Tuesday, May 29, 2012

MEMORY, LOSS AND KEEPING THE FAITH


“The backward glance is distorted by the lens of the present….Memory distorts memory. Is all memory simply the application of narrative to past events, and is it only human and coherent to do that work?”  Dana Spiotta, Stone, Arabia

When I read the novel Stone, Arabia last year, some passages about memory really grabbed me. The author remarked on how we can never actually remember anything perfectly. Because the narrator’s mother suffers from dementia, she is trying to piece together fragments from her own past. She appears to be saying that we are taking experiences and creating narratives, using words to describe them. To me, that is part of why no two people can ever remember anything exactly the same way. We each possess different vocabularies, histories, and contexts for what we see, hear, and taste. One person’s cold can be another’s hot even when the temperature is 60 degrees.

One of the more complicated aspects of coping with multiple sclerosis is that it can be tricky to put into words precisely what we are encountering. After all, so much of what we are forced to face comes down to the loss of things we once had in the past: of vision, touch, mobility, taste, and so on. To those of us in the know, we have an elemental sense of what is happening, but finding the right words to describe this experience can be woefully elusive. I suppose it can be a little like trying to describe what it is like to grow old. But unless you are going through it, you don’t really know what the experience is like. Mere words can be insufficient to describe what it feels like to live with the disease. Which is part of why the MS Society holds “you look so well” support groups. To the observing eye, there are no symptoms, nothing to put into words. But we know better, don’t we? Worse case scenario: on the inside we can actually be going through hell.

So when we try to describe our symptoms to our doctors in a way that accurately represents the disease, we use words in relation to what we believe “normal” used to be. Beyond the physical aspects of the disease, there are the emotional ones, too: the constant readjustments of our expectations. How do we put into words the aspects of the disease one cannot touch or see: the bitterness, the anger, the frustration that can be a regular part of living with MS?

This most often arises from the “not knowing” what our futures will hold. Unless we are in therapy (been there, done that), we are left to ponder the future of our fates in relation to our pasts. We can have conversations, the words circulating around in our heads, about what we once had, where we are now, and what the future holds for us. Ah, yes, the “future.” I don’t have these thoughts all the time, mind you, but I feel we MSers have them more than “regular” folks, mainly because the future is so uncertain. In what condition will I find myself next year, in five years, or ten years? These thoughts can be quite daunting, even if the future of research and pharmacology looks brighter and brighter.  

What are my limitations? How long will I be able to walk to work, ride my bike, throw a ball around with my kids. I never thought him much of a philosopher, but Billy Joel sang some meaningful words back in the day, “the good ole days weren’t always good and tomorrow’s ain't as bad as it seems.” 

We shouldn’t harp on what we’ve lost and try not to fret about what is going to happen tomorrow. We’ve got to live in the moment and make the best of the time and situations we still have. An old Latin phrase, carpe diem, works best for me: seize the day!

Have a good couple of weeks. Stay cool!

Peace,

Marc

Billy Joel’s Keeping the Faith
http://www.youtube.com/watch?v=U2pU0QJkMck

MS MEMORY AND WHAT I LOST


“The backward glance is distorted by the lens of the present…Memory distorts memory. Is all memory simply the application of narrative to past events, and is it only human and coherent to do that work?”  Dana Spiotta, Stone, Arabia

When I read the novel Stone, Arabia last year, some passages about memory really grabbed me. The author remarked on how we can never actually remember anything perfectly. Because the narrator’s mother suffers from dementia, she is trying to piece together fragments from her own past. She appears to be saying that we are taking experiences and creating narratives, using words to describe them. To me, that is part of why no two people can ever remember anything exactly the same way. We each possess different vocabularies, histories, and contexts for what we see, hear, and taste. One person’s cold can be another’s hot even when the temperature is 60 degrees.

One of the more complicated aspects of coping with multiple sclerosis is that it can be tricky to put into words precisely what we are encountering. After all, so much of what we are forced to face comes down to the loss of things we once had in the past: vision, touch, mobility, taste, and so on. To those of us in the know, we have an elemental sense of what is happening, but finding the right words to describe this experience can be woefully elusive. I suppose it can be a little like trying to describe what it is like to grow old. But unless you are going through it, you don’t really know what the experience is like. Mere words can be insufficient to describe what it feels like to live with the disease. Which is part of why the MS Society holds “you look so well” support groups. To the observing eye, there are no symptoms, nothing to put into words. But we know better, don’t we? Worse case scenario: on the inside we can actually be going through hell.

