3.31.2009
Randomness
Happiness was delivered today in a package from Tar-jhay. Two pairs of cropped pants--one olive, one khaki--both with the Louise-friendly waistband. Sigh. My standards are so altered. But. They fit, and require little dexterity. I will positively BEAM while wearing them. Everyone will be blinded by my beaminess.
I discovered today that I must lean on my shoulder when I stretch my calves. Hands/arms don't do it anymore.
The on/off switch on the vacuum is too hard to push. Don't even bother asking why it took me this long to discover. No. Don't. I managed to make it work by holding the vacuum handle against my chest while I pushed the switch with a pen I held with both hands.
My teeth are an inferior third hand. But, inferior though they may be, I did succeed in using them to open the (not-so) easy open goat cheese.
I love Georgette Heyer. Introduced to her when I was 12 by Aunt Bette and Aunt Esther, I never tire of her witty, delightful, fluffy romances. I plan to take one on my trip and do some time traveling. The difficulty is: which one?
Speaking of books, this is the first one I read after my diagnosis. There is a passage within where the author talks about wishing she'd run more when she had the opportunity. I think of it often.
I think I've run on enough for one evening. Oh my, an inadvertent pun. Aren't I just the cleverest little blogger.
I ran
There were a couple times when my quads felt iffy, but I ignored it. I'm going to get out as often as I am able, and to hell with an iffy quad.
(Note to Kendall: thanks for taking your pace down and staying with me. You are such a dear.)
This is special, you know. I used to run 5-6 days per week, and now manage only 1-2. Adding a midweek run is huge. Huge, I say, huge! Haha, like I have become since I've stopped running so much.
I ran. Ahhhhhh.
3.30.2009
Stuff in my head
First of all: Saturday. Becky and John ran the Monument Avenue 10K. Last year Lynne and I ran it, too. Becky ran with me and we managed a solid 10 minute pace. This year she ran an 8.18 pace; John did a 6.16! They are machines. While Becky was running I decided to walk -- I followed the course up Monument Avenue, turned around at the second circle, and walked back to the finish. As I walked up the street, the first wave finishers were on their way home. I love watching runners near the finish -- they are so strong and so determined. The residents of Monument Avenue make a party on race day. I saw people drinking mimosas and coffee while eating a breakfast on their front stoop -- how wonderful. At the second circle I turned around. Now the runners and I were going in the same direction. As I walked, listening to my iPod, smiling at the breakfast eaters, feeling the energy of the runners, I became increasingly blissful in this space I occupied. I likened it to an individual's journey through life -- the people moving quickly by, those standing still, the occasional interruption when one gets in your way -- and the more I thought of it, the more blissful I became. It felt delicious.
This same deliciousness was with me Sunday morning, during my run. I forced myself to get up, no easy task these days when I'm feeling so lazy. The first moment of deliciousness came when I used my hooks to pull up my running socks. They haven't gone on so well in months. I don't know why I hadn't thought of this before. Anyway, I drove to the grocery store parking lot, got out, and began to walk. There was a light mist and it was cool, no -- it was cold. I walked for about five minutes or so, then began my slow trot. The deliciousness was building. It felt so good and the mist/light rain on my face and in my hair was a gift. I think I ran about 2-2 1/2 miles before I turned round. When I did turn around I could tell my legs were tired and my breathing was harder. I took down my already slow pace and slowly, determinedly made my way back. There are more hills on the return so I walked a bit more, but a hill is a hill and my legs worked to carry me up. Even in my fatigue, I was aware of feeling delicious, almost unbearably so. I can't tell you how many negative thoughts tried to intrude and penetrate. Now and then one would slip through and start to take shape in my mind. I wasn't having any of it; once I realized the negative thought was there, I booted it out. I finished my run feeling fabulous.
Today when I got to work my first stop was the mailroom. As expected, the weekend mail was abundant and was difficult for me to extract. As I was about to look for some help, a man walked into the mailroom. I'd never seen him before, but asked him if he would help me. He very kindly agreed. After he had extracted my mail, he started to go out -- he had had no reason to be in the mailroom. I think it's cool he showed up just at the right time -- someone or something sent him. We rode up the elevator together and had a pleasant chat. He was like a bright light, and when he got off the elevator I went and stood where he'd been so I could share in his bright light. It was such good energy.
Now for some other observations:
- After Sunday's run I feel very sore and tired. I stretched for a long time yesterday and will again tonight.
- I don't think I've mentioned this. But my face, particularly my mouth, has been twitching fairly consistently. As well, I have begun to notice that sometimes it is hard to say words, like my mouth can't form them properly. I mentioned this to Lynne, who said she had noticed a difference. Shit.
I will smile me a big fat delicious smile and find the strength. It'll be like running that 10K as fast as Becky and John did.
3.27.2009
Quotables
Every human being is the author of his own health or disease. (Buddha)Is this so? Did I bring this on myself?
Can I change it?
------------------
The secret of health for both mind and body is not to mourn for the past, nor to worry about the future, but to live the present moment wisely and earnestly.I like these.
Thousands of candles can be lighted from a single candle, and the life of the candle will not be shortened. Happiness never decreases by being shared.
------------------
You can see I came away from the meditation session just bubbling with Buddha-isms.
I have to confess I was a little sketchy at first. To be told to relax, close my eyes, and meditate when I have never meditated (at least not consciously) made me a little nervous. Add to it that we were supposed to do this for 30 minutes -- how the hell was I going to sit still for 30 minutes? Amazingly, I managed to relax and give in to it. When the 30 minutes was up, I was surprised at how quickly the time flew. I actually felt the energy in my body; my mind was full of blue; my breaths were minimal but sufficient. It really was a unique experience.
Jonathan, the session leader, has a soothing voice and a very gentle way about him. Much of what he imparted are conclusions I've reached on my own, particularly as it relates to managing challenges and existing in the world. I wouldn't say I am necessarily enlightened, but I feel that I have an awareness of where I am in this space I occupy.
The entire evening was time well spent. I don't know if I can manage every Thursday, because it's a very late night, but I'll go when I can.
3.25.2009
The Glow
I ordered my fancy-schmancy pens AND a highlighter (one never knows when one will require a two-pronged highlighter, but I'm ready). They've shipped, so I should be getting them soon.
Also shipped: a couple of pairs of "specialty" (translated "pregger") pants, one in khaki and one in olive. I hope they are suitable. I've been eagerly awaiting their arrival to pump up my current wardrobe. How many pairs of black stretchy pants can one own, after all?
I'm going to a meditationy and awareness sort of thing tomorrow night. I heard of it from Marvelous Mike and I'm curious, so off I will go. There will doubtless be a hint of Eastern Philosophy. Tomorrow night's topic is "Engaging in Social Change" but the one I'm most curious about, which is next month, is about illness and dying. I think it would be better to say illness and LIVING. It should be interesting.
Still glowing. What a great day.
Hugs.
3.24.2009
I dug deep, and look what I found

There are five classy colors, but sadly no leopard. I will endeavor to live without spots. It will be enough to dazzle with my fancy fingerwork.
Retail therapy. Always good.
...Violent ends
I spoke to Ellie today and told her I wanted to pursue the ceftriaxone study, provided I am eligible. We had some conversation about the IV catheter and she assured me I should, while I still have the dexterity and strength, be able to self administer.
