Are you prepared to die?

Before I continue, let me assure you that this is NOT a suicide note, nor is it a notice of my impending death.  This is a question I’ve asked and answered myself many times in my life.

If you’re not dying, why do you bring this up now?

I just received some unsettling blood tests, and I have some choices that I have to make.  When I receive bad news, in order to not “freak out”, I look back at all the things I have survived in my life to remind myself that I can be pretty damn tough.

As many of you know, I was diagnosed with MS over 20 years ago.  What you may or may not know is that I have had 3 family members die from complications of MS.  This disease has been “in my face” for many years before it actually caught me.  When I was diagnosed, I asked myself if I was ready to die, not if I was prepared, but if I was ready.  The answer was, “HELL NO!”  For the first year though, I didn’t do much to FIGHT it.  Instead, I began drinking ALOT.  I also started behaving very manically, (well if I’m going to die anyway, I’m going out with a bang)

About a year after my “MSaversary”,  I finally stopping running and faced the diagnosis. I began taking the disease modifying drug Betaseron.  For 10 years, I gave myself an injection every other night, yet my MS symptoms continued to steadily progress to the point that I was in a wheelchair more often than not.  I was constantly depressed.  During this time, my kidneys began shutting down, AND I was diagnosed with cervical cancer.  Around the 10 year mark, I think I WAS ready to die.  Not prepared, but ready.

At then end of 2009, my girls and I made the very long hard decision that I was going to begin receiving monthly infusions of Tysabri even though it could kill me.  I decided that QUALITY of life meant so much more to me than QUANTITY!  I have previously written about how the decision was made in a Five part series if you would like to read.  The decision to start Tysabri Part 1The decision to start Tysabri part 2, The decision to start Tysabri part 3, The decision to start Tysabri part 4, and finally, The decision to start Tysabri part 5.

To date I have received 121 infusions of Tysabri.  I credit this drug for giving me my quality of life back.  I do not regret my decision in anyway, in fact I have even argued with my doctor about NOT switching medications when he suggested that I consider it. Last year, I wrote “Who’s the boss anyway”? explaining my reason for denying the change.

At the end of last year, I had to see my neurologist so he could perform my yearly neurological exam, refill my prescriptions, and send me for the required JC virus test to be allowed to remain on Tysabri.  My son in law was nice enough to drive me to Chicago for the visit.  Because of my newest list of injuries, the doctor was unable to provide a complete exam.  The parts of the exam he was able to perform showed that I had increased numbness (lack of feeling) on the left side of my body.  I have also been having some issues with my vision (though I have been attributing that to my age).  He wrote the refills for my prescriptions, and the order for the bloodwork, and we agreed I would come back for a full exam once my foot healed enough to be able to walk on it.  (hopefully March)

NOW let’s talk about these unsettling blood tests….

My bloodwork came back stating that I was now JC+, meaning I had the John Cunningham Virus (JCV).  Not only did I test positive for the virus, but my titer levels are considered very high. 4.8!

hmmmm now what?  I have a decision (well several to make)

Here are the drug facts

In addition to revealing that I have now become JC+, my bloodwork revealed that my Absolute Eosinophils are high.  What the hell does that mean?  A quick Dr. Google search said…

Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels of eosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).

OF course the first thing I saw was CANCER……cmon!!!!!!!  Seriously?!?!?

After speaking with my Neurologist, WE have decided first to have the bloodwork performed again.  (there is always a chance for a false positive?)  Because of the decreased sensation on one side of my body, the increased balance issues, and vision changes, IF the test still comes back with a high Titer level, the first step will be to undergo further testing for PML.  I haven’t even thought about further testing for the High Eosinophils, I honestly believe that everything else going on in my body is causing that.

I have so many questions and decisions to make that I find myself asking again, “Am I prepared to die?”

 

 

 

 

3 Broken Bones and a Lisfranc Injury

Last year I told you I had another WTF moment.  No surprise there, I’m sure. When I left the Immediate Care, they told me that I had broken two bones in my foot and would need to follow up with the orthopedic surgeon the following week.

On Monday,  I saw the KNEE surgeon.  (remember I had knee surgery the previous week) He said while they were able to do the Meniscous repair and “clean up” a bit inside of my knee, they were still recommending a partial knee replacement once I healed from my newest injury…smh

On Thursday, I saw the Foot Surgeon.  When he came into the room, he shook his head saying, “Well Grace, you really did a number on yourself this time”.

and then he said nothing and still nothing.

He stood there and continued to shake his head.  I’m not sure what the actual pose is called, but you know when someone is deep in thought and they almost rest their chin on their hand, slightly covering their mouth?  Well that’s the pose and the longer he had it, the more nervous I got.

Finally he sat down next to me and said, “Well you’ve got some options.  You have 4 broken bones and may have a torn ligament.  If we go in for surgery right now, I will have to place a plate and screws in each of the bones you’ve broken.”

Now it was my turn to be silent.

Holy shit!  No! No! No!  A million thoughts ran through my head mostly about all of the plans I had for the holidays.  I couldn’t wait to see the twins opening their presents on Xmas.  Thing 2 had just gotten a puppy and I was looking forward to training her.  etc etc

When I finally spoke it was to say, “This can’t be happening!”  Einstein quickly chimed in with, “Oh, it’s happening sweetheart”. (from the state farm JACKED UP commercial)

I pleaded, “But you said I have options right”?!?!?!

After much discussion, we decided to continue with R.I.C.E to allow the swelling to go down and to allow me some time to absorb all that he had told me.  I left his office that day in an orange split cast with instructions to stay in bed for the next two weeks with my foot elevated above my heart and the Ice machine continuously running on my knee.

leg above your head (7)

While laying in bed, I spent TOO much time on Google, researching the various options that might be possible.