So when we try to describe our symptoms to our doctors in a way that accurately represents the disease, we use words in relation to what we believe “normal” used to be. Beyond the physical aspects of the disease, there are the emotional ones, too: the constant readjustments of our expectations. How do we put into words the aspects of the disease one cannot touch or see: the bitterness, the anger, the frustration that can be a regular part of living with MS?

This most often arises from the “not knowing” what our futures will hold. Unless we are in therapy (been there, done that), we are left to ponder the future of our fates in relation to our pasts. We can have conversations, the words circulating around in our heads, about what we once had, where we are now, and what the future holds for us. 

Ah, yes, the “future.” I don’t have these thoughts all the time, mind you, but I feel we MSers have them more than “regular” folks, mainly because the future is so uncertain. In what condition will I find myself next year, in five years, or ten years? What are my limitations? How long will I be able to walk to work, ride my bike, throw a ball around with my kids. These thoughts can be quite daunting, even if the future of research and pharmacology looks brighter and brighter.  

I never thought him much of a philosopher, but Billy Joel sang some meaningful words back in the day, “the good old days weren’t always good and tomorrow’s not as bad as it seems.” 

We shouldn’t harp on what we’ve lost and try not to fret about what is going to happen tomorrow. We’ve got to live in the moment and make the best of the time and situations we still have. An old Latin phrase, carpe diem, works best for me: seize the day!

Have a good couple of weeks. Stay cool!

Peace,

Marc
marc@empirelifecoaching.com 

Billy Joel’s Keeping the Faith
http://www.youtube.com/watch?v=U2pU0QJkMck

Billy Joel’s Keeping the Faith
http://www.youtube.com/watch?v=U2pU0QJkMck

Wednesday, May 9, 2012

THE GREYS OF LIVING WITH MS - A TWIST OF FATE


It seems like everywhere I turn these days I see grey: the erotic novel 50 Shades of Grey is a monster best-seller that Saturday Night Live poked gleeful fun at this past weekend (see below), and Liam Neeson’s film The Grey arrives on video this week. Is it a coincidence then that my mind has been turning around the color grey and its relation to multiple sclerosis? Or some kind of destiny?

Let me begin by explaining that when I was younger (I am 47 now), I found it easier to reduce my understanding of issues and relationships to black and white. One politician was good, and another was evil. If a marriage ended, it had to be one person’s fault, the other the victim; I didn’t have a sense of mutual culpability. It sure made life easier: I didn’t have to analyze or understand the greater complexities of life. 

I believe I turned a corner when my wife’s co-worker’s family was described a few years ago as perfect, devoid of any problems. It just didn’t seem possible to me: how could a family not have problems, how could everyone be perfect? Now I’m not saying I wished this on anyone, but when a divorce recently rattled the family, I wasn’t especially surprised.  Life doesn’t usually spare a family from some measure of pain or adversity. Very few just get off, have a “white” life. After thinking it through, I realized, sure, some have it harder than others, some easier, but generally life is grey (even amid the spectacular color of spring here in the Northeast).

This is a long way of saying that for those of us with MS, life can be greyer than it is for people who don’t have to live with a chronic disease. We get to ask ourselves questions like: Has the disease made me a better person? Is it a gift that has afforded me an opportunity to grow in ways I never would have otherwise? Like many of us these days, I do a fair amount of reading on the Internet and regularly encounter this attitude, one I cannot embrace. There are many people sharing quotes about perseverance, pictures of  kittens and positivity.  On the one hand, I get it: If it doesn’t kill you, it will make you stronger. On the other hand, I can’t get all mushy about a disease that picked me. I played no role in the decision-making process that led to my contracting the disease: it was just, as Bob Dylan said, “a simple twist of fate” (see below). I didn’t choose MS; MS chose me.

The flip side of all the positivity on the Internet is anger about the disease that has changed our lives in so many unexpected ways. But I personally find anger to be a negative energy, counterproductive to the way I want to live my life. Which isn’t to say I don’t get angry about it. I get pissed off, no question. I just cannot let my anger be a guiding principle.