Who ever thought I would have such a conversation.
Diggin' deep.
3.23.2009
The other end of the spectrum (updated)
First symptoms in May 2007.
Arm onset.
Diagnosed August 2008.
She died yesterday.
In her words, "there is no ALS in heaven."
Update: as it happens, she fell in her room and was not discovered for several hours, very late at night, and was gone when her family found her. Makes this even more tragic.
3.21.2009
Smile, though your heart is...
I decree today a Louise-free day.
Dreamin'
The next thing I know, I'm outside riding my bike. I'm able to ride my bike without any problem and I'm enjoying the beautiful weather and all the scenery. I rode through a new shopping center and saw a restaurant I knew Lynne would be happy to see. I kept riding and finally came out on Lafayette Blvd., down near the Spotsylvania Courthouse. I was delighted because this meant it would be easier for Lynne and I to connect for a run. Tons of people were out, many of them members of the running community. I weaved my bike in and out and then discovered there was something going on with the right handlebar -- it was loose and was not connected properly. I got off the bike and flagged down a man and asked him to help. He was somewhat offputting but did agree. He reminded me of my old podiatrist, Dr. Pribut. As this man was loading my bike, I was on a clinic table. What was odd was the man was also changing clothes. He finally finished and drove away with my bike.
I found myself in a building much like a gym or pool locker room -- all cinderblock and toilets. I saw many of my friends who were there to attend a swim meet. I knew Lynne would be there to watch her daughter Stephanie. But then everyone was gone. My clothes were sweaty from my bike ride so I thought I should change. I went into a stall but it was so nasty I had to leave before I got sick. I found a clean one and took off my sweaty clothes. But I had nothing else to wear. I began to cry because I had no clean clothes, no bike, no phone, nothing. All I had was this strange cylindrical device that would only sporadically pick up radio signals. Crying, I put back on my sweaty clothes.
Then Melinda was there, with a chocolate chip cookie casserole. The edges of the casserole would not stay down, but Lynne's daughter Stephanie was able to fix three of the four edges. I was lamenting the loss of my bike when the man who had taken it drove by. He was driving a Porsche that was painted orange and white. He called to me to tell me that the paint had been chipped. I told him I didn't care about chipped paint, I just want the handlebar fixed. He said it wasn't the bike's paint, it was the car's and it happened while he was loading the bike so I had to pay. I thought to myself the only thing I could do at that moment was give him a business card, so he'd know I was legitimate.
I was also beginning to panic because I was not able to contact my clinic to tell them where I was. I was so upset about the car and the clinic, I could feel the anxiety even in my sleep.
Then I woke up. The dream was so fresh in my mind and I was so relieved I didn't have to deal with any of it. I had to put this all down before I forgot.
Time for a wog.
I had a great run. I got out later than I had hoped, but it didn't matter. I knew if I was home by 10:20 AM I would have time to clean up before my hair appointment. I ran for what I thought was about 30 minutes, then turned around and came back. When I got in the car and saw that I'd been out for almost 90 minutes, I was shocked. I haven't worn a watch in a long time but maybe I need to start. Clearly I am running slower than I thought.
While I was running I kept chiding myself for being tired. I told myself if I didn't pick it up I'd never be in marathon shape again. I crack myself up!
Having run longer than I anticipated, I had to rush right over to the salon. I hope my poor stylist wasn't too offended by my rankness.
So, back to the dream. What I most remember is the feeling of elation I had while riding the bike. I was strong, I could feel the air, I could feel the sun, I was so happy. The last time I rode a bike was this time last year. I had run the shamrock half marathon (as a bandit, but so what) and then hopped on my bike to find Lynne. I ended up riding approximately 21 miles, after which my right hand and arm were so sore I decided it was better to give up biking.
I must go pack. Overnight in Virginia Beach for the marathon. Lots of my friends are racing. This might be tough.
3.20.2009
Liberation
WTF? Sort of looks like a badly made ant headband, I think. Odd looking little gadget, but the zipper pull (the side with the hook) allowed me to wear jeans today--the first time in ages.
I look rather suspect when I head to the bathroom with my enhanced key and one of these contraptions in my hands. I'm sure people wonder what the hell I'm doing!
Anyway, my jeans were like an old friend. This zipper pull is like Rilutek for regular clothes wearing.
Another pause in the day
Buddhism speaks of the pain and ‘ the second arrow.’ The first arrow is pain itself. That is inevitable. The second arrow is how we react to it. When we add aversion, craving, resistance, worry and obsessive thinking, we add immeasurably to our experience.
The writer said he had to keep reminding himself that the second arrow is optional.
There are a lot of different arrows that cause a lot of different pain, and this applies to them all.
3.19.2009
PLM Post
From today. What caught my eye was the title "Arm Weakness." I'm so lucky I'm not here.
Hi everyone, my arms are getting weaker and weaker, they seem to be ok from the elbow down (if that makes sense) but I'm having real trouble when I'm trying to lift a cup or spoon to my mouth. It's pretty funny if I'm trying to eat peas, by the time I get my arm up my hand is shaking so much all the peas have fell off. Does anyone know of something to help support my arms or tips on pea retention?
N
--
N:Some mashed potatoes or other textured food that might help hold your peas on the fork ~ I too have had to invest in Vanish strain remover for my tops getting covered in food dropped from a wobbly fork/spoon. I also have melamine dishes and plates, light to lift or move and the pattern I got has a raised edge to it so gives something to push the food against to get it on the fork.XXX has posted about the Neater arm support, great device and here on alternatives How do you eat when you lose arm function.
I find for now using certain types of cutlery that are easier both to hold on to and to hold food ~ i often will use a 'Spork'
Your OT should be able to help you get these things, although I have found things myself online for a reasonable price.
Hope this helps..
L
--
I eat my peas with honey./I've done it all my life./It makes the peas taste funny,/but it keeps them on my knife.
Seriously, as XXX is mentioned, there are a number of assistive devices to help us eat. I have had trouble with my arms for some time. I always use a soup spoon to eat with, because I cannot get things to stay on a fork. I have to have someone cut my food into bite-size pieces. Recently, my OT found an arm support that clamps onto the edge of the table and supports my forearm while I am eating. I don't know the name of it, nor do I have a picture, but I will try to research it for you. Check with your OT and the ALSA loan closet near you. They may be able to help.
--
Hey N, I have the same problem eating peas, but usually I eat with a fork
so I recommend a table spoon if you're also using a fork. Try to keep
your elbows/arms relaxed on the table, (have enough space) and lower your
head more to reach the spoon. Avoid stress and cold, in my case they make
my hands and arms weaker.
A tip, if you smash the peas a little bit while coocking them, they will be
more stable in your plate and on the fork.
A pause in the day
The Madness has begun! Love this time of year. My current regret: not hitting "save" when I did my brackets. By the time I realized my error, it was too late.
Back to work.
3.18.2009
Tweet
Sounds like a Twitter or a Facebook status update, doesn't it? I must confess to being a user of both. I started using Twitter some time back just to check it out; I was influenced by Matt (who also encouraged Facebook). My initial feelings about Twitter were lukewarm, but the last couple of weeks I've visited more. The man who writes Paris 2e (see the link to the right) "tweets" and his updates are very entertaining. Amalah tweets, too, and she is another favorite.
