Category Archives: Multiple Sclerosis

Lonely With a Cure

I love you despite your craziness if you don't mind my obsessive drive to eat poop.  Deal?
I love you despite your craziness if you don’t mind my obsessive drive to eat poop. Deal?

It seems I have written before about the gulf existing between Wellville and Sickville. It comes to a point where it feels impossible to remember what it was like to be well or even have one’s feeling truly understood. It is certainly an emotion commonly expressed on message boards and amongst friends with similar conditions. However, there is a side effect to this gulf because it sits between us and those with whom we would otherwise be closest. How many things are more isolating than feeling like those who have known you longest and often best no longer understand what you experience? What’s worse is feeling the only way they would understand would be to have the same experiences and know you would never wish that upon them. So the loneliness problem is a common side effect of any medical condition.

In the U.S., we prize our individualism. We celebrate our poets who could go off into the wilderness to find themselves. We rarely talk about our cultures increasing segmentation and physical divisions. For example, I find instant messaging with in the office to be a terrible, yet common, practice. I am 3 cubes over. Stand up, walk over, and let’s talk. Ten years ago, I heard a presentation where it was pointed out the best way to predict levels of crime in a neighborhood was to find out how many people knew their neighbors first names. I still find it hard to believe how many people do not know their neighbors. As a culture, I guess we go home, shut our doors, eat and watch TV/go online.

No wonder we do not recognize the public health risk of loneliness. How does one recognize the lack of something one is not used to having? Our culture makes being alone seem desirable or at least like we should feel fine being alone. Now there is a growing body of evidence suggesting loneliness is a driver for many adverse medical conditions.

One of my favorite meta studies looked at 70 studies involving more than 3.4 million people who were on average 64 years old at the time of their study. Over an average duration of study of seven years, roughly a quarter of the participants died. Those who reported being lonely were 26% more likely to have died during the study, and people living alone had a mortality rate roughly 32% higher than those living with others. One write-up of this study can be found at lonely.

The double edge of life in sickville is when our illnesses drive away those whom we love. It’s not easy sleeping in a bed with somebody whose spasms wake you in the night. Who wants to be close to a person whose touch can be so warm as to burn, whose emotions and thoughts seem to wander randomly? It’s hard on everyone, and it creates a cycle where illness pushes people away causing loneliness leading to still more illness.

On the more positive side, there is an increase in looking to “fix” the brain rather than just treat symptoms. brain hack

Rather than try to increase the pleasure chemicals in our brain to combat depression, what if we could just fix the part of our brain causing the problem? From my perspective as an MS patient, this treatment route sounds fascinating. If you are studying the circuits in my head, can you just fix them? Will doing so still leave “me” in tact? While you’re in there fixing my circuits, could you please make everything run just a little more smoothly or would a perfectly operating nervous system leave me without anything to commiserate over with others. Would it leave me more lonely?

The part of this study which scares me is the seeming potential to change who we are. It leaves open the question of what exactly make us the way we are. Are our neurosis a key part of us. Love me, love my craziness, but don’t worry we can change the crazy me to a more comfortable me later?

At least my dogs love me the way I am.

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A Year of Milestones: 2015

Maybe we all need the blind to read to us, especially if they are reading to us about us. (K reading to Scarlet from a book made about Scarlet)
Maybe we all need the blind to read to us, especially if they are reading to us about us. (K reading to Scarlet from a book made about Scarlet)

I have a habit of looking back at the end of a year and taking a moment to think about what was important in the year. Often things which seemed huge at the time seem much smaller with the gentle lapping of time’s waves. Other events which seem trivial loom large as their occurrence warns of an incoming avalanche.

With that said, here are my most salient memories of 2015. I turned 40, and I realized I have had MS symptoms for 10 years. Now just having MS for 10 years doesn’t seem like that big of a deal ten years into it. However, early on when I was dealing with head aches bad enough to make me pull over to the side of the road to puke or could not hold on to a soup cup for long enough to pay for it, my ability to still maintain a full time job and help my wife raise three medically fragile children would have seemed foolishly optimistic. So here I sit at 40 years old and having had ten years with MS, and I am planning to run the Yellowstone half marathon in June. It is my way to “rage against the dying of the light.”