A couple of years ago, an MS friend directed me to an exclusive on-line group for people with the disease. They took pride in saying it was a “unicorn-free zone,” no new-agey optimism allowed. To be fair, the group was a place where people could vent about the challenges they had to face, not a bad thing to be sure. Perhaps I misunderstood the group’s mission, but there was so much negativity and snarkiness that I ended up feeling bummed. Needless to say, I eventually lost interest. Didn’t Woody Allen use a quote from Groucho Marx in Annie Hall to describe his love life, “I wouldn’t want to join a group that would have me as member”? Well, that group anyway.
Unfortunately, we can’t quit the MS club. We each have to find ways within the boundaries of black and white to cope with the challenges brought about by the disease.  I don’t use the word grey in the context of MS to say MS makes life colorless. Not at all. It just makes it even more complicated. The way life would be without the disease but more so.

So keep fighting the good fight. Make every day count!

Peace,

Marc

914.715.9596
marc@empirelifecoaching.com

Bob Dylan Simple Twist of Fate
http://www.youtube.com/watch?v=7-YjEGyaRGc 

50 Shades of Grey/SNL 
http://newsroom.mtv.com/2012/05/07/50-shades-of-grey-snl-saturday-night-live-video/

Wednesday, April 25, 2012

ACCESSIBILITY ABSURDITY


Accessible: easy to approach, reach, enter, speak with, or use.
 
The above definition is from dictionary.com. I looked it up before I began writing this blog just to make sure I understood the term properly. How often have you seen signs for something that is accessible or even called a theater, restaurant, store, fill in the blank, and are told, ” yes we are accessible,” only to arrive at your destination to discover that they are not accessible at all or only accessible under the most ludicrous circumstances possible? More than once, I have had to navigate through garbage or storage under humiliating conditions to gain entrance to a restaurant. I have gone up or down ramps that made me feel as though my life was in danger, at angles that surely would've impressed extreme sports enthusiasts. I am a pretty easy-going guy and it can take a lot to get my blood boiling, but all I can say is, living with multiple sclerosis has the potential to really raise one's temperature.

Last week, we were sitting on the bench outside of Mud, one of our favorite java joints, enjoying iced coffees in the warm spring sunshine when I felt the urge to use a restroom. As much as I love the coffee, Mud is unfortunately not accessible (an immense step at the entrance). I needed to act quickly. MS and bladders, man oh man. There was a Starbucks on the next block and, since New York lacks public restrooms, I headed straight there. The only problem was, since everyone else uses Starbucks as a public toilet, there was a line six people long when I got there. I remembered that our favorite Ukrainian restaurant, Veselka, was across the street; they have a "disabled" bathroom, so I headed straight over there. Except, my scooter was too big for the space. After a minute or so of trying to force my scooter to fit, I accepted the reality of having to go back to Starbucks and get back on line. Fortunately, a woman who had been right behind me on the line before very kindly let me go ahead of her. Disaster averted!

Last year, I read about a new restaurant in my neighborhood, Redhead's. The review said it was exceptional and, to me, the food sounded altogether appealing: Southern food updated for New York sensibilities. They told me over the phone they were accessible. When Alida and I arrived, there was a step about a foot high I guess I was supposed to navigate over on my scooter (maybe I could fly?). Who in their right mind could think getting over a step like that made the restaurant accessible? I cruise around my neighborhood often and find myself dumbstruck by the amount of restaurants and stores with only a three or four inch lip that could easily be adjusted for a smooth, straight entry. The powers that be, however, never think about a simple adjustment that would make my life and many others like mine so much easier.
They won't get my business, but that's not the point. In a modern city like New York, these issues should not exist. Heck, they shouldn't have to exist anywhere. It boggles the mind when a rinky-dink little deli or drugstore has gone to great lengths to adjust their entrances but a chichi restaurant will leave its entrance untouched and therefore inaccessible. My mom says I should write to the newspapers to let them know about this discrimination and the issues with insurance companies, too (don't get me started on that one). So many indignities, so little time.