ANYWAY, Twitter and Facebook aside, this post's opening sentence says it all. Well, almost. I am also tired, a good, solid, wonderful day sort of tired. I am looking forward to feeling my pillow against my cheek and the cool air coming in through the window. MMmmmmm.
Tweet dreams.
Happy, happy, happy
...these violent delights have violent ends..." I am preparing. How? I am determined to show only a smiling face, at all times, no matter what. It makes sense, doesn't it, to face every day, every minute with an upturned face and optimism? That is my intent, now and all the rest of my life.
3.17.2009
Luck o' the ?Irish?
How lucky am I to have these people in my life.
3.16.2009
Hopefully no number three
The second occurrence took place in the HOV. Traffic was merging on from the right so I was in the left lane. Two state policeman entered the HOV and, within minutes, had their lights flashing. The car in the right lane tried to move out of their way by going into the left lane. Just like before, I hit the horn and the brakes and just narrowly avoided being hit. I was not surprised when one of the state troopers pulled in behind this guy -- the miscreant was in the HOV illegally. Both state troopers stayed on his butt until he finally pulled over.
Needless to say the rest of my ride home was done cautiously -- things happen in threes, right?
Spring break update: Cecilia and I will be joined by my niece, who is studying abroad this semester. I'm very excited to see her as it has been a number of years.
Time to make some "pan-crepes.” Delicious!
Will Power
I wonder what I will say yes to later.
3.15.2009
The weekend
Now, this is not the first time she's displayed an elevated level of upset, but this is the first time in a long time and it was very low key compared to what came before. I looked at her and reminded her that I am very lucky to be very slow, that we should not look too far ahead but should enjoy where we are now. It must have stayed in her mind, however, for her to have posted what she did on Facebook.
We have our wonderful spring break trip ahead of us, and we are both looking forward to that.
Saturday I met the team, despite my protestations. Lynne refuses to let me be separate and I don't have the energy to argue. I did send them on their way without me, as I had decided to accept the fact that walking was best. I hadn't considered that I wouldn't be able to zip up my jacket, which I never would have worn to run, and I had to knock on the door of the still-closed Hyperion to ask for help. This, like asking for help with the gas cap, slightly unnerves me because people look at me questioningly since I don't appear to have an issue. But the young man was kind and helped with a smile, and away I went. I walked, and thought about something Cecilia said on our drive home. She called me "runner mom," and I laughed and said I wasn't much of a runner anymore. She told me I'd always be runner mom. Remembering this, I decided to give it a shot. And I ran, slowly, easily, wonderfully. As I said later to a friend, I go back and forth so much with this, but the run yesterday morning was restorative and reassuring. I guess I am still runner mom.
Hoops: Even though Maryland didn't beat Duke, their wins over NC State and Wake earned them a spot in the NCAA tournament. Nice!
3.14.2009
3.12.2009
Worthy of sharing
A Heavy LoadTwo traveling monks reached a town where there was a young woman waiting to step out of her sedan chair. The rains had made deep puddles and she couldn’t step across without spoiling her silken robes. She stood there, looking very cross and impatient. She was scolding her attendants. They had nowhere to place the packages they held for her, so they couldn’t help her across the puddle.
The younger monk noticed the woman, said nothing, and walked by. The older monk quickly picked her up and put her on his back, transported her across the water, and put her down on the other side. She didn’t thank the older monk, she just shoved him out of the way and departed.
As they continued on their way, the young monk was brooding and preoccupied. After several hours, unable to hold his silence, he spoke out. “That woman back there was very selfish and rude, but you picked her up on your back and carried her! Then she didn’t even thank you!”
“I set the woman down hours ago,” the older monk replied. “Why are you still carrying her?”
3.11.2009
Oh!
I don't know your name but I know you have a good heart. All my gratitude.
Clinique
Clinic was fabulous. My FRS is 42, my FVC is 90%, and the "squeeze test" indicated no change in my left hand and the expected additional weakening in the right. Once again, I dazzled my speech therapist with my fancy facework, she was impressed with my water drinking ability. My lovely OT and PT ladies were pleased to see that I was virtually unchanged from December. The dietitian was pleased with my weight (even though I am not, but whatever). I have decided to try to work on accepting this newer, expanded version of myself. I will refer to it as "fattitude" and I will use it to battle stupid Louise. So there.
Because I am a slowpoke I don't need to go back for four months. The usual return is three, so I am gratified. All this is dependent, however, on whether or not I am included in the study.
Fun, fun, fun. If I am included in the study, it will present a whole new set of challenges. It will require an IV catheter in my neck which will exit from my chest, as well as twice-daily injections of what may or may not be the ceftriaxone. As I lack both the stomach (despite the fattitude) and the dexterity to self-inject, this will be a bit of a hurdle. I will deal with it and make it work, but I'm not going to worry about it right now.
Right now I am going to finish my flying dog classic pale ale. Cheers.
Clinic
One thing I want to mention, though, is that I MIGHT be participating in a study IF I show evidence of a third indicator (currently only evidence two, which renders me ineligible). Brief info below:
Screening Effort Identifies Ceftriaxone as Potential ALS Therapeutic
[QUICK SUMMARY:A consortium of researchers has found that Ceftriaxone, a drug that alters glutamate, has been found to prolong survival in animal models of ALS.]
Researchers have published results in the January issue of the journal Nature, on a potential new treatment route for patients with amyotrophic lateral sclerosis (ALS), using an already marketed drug. Unexpectedly, the compound alters the levels of a protein that regulates the nerve cell messenger, glutamate. Now the drug, called ceftriaxone, is about to enter clinical testing in ALS.
“We now have a candidate going to clinical trials, due to this unique effort that brought drug screening into the academic arena,” commented ALSA Science Director Lucie Bruijn, Ph.D., who is an author on the paper.
Originally designed to target microbial metabolism, many of the beta lactam class of compounds can also affect glutamate transporter protein expression. Glutamate is a critical messenger for the central nervous system. It is kept at proper concentrations by means of a transporter molecule, called EAAT2, which collects any excess. Scientists funded through a consortium effort discovered that several beta lactams can affect the readout of the gene coding for the EAAT2 transporter and thereby influence levels of glutamate.
The revelation about this action of beta lactam drugs came about through a concerted effort to screen existing compounds for potential in neurodegenerative diseases. “These studies document a new property of a very common antibiotic,” write the researchers, “and demonstrate that beta lactams can activate the gene for a neurotransmitter transporter.”
The drug screening effort was initiated as a joint project of The ALS Association (ALSA), the National Institute of Neurological Disorders and Stroke (NINDS), the Hereditary Disease Foundation (HDF), and the Huntington's Disease Society of
Drug companies frequently conduct rapid drug-screening programs that examine many thousands of compounds at a time. The effort that revealed the glutamate action of beta lactams is noteworthy in that it was publicly funded, involved primarily academic researchers, and targeted drugs already approved by the FDA.
Already marketed drugs have significant advantages compared to newly identified compounds because they have undergone years of use in humans. This means that they could be immediately available for testing in patients if the data from the drug screen look promising. A clinical trial in ALS of ceftriaxone is slated to start in the spring.
Drugs that show statistically significant activity in multiple assays are especially promising candidates for tests in animal models. Ceftriaxone was one of these compounds. Led by investigator Jeffrey Rothstein, M.D., Ph.D., at Johns Hopkins, the team found that ceftriaxone increased levels of the glutamate transporter protein, at concentrations known to reach the brain.
