Health Update Part 2 /3 : More Unfortunate Events and Some Romance

Day 4. Air, beautiful air! Over the five years I have had ALS, I forgot how it feels to take a full breath. I wish I had done this months ago. (Dr. Libby, take that and rejoice!)
My mom arrives, and the first words out of her mouth are, “You look so good!”
Evan tells crazy stories about our pets. We get a room in 2R, the respiratory unit, where there’s an actual cot for Evan. It is all around a joyful day.

Day 5. We are settling in nicely for what we hope won’t be a long stay. Evan organizes the machines that will keep my lungs clear and pumping. I nap, and mom collects some food from the cafeteria. Today ends with a far more solemn Evan reading the manuals for the machines. He also dives into learning the functions I will need to survive. I am a patient guinea pig, even when it hurts, even when it feels like I am suffocating. Mom watches with fear in her eyes. Even at age 32, I will always be her baby.
The nurses start giving me nightly injections of blood thinner in my stomach to prevent blood clots, and an inky black substance that no one else can see appears beneath my fingernails. I know exactly what it is, though. Something wicked this way comes.

Day 6. The hospital stay has been long enough to wear on everyone. The black thing runs up the veins of my wrists.
Evan develops what he calls “hospital hair,” a product of not showering and running his hand through his hair in anxiety. He says he worries whenever he is away from me. I worry, too. I’m an expert at that. When mom is gone for the night, I ask Evan a question that has been weighing on me. “Will you ever get tired of the sound of my machines?”
He puts the manual down.” No,” he says without hesitation. “That’s the sound of our forever.”

Day 7. Friday rolls around, the day of the scheduled surgery.
The pulmonologist comes in and says, “You’re stable and ready to go home once you get your ventilator from the equipment center.”
My heart soars! The excitement in that horrible beige room is tangible.
“We brought our ventilator with us,” Evan says, pointing to the machine we received from our clinic.
“That’s an Astral, and you need a Trilogy. No one in the hospital even knows how to work one of those.” The insidious black has climbed up my arms and is webbing across my neck.
“I bet we get Trilogy this afternoon and are home tomorrow,” Evan says.
“Hopefully,” the doctor says. “The equipment center is only open business hours, so either you get a Trilogy today, or you’re here for the weekend.”
My heart plummets through my stomach and goes splat on the floor like a rotten tomato.
This Trilogy doesn’t come today.

Health Update Part 1 / 3: A Series of Unfortunate Events

Day 1. I wake up in the worst possible way. I’m feverish, my oxygen has plummeted to 83, and part of my left lung has collapsed and is filling with fluid. Someone calls 911, but everything is a blur, and I just want to sleep. I don’t care if I live or die. I actually think this is a very peaceful way to go. I try thinking of Evan to bolster me, to give me some of my old fight. That doesn’t work. I’m on a gurney, and on the way out the front door. My dear, purple-haired caregiver Lorraina, calls, “I love you!”
In the ambulance, someone shoves a mask on my face. A man says, “I know these things are unbearable. Just hang in there. We are only ten minutes away.”
I don’t know what the man is talking about because to me, the mask is heaven. It smells like maple syrup, and it’s pushing air into my lungs. Suddenly, I care very much about living. I look up at Evan, who attempts a small smile and squeezes my hand.
The ambulance stops with a jolt, and I am whisked through hallways to a glass room in the ER. Evan arrives breathless seconds later with my tobii, wasting no time setting it up so I can communicate.
“Am I going to die?” I ask him.
“No,” he promises, as if his love and will are enough to keep me, but when the doctor comes in, the first thing he says is: “She’s out of danger now, right?”
The doctor nods, saying, “It’s a good thing you came in when you did.”
I don’t remember anything of the next 24 hours.

Day 2. I wake up to searing pain on my lower back. I am being transferred to another gurney, another ambulance, another hospital. My hospital. Apparently, I couldn’t make it that far yesterday. Evan says I was on oxygen and a machine that breathed for me all day and night.
This ICU room is smaller than the last, and the IV in the wrist hurts worse. This little pain temporarily distracts me from the burning of my back. However, once we are settled in, the clawing pain returns tenfold, so I tell the nurse, and he rolls me onto my side. We discover a foot long wound across my back. He cleans up the blood while Evan holds me. Once the wound is bandaged, I am rolled over onto my back. This pain feels more bearable now.
“Transfers can be violent depending on the material you use,” the nurse informs us.
We’re alone only seconds when the surgeon walks in and introduces himself so quickly that I don’t catch his name.
He says, “You have two options. Surgery is tomorrow, but for now, I can have a tube put down into your lungs with a camera at the end to give me a better look at what’s going on. The other option is to let the monitors do their job and send signals if you are in distress.”
I feel so ashamed when I tell him that I don’t want the camera. I have been scared terribly before, but that has made me cautious. I have never actually shied away from something out of fear that I can remember.
Once we’re alone, Evan says he is proud of me.
“For being a coward?” I ask.
“For being brave enough to make these tough choices,” he says.
I don’t – or can’t – believe him, so I switch the subject. “Where will you sleep?” I ask.
After surveying the room, Evan pulls a chair across from me so if the tobii dies, he can read my face. We settle in for the night.

Day 3. I remember shockingly little of the day of the surgery. I sleep up to and after the main event. All that stands out is Evan asking, “Does it feel weird?”
“No,” I say, not entirely sure what he means. Then lights out.

