January 10th had been a good day. I had a few visitors, which always lifts my spirits, I had been working on a few orders for my Etsy shop, and we were getting back into a routine again after Christmas break. I went to bed a little early because I had worn myself out a bit.
A few hours later I woke unable to use my muscles to get a big enough breath. I couldn’t swallow, couldn’t breath, and knew I needed help fast. I quickly woke Mark, and motioned for help, and then got far away from our sleeping littlest hoping not to frighten him awake. That was about all I had left, and I collapsed on the floor, trying to conserve energy. It wasn’t long before everything faded to gray and I could hardly hear.
I was vaguely aware of the paramedic boots that tromped across the floor and scooped me up, carrying me into the night air. The next thing I was aware of as the stretcher bounced across the potholes of town was the excruciating pain and sickness that crept over me as the paramedic pushed a full dose of Narcan, throwing my body into instant withdrawal from my chronic pain medications, bringing on a slew of muscle spasms, and constant vomiting. My fight to breathe became more desperate as I choked on my own vomit gasping for each breath.
After some agonizing time in the ER, I lost all touch with reality, and woke later the next day in the ICU, biting and choking on the hard breathing tube that was down my throat, my hair a mess of blood and vomit. My respiratory muscles had weakened to the point that I could not breathe as deeply as my body needed me to, and I had been sedated and intubated.
We had already been having conversations with my pulmonologist and met with the surgeon to discuss it being time for a tracheostomy, so it was natural for these topics to surface again. They actually had time to do the surgery for me the next day. At first I objected, panicked at the rush of it all, and the lack of having my mind wrapped around it. After some reassuring conversations with friends who are doctors though, it was clear this timing was divine, and it was time to go ahead. I asked to be further sedated until surgery, so I didn’t have to spend the long hours fighting the tube.
Along with my wingman, my “Mama Sandy” was there with me to encourage and read scripture with me, and despite the embarrassing state of myself, I welcomed the presence of my dear pastor as he came to pray with me.
Despite the rush of it all, I felt peace; held in my fear and my questions, and comforted that God was walking every step along with me.
The wait for surgery felt long, but finally it was time, and I smooched my hubby as they rolled me away for a new airway. I was immediately more comfortable upon waking; the tubes removed from my mouth and throat, and now just one directly into my airway through the front of my neck.
A few days later I was transferred to a rehabilitation hospital, where I have remained for the past two weeks. It has been steps forward and steps back, and a tremendous amount of boredom and missing my babies, but each day is one day closer to home and this new way of life. My trach and vent have provided me much more relaxation with my breathing, and as we learn the routines it brings us more confidence managing this ourselves at home.
I cannot wait to get back to my family and my tribe… that comes next!
As my baby sis and I chatted back and forth today on what would have been my nephew Angel’s 11th earthly birthday, my sister said something so incredibly true and equivocally profound that I am left pondering over it hours later.
“You know what’s amazing?” she said. “Angel refused to believe he was a burden (and he wasn’t). But by society’s standards, he was. He couldn’t move a single muscle other than his eyes. He was 100% dependent on others for literally everything–life, health, engagement, communication…all of it. Yet he never apologized for taking up space. He had high expectations for how he was to be treated and honored and considered and included and he didn’t tolerate those who saw him as worth less than anyone else. He KNEW his worth. He knew it so deeply. And I can’t say that for myself. I at times feel overwhelmingly guilty just for existing and have since childhood. But not Angel. He. Knew. His. Worth. No matter what. And that is really, really powerful.”
This struck me to my core, because I at times get caught up in how much of a burden I must be, and how I wish I didn’t have to depend so much on other people. But Angel never felt sorry for himself like that. He knew he was a treasure; a child of royalty, and he did not accept being treated as anything less.
While a lot of that came from being just the incredible little boy that he was, there is also loads to be said about the fierce way my sister and brother-in-law fought for Angel’s worth. He knew he was valued because he was constantly treated as valuable, and he was shown that what he brought to the table mattered. He was fought for, given a voice, listened to, applauded, and all of those things only cemented his knowledge that he was worth it.