Spinal cord tissue taken from nine day old rats, provided the initial screen. The investigators confirmed the action in living rats and went on to show that the drugs work to turn on the gene that codes for the transporter protein. Ceftriaxone was able to raise the amount of transporter protein in the brains of rats for three months, the maximum duration of administration tested.
The team then turned to various test tube models of neural injury and found the drugs effective in preventing cell death. Finally, they studied the drugs in the SOD1 mutant mouse model of ALS, in experiments co-funded by ALSA, NINDS, the Packard center, and Project A.L.S. (The animal testing was performed at PsychoGenicshttp://www.alsa.org/research/grant.cfm?id=175). Ceftriaxone delayed loss of muscle strength and body weight when treatment began at disease onset, 12 weeks of age in the mice. Earlier treatment did not add to the effect. Survival was prolonged similarly, for about ten days, by treatment that began at either 12 weeks or at six weeks of age.
Mice who were treated beginning at 70 days showed less glial scarring, and had more motor neurons surviving, after two weeks of treatment, compared to untreated mutant SOD1 mice, the researchers also found.
Early treatment would not necessarily produce longer survival, Rothstein and colleagues wrote, as the loss of transporter is not evident until around 90 days in these animals.
Rothstein and collaborators have organized a trial of ceftriaxone in ALS, funded by the National Institutes of Health. Details of the trial, including clinical sites and start dates, will be available by spring 2005.
3.10.2009
PLM post that made me queasy
---I've got some hard build up/deposit inside my peg tube. We've tried coke several times, and my husband has even scraped it, and it will not come off. Has anyone experienced this? Any suggestions on how to disolve it. Thanks.
Hi ,
Last year we had a similar problem with XXXX's peg tube. We tried the Coke too and had some results but the tube was still slow.
We then washed out one of the hanging bottles that XXX's food comes in and placed 300 to 400 ml of cranberry juice in it. The cranberry juice is the type with no sugar, just straight cranberry juice that you can probably get at the helalth food store, we used Lakewood brand pure cranberry juice. From the information that I could find, the cranbery juice had a lower Ph than the coke and would probably be more active in cleaning the tube. We set the feeding pump to deliver 75 to 100 ml per hour and let it run with the cranberry juice all afternoon. This slow prolonged application seemed to work. Every few hours we would give the tube a good forceful squirt of warm water to help flush anything that the cranberry juice might have loostened up along with rolling the tube between our fingers every now and then to help loosten the caked on material. We did this once per week for several weeks until the tube was changed on its normal schedule.
We now flush the new tube with a bit of cranberry juice every day. 4 oz caraberry juice plus 4 oz water split up into (4) 2 oz squirts throughout the day. This seems to do the trick. The daily cranberry juice helps with UTinfection control also.
Hope this is of some help.
A challenge.
Putting a key adapter on it won't help because I still won't be able to turn it, no matter what size. I need to create another lever-y type thing, but the key design and proximity to the wall may limit what I can do to effect this adaptation.
Any thoughts?
Update: Our building engineer is ON IT! I feel a big fat smile forming!
More on IPLEX
The ALS Association hopes that the FDA-approved program will develop informative data about IPLEX that can lead to a better understanding of its efficacy and safety and enable both patients and clinicians to make more informed decisions about the use of IPLEX and its potential as a therapy for ALS. To this end, The Association encourages the FDA and Insmed to establish partnerships with the ALS community to ensure that the program yields meaningful results that will guide the next steps in determining whether IPLEX is effective and safe for ALS.
IPLEX originally was approved in the United States as a treatment for children with growth failure, but it is now discontinued and no longer available for this population. The drug is being tested in a now-closed study involving myotonic muscular dystrophy (MMD). Insmed is supplying IPLEX to the Italian government under an "expanded access program," but it continues to be an untested and unproven treatment for ALS in the United States.
Based on existing clinical and scientific evidence, The ALS Association cannot encourage or recommend the off-label use of this medication without substantive evidence of its efficacy through a rigorous clinical trial. The ALS Association is continuing to monitor and assess information about IPLEX as it becomes available to provide the public with the most up-to-date reports about its potential for ALS.
More details to follow...
Sat, Jun 20, 2009 at 7:30 pm - Colonial Beach, VA
10K road race through south east road of Colonial Beach, Virginia. Fund Raiser for ALS Association. Post race BBQ and beer!
3.08.2009
Hi Beautiful
Beautiful day.
Beautiful life.
There was a support group meeting today. All the regulars were there. A young woman was joining us for the first time; her mother had been diagnosed with bulbar onset only a week ago. In the room there were three wheelchairs, two other bulbar, and me. Not for the first time was I struck with how different I am from my friends. I am 17 months post diagnosis. Average life span after diagnosis is 2-5 years. I am so not average. I am so grateful.
Beautiful, beautiful, beautiful.
I have hit a catch 22. I run less because it is harder to run; it is harder to run because I run less. I did not run last weekend (notice there was no post about this). I ran for an hour yesterday, and ran only about 1 mile today. The plantar fasciitis in my left foot is very much aggravated when I run but not so much when I walk. Walking is looking more and more appealing. And in weather like this, I could walk forever.
Making lemonade, and lemonade is beautiful.
3.06.2009
Whose ALS is "worse" continued
From the moment of diagnosis forward, every PAL experiences profound and grievous losses. Neverthess, the disease has no direct effect on our capacity to love and to be loved, our ability to project love and kindness into the world, or our capacity to cultivate within ourselves an abiding sense of joy and inner peace.
You can see why he is a favorite.
Another:
The worst case of ALS was in pALS that have already passed away. As long as we are alive, it's not even close.
Whose ALS is "worse"
Saw this on PLM today. I've sometimes thought I would trade my legs. We aren't given the option, though. We have it the way we have it, for better or worse.
I read a comment in another thread that (paraphrasing) [there are many PALS who are "worse" off than a PALS who can still at least stand]. I am really, really bothered by the mentality that someone with ALS who can still stand or walk is automatically "better off" than someone who can't. Obviously, someone who is "locked in" is worse off than someone who is not. They can't even communicate their needs. But who is to say what "disability" is harder on a given person or their family? To some degree, I understand this mindset in the general public. Most people can more readily imagine the changes that would come in their life if they couldn't walk....much more so than they can imagine what it would be like to loose their speech (while still remaining cognitively intact). But I'm disappointed that that kind of comparison is being done here on PLM.
I, for one, would happily trade my legs to have my voice and breathing back. For another PALS, who worked with his hands, loosing arm funciton (while at least having the ability to speak clearly and to walk) would feel like a major loss. Unfortunately, trading with another PALS isn't an option and unfortunately, all ALS eventually ends the same way that my bulbar ALS will. While the FRS measures progression, it is less well-suited to measure life-impact.
Just hoping to raise some awareness of the kind of subtle prejudices that we can harbor even among ourselves.
3.05.2009
I know. But I don't really care.
Mike also said my radicular (??) function was good, relatively unchanged, about a 32-26. Oh no! Another number! I warned him about telling me too much. Too damn competitive, and I'm the competition.
I don't care, I don't care, I don't care....