 

 

 

Since that first day, I have been back to be recasted 4 times. I am currently sporting the ‘sexy’ black one.

There is still a lot of swelling, I’m not spending all my time in bed anymore though either.  The current plan is to remain in this cast until the 30th (unless the swelling continues to go down) Then evaluate the extent of the lisfranc injuries to determine the next step.  Hopefully the 2nd, 3rd, and 4th Metatarsals have begun to heal by then.

Some positive notes

  1.  amputation is not an option
  2. I have time to blog and catch up reading everyone I missed
  3. I am getting great upper body strength while using the wheelchair
  4. I have mastered getting 1/2 in and out of the tub without getting the cast wet, though not without making a bit of a mess.

beautiful tubs

 

 

 

 

 

 

My decision to start Tysabri Part 5 of 5.

In February of this year my doctor said, “Hey your MS seems to have been pretty stable for some time now, I know you are JC neg, but you’ve also been on Tysabri for about 8 years, why don’t we look at switching you to an 8 week cycle?”

W H Y ? ! ? ! ? ! ?

The long and short of it……

“Someone, somewhere” said “The longer you stay on Tysabri, the greater your odds are for developing PML or the JC virus.  Tysabri stays in your system for 8 weeks anyway, why not get fewer treatments, so you can continue to receive the drug longer?”  Blah, Blah, Blah.  (I hope you can tell by the tone of my writing, I feel and FELT this was a very bad decision for me.)  What the hell do I know anyway, I’ve just been living with MS for 20 years?!?!

Reluctantly, very reluctantly, I agreed to switch to a 6 week schedule.  I would compromise by stretching it out two more weeks, but would not agree to stretch it to 8.  For the first time ever, I experienced what people refer to as “slump week”.  As I sat here trying to define “slump week” for you, I decided to try to “Google” it for kicks.  I typed slump week, and the search finished it for me slump week tysabri with pages and pages of listings.  Heh, so I’m not alone.

For me specifically, I describe “slump week” as all of my MS symptoms worsening.  I didn’t get new symptoms, but the fatigue I have DOUBLED, as did the amount of time I spent sleeping.  I had a harder time focusing.  I felt like each of my limbs had gained 30 lbs, and I spent week 5 on the couch. NOT FUN!

In June, 4 months later, I was at my niece’s wedding in Georgia and I suddenly couldn’t raise my toes on my left foot.  In fact, the only way I could walk without tripping was to try to lift my entire leg from my hip.  (visualize marching?)  I don’t have that kind of strength in my hip, leg, or foot, and I fell 4 times that week before I could get home to Illinois to see my doctor.  I also developed sciatic pain down the right side of my body.  While they say this is not related to MS, I have to disagree.  My body certainly did not like the additional sitting I had to do, or the weird way I was having to walk and it was letting me know with all kinds of new pain.

I spent the next 2 months getting MRI’s, seeing a neurosurgeon, (you know it must be the displacement of my spinal cord from 7 years ago) going back to physical therapy, and eventually being fitted for an AFO for foot drop.  I was angry, depressed, or sleeping all the time.  Wearing the AFO, helped me not trip over my foot, but it caused my calf muscles to spasm daily.  Yah more pain!?!?!

ENOUGH was enough!  Time to put on more armor and fight!jousting

In August, I told my neurologist that I didn’t care what “someone somewhere” said.  I wanted to be on Tysabri every four weeks.  It works for me.  Stop trying to fix what wasn’t broken!  I am very angry with him still ,and I do blame the length between doses as the reason I feel I have regressed.  I know, logically, the heat could have affected me, as could all the “family time”, but my gut says it was the schedule change of the medication.

I have received 2 doses at the 4 week interval again, and I am due for the next infusion  next week.  I am seeing a chiropractor biweekly, and I’ve made it a goal to walk on the treadmill every  day for at least a total of a mile.  (which I have done every day for a full two weeks) I am not “back to where I was” in February, but I am working hard to get there.  One step at a time.footprints

 

 

Waiting for test results

Today I’m here with another random unedited rant. Waiting for test results. I have been trying to keep myself busy doing random things around the house, but in the instructions for the biopsy I am not allowed to do housework, or other repetitive actions. Heh. I also have had to keep this very tight fitting bra on since the procedure. Wearing a bra in itself is uncomfortable, but mine is filled with ice (also on the recovery list), and since I can’t actually do anything (see restrictions) all I can think about is how I want to take this damn thing off. Kind of like when you have to fast for bloodwork, you are hungrier than you have ever been in your life. Or when you were a kid and your sibling would hover their hand above your arm and you screamed “Mom make them stop touching me”, but they weren’t actually touching you?
Speaking of food, I could go eat. I’m not fasting, but I’m also not hungry. See the funny there? It would also defeat my goal for losing weight….. hmmm what else? Bills are paid, laundry, dishes, etc, are done. I tried to watch more word press videos, and to read a bit, but I can’t concentrate…DAMN BRA!!!!
I’ve done good staying off of Dr. Google, so I shouldn’t sit at the computer too long. I still don’t want to call anyone because I don’t have answers yet….. I’ve got it back to the X stitch goal.
Hope everyone has a good day. Friday the 13th has been a favorite day of mine for many years as Good things usually happen to me on that day (whether I know it or not at the time) For example, I found out I was pregnant with both of my daughters on Friday, December 13th. Being young and single on those days did not make it good news, but considering they are the best things that ever happened to me I will take it as good news.
End rant