Spring!

By Lisa Scroggins

Finally, spring is here, and I feel more energized than I have for some time! I suppose it’s a combination of the improved weather, and an improved outlook.

When I saw my neurologist in February, I asked about Lemtrada as well as Ocrevus (which has since been approved by the FDA). My doctor wasn’t very encouraging about either option, and I was frustrated. I talked with my husband about getting a second opinion. I wanted the latest, greatest treatment, and I wanted it now!

I suppose I’m the classic dissatisfied person with long-time MS. Things really went south for me a few years ago, and I won’t lie: I was deeply sad, and shaken by the newest losses I was experiencing. We have made trips to see a specialist, and had high hopes for something new that might help me improve. I’m sorry to report that not only did the specialist not have any new ideas or ones that differed from my general neurologist, but she turned out to be a truly unkind person. By that I mean that from the first moment I met her, her basic social skills were sorely lacking, to the point of rudeness. (Example: when I first met her, I held my hand out to shake hers, and began to introduce myself. She held her hands up, palms facing me, saying, “I just washed my hands!” My gut told me this was weird, but I fought my instincts. I didn’t know this doctor yet, and we’d traveled quite a distance, incurring hotels, meals, gas, etc., and the last thing I wanted to do was go back home without getting seen.) That kind of thing can happen to anyone, but somehow, because MS is a chronic illness, and I made special arrangements to see a so-called expert, I was unprepared for the callous way that the “expert” treated me. It seems obvious in the abstract that not all doctors have a great “bedside manner,” but I confess I was really vulnerable and it hurt, probably more than not being offered something new to try.

Back to my local neurologist and my silent demand that I must be on something new. While I have not officially gotten a second opinion, I feel as though I have. I watched a YouTube presentation by two MS neurologists in another geographical area, and even though the words they used were very similar to what my doctor had said, it essentially was confirmation of what he had told me in February: those two treatments are new, and it remains to be seen if either or both have unanticipated, even serious side effects. I know they didn’t mean it in a disrespectful way, but they as much as said, “let others be the guinea pigs.” Worded more professionally, for people who continue to experience attacks while on another medication, one of these drugs might be a Godsend for them. But if attacks are not occurring, it’s much safer and wiser to remain on one of the drugs with a much longer safety profile.

I did not want to hear this, and yet, I needed to hear this. My husband didn’t say so, but I suspect he is relieved that I’m not pressing to hit the road again in search of a different answer. I’ve come to a proverbial fork in the road of navigating life with a chronic, sometimes cruel illness. The best thing for me to do is to continue on the therapy my doctor has prescribed.

People with MS are taking big risks to try to improve their functioning, and both Lemtrada and Ocrevus have the potential to be quite risky. The biggest buzz seems to be about HSCT (hematopoietic stem cell transplantation). This has not been approved by the FDA, although there are studies in progress. So far, the number of patients is small, and while it looks promising, I realized that I didn’t want to die in an attempt to get the procedure. I know of people who have gone to other countries to get this procedure, and have gone to great lengths to raise the money (in excess of $100,000) to do so. Not only am I unqualified to determine if protocols done anywhere are best practices, I’m also not fluent in any of the languages spoken where some are having HSCT.

Some of these people have died. Some advocates describe that a specific thing happened to this one or that one, and maybe those stories are true. And maybe they aren’t. I really did some soul-searching, and tried to imagine if I pushed to do this. I’m in a foreign country with my husband, when suddenly, I develop a complication. Things don’t improve, and I actually die. Well, then, my husband, having watched everything, has to contact everyone in our family and tell them. He has to get himself (and my body) back home, and deal with everything that happens when someone dies. I’m not trying to be dramatic, but I had to really imagine this. As much as I wish for an improved (maybe even cured!) condition, it seems cruel to put the people I care about most through the wringer. A less dramatic scenario could happen, too, wherein I didn’t noticeably improve, but we’ve spend a massive amount of money, not to mention the emotional capital draining away. And maybe I’d be one of the lucky ones, the folks who swear they’re like new.

Even as I write this, I wonder if I’m giving up too easily. Never stop fighting, right? The truth is that many people with MS profess to be willing to take gargantuan risks to get better. I counted myself among them. I’ve realized that I’m not such a badass, after all.