3.04.2009
Random acts
On the ride home tonight, I was pondering what to make for dinner. Since C Claire seemed to enjoy the "pan-crepes" I made last week, I thought I might make them again. Last week I had used Camembert cheese but decided to use brie tonight; I also decided raspberry preserves would be nice complement.
All my items (all two of them) in hand, I went to the register. The young woman behind the counter -- Alisha -- rang me up. Cheese and preserves aren't very expensive and I decided to pay with cash. Switching my tote to my right arm, I rooted around to find my wallet. Success. Now the hard part: unzipping the little pocket. Seeing me struggle, Alisha offered to help. At that moment I got the zipper undone. My next challenge was removing a $20 bill -- I got the bill out but couldn't unfold it. Once again, Alisha offered to help. This time I accepted, gratefully. She unfolded the bill, counted out my change, put it back in my wallet, and zipped it up. I was touched by her simple act of kindness.
Thank you very much, Alisha.
Italian chatter
More good news!
http://www.ansa.it/site/notizie/awnplus/english/news/2009-03-
So now that they have the gene, where do we go from here? It is good news if they do something with it. I'm not being cynical, just say'in. Let's get a move on.
I know what you mean but it's got to be a step forward. Better than finding nothing at all.
Thank you for posting this new goods news sara ! yes very peice of th jigsaw puzzle as they say is great !
thanks for the good news sara,lets hope they get some more peices of the jigsaw soon
I do not mean this in a negative way BUT show me something other than press releases... lithium iplex.... The Italians are great people! But I can only eat so much Italian! They do however get a A++ in ALS propaganda
I heard that it may not be true.... I'm not going to believe Italian information anymore. Food is good, ALS reporting rubbish.
A little irony to go with your morning coffee
Still haven't found a decent pair of pregger jeans, though. I don't remember the last time I went this long without wearing denim. I doubt I have EVER gone this long.
GROAN.
3.03.2009
Interesting news
| Italians find ALS gene |
| 'First piece of jigsaw, ' researcher says |
''This is a first but very important piece of the jigsaw in discovering the causes that trigger this mysterious and crippling disease,'' said lead researcher Adriano Chio' of Turin's La Molinette hospital. The study, which appears in the current edition of the journal Human Molecular Genetics, was carried out last year by ten Italian research centres, five in America, two in London and two in Germany. It was coordinated by La Molinette's neurology department under the direction of Roberto Murani. Tests were performed on 2,161 patients, 900 of them Italian. The others were American and German. The 1.5-million-euro two-phase study, which looked at the so-called 'sporadic' type of ALS and not the hereditary type, identified a gene called Sunc1 which appears to play a predominant role in regulating ALS. But Chio' said Sunc1 was ''probably just the tip of the iceberg''. He said the study will now move into a third phase in which 300 new patients will be examined, all of them Italian. ''The goal will be to try and find the other genes,'' Chio' said. Chio' has been helping Turin prosecutor Raffaele Guariniello investigate the apparently disproportionate occurrence of ALS, or Lou Gehrig's Disease, in the Italian soccer world. But the researcher stressed that ''ALS can strike anyone''. ''We recently discovered a higher occurrence (of the disease) also among farm workers and welders who frequently handle certain types of metals,'' he said. However, Chio' cautioned that ''thus far, epidemiological studies on the diffusion of this disease are far from discovering its true cause''. ''The important thing is to press on with research, especially now that these important results have laid a major building block.'' The 2008 study was funded by the Italian Soccer Federation (FIGC), the Italian government's Health Institute and the regional government of Piedmont. The third phase has already been approved and the Italian health minisry has already earmarked 400,000 euros towards it. SOCCER DEATHS. Guariniello, the Turin prosecutor assisted by Chio', has been investigating suspect soccer deaths for ten years. He is probing the deaths of 35 former soccer players. ALS funding received a boost last year when former AC Milan and Fiorentina striker Stefano Borgonovo, 44, revealed he was suffering from it. The Italian funding drive kicked off last October when Borgonovo's ex-team mates including Ruud Gullit and Roberto Baggio appeared at a charity match in Florence. Baggio called Borgonovo ''a modern hero''. The FIGC and other bodies have backed Borgonovo's call to find ''a new penicillin''. Before Borgonovo, former Genoa skipper Gianluca Signorini was the most prominent victim of ALS, dying of the disease six years ago at the age of 42. Former Juventus striker Gianluca Vialli is also putting money into ALS research, stressing that suggested causes for the soccer cases like doping, traumatic injuries and pitch chemicals, have not been proven. In America ALS is commonly known as Lou Gehrig's Disease after the first top sportsman to die of it, a legendary New York Yankees baseball player who died in 1941 at the age of 37. British physicist Stephen Hawking is probably the best-known person living with ALS. ALS is one of the most common neuromuscular diseases worldwide, and people of all races and ethnic backgrounds are affected. One to two people per 100,000 develop ALS each year. In the general population, ALS most commonly strikes people between 40 and 60 years of age. Men are affected slightly more often than women. Scientists have been vainly trying for decades to find a cause for ALS. The onset of the disease has been linked to several factors, including a virus, exposure to neurotoxins or heavy metals, DNA defects, immune system abnormalities and enzyme flaws. photo: Borgonovo with Baggio in October |
3.02.2009
Kindness
March is a lion
Working from home today. The snow is pretty, but hell to drive in. We have eight inches and it's still coming.
Back to those amethyst sheets for the time being.
3.01.2009
Sunday
We got a tiny layer of snow last night but the forecast calls for more overnight tonight. Part of me is hoping like a small child that we get a snow day, especially since I put my ultra favorite sheets on my bed. Yep, the 1,000 thread count, amethyst ones. Smooth like butter, they are, and perfect for midday napping.
Before the deluge, however, I have a few errands to run. All on flat surfaces , ha ha!
2.28.2009
Should I worry?
But I'm fine, the laptop (my first concern) is fine.
So should I be concerned?
2.27.2009
The ride continues
Where would I go.
This same restriction also renders me ineligible for drug trials, one of which is going to be conducted at MY hospital in the near term. I am very frustrated.
Why must I be sicker when I've had my diagnosis confirmed by four different neurologists?
Today is not a good day. Part of me wants to go away, from everyone and everything, and just be gone. No, not part of me. All of me.
Tis better.....?
Part of this stems from a conversation I had last night, I was asked how I'm doing, if I'm still running. When I said I am maybe getting in 6-7 miles A WEEK, I was told how they (the inquirer) could never have run that at all. Which is not relevant. Because I COULD run longer and I DID run longer. Apples and oranges.
I have an MRI at NIH today. I look forward to the nap.
2.26.2009
Hands
The right:
The left:
Right. Notice significant atrophy in the thumb muscle, and how swollen are the fingers:
This is as far as I can go when making a fist with the right:
Side by side:
Here is an earlier posting--I think there is a big difference since May.
2.25.2009
Buttons
A special thanks to Kendall and Cecilia; they were both great help today. I wore a suit, the jacket of which has many buttons. Kendall buttoned me up after our workout (translated: 20 minutes on the elliptical and 5 minutes stretching my arm) this morning, Cecilia unbuttoned me this evening.