When I think of big events of 2015 for me and my family, the events list start with the adoption of K. She has been with us so long, the formal adoption was almost taken for granted. She has been family almost her entire life, and we take it for granted at this point. Of course that is a sign of the truth of the statement in fact as well as in law that she is family.

For other family events, it is hard to come up with one bigger than the summer family reunion in Arkansas. For me, it is still amazing to see the family bonds strong enough to pull more than 75 people together from all over the world every five years. It feels like living in a story from the fifties because I don’t see or know of many of my friends still having big family reunions. It’s an invitation to be accepted into a family group larger than our nuclear family and close friends. For our kids, how great is it to get to know they are connected to so many people of different cultures who approach things differently? Still better, the family reunion was followed by a week with just uncles, aunts. grandparents and cousins. So their personal net of connections got cast out wide and then pulled back just a little to deepen the ties a bit closer on the family tree. The whole trip was a fascinating time to renew friendships and definitely one of my favorite highlights of the year.

Continuing on the family side, I was also lucky enough to chaperone each of my two oldest on their respective scout camping trips. It may seem silly to rate nights spent laying on the cold ground as highlights, but I enjoyed the time bonding with my kids and watching their interactions with their peers. I figure I am not that far away from a time when my kids will grow apart from me and not want me hanging around. After all, the “cool” dad role has a definite expiration date. So for the time being, I will enjoy the chance to tell stories around the camp fire and laugh as other kids are now old enough to know some of the myths I draw from to craft my stories.

Happy moment of found family 2015
Happy moment of found family 2015

On my work front, 2015 was rewarding, informative and depressing all at once. The project I manage lost 6 of it’s 4 employees during the most hectic part of the schedule before publication. No that is not a misprint or a mistake. We lost the replacements of 2 of the spots as well. When we published in September, there was another project manager and I along with two employees who began April 1st and 2nd. When I say rewarding, it is because we accomplished what most outside our group said could not be done for months leading up to publication. I was lucky to get good employees who quickly grasped what I was trying to teach and then were able to move forward. The depressing part was being given a rating of barely passable performance by new management who never understood what was involved in meeting our publication dates. So they praised us in public for accomplishing what most thought could not be done, and then in private they rated us as low as they could without having to justify the ratings. As a kicker, the other project manager was removed from our area in the weeks following publication. The upside is the rating has reenforced in my mind the need for cultivating an ability to appreciate accomplishments regardless of others’ opinions. I teach it to my kids, and this is just an example where I need to live what I teach.

Thankfully, if my job threatened to make me question my abilities to think critically to work towards a goal, my work with the American Board of Internal Medicine (ABIM) as patient’s advocate has been rewarding. It is fascinating for me to learn how they determine what a doctor should need to know after they have been practicing medicine for years. ABIM then gave me two great recognitions of my input. They extended my term of service on the board as my initial term was expiring, and they asked me to help them on another as they set up a conference promoting patient centered medicine. Not much makes me feel more appreciated than being asked to continue and then asked to do more.

Still, the highlight from a feeling of possibly having an impact on healthcare came when I was asked on a Wednesday afternoon in October if I would present at the FDA on the following Monday. The kicker was I had to have a presentation to them by Friday. Thankfully, the topic of the presentation was REMS: Understanding and Evaluating their Impact on the Health care Delivery System and Patient Access. It was an opportunity for me to talk about risk management from a patient’s perspective because I take a drug with a chance to leave me with a brain infection likely to cripple or kill me if I get it. Talking about numbers and what they mean is the type of conversation I frequently lead at work as we review data, and I had just written about our inability to really conceptualize large numbers. So I wrote up the presentation on Thursday night and gave a quick run through with my coworkers on Friday before submitting. On Monday, I gave my presentation and actually had some applause which shocked me. Having people come up to me for the remaining 2 days referring to me with “you’re the numbers guy right?” was a great shot in the arm. I was even contacted months later by another patient advocate who watched my testimony and was impressed enough to re-watch it before presenting to the FDA at the request of the MS Society. Giving that presentation was a high water mark for feeling my thoughts on our healthcare are respected even if I think they are often given more weight than they deserve.

My theme for this past good year could best be stated, “It feels good to be valued.”

There is a some times shy super hero inside us all. This is one of my favorite pictures from 2015.
There is a some times shy super hero inside us all. This is one of my favorite pictures from 2015.
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