One of the greatest shocks I received occurred a few years ago when a classic Hitchcock film was playing at the Ziegfeld, one of the last remaining movie palaces in New York City. Excited about seeing the film, and since I had never been there with my scooter, I called the theater in advance to make sure I could get in. To my dismay, they did not have a disabled entrance nor did they adjust any of their many doors in order for someone like me, or perhaps you, could get in and go to the movies. The ultimate fuck you! Needless to say, it can feel disheartening when simple pleasures in life are eliminated as a result of the clumsiness, thoughtlessness, disrespect, and/or bone-headedness of able-bodied individuals. 

We become especially sensitive to these exclusive situations. I go down beautiful tree-laden streets in historic neighborhoods and become acutely aware of the fact that, even if I wanted to, getting into any of those houses/buildings is an out and out impossibility. It sure makes me feel grateful for the ramp they built into my building a few years back. And I shudder to think about what things must have been like in the years before I required a scooter. Fortunately, these days inaccessible buildings are the exception rather than the rule. 

And while New York is one of the better cities when it comes to corners that have been adjusted for scooters and wheelchairs, there are still those moments when one is scooting along at a good clip and you suddenly come upon one of those old foot-high corners that has not been adjusted. It feels like a slap in the face. You don't have to think too hard about "what if" I accidentally went flying off such a corner.  One thus becomes used to memorizing the problem corners and adjusting routes accordingly. Except when you forget and get stuck, forced to go back a block and off the curb of the previous corner.

So what is the moral of the story? We need to be resilient; we need to be strong in the face of adversity and inaccessibility. Because we never ever know when it's going to look us straight in the eye. I don't know about you, but getting out there and facing and overcoming these everyday challenges, however miniscule, frustrating, or annoying, is still a darn good reason to get up and out the door in the morning. It sure beats staying inside all day wondering about "what if?"

Have a great couple of weeks.  I hope you can enjoy the spring wherever you are.

Best Wishes,

Marc

Bonus information for New Yorkers:

FYI, this is what I came across at ehow.com regarding rules for restaurants that make the issue even murkier:
Where problems arise for disabled, and specifically wheelchair-using patrons is in buildings constructed before 1990. The ADA requires what has come to be described as ‘reasonable accommodation.’ What may seem reasonable may or may not be realistic, and, try as they may, some building owners are unable to provide full accessibility.”

Read more:

Also in Metropolis Magazine regarding restaurant accessibility, from two year’s ago:

“This is all to say that it’s a somewhat complicated process, designed to accommodate a variety of interests. And while the vast majority of existing city housing does not have to meet accessibility standards, anything built in the last twenty years or so, and any future construction, does.”
Read more:


Friday, April 6, 2012

THE PROBLEM WITH ELEVATORS AND IGNORANT PEOPLE


This is a blog in two parts, though you will see they are thematically related. Needless to say, the adjustments we often have to make as a result of living with our disease can be head-spinning!

PART I
Remember the Peanuts movie from the ’70s, Snoopy Come Home, where Snoopy kept trying to go to places like the beach, the park, the library, etc.? And every time, he encountered a sign that read, and a voice that intoned, “No Dogs Allowed.” (see YouTube clip below). That is often the way I feel lately when I go places where able-bodied people can climb stairs and reach their destinations with relative ease. When an elevator is broken, as was the case several times recently, I felt a little like Snoopy appeared in the movie: angry, annoyed, and agitated. 

Two weeks ago, I went to the gym to discover the elevator was out of order, which meant I could not get to the second floor where all of the Nautilus machines that are important to my regular workout are located. No elevator, no workout. Readjustment again, which is kind of like living with MS in a nutshell.

Then on Sunday I went over to the movie theatre early in the day to buy tickets for a late afternoon show of The Hunger Games. I’d loved the book and was enthusiastic about seeing the well-reviewed film. When I arrived, the fellow by the automated ticket machines pointed to the broken elevator. Well, those plans went out the window pretty quickly. I realize it’s not personal, but there seems to be a sign only we can see: "No Crips Allowed."

PART 2
One of the perks of being disabled and using a disability device is you are entitled to discounts to theater, some concerts, and other forms of live entertainment. So last week, Alida and I saw Death of a Salesman on Broadway. Typically, when we go to a show, there is a space where a seat was removed that allows me to park my scooter and stay there throughout the show, no problem. Well, Death of a Salesman is running in an ancient theater, and the seats have not been adjusted to accommodate mobility devices. As a result, I had to transfer to a seat. This meant: I also had to navigate two small steps, unexpected but manageable.