This puts me in mind of something that happened this past weekend. I have a pair of casual cotton pants -- the last pair of pants I have with a button and zipper. I had a difficult time buttoning them on Saturday -- I got them buttoned, but only just. Recognizing there would be difficulty if I had to use the restroom during our dinner out, I changed back into one of my pairs of "easy" pants. I joked about retiring the cotton pair, saying I would consign them to a watery death in the ocean. We all laughed about finding the pants washed up on the sand or hanging from one of the fences protecting the dunes. Sunday morning, however, I packed them. I'm not ready to retire this pair just yet. I might not wear them, but I'll still have them.
Just to clarify: the buttoning process is more difficult because my left hand is getting weaker. So is the right, so, even when working together, it's not enough.
I think it may be time to upload some new pictures. I'll see if I can get my resident photographer involved, if I can get her away from taking pictures of the bird and the cat. These won't be fun pictures, they'll be a visual record of what's happening.
Maryland plays Duke in five minutes. Hope it's a better game than last time.
2.24.2009
A brief note
During the Saturday morning run with certain members of The Team while we were at Bethany Beach, I wondered about something. The Team makes running look so effortless, they lope along and talk--it's so easy for them. I wondered, if I was given a chance to do one more long run at that pace, talking with my friends, taking on hills like the machine I wanted to be, but the trade off was that I would not be able to run again, would I do it. I have to say, I gave it a ton of thought. Haha, not like I'm being given that opportunity, right?
Oh, something to make note of. My right thumb and forefinger have ceased to serve any real purpose. Mush, they are.
2.19.2009
She of the competitive nature
In the grand scheme of things, this doesn't mean much. After all, it won't make me well. But now, for the time being, I feel as though I'm maintaining.
If I've not said it before (and I know I have), let me say now that I absolutely adore my physical therapist. He is phenomenal.
Oat Meal
Well some dimwit suggested I give mom some oatmeal thru the peg tube. Let me tell you about the mess I have, its in my hair, my clothes on the ceiling'
I think I did sumthin wrong
i don't understand? was there a gastric explosion?
LOL, no I couldn't get it to go thru the 60 cc syrenge so I went int he kitchen and tapped on the plunger and out it came everywhere, what a mess. Hmmm bet if I had a house keeper they would wish they worked somewhere else at this point.
I remember reading a post from (DELETED). She had sneezed her oatmeal all over her careworker. Laughing We just have to laugh at these mishaps.
Maybe more liquid in the oatmeal for the tube. Make it really thin.
(DELETED) so sorry for this event. Was the oatmeal consistency similar to that of ensure or was it thicker? If it was thicker, this may have contributed to the "explosion"
Next time make the oatmeal thin and to be sure chop it in a blender,
oh dear, you're not using whole rolled oats are you? the cut/instant would be best. Better yet, how about oatbran? very fine consistency compared to oatmeal. Don't make it too thick.
to heck with that, got the mess cleaned up and she got cream of wheat instead lol
The conversation above is from this morning's PLM forum. I cracked up when I read it. Sort of.
Let me put it on record right now that I don't like oatmeal, I have never liked oatmeal, and I do not want oatmeal shoved down a feeding tube. Just sayin'.
2.17.2009
Brownies 151
It occurred to me today, as I came back from lunch and had to go through three sets of heavy glass doors, that eventually I won't be able to pull open the doors. As it is now, if I use my right hand, I only can pull the door open a smidge, then I have to use my leg/shoulder to open it the rest of the way. I'm still okay with the left, but the left is oftentimes holding whatever I can't hold with the right. It's frustrating as hell.
One of the guys here at the office was talking about his recent leg injury which put him in crutches for a time. He was saying how he never realized how much he used his leg until he didn't have it. There's that whole "taking for granted" thing I referenced before. He has an awareness now, though it will fade in time. Thank heaven for him it will fade, yes?
Well. Must leave this post before it turns gloomy. I have a big fat brownie sitting here doing its best to make me smile. Yes. It is succeeding.
2.16.2009
Gasp
I was going to write about my thumb and about one of the threads on PLM. I'd rather look out the window.
2.14.2009
Need a tissue
I was cleaning out my gym bag and came upon a couple of feminine items I no longer need. I keep some in the event someone else might need them, so I was putting them away when I remembered the time a few years ago during a long run in Richmond. Lynne and I were training for the Richmond Marathon. We were in a residential area near the river and I realized I was "unprepared." Fortunately we met a woman who was doing some yard work and who happened to be able to help me out. We thanked her and off we went, still having many miles to go.
This memory flashed in my mind so quickly, and with it the recollection of how incredible that run was. I won't have that again. My favorite running buddy and friend, my favorite activity, my favorite part of that marathon course. It made me cry.
I'll get over it. There are new favorite things to do, new happy memories to create. I just have to stop crying first.
After the breakup
It was cold -- about 28° -- so I wore long pants and two long-sleeved technicals. The iPod was all set with an episode of This American Life. I started out awkwardly. It was like I didn't know how to run. I thought I was keeping a conservative pace, but it felt like I was out of breath almost immediately. I stopped, coughed, started again. Same thing -- I became winded within seconds. Panicky thoughts ran through my head, was something happening? Was my breathing changing? Was I no longer able to run? If that was the case, then I would walk, thinking it was better than nothing. I walked for a few minutes. My breathing became regular, I felt calmer. I gave it another shot and started a slow, easy "wog” (which is the word I use to describe my running -- sort of a cross between walk and jog). This time I had better success. With the exception of walking the part of the course that has a bit of a rise, I did four solid laps.
So, that's that. I made it out the door without having anyone to meet, I came home without having an after run refreshment. I suspect I will catch up on a lot of podcasts this way. Not a bad way to spend a Saturday morning, all things considered.
Hand update: the nails on my right hand are growing beautifully. I guess this is to make up for the fact that I cannot even come close to making a fist. I can curl my fingers about halfway but there is no way in hell my fingertips ever make contact with the palm of my hand. I don't think the right hand has atrophied anymore, mostly because I don't think there's any muscle left. It is so surreal.
The left-hand is still capable of making a fist. The fingers are definitely separating and I do notice some swelling. The atrophy is more noticeable between my thumb and first finger, but my thumb muscle still has much of its bulk.
On a functionality scale, one being the worst and 10 being the best, I would say the right-hand is now about a two, and the left-hand is a 9.5.
And finally, there was another death announcement on PLM today. I've stopped reading them. I don't mean any disrespect, but I can't look. I used to read the Washington Post obituaries every day, but I was detached and simply curious. The death announcements on PLM are all about people who have the same disease -- my stupid disease. I am not anywhere close to dying and I don't want to read about those who have died. Maybe later, but not now.
Terps play in half an hour. Not a bad way to spend a Saturday afternoon.
2.12.2009
2.11.2009
Ultra random ruminating
I still and will always hate when my arms twitch. Remembering that when they stop twitching it's bad doesn't make me like it any better.
When I use my voice recognition software and want to sign my name, the software always writes "Death."
I was starving at lunchtime today and couldn't decide if I should get a Wreck . I was so tempted. At least I didn't consider these. (Check out the whole site. Ugh.)
Somewhere deep inside me I don't believe I have ALS. Until I reach for something or try to put on socks.
I hate the "creepy crawly" burning feeling I get in my back near my neck and spine. It's gotten so bad, and the only relief comes from C Claire applying a strong, pointy, determined elbow to it several times an evening.
All those times in my life I wished I was dead, I take it back.