Friends of Rachel

I am on a ventilator, and I love it! However, I need 24 / 7 care for the rest of my life to prevent blocked lungs that could lead to a coma.

If I ever taught your children in my life before ALS, and you were happy with the work I did ; if you have ever been moved by a story you have read on this blog, please consider becoming a Friend of Rachel!

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Thank you.


Winding Down

I told you that a long absence means a decline in my health. Read on for the most important health update I have ever posted over the years.

When I heard the news that my pulmonologist wants me to go on a ventilator, I thought, “I’m not ready. I need more time free of a machine.” Another few years wouldn’t have changed that feeling, though. I can’t believe my time is almost up. If not for the technology of a ventilator, my lungs would just stop. I just really felt that my will was strong enough to make a difference. I was stubborn and arrogant, as if no one before me ever had this much fight in them. I am no different than any of thousands of other people living with this merciless disease.

I have no delusions about how difficult my future will be. My greatest fear is that we won’t be able to organize the 24 / 7 care that is necessary for people on ventilators, and I will end up in a group home. Being on a ventilator will be a hard way of life, but I will be alive. As long as Evan lives, I am not done. I will do absolutely anything to stay here on earth with him.

I’m afraid, but there is a great deal of work to do now, so I’m trying to be brave and throw myself into it. We are making a list of questions for the medicaid representative regarding skilled care coverage and availability (even if care is covered financially, finding caregivers who meet Medicaid’s rigid qualifications can be a real struggle).

My neurologist said I’m ready for this in a lot of ways because I already use the hoyer lift for transferring, the tobii for communicating, and the feeding tube for eating. I guess people whose lungs fail first have a really hard time adjusting to losing speaking and eating all at once because the trach (the procedure to go on a ventilator) takes away all that. I have had the luxury of easing into ALS in a way I can tolerate. For that I’m immensely grateful.

So here we go on yet another ALS adventure. I am dealing with negative side effects of living with lungs that are only functioning at 25%, mostly extreme exhaustion. I wake up tired. I have to take a long nap after getting my hair brushed and face cleaned. I’m looking forward to being more energetic. I miss spending time with Evan, family and friends, writing and reading. I miss my life. The ventilator should give it back.

My Gratitude List

  1. Evan, Evan, Evan!
  2. 2. The family, friends, and dogs who support me as I face the monster inside of me
  3. 3. Every day without spasms
  4. 4. Every hour without pain
  5. 5. My caregivers – they are remarkable women
  6. 6. The fact that ALS will never take my mind
  7. 7. Writing
  8. 8. Books
  9. 9. I will never lose sensation
  10. 10. You, dear reader!

Kissing Teeth

it’s Saturday night. I have been asleep for hours. My husband Evan is hard at work, though. He is sorting 25 medications into a multi-tiered organizer. He handles each of the 270 pills, placing them gently in the correct box, all to keep the failing machine that is my body going. He makes food move through my body and protects me from spasms, pain, anxiety, and depression. In the doctor’s office, he answers questions about my medication and knows the brand and generic name of every single drug. I have no idea what he and Dr. Goslin are discussing. To many, this might not seem like an empowered position, but my point of view is that I have to suffer ALS, and Evan has taken this off my shoulders. From rubbing frankincense into my spasming muscles to learning how to use a feeding tube, he has been there for me every step of my final way. He even quit his job to take care of me 16 hours a day. He is my hero.

He was my hero long before ALS, though. He saved me when my rapist became my stalker. It was a waking nightmare made worse by the fact that no one believed me – no one except my new friend Evan. He made sure I never went anywhere alone and would not be intimidated, even when the man showed up in his classroom and made a scene. He stood by me, and we fell in love. Even though we were only 19 and 20, we knew after a week of dating that we wanted to get married. However, we decided to wait until we graduated college.

My husband is a better person than I am, but I don’t mind. He is my sun, and my heart blooms under his light. It’s been 13 years, and my stomach still flips when he enters the room. He makes me laugh even now, and the best part of my day is the time when we are alone together. I love him unconditionally. I smile so wide when I see he’s about to kiss me, he always ends up kissing my teeth, but he hasn’t complained yet. When he says he loves me, I repeat it back to myself. HE loves ME, and I search his face for sincerity. Every time, I find love light in his true blue eyes, and I think about what a miracle this is.

Evan gives me the strength to fight. I’ve always known I would die for him. Now I know I would live for him. He is my everything.

Things I almost say

I only just catch myself before I say something wrong. It’s such a close call sometimes, my heart races and my stomach flip flops for minutes afterwards. Here are two examples:

First, during a visit with my mom, we were listening to music when this beautiful song came on. It was so feminine, so pretty, that I could feel the the silk ribbons of my Pointe shoes lacing criss-cross round my ankle, the unforgiving cardboard and leather toe box slipping over the end of my foot. The choreography unrolled before me. Just at that moment, I almost said, “I would have loved dancing to that when I was alive.” Did you catch that? “When I was alive.”

Second, “I should have tried one of those in real life.” That’s what I almost said to Evan as he ate a vegetarian reuben sandwich. The words were on the tip of my now dead tongue. If I still spoke, the words would’ve reached him, and we would have had to talk about it.

Am I in Purgatory? Then what’s Evan doing here? Is Elon Musk right? Is this a simulation? All of this assumes I am so intuitive that I figured out my creator’s machinations. Or maybe I am in denial/ losing it.