All of this has served as a kind of “spring cleaning” of my attitude. It’s surprisingly freeing to imagine not questing after another drug! Instead, I’m trying to focus on things that will bring me joy, as well as new “treatments” that I can control. I’m fortunate that we could afford to buy a Freedom Chair, and that allows me to ‘walk’ our neighborhood. I recently signed up for equine therapy and am looking forward to being outside on the back of a horse. Perhaps most telling of all, I found a book that has given me a lot of hope. I know I’ll still follow everything related to MS, I’ll research it and ask my doctor about it. Other people may push hard for something to get better, and maybe that’s fine for them. I’ve decided to focus on the here and now and the known.

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Change Perceptions

By Lisa Scroggins

“In this world, nothing can be said to be certain, except death and taxes.” – Benjamin Franklin

Death and TaxesI would argue with Mr. Franklin that his famous aphorism should be amended to include the word “CHANGE.” Change happens whether we want it or not, and this is true for all people. However, for people with MS, change, generally, tends to be unwelcome.

Maybe I need to change my perceptions of change.

Maybe, since change is going to occur, I need to change.

You probably know some older people who frustrate you with their rigid approach to life. Those people whose most common complaint is something to the effect of this:

Young people today are shallow and don’t know how to work!

Or this…..

She is such a malcontent. Always complaining about MS symptom this, and MS symptom that. She should just DEAL with it! I’m not even sure that’s a “real” thing.

For me, change in regards to my MS has generally been negative. Changes, especially in the past few years, have meant less mobility. For others, it may mean cognitive difficulties or the loss of another ability. Given the vast array of symptoms presented by MS, there is almost no limit to the loss (DISability) that might be sustained. It’s exhausting, dealing with MS, or as I have written in the past, “I’m fatigued and I’m tired of it!” (Pun is definitely intentional.) I am one of those people who have been dragged into my new normal, kicking and screaming and protesting loudly all the while! Inexplicably, I have recently changed my resistance to change in one small way. For the most part, I get annoyed with the way that many people seem to prefer watching a video for everything. It’s probably related to my learning style, but I much prefer to read about something. For example, when I Googled “multiple sclerosis symptoms,” I got a huge list of links, and many of them were to recordings, a great deal of which were on YouTube, with some to news broadcasting stations and to WebMD. Typically, I would ignore those and look for the links with lists.

But I stumbled upon a new link and a lot of the information there is in recorded videos. The information is new to me, and I find it very helpful. I have actually listened to and watched several of the videos. This particular website was created by a person with MS, and I have found information there that was new: http://www.msviews.org/msviewsandnews4/ I have to fess up: I only listen to some of the videos there and don’t always watch, so I guess I remain stubborn. The website was previously known as Stu’s MS Views and News, but Stu has managed to get a lot of help on his side and his website has grown a lot. There are partnership links there, and you may or may not be impressed by those, but in any event, there is probably something there for you to take in. I really enjoy Dr. Ben Thrower, who is a neurologist and offers a lot of information in a form that people without a science background can understand.

I was diagnosed a long time ago, and have seen many headlines that read as though the misery that is MS was about to end! HUGE breakthrough! Promising treatment! All the excitement has worn thin for me, and I view such headlines nowadays with skepticism. Remembering the time when I was diagnosed means telling you kids a story. It was the early nineties. My resources were limited: the public library, my doctor, and any local support groups. Email was nonexistent, as was the World Wide Web. There were a few national organizations, and they had 800 numbers, and mailed out written publications. I don’t remember when or how I learned about the MSAA, but it was not the first organization devoted to MS that I knew about, even though it was founded in 1970!

The truth is that a lot of change in the field of MS has vastly improved:

  • The availability of information
  • Treatments: there are more than a dozen treatments available
  • Organizations that help patients dealing with MS
  • Research into the etiology of MS

Now, there are many organizations specifically formed for us, the MS patients, and information is overwhelming. It can be difficult to navigate and even to discern which information is reliable. The pace of change is brisk, indeed, which I believe is positive for us.

Dealing with change can be done with grace and likely will benefit you. I have changed my perception of videos about MS.

What change in dealing with change will you undertake?