+++++++++++++++++++++++
We had a visitor in the office today. While he was waiting for Melinda, he and I had a very nice chat. Somehow the conversation turned to being outdoors, running, walking, being smoke-free. The visitor commented on my very healthy lifestyle -- I smiled, and thought about the irony.
2.10.2009
Enchantment
Everyone deserves an enchanted April...
I'll stay awake as long as I can.
2.09.2009
Links, links, and more links
Bidet toilet seats, which includes discussion about Toilevators. I'm thinking the TOTO Washlet looks pretty nifty.
Fun, fun, fun.
I want to quickly recount some thoughts I had today as I was walking to the lab, to the bank, and to Super Pollo. First of all, it was in the high 40s or low 50s, mostly sunny and beautiful for a walk. Do you recall my post about watching people at the clinic; how I watched them use their hands? Today, while I was walking, I was aware of every step. I felt my legs moving, I felt my feet on the pavement, it was like I was walking for the first time. I promised myself right then I would not take walking for granted.
That's all. Nothing earth shattering. But it left an impression.
2.08.2009
Perspective
There was a 4 mile race this morning. Lynne and several of my other friends were running, so I went to support and to provide Lynne with a much-needed refreshment afterward. It was strange not running. At the last race -- the half marathon -- I didn't race, but I still ran while the others were gone. Today I saw everyone start, I saw them just before the 1 mile mark, and I saw them as they climbed the hill from hell on their way to the finish. Between the 1 mile mark and the finish, I walked to my car, took my meds, and just sat for a minute. It was a new experience, that's for sure.
Despite the difficult course, Lynne broke 34 minutes. She is a very strong runner. That's why I made the decision and announcement yesterday that I wouldn't be running with the team anymore -- at least not on Saturdays. I appreciate that Lynne runs back for me, but she's not getting the benefit of a good, solid run with people who will push her. For a time I thought it might work, but the slower I get the more difficult it is. I'm being selfish to stay with this group. This is just one more thing I'm giving away.
I've mentioned before how difficult it is to open my mail. Today I caught up on some mail that had been piling up, and even now, several hours after I finished, my hands and arms are tired. I'm going to have to delegate letter opening in the future.
I hate ALS. There better be a good reason for this.
Blah blah blah. All things considered, life is fabulous. After the race today, I looked up in the sky and saw the clouds and blue and thought how wonderful it would be to be up in the air, soaring, looking down at the ground from up above -- how exhilarating, how liberating, how wonderful. There are so many thing to be grateful for, I don't have any right to complain.
Sweet dreams and all my love.
2.05.2009
Deux choses
When I went to PT today Mike commented that he'd not been able to stretch my shoulder so well in a long time. I can't tell you how pleased I was to hear this.
So that was the first thing. Thing number two: when I got off the highway and was almost home, I decided to get some gas as I was close to empty. The station near my home is too expensive but is very convenient if you only need a couple of gallons. So I pulled in, but there were no other cars. The employee inside was an older woman who hasn't much more strength than I. Since I require a strong arm/hand to open my gas cap, I decided to wait until someone pulled in who could help me. Fortunately I didn't have to wait long. A couple of guys on their way from New York to Florida pulled in and gave me some assistance. Since I only got a couple of gallons it wasn't too terrible an inconvenience to them.
I'm yawning like a mad fool so it's time to get ready for bed. And homework.
2.04.2009
Stats
It was also the 50th anniversary of the New York Road Runners. I laughed to think I am the same age as this club.
It's a pretty certificate but I'm going to pitch it. I think I still have the certificate from my first marathon, but I don't see the point in keeping the certificate from my last.
2.03.2009
Advocacy Day
I found my way to The Renaissance Hotel and meeting room 15 and, since I didn't know anybody, found an empty seat at one of the tables. It didn't take long for me to meet other people -- and other people with ALS -- and we slipped into the sort of conversations typical in this community: when were your first symptoms, when were you diagnosed, what was your onset, etc. I also met people who had family members who had ALS, including some of the association staff members. Two of the women from my chapter had lost a parent to the disease; their involvement with the Association did not cease after their parents' death. I think that is commendable.
I met one man whose son was diagnosed at the age of 18. The young man is now 27. His parents have cared for him his whole life, and he is now (according to his father) close to locked-in syndrome -- where nothing except the eyes work. Listening to this man speak, I was struck with the thought that he would have given anything to have borne this burden in place of his son. My heart ached with the thought of watching a child suffer with this disease. I was reminded of something I said in the early days of my diagnosis, that if my having this illness meant that someone I love did not, it was worth it. My heart goes out to this man and his wife as they care for their son. It must break their hearts every day.
The meetings on the Hill were interesting. We met with staff members in the offices of Congressman Moran and Congressman Wolfe, and made an unscheduled visit to Congressman Connolly's office. On the Senate side we split up, one group going to Senator Webb's and the other going to Senator Warner's. I was with the Warner group. All the staff members were kind and seemed interested, but you could also tell they were thinking about their next meeting and all they had to do. It was nice that they met with us at all.
All of a sudden, I am so tired I can hardly keep my eyes open. Sweet dreams.
2.02.2009
Correction
Continuous involuntary sustained muscle contraction which is often a manifestation of BASAL GANGLIA DISEASES. When an affected muscle is passively stretched, the degree of resistance remains constant regardless of the rate at which the muscle is stretched. This feature helps to distinguish rigidity from MUSCLE SPASTICITY. (From Adams et al., Principles of Neurology, 6th ed, p73)
Definition
Muscle rigidity is a state of continuous firm, tense muscles with marked resistance to passive movement.
Alternative Names
Muscular rigidity, rigidity, rigor.
Synopsis
Muscle rigidity is an alteration of muscle tone in which the muscles are in an involuntary state of continual tension. Muscle rigidity can be a manifestation of neurological damage (basal ganglia diseases) or a side effect of certain medications. Muscle rigidity is the continuous, tonic contraction of the skeletal muscles, often more marked in the flexor muscles than extensors.
During conversation with Mike today, I discovered I had used the wrong term to describe what's going on with my shoulder. It is in fact rigidity, not spasticity. I experience spasticity in my forearms and hands. My apologies for the error.
Diligent adherence to my homework schedule resulted in an improved internal (bending my arm down), but the external (bending my arm up) still sucks. And no matter which way I move my arm, the idiot thing hurts like crazy.
Stupid, painful arm notwithstanding, I can still move it some. Pretty good record, don't you think?
Tomorrow is Hill visiting day. Don't have a clue as to the schedule, but it doesn't really matter. I'm there regardless.
Homework calls.
2.01.2009
February 09 -- my blog is one year old
I was home alone this morning, everyone having gone to Richmond last night for a concert. I encountered a difficulty when I tried to feed Lydia. The only food in the house was canned; the small cans with a pop top. My first two attempts were miserable failures, so I had to put on my thinking cap. Sliding a table knife under the pop top ring, I pried the ring up so that the can was just open. My right hand is unable to pull the top completely off, and unable to hold the can if I tried to use my left. So I took a long wooden spoon and slid it through the ring and, holding the can with my left hand, I pushed down on the spoon as with a lever, and off came the top. I was quite pleased with myself, and the kitty was happy to be fed.
I made a flank steak for dinner tonight and used part of it to make soft tacos. I was really pleased that I was able to cut the steak into thin, small slices all by myself. I had to use a really small knife, which I held in a very convoluted fashion -- but it worked.
