They didn’t know (or maybe they did) that I would have paid them to print my essay. After all, their monthly circulation is about 100,000 copies.

We went through a couple rounds of editing, and the finished product is now on newsstands—Down East Magazine, November 2016 edition, page 48. The essay is entitled “Deer Spotting: A longtime sportsman faces down illness — and heads out into the field one last time.”

What a thrill this has been for me.

Now, back to work on finding a literary agent for my book…

Note: As of now there is no free, public link to the story, but I’ll let you know if that changes. For anyone who is interested in purchasing the November issue of Down East for $5.99, click here. To purchase a subscription, click here. 

As Hope Fades, I Press on: Here’s How

Hope can be an effective
tool to ease human suffering. In many cases, though, it’s not enough.

After my diagnosis 15 years
ago, I set out to become the most informed patient on the planet. Even though
there were no FDA-approved treatments for
primary progressive multiple sclerosis (and there still aren’t), I knew the answer was out there. I just
needed to be smart, brave, and hard-working enough to find it. Oh, and cocky
too. Every fighter needs a little swagger.

I tried chemotherapy and
immunosuppressants. No luck. I self-administered daily, painful shots. Didn’t help. I participated in a clinical trial
where I had to drive two hours each way, two times a month, for two years. It
slowed down progression for a while; then it didn’t. I convinced interventional radiologists to thread catheters from my
groin into one side of my heart and out the other,
so that they could balloon supposed restrictions in my internal jugular
veins—twice. In retrospect, I doubt there was anything wrong with
those veins. I lobbied doctors to inject powerful medicine into my spinal cord
every two months for two years. Again, helped for a while; then it didn’t. I
pursued all these treatments in the hope that I might slow down, stop, or even
reverse the course of my disease. Instead, I progressed from a limp to a cane
to a wheelchair, and my arms and hands are
headed in the same direction.

Understandably, I began to
lose hope that I would ever find a medical solution. I discussed this
with a well-intentioned friend who warned me, “If you don’t have hope, you have
nothing, right?”

No. That didn’t describe how I
felt. As hope faded, something else took over, and it wasn’t despair. I remained in generally good spirits, even though I knew I might never
get better. Something more impassive, almost comforting had intervened.

Acceptance.

Where hope receded, acceptance
filled the void.

It’s not that I studied the
alternatives and chose acceptance as the best path forward. It lived inside me
the whole time, waiting to be called upon.
Perhaps I inherited it from my mother or
learned it by watching her live as a quadriplegic for 39 years. No matter its
origin, I was fortunate to have such a tool at my disposal. I
suspect, however, that acceptance can be discovered, learned, or acquired if
you don’t possess it already.

Acceptance should not be confused
with surrender, although the differences are subtle. Surrender carries a
negative connotation. “I give up. Do with me what you will.” Acceptance carries
a neutral connotation, “If this is my life, then so be it,” or sometimes a
positive connotation, “If this is my life, I will make the best of it.” In its purest form, acceptance has a Zen feel to it. You are
exactly where you are supposed to be in
life. Don’t fight it. Embrace it.

I don’t
lament what might have been, envy what healthy people can do, or ask “why me?”
I’m grateful for what I have, and I accept what I’ll never again be.

I haven’t given up all hope. I continue to keep one ear to
the MS research world. In a dispassionate manner, I evaluate each potential
treatment on its merits. But I don’t rely on this
hope to motivate me. I’m not
emotionally invested in it. I keep hope around only for practical reasons, so that I don’t miss an opportunity
for a treatment that may work. There is a lot of research going on. I just don’t
know if it will become available to me in time.

Hope is the much sexier cousin
to Acceptance. Hope can produce spectacular
results. Books and songs have been written
about the power of Hope. Acceptance does its work anonymously. The results, important
though they may be, don’t garner much attention, save for this obscure essay. Although
it may seem counterintuitive, I find that hope and acceptance work together quite well.

For my healthy and disabled
readers: how do you manage hope and acceptance in your lives?