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The Pale Brown Line

I need to find a way to teach productive acceptance of our conditions.  I would hate to see A live a life of boulder pushing.
I need to find a way to teach productive acceptance of our conditions. I would hate to see A live a life of boulder pushing.

The author, Richard Cohen, recently described living with MS as akin to living as Sisyphus, condemned forever to roll a boulder up a hill only to watch it roll back down (http://richardmcohen.com/welcome-to-sisyphusville/). As I think about MS, rather than pondering the deliberately frustrating task of rolling a boulder all day for no result, I picture myself trying to walk the thin pale line barely visible to this color challenged dad.

On one side of the line, I see only today. Every day feels much like the last. The pain is still there to keep my foggy mind company. I take my medications to enable something akin to a normal day’s worth of activity. I do so knowing tomorrow and all of tomorrows’ tomorrows will lead down a path of increasing symptoms. Why bother? As I look at today, it seems so pointless, so like yesterday.

On the other side of the line is the sight of the distant future when I am dead and scattered in the wind somewhere. After all, the opponent on the other side of the line is Father Time, and he has yet to lose.

Somewhere in the middle is the pale brown line, just subtly different from the marble of daily experience on which we all walk. Along this line, it is possible to see the impact of the marginal daily gain. I think of it as the trail of the poo of life. With a 3-year-old, a 7-year-old boy and an eight- year-old girl with bowel issues, the juvenile side of me can’t get poo off the brain. In this case though, it gave me a new perspective.

At first all a baby seems to do is eat, sleep, and poop. Every day seems the same…for months. Then come the little changes which at first are little but annoyances. Why must every kid take off their poo filled diapers? Then comes the endless story telling to occupy a kid’s mind while they sit on the potty. Every day, it is another story, and the only change comes in the form of a different story. It’s mind numbingly exhausting some times, but it is eventually traded in for the often repeated and always ill-timed, “I have to go potty RIGHT NOW!” Some times they make it. At other times, it is back to cleaning up poo.

Still, mired in all of this poo, is the faintest whiff of progress to give hope. From a daily perspective, it often seems pointless to try. In the long-term, we are all fertilizer. It’s along the faint brown line, faded by years of potty use instead of inadvertent dumps, we can see how much we have grown.  It’s only when I can choose a middling perspective between now and the future that I get to enjoy life’s progress.

I try to think of my MS as the need to take a dump. Each day, I hope I deal with it a little better whether it is a dry erase board to remember tasks to be completed or just confidence I can overcome the trials of the day.  To ignore the MS is to create a much browner spot along the line, but to focus too much on it is to fall into the “woe is me” depression and lose sight of the line.

 

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Temporary Reprieve and Patient Centered Research

I think one of the hardest parts of having a chronic condition is the almost inherent loneliness which comes along with all of the symptoms. When I think about my MS and my family’s understanding of it, I am forced to concede I would not wish them to understand. I think it is difficult for outsiders to understand not just the effect of the symptoms at any given point in time but also the fear and unpredictability of timing for likely outcomes. So I can not just wish my family to experience MS for an hour or a day because the worst part is the unknown.

It is with this feeling of isolation of experience that I went to the conference for patientlikeme.com this past week in Boston. It may take awhile for the trip’s success or failure to be seen in term of expanding the utility of the site by generating common language to tease out health information across medical conditions. What is known now is how much I and others across the spectrum seemed to enjoy meeting each other and the staff of patientslikeme.com.

After our last meeting, I was trying to phrase why it meant so much to me to meet these strangers previously known only from a web site. The closest I came was the realization of the honesty with which we all talked. There were no walls needed to spare the imaginations of those with whom we spoke. Everyone there had faced their own medical trial and moments of uncertainty. Watching the group dynamics was fascinating as we tried to capture in words and questions the ideas of “health, well-being and sickness.”

Very basic questions remained unanswered, such as for what purpose are we asking the questions.  Are we using the questions for diagnosis or tracking known problems.  Answering this basic question will be key for determining the wording of questions and ultimately the utility of the instrument designed.  I was surprised to hear such differences and commonality in unexpected places across the spectrum of our experiences when it came to defining such basic terms as “health.”  I can hardly wait to see where the patient centered research project goes from this hopeful first step.

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On a side note going back to last week’s appeal of Blue Cross Blue Shield’s rejection of covering Adderall for me, my neurologist wrote them (after their decision in my favor as it turned out).  In his letter to them he quoted three studies showing the positive impact of adderall for MS patients.  What I found especially heartening was the three studies show the same results as looking at Patientlikeme reported data.  It boosts credibility of a method when the same results are reached using an already approved methodology.   The use of patient oriented research could allow for much faster segmentation of study populations to better recognize where a treatment is likely to succeed or fail.  The better segmentation should drive down research costs over time and hopefully allow for a shorter time between discovery and market for new products.

If we can not have a cure, the next best thing is an improvement in how we search for cures.  It is my hope that patient centered research will allow for quicker, cheaper and possibly better studies of new treatments.  Maybe what we are seeing now is a first step in the right direction.  I’m not betting on getting it right the first time.  I’m betting on being able to learn ever more quickly from our missteps.

Which way to room 303?  For all researchers, I hope our information is clearer than this sign.
Which way to room 303? For all researchers, I hope our information is clearer than this sign.
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