After dinner, I discovered I am no longer able to scoop ice cream unless I let it sit and get soft. I like soft ice cream anyway, so no worries.
On a different subject: I did not run today. I had a bit of a headache (no doubt the result of last night's outing with the girls) and I was tired. But it was a beautiful day out so I determined I would walk while the others ran. Lynne was also feeling a little tired so she walked with me. We did a little over four -- possibly closer to five -- miles. The best part was her company. This last year I have missed her company during our runs. I have posted before that I run behind while the others run their pace, so I don't really run "with" them so much as behind them, and there is little, if any, deep conversation. So today's walk and talk was a gift.
It's now 8:20 PM and I'm going to get ready for bed. And do my homework. Sweet dreams.
1.30.2009
Spasticity
Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and may interfere with movement, speech, and manner of walking. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. It may occur in association with spinal cord injury, multiple sclerosis, cerebral palsy, damage to the brain because of lack of oxygen, brain trauma, severe head injury, and metabolic diseases such as adrenoleukodystrophy, amyotrophic lateral sclerosis (Lou Gehrig's disease), and phenylketonuria. Symptoms may include hypertonicity (increased muscle tone), clonus (a series of rapid muscle contractions), exaggerated deep tendon reflexes, muscle spasms, scissoring (involuntary crossing of the legs), and fixed joints. The degree of spasticity varies from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms. Spasticity can interfere with rehabilitation in patients with certain disorders, and often interferes with daily activities.
When I first heard the term "spasticity," I thought its meaning was similar to spasm. I've since learned the correct synonym is "stiffening," and when used to describe a shoulder can be called "frozen."
Today's educational moment is brought to you by my very own stiffening shoulder. I'm sure I've mentioned in earlier posts that the range of motion in my right shoulder is decreasing. Little things like lifting my arm to turn on the car radio, or reaching in to get something out of the refrigerator, or taking a dish out of the microwave are becoming very, very difficult. I see Mike twice a week and he works on trying to loosen my shoulder and increase my range of motion, using massage and whole arm movements. Sometimes, early in the session, these activities are incredibly painful. I grit my teeth and use breathing techniques to work through the initial pain. By the end of the session, I feel okay.
Mike is concerned about how much range I've lost. He stresses the importance of my doing my "homework." I do it, but it hurts like hell. Let me describe for you what I do; you do it, too, so you can appreciate what I must go through.
In a standing position, place the back of your right hand against the small of your back. Make sure you are standing straight. How does that feel? Probably not bad at all. Well, I can't do it unless I'm bent over. Anyway, now gently squeeze your shoulders back. How does that feel? I used to like how that felt. I don't anymore because it hurts too much. Finally, slide your hand just slightly up toward the middle of your back. Well? Can you guess how I feel when I do that? I'll have you know it doesn't hurt at all -- because I can't move my hand that far. Okay, exercise over.
I find it interesting to note the change, considering I was able to do this not very long ago. Spasticity is part of the disease; I knew on one level it would happen but I am amazed on another level that it did.
The worst part is the slow, creeping loss of ability. It doesn't happen overnight -- it happens gradually, and one day you realize that you are changed.
Several PALS use baclofen, either in pill form or via a pump, to help with spasticity. During my next clinic (in March) I will mention it to Dr. Bayat. As an aside, let me tell you I've read of another ALS patient who, after having the baclofen pump installed, actually experienced improvement. You never know.
On another note, Cecilia told me they are studying genetic diseases in her science class, and that one of the diseases listed was ALS. I reminded her that only 5-10% of all ALS cases are familial; the remainder are sporadic.
Time to do my homework. Have a super weekend.
1.28.2009
Last of the fall
As well, my thoughts today were not consumed with the possible negative effects. After all, it is what it is and each day must be dealt with as it is presented. Worrying about what might be is just a big fat waste of time. I apologize for yesterday's gloom.
I received the summary and the talking points for the February 3 visit to Capitol Hill. The e-mail distribution list included me and three others -- none of whom are identifiable by their e-mail addresses. We are meeting at 8 AM at the Renaissance Hotel near Metro Center. From there, we all go to the Hill together. I'm interested to see who else makes up our group, and I'm also interested to see which members of Congress we visit. I won't get a schedule until Monday, February 2.
Not a bad day, all in all. I expect tomorrow will be fabulous.
1.27.2009
After the fall
I didn't sleep well last night, every time I turned I felt the pull of the bandages and it hurt. When I woke up, I was sore but not as much as I thought I would be. The immediate impact of the fall I felt in my left shoulder. My left arm is my strong arm now, but when I opened the office door, the car door, or tried to lift or move anything, I realized I had banged my arm pretty badly.
Worse yet, I couldn't stop thinking about what Ellen had said at the last support group meeting about how traumatic to an ALS patient a fall is. She said that falling often is so traumatic it adversely affects progression. So, whether my fall was an ALS fall or just a regular fall, it was a fall. No matter how hard I tried today, these thoughts kept running through my head. It scares me to think I might have done something that will make me even worse.
I must, I will push this stuff out of my head.
I managed to shower tonight, sans bandages. Since I'm not in freak out mode like last night, the scratch doesn't look as terrible. It ain't pretty, and I've got some bruises already forming, but it's less deep than I thought it was. There's also a bruise on my hip and my shoulder. I am a ravishing beauty!
I suspect I will be a bit more sore tomorrow; the second day after a marathon is usually the most painful. And I know my left side will be less functional for a day or so. I also know this will improve because, fall trauma notwithstanding, my left arm is still strong.
Now I must watch as the Terps spiral downward again, then to bed. Sweet dreams.
1.26.2009
Damn
The stupid cat had jumped up on top of the birdcage. Actually, I was the stupid one because I left the door open, giving the cat access to the birdcage. Anyway, I was hurrying toward the cage and somehow managed to fall sideways. My back caught one of dresser drawer handles as I made my way down -- I have a big ugly scratch on my back, and my sweater is torn. I have another scratch on my left shoulder.
Since I can't reach back there, and Cecilia doesn't like to touch people -- even her mother -- I had to wake my neighbor and ask her if she could help me. Bless her heart, she came right over.
There will be one big, ugly bruise in a few days. I anticipate being very very sore and stiff tomorrow morning.
That will teach me to leave the door open.
1.24.2009
1.21.2009
Maybe...
I have been sad today. I don't think anyone knew it, I didn't want anyone to know it, but I was. I laughed and joked and did all the regular things, but inside ran all those thoughts -- you know the ones.
My right arm gets so tired. It's so hard to move it very much; when I do, it hurts. By this time of day there's a soreness that runs from fingers to shoulder. And my dumb left hand, though stronger than the right, continues to decline. At work today I was less able to do certain things. As I said before, slow progression doesn't mean no progression. No one sees it, but I feel it.
I've been asked to go to Capitol Hill in early February, along with representatives from the national chapter of the ALS Association. I'm to be one of the "faces of ALS" as we meet with members of Congress to ask that they remember the 30,000 PALS as they plan their funding for research and healthcare. If given the opportunity, I'll say I'm there representing the ALS patients who can no longer walk or talk. I hope I acquit myself well -- I'd very much like to participate in the full-blown lobbying effort in May.
Anyway. I'm tired, my arm hurts, and it's time for bed. Maybe when I wake up it will be better.