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Dear Newly Diagnosed

By Lisa Scroggins

This should have been easy for me to write. My topic is coping with getting a diagnosis of MS (multiple sclerosis). Mine occurred quite a while ago, and that is why I believe it’s been somewhat difficult to write about. Not from lack of memory, nor lack of interest. So much has changed since I received a diagnosis, that at first, I thought, there are treatments now – not so when I was diagnosed. There is so much information available on the internet now, yet when I was desperate for information, that now well-traveled virtual highway was known only to a handful of adventurous folks; that is, not to you and me. I was limited to what I could find at my local library, which was paltry, at best.

Then it came to me: the same technology that has made instant communication possible, that has transformed the world, truly, is not all lollipops and gumdrops. If I were speaking to someone newly diagnosed, I think one of the first things I would say is that he/she should tread lightly in cyberspace.

Over the past few years, I have participated in a few Facebook groups organized by people with MS. I didn’t participate in some of them for long, however. It’s pretty astonishing how many people seem to use Facebook as their “go to,” for lots of things. Apparently, a fair number of MS patients fall into this group. If the information found were always correct and/or helpful, this might not be so bad. But as some of you reading this have learned, some of the information found via social media and the internet is undoubtedly anything but accurate or helpful. It’s true, just as in the bad old days, that misinformation and the “awfulizing” of MS still live large.

More important than being wary of social media or things that friends and acquaintances might say to you about this recalcitrant disease, do not take as medical gospel much of what you read on the internet. Not only do you have to consider the source, you also have to realize that MS is just as unique as is your very own fingerprint. No two people have the exact same symptoms, nor do they have the same disease course. In my experience, well-known websites staffed by bona fide medical people generally give a, well, general description of MS. There are still so many unknowns about MS that despite as many as 13 FDA-approved therapies for MS, scientists still seem to struggle with which people should get this drug, and who should get that drug. Efforts are underway to figure out how to personalize the drugs (and not only for MS), but that strategy is in its infancy.

Sadly, there are still some neurologists out there who either have a hopeless attitude about MS, or their bedside manner is atrocious. Both can be devastating for you, dear newly diagnosed person. I started to write “dear newly diagnosed YOUNG person,” but since in the past 10 years or so, I’ve known quite a few people who were diagnosed in their 40s or 50s, and even one man who was past 60 years of age when diagnosed, to assume that all newbies to the helter-skelter world of MS are young would be a grave mistake. I am nothing more than a layperson with no special medical training, and yet, my strongest advice to those just setting out on this journey would be that you must be your own advocate. I know! That’s not what you feel like hearing, and you may even resent me for saying it. But trust me, nobody cares more about what happens to you and your body than you do.

As you seek information about MS, you will come upon some that is heart-breaking. You will probably see and hear about people who have had a miserable course. I remember when I tried to avoid those people. It wasn’t because I thought it was contagious, but it was because I didn’t want to hear them as they railed against the unfairness that is at the heart of MS. I must hasten to add that even though I said I avoided “those people,” that isn’t an accurate assessment of what happened. I knew one woman in the first year after I was diagnosed, who was the leader of an MS support group for the newly diagnosed, and she used a scooter. She was such a kind person, a real leader in all the meaning of that word, that I don’t believe any of us looked at her in the scooter and ran for the hills. She offered resources when she could, but she listened, she sympathized, she even shared a couple of times when she cried. But she ultimately was there for us, and we knew it. Nobody else could have understood so well what the deepest fears of every one of us were. Other groups in which I’ve participated consisted mostly of a lot of complaining about the difficulties of having MS, and those, my friends, are legion. You may already have experienced some of those. If so, then right now, please do whatever you have to, to keep your sanity. I remember soon after getting the diagnosis, my family and I were on a cross-country trip, and we were about to enter a long tunnel. I had a sudden thought and was terrified that when we came out of the tunnel, I might be blind. That didn’t happen. As far as I know, nobody has something that happens THAT rapidly. Take a deep breath. You don’t have to get everything figured out today, or tomorrow, or next week.