This left the issue of what to do with my aisle-blocking scooter. Let’s just put it this way: you’d have thought I was the first person to ever enter this theater in a scooter or wheelchair. After I got into my seat, the couldn’t-care-less usher pointed to a space behind the back of the orchestra seats and told me to park it there, which Alida did. After we were finally settled in, another theater staff member approached me to say (in a not particularly sensitive or friendly way) that I couldn’t leave my scooter where it was; it needed to go all the way down the hall to a space on the side of the orchestra. Well, we flat out refused despite the guy’s forcefulness. It just didn’t seem right. Eventually, the kind house manager showed up and offered to move the scooter for us, which we greatly appreciated. This is what should have happened in the first place! 
But the story doesn’t end here. At intermission, another equally clueless usher told me I needed to move the scooter yet again because it was blocking the exit door. At least we could say the manager put it there. All along, there was a feeling that everyone thought the disabled person (me!) was able enough to move his own disability device and then walk back to the seats. Like I was just being difficult to piss them off. Seriously? Talk about ignorant and disrespectful. What would they have done had I been traveling solo? I shudder to think. I’m lucky to have been with Alida, but she (or anyone else I happen to be with) shouldn’t be forced to move my scooter because of an organization’s incompetence and poor planning (which I’m guessing is a violation of ADA).

All of this goes to show you that things are rarely as straightforward as we want them to be. We constantly adjust and adapt to circumstances beyond our control, scenarios able-bodied people never have to face. Sometimes it is a wonder we even get out of bed in the morning. And yet we do. Because as problematic as life with MS can be sometimes be, it’s the only one we’ve got, and there isn’t a doubt in mind that it is worth living.

By the why, Death of a Salesman was excellent, Philip Seymour Hoffman as Willy Loman superb. You’re going to have to wait for my response to The Hunger Games (the elevator should be fixed by now!).

Next time: when the word “accessible” doesn’t mean “accessible.”

Have a great, productive couple of weeks!

Peace,

Marc
marc@empirelifecoaching.com

Snoopy Come Home:
http://www.youtube.com/watch?v=WUMAECmL6WA&feature=relmfu


Friday, March 23, 2012

MS, FRIENDSHIP AND THE TIES THAT BIND

So many faces in and out of my life

Some will last
Some will just be now and then

Life is a series of hellos and goodbyes

I'm afraid it's time for goodbye again – Billy Joel, “Say Goodbye to Hollywood”


One of the most significant aspects of coping with the effects or mere fact of multiple sclerosis in our lives is the reaction of the people when they learn we have it. The response from individuals close and far can vary widely. I’ll never forget when I was at my last job, following a day out sick as a result of a high, debilitating fever, I decided to tell my boss (the woman who hired me about six months before) that I had MS. I hoped she would be sympathetic to my situation.  Instead, she made it about herself ("How could I do this to her?") and was shocked that I hadn’t been forthcoming in the first place. Our relationship had always been turbulent, but after that incident, there is little doubt in my mind that she treated me differently, in a negative way. Unfortunately, we always have to worry about how people in all areas of our lives -- supervisors, colleagues, friends, relatives, neighbors -- will respond to discovering our "dirty little secret."


Many years ago, shortly after I was diagnosed, a friend from college with whom I had always been very close reacted to news of my illness with shock and confusion. My wife is convinced he couldn't cope with the fact of my disease. Our relationship deteriorated quickly after I told him about it. Though we'd been best friends for many years, we fell out of touch very quickly thereafter, despite his living just a few hours away. Clearly, physical distance was not why we went our separate ways, a fact that still pains me today.


I’ve been pondering the general nature of friendship as a result of recently reconnecting with another old college friend via Facebook. When we got together for lunch the other day, we picked up precisely, and reassuringly, where we had left off some 24 years ago. I was extremely grateful that my obvious disability didn't freak him out (I did prepare him on the phone, but still). Despite my general comfort living with the disease, you never know for sure when it is safe to divulge. And so much depends on who you choose to tell; from my personal experiences, some people can handle this news; others, not so much.