As Angel’s 11th birthday winds to a close my heart is so tender, but so grateful that for a boy who could have felt less-than, he always knew right where he belonged, and now in Heaven, he has claimed his true worth, his royalty; the crown he fought so hard for and was bestowed by his King. And I can’t imagine a bigger smile than on the boy who always knew- I am worthy.
A little over two weeks ago I said at two different times; “I really miss sunrises and sunsets.” I mean, we have them, but they are pale and washed out, not the brilliant fluorescent colors of my hometown sky that I loved. “it’s just not the same,” I said, “and I miss it.”
The next morning I awoke in the ICU after some some serious respiratory struggles the day before. The first thing I noticed when I opened my eyes was the hot pink morning sunrise streaked across the sky.
God cares about the big things, like saving my life that night. He also cares about the little things, like the colors that take our breath away. I think he delights in saying, “I heard you, and I got you.”
Most of you that see me see a small snapshot of me as a whole – usually on the best days- when I’m able to get out to church or to my kiddos’ performances. Because I’ve always been a kind of a private person, and I also fear being a burden to others, there are very few that have seen me at my most vulnerable as this awful disease has ravaged my body.
Maybe because the hard days are starting to outnumber the easier, or maybe because I am desperate for others to understand the depth of my need for help and prayers, or maybe because it’s so extremely isolating to live in this place of putting my best face forward, I am going to give you a glimpse of what it looks like and feels like to wake up and do battle against a body that is trying to kill me.
***I gave my husband permission to take some pictures of some of the hard moments***
A morning snapshot:
5:40 am. My alarm goes off. This gives me time to swallow a few pills to try to ease some of the pain searing through my body before I have to get out of bed. Snooze button a few times while the meds start to work, and then it is time to wake my littlest to start his morning routine.
Fatigue starts early, filling my arms and legs with wet cement as I go about fixing him breakfast and snuggling in on the couch to read our devotion together and watch part of a show.
7:00 am. My little is getting ready for the bus and I have to excuse myself as I’m dry heaving- my body rejecting the fact that I put pills and a sip of water into a digestive tract that has little function left.
7:29am. Last kisses and hugs before my little man heads outside to catch the bus. Worry creases his forehead. “Are you sure Mom? I can stay home from school and take care of you. All I’m going to do is worry about you all day.” I force a smile and convince him I am fine, that I’m just going to rest today. Reluctantly he walks out to the bus, stopping at least four times to look back and blow kisses and throw I love you signs. My heart could melt.
7:32am. I limp for my hospital bed that is set up in our den where I can be closer to the family. This is where I spend the majority of my time.
When you see me out and about at church or one of my children’s games or concerts it is because I have saved every bit of my energy that day and probably the day before in order to attend that event. It takes everything out of me, and I usually make it home and collapse for the remainder of the day, every bit of me used up on the best things.
8:00am. Through the shower and ready for work, Mark comes in to check on me and gives me any medicine I need, makes sure I am on enough breathing support, and starts a tube feeding if I’m not too nauseous. Then he goes around the corner to where his desk sits conveniently close to where he can hear me if I need help.
If I have no appointments, this is where the bulk of my day is spent. Resting and saving every drop of energy to be present for my family when they are all home in the evening. I have had to choose between the things I enjoy and feel like I should be doing- like keeping house and meal planning and grocery shopping- and instead spend time napping, writing letters for the futures of my loves, reading and sketching in my Bible, writing some works I hope to see published some day. This conserving of my limited strength allows me to be awake and upright to ask about the stories of my childrens’ days, and share a meal around the table, or attend their concerts or sporting events.
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Tucked in the binder that holds all my important medical papers, behind the copy of my DNR is a sheet that documents most of the complications that I am affected by as a result of my disease. It is a spiderweb of symptoms, doctors, and treatments that all fall under the same central header; Multiple System Atrophy. Some of these ailments are very visible, like having to use a wheelchair, or needing support for my lungs to breathe, but many of them are tucked beneath the privacy of my roof; wrestled with far from the view of my family and friends.