One more point about finding information about MS on the internet. Along with great strides in therapies for MS, there have been many that fall in the realm of CAM, or complementary, alternative and integrative health measures you may try. In this area you may find some relief. You also may find some very strident people who insist that you must never eat X, or always eat Y, or maybe if you do THIS, but stop doing THAT, you will be cured. Read, research, try to vet the proponent of the ideas you consider. Talk to your doctor about it. There are those who stand to profit from banking on your fears. The truth is, that at this very point in your life when you likely are feeling the most vulnerable ever, you will be called to muster up your best intelligence-gathering efforts, and your ability to discern what makes sense and seems likely to benefit you. You can rise to this challenge. And you will probably be called to do so again and again. A better way of describing what you need to do is to be ever vigilant, ever on the quest, but always remain hopeful.

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Meet MSAA’s Newest Guest Blogger – Lisa Scroggins

I am Lisa Scroggins, wife, mother, CPA. I was diagnosed in 1991, and my mother had MS. There’s more: two of my five siblings also have MS. So, obviously, I am a person with MS: a patient. I don’t like to be called an MSer. I also resist substituting different words for the letters, M and S, such as “Made Strong:” I like to think of myself as an advocate, and I have written to members of Congress on various issues. I’m currently in the process of trying to correct an inadequate parking situation in my community¹.

If I’m brutally honest with myself, I just don’t like being a disabled person, and I have hope that I can improve. Having officially stopped working because of disability, I am having an identity crisis, as well as an existential one. I know I have pretty severe limitations, which mostly have arisen in the past three to four years. There’s my first clue: it seems as though it’s very recent, but I just typed the truth: my walking ability has worsened over several years, not the one or two that I’ve been telling myself. It has been only a couple of years since I’ve worked, but it’s important to know that I experienced a life-changing series of events which have left me reeling to this day. In other words, it’s complicated.

I’ve had MS for a very long time. I’m lucky, in that for many years, my symptoms were invisible to others. Although they were always in the back of my mind, I had learned to compensate for them.

First example: I’m shopping in a Sam’s Club store. It’s a huge building, and as is typical, I’ve walked around for a while, just browsing for things that I might want to buy, when I realize that fatigue² is kicking in. I’m not prepared to check out, with all that entails: getting my payment and membership cards out, unloading my items to the conveyor belt, putting them back in my cart, storing my cards safely, but keeping my receipt ready to be checked before exiting, trekking to my car, unloading my purchases into my trunk, parking or maybe just abandoning my cart, climbing back into my car where I will rest for a few minutes, while hoping that no one is idling behind me, waiting for my parking spot—oh the pressure! Also, I’m a pretty good distance from the checkout lines, and those lines were fairly long at last glimpse. What to do? I head over to the book section. I park my cart so that hopefully, it won’t impede any other shoppers, grab a few books to peruse, and sit down on the floor to rest and look through the books. Occasionally, I get some questioning looks, but hey, you do what you have to do.

Second example: I have what’s known as a “neurogenic bladder.” Real world translation: I experience urgency, which means I have to pee now! It doesn’t matter when I’ve last relieved myself, or how much my fluid intake has been. (That commercial for an overactive bladder medication is spot-on and even cute! The bladder IS in charge and drags me where it will.) Whenever I enter a building, if I don’t already know where the bathrooms are, I focus on finding their locations. When driving, I have been known to pull over to the side of the Interstate when I couldn’t make it to the nearest restroom. The technique involves putting on my car’s flashers, exiting my car, rapidly walking over to the passenger side, opening both front and rear passenger doors to provide a modicum of privacy, grabbing a fast food napkin or two from the map storage compartment door on the front passenger side for, oh, come on, you know what it’s for (always kept stocked for emergencies such as these!), and doing the squat. There’s just no way to do this in a dignified manner. I always feel guilty for littering. The pre-MS me would never have done such a thing.

The nature of my MS has changed and its effect on me has been nothing short of dramatic. As isolating and terrifying as it is, I know there are thousands of other people going through the same thing. The need to redefine myself in this new state of existence, is a powerful one. In our culture, what we “do” defines us. I’ve been treading water for some time, trying to figure what it is that I “do” now. If it’s true that “necessity is the mother of invention,” I’m looking for some tools. Maybe we can search together.

¹ You may have thought, as I did, that the ADA fixed this stuff, but that is incorrect! An explanation in a future blog post is in the making
² Often cited as the most common and disabling symptom among people with MS.

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