Those of us living with MS have to accept whether or not to share a unique, often damaging, secret with friends, family, co-workers, even if we "look so well." For many of us, it can feel as though we are, as the cliché goes, "circus clowns smiling on the outside but in tears on the inside." By letting the metaphorical cat out of the bag, our vulnerability reveals itself. We are faced with choices about who we can and cannot tell about our disease; in the process, we learn important lessons about ourselves. Still, it can also be liberating to find out who our true friends really are. And we can make new friends, too, by joining a community of MS patients either locally or via the internet. Whatever would we do without the electronic superhighway?


Enjoy the spring. Keep fighting the good fight.


All my best,


Marc
marc@empirelifecoaching.com
914.715.9496

"Say Goodbye to Hollywood"
http://www.youtube.com/watch?v=47PtUvHIQpk

Tuesday, March 6, 2012

VIAGRA: SECRET REVEALED

“Medicine sometimes snatches away health, sometimes gives it.”
 - Ovid 



Multiple sclerosis is the disease that keeps on taking. It takes away our mobility, our basic functions, touch, feel, bladder control, and diminished sensations.  We take medications to treat the symptoms, to prevent the progressive disease from progressing.  Sometimes, the side effects of these drugs can be more severe than the disease itself.  Oh man, when I was on steroids (prednisone, dexamethosone, oral, intravenous), it really sucked: the sleeplessness, the withdrawal, the highs, the lows, the feeling that I was being electrocuted.  We can invest so much faith in these medications, hoping upon hope that maybe, just maybe, they'll be beneficial.  I just finished a year-and-a-half tour with Tysabri.  Did it work or didn't it?  I couldn't say for sure, but my doctor was concerned about PML (the scary brain infection).  Onward ho to Rituxan.



Occasionally, we get a little something back, as evidenced by the following experience: When it comes to intimacy, the disease has caused what is, from my understanding, a not uncommon effect on my sexual function.  What is the number they name in the ad for men who live with the issue, MS or no?  20,000,000 men are using it, this little pill called Viagra.  Add this one to the long list of medicines and treatments I never expected to be using.  The affliction it treats is commonly known as ED (erectile dysfunction).  I didn't know the official name for it until I heard an ad on the radio a while back talking about a remedy for "ED."  The reason I am going public with this secret is that I recently noticed an uptick in over-all function (not just down there) whenever I use Viagra.  I even notice a little more energy the next day at the gym.



So, being the modern guy that I am, I went on the Internet and Googled "Viagra MS" to see if there is anything to my little theory and, lo-and-behold, what did I find but the results of a study on mice published last year describing the benefits of Viagra for restoring function.  Read about it here: http://www.sciencedaily.com/releases/2011/05/110519090354.htm.  Of course Stu at Stu's Views and MS News was on this one last year shortly after it was published: (http://wwwmsviewsandrelatednews.blogspot.com/2011/05/viagra-could-reduce-multiple-sclerosis.html). Beginning this week I'll be taking a generic form of Cialis, a daily pill that contains the same active ingredient (tadalafil) as Viagra to see if I can get the benefit all the time.  What this means for women with MS I am not entirely sure.  



My other little secret: I am tapering off Baclofen.  Why, you ask?  Well, I got thrown out of whack when I slept through the night.  Usually, I take a Baclofen along with Tizanidine and Clonozepam when I wake up in the middle of the night.  Instead, I took the combination when I woke up.  Five hours later I went to physical therapy and had the best session I've had in months, since last summer.  Crazy, right?  Then I remembered the reason I stopped taking Baclofen many years ago: It made my legs heavy and, thereby, more difficult to walk.  I will live with a little more spasticity if it might make it easier to walk.



Here's the thing: we're always hoping to somehow get better, even completely recover, as unlikely as the possibility can sometimes seem.  Our anxieties can interfere, too. We may be willing to try anything, hoping to improve our condition – or nothing at all, out of fear or denial.  We each have our own ways of coping.  Myself, I've always kept an open mind. Hey something's got to work, right?  And I am fortunate enough to have a doctor I can trust like a brother.  But in the end, we must be our own best advocates and remain aware and informed in order to make decisions that keep our best interests in mind.

Be well,

Marc
marc@empirelifecoaching.com