Pain and spasticity are big ones near the top. They are managed by a team of two of my kindest doctors who do their best to relieve my discomfort and keep me moving. It is a never-ending battle, trying to calm the muscle spasms and ease the pain that they create. One of the big guns I have for this battle is an implanted medication pump that sits in my lower abdomen and delivers antispastic medication directly into the fluid of my spinal canal.
Some of the worst spasms I experience are from my esophagus. These come on as crushing chest pain, making it nearly impossible to talk or swallow. The only relief is small tablets that dissolve under my tongue, and then I wait for the spasm to cease.
Gastroparesis is a fancy word that means the contractions of my digestive muscles are too weak to adequately push food through in the way it should go. This has resulted in a lot of weight loss and malnutrition, and frequent nausea and vomiting.
I have two feeding tubes currently. One that goes to my stomach that I can “vent” when I’m feeling sick, and one that goes directly into my lower intestinal tract where my feedings have the best chance of being absorbed. This means often not having an appetite, or if I do eat it sometimes comes right back up.
Another consequence of my digestive malabsorption is that the nutrient deficiencies cause anemia. This has resulted in the need for blood transfusions and iron infusions.
Not being able to eat enough to maintain my nutrition also means being chronically dehydrated, so I have a port implanted in my chest for receiving fluids throughout the week. This has to be accessed once a week by a sterile process of introducing a special needle that stays in the port for the week before changing it again. Fortunately this was one of the easier things I had to learn, and my previous medical career was a big help.
Impaired balance, weakness, and muscle wasting is a result of my nerves not communicating with their assigned muscles. Weakness and balance issues causes a lot of falls, and some embarrassing situations like squatting down in the grocery store and then not having the strength to stand back up. Some of these things I’ve learned to compensate for, and some of them just mean adapting to a new normal which involves a lot more frustration than used to be.
POTS is another result of having MSA. It stands for Postural Orthostatic Tachycardia Syndrome, and it means that when I go from lying or sitting to standing, my heart gets significantly less blood return than it needs, which causes extreme lightheadedness and fainting. My heart speeds up to try to compensate, but without the blood return it turns to a losing situation. I’ve gotten to where I can usually tell when I’m going to faint (so can Mark), and sometimes I’m able to sit safely before falling, but other times it results in goose eggs, an assortment of cuts and bruises, and an occasional broken bone.
Since this illness first took hold I have had to go under for 10 different surgeries. Feeding tubes, medication pump, port implants, repairing damaged joints, and some involving my brain. My body is a roadmap of scars, boasting of the battles I’ve won.
When I had a series of seizures after my second brain surgery I sustained damage to the part of my brain that allows for short term memory. When my memory was tested following this event, it was described as severe and profound memory loss. Daily it’s a frustrating struggle as I repeat myself and ask the same questions over and over.
The disruptions in my ability to think and concentrate makes it difficult to control my emotions, leading to bouts of depression and anxiety.
Neurogenic bowel and bladder means I can’t just hop up and use the restroom; I’m confined to making sure I have urinary catheters with me at all times in case I need to empty my bladder.
Fatigue. There are probably a hundred different reasons why I feel utterly drained most of the time. Pain is tiring. Sleep apnea is not restful. Using so much energy to breathe and fight spasticity every minute of the day is simply exhausting. The combination of all of these things leaves me feeling like I could crawl into bed and hibernate for months.
The most disruptive and serious of the symptoms of MSA for me is chronic respiratory failure. This started with me having low oxygen saturation and needing extra oxygen through a nasal cannula, and wearing CPAP and eventually BIPAP at night.
It has progressed as my breathing muscles have gotten weaker and weaker, and now I have to use a ventilator with a mask throughout the night and most of the day. My doctors have had to continue turning up the pressure of how hard my vent has to blow, which is not only uncomfortable, but it makes it difficult to hear and speak. At this point even with the higher support I’m still struggling to get a good breath, and the side effects of using my vent are becoming more bothersome. My doctors are working on the next steps I need to be able to breathe better and conserve my energy.
As the muscles in my legs have grown tighter and weaker it has gotten harder and harder to walk any distance. That coupled with the extreme shortness of breath that even a short walking distance involves have left me no choice but to use my wheelchair for getting around. As much as I would prefer to walk hand in hand with my people, I am nothing short of grateful that insurance worked so kindly with us to provide a chair that gets me around and provides comfort for my tender places.
These are the hills and valleys I battle on the daily. Some days it is easier for me than others, but on all of the days I have found myself constantly held and loved and comforted by my Heavenly Father, even in the pain and uncertainty. He has given me the privilege of being able to give him all the glory, and he sustains me and provides for me whether anyone else shows up or not. He is a good, good Father.
Looking around at the faces in my coming and going these days, it hits me that the majority did not know me before I was sick. The me that they know has always been the me that needs help, that is in and out of the hospital, and navigating much of life from bed or a wheelchair. That makes me sad. I miss my strength.
I wish all my people could know the strong me that could hike a steep mountain trail. The me that loved to do all the creative Pinterest things with and for my little people. The me that was social, driven, confident, and strong.
It has been a gradual and subtle loss. The landscape of life being destroyed slowly, one square inch at a time. Suffering lingers on and on, and pain wears me down like friction wears down metal. On the best days, little inconveniences, like having to drag a stool into the shower to sit remind me that I’m sick. On the worse days I don’t make it out of bed; strapped to a ventilator and dependent on someone else to wake me round the clock to swallow the pills that give me some semblance of comfort.
I have no idea what is going to happen over the next 3 months, or even the next 3 weeks. It looms over me, casting an ominous shadow over my entire world. No matter what I am doing it is always taking up a portion of my thoughts. Yet I push it away, determined to suck every grace drop and dribble of joy from my moments.
In the sleepless dark hours I wonder over the future of my husband and my little people. I pray the loss of me will not stifle them. I replay the losses we have already been through. I weigh the scars that have already been created, and I hope that these new ones will heal too. I compare the losses and try to estimate the outcome based on what we have been through. Anyone might agree this is a waste of my time.
Loss is loss, whatever the circumstances. All losses are bad, only bad in different ways. No two losses are ever the same. Each stands on its own and inflicts a unique kind of pain. We tend to quantify and compare suffering and loss. So, I shift my thinking and pray that meaning can be gained by this suffering, and that we can all grow through it.
I pray that the scars tell a story that changes lives for the better and points to the God of my salvation who has carried me through every hard step. I pray that louder than the story of devastation, people hear the story of grace woven through it; how each time I met the end of me I was met with the grace to fight a little more, to grasp hold of more moments, and to turn broken into beautiful.
I echo my friend who was dying of terminal cancer when I say, “I feel like a little girl whose daddy has come early to pick her up from a party. I’m not afraid to die, I just don’t want to go.” I want to be here for the mundane afternoons after school; racing through homework to get to indulge in the better parts of the day. I want to be here for the sending off of each of our birdies… sending them soaring in the directions of their dreams and always having a soft-landing place back home when they need it. I want to be here for the blush-faced budding relationships, and the promises and the ceremonies and the rings. I want to get to be Grandma Nanny, with long grey hair and crinkly smile lines, rocking my grand babes to sleep.
A slow stripping of my pride and my dignity leaves me vulnerable and weary. The people I meet now have to take me as I am, with the understanding I may not have much to give back. This changes the landscape of my relationships, because those saints willing to walk into my mess with little promise of gleaning anything for themselves out of it are few and far between.
Still, here I am— hands open, life open, ready to embrace any who are brave enough to walk this life with me. And the times when my invitation is met with the sound of crickets, I know I am held and I am kept in perfect peace in the arms of my Abba Father, who takes me as I am- all my pieces-and traverses this bumpy, winding road alongside me. I have never been alone, in my strength or in my fading.
Choosing Hope 