The Empty Chair

Dedicated to the grieving families of Seth Poling and Sandra W. Marlowe. May peace be with you.

Does anyone ever sit in the place the missing loved ones had at the table? No. It will never just be a chair again. I had a place, you had a place, but that chair that was your favorite is now free for anyone to sit in. There is no chance I will see you sit in it again. No more memories will be made. I have to try to close the hole. I should at the very least take back this spot, sit once in your chair. Otherwise I will always be staring at a gap in space. But I can’t. It will always belong to you. So will I.

Photo by Paula Schmidt on Pexels.com

Back to Basics: What I’m Grateful for This Thanksgiving

This is not the Thanksgiving piece I intended to write, but this year I’m grateful and lucky simply to be alive. I’ve been hospitalized 3 times this fall. The first time I had double pneumonia. My lungs were a total white out when I was admitted. Lungs are supposed to be black on an x-ray, but mine were completely white and filled with fluid. No matter how much oxygen they gave me, I felt like I was suffocating.

The second time, one of my nurses saved my life because she noticed very quickly that my secretions – what I cough up – were getting too thick and had a blood tinge. I almost died during that hospital visit when my blood pressure dropped 80 points all the way down to 46, but I’m not ready to talk about that.

The third time I was hospitalized, Evan took my BP for morning vitals, and it was 72. He kept giving me midodrine to raise my BP, but it didn’t work. I was unconscious and Evan couldn’t wake me up for more than a second to answer questions like what my name was, so he called 911. I woke up in the ER. He explained why I was there. It is disturbing not to remember. I vaguely recall getting a CT scan, but it was like a dream.

I have a 10 cm wound from the rough treatment at the hospital. Evan and I are worried because I can’t feel anything at all on the wound, not even when Evan puts cream on it, and that is a sign of nerve damage. It’s getting wider and deeper every day. It’s a Stage 3 wound that is currently 3 cm deep.

I had planned to write Evan a letter of love and gratitude for my Thanksgiving post, but I’m exhausted so this will have to suffice:

Evan teaches me how to love every day. He has been taking care of me for 8 years without a break, and he is on call 24/7. There are no words to describe and thank him for the countless sacrifices he has made to ensure he gives me the best possible care. His love and devotion are almost beyond comprehension.

“Love is patient, love is kind…
It is not self-seeking,
It is not easily angered,
It keeps no record of wrongs…
Always protects, always trusts,
Always hopes, always preserves.
Love never fails.”

1 Corinthians 13:4-8

This is perhaps the most loved section of Paul’s letter to the Corinthians. Paul was writing about Evan. He just didn’t know it.

Photo by Tima Miroshnichenko on Pexels.com

On My Husband’s 37th Birthday

“Nothing prepared me for the privilege of being yours.” – Sleeping at Last, “Turning Page”2

What you have to understand about the way I love Evan is that I am desperate for him. I can’t shut up about him, and I don’t want to. People say that the sign of a strong relationship is that it doesn’t appear on social media because the couple has nothing to prove. That makes me laugh because I am not writing about Evan for you. The truth is, I’m obsessed with my husband.

He is my laughter and smile and safety. He is the oxygen filling my lungs, yet he snatches my breath when I catch sight of him unexpectedly. When I fell in love with him, I felt like my real life had finally begun. I understood everything, who I was and what I could be with him beside me.

It feels like this: my heart beats him out, and he saturates every river of my blood until he marinates each cell. That’s not pretty language. It’s science, a completely accurate description of a biological phenomenon that I live every single day.

He is absolutely brilliant, an avid reader of Russian literature and history books that dwarf encyclopedias, relaxing by cruising biology journals. He also does hilarious impressions. I especially love when he puts on my glasses and becomes John Lennon. He is, in my correct opinion, the best caregiver in the world. I will always remember him telling me, “Stop saying you’re sorry. You don’t need to add qualifiers. I love you, and I’ll do whatever you want.”

My mom once said to Evan, nodding towards me in my hospital bed, “I know how this would have gone without you. She wouldn’t be alive.”

He looked at the floor and said, “I don’t want to think about that.”

Evan, you are why I fight. Happy birthday, darling.

On our honeymoon in Rome.

My California Kitchen

Photo by Ella Olsson on Pexels.com

This piece is about the last summer I could eat before losing the ability to chew and going on a feeding tube.

Summer in Amber

We held that whole summer
In our strawberry sticky hands,
Trapped it in our tiny kitchen
Where sunbeams tangled with our legs
Around too much furniture,
Each piece an island
Of earth-born treasure:
Paper cartons of berries on the unfinished wood cart,
Artichokes and avocados, mangoes, tomatoes, and ginger roots
On the battle – scarred table.
Sometimes a lone carrot
Hid from our merciless knives.
We hid from the diagnosis that confirmed,
Even scheduled, my end.
During those hours, our fears dulled to hum as
We took turns navigating
The narrow channels of the archipelago,
My hips and your feet too wide to sail in tandem.
We worked on recipes and honesty,
Rushing to use all the food before it spoiled
Sharing fragile secrets before they
Rotted us.
September stole those golden months away,
Leaving us gripping memories of
Overflowing brown paper bags from the local farm,
And hanging baskets by the window
For pounds of onions, beets and sweet potatoes.
They’d spent long enough underground
Dreaming of the sun.
Best of all, I imagined
The round prints of your toes
On the flour-coated floor:
Our very own happy paths.

The 4th of July – ALS Style!

This is a photo I took on our cross-country road trip just before we crossed the Mississippi River.

Ever since we adopted dogs, I haven’t been a fan of fireworks. They terrified Malka, our dog who passed away on September 26th, which was surprising because she was a fierce protector. She used to huddle with our other dog, a chihuahua named Pickle, to hide from the fireworks. We’re not surprised Pickle is afraid, though. As Evan says, we raised a coward. Here’s a picture Malka and Pickle huddled together. By the way, our bird Jasper is a saint during fireworks.

Pickle always got to be the small spoon.

Now that you know how our pets celebrate, it’s time to hear my idea of how to celebrate the fourth, and to me independence means a cure! Let’s start with getting me off life support – goodbye ventilator! No more food pump for my feeding tube pushing food in my stomach 24 hours a day. I want to EAT!

I will start with enchiladas from Los Gorditos in downtown Portland next to Powell’s Books. Then Thai food and falafel in the huge city block of food trucks. I will finish with Indian and Ethiopian food before heading home where Evan will make all my favorite dishes. I will end the feast with a nap with Evan.

And since I’m cured, we might as well imagine my nerves have regenerated so I can cuddle with Evan during my nap. Our last hug was 7 years ago! I want to hike and climb. We once climbed a 50 foot cliff in Great Falls, Virginia. I was strong! I want to dig for fossils and row Carlos the red canoe at sunset, splashing Evan and singing all the while. I want to drive for hours and hours on a thousand road trips. We did four major road trips, but my favorite was our cross-country trip. We went the northern route to end in San Francisco, but I want to do the southern route, too. I want to see and do everything!

Happy fourth of July!

Here’s a picture of us in Carlos the red canoe setting out for a sunset paddle on the York River in southern Virginia.

Eight Years In…

Photo by Hakan Erenler on Pexels.com

Eight years ago on June 8th, I was diagnosed with ALS. At diagnosis, I was given 2 – 5 years to live. We all are. I was just 28 years old.

After my diagnosis, I immediately said goodbye because that’s what I was told to do. I was told there is no cure for the monster that had taken over my body, my life. I posted something on Facebook to the effect of, “I’ve just been diagnosed with ALS. Thank you all for being a part of my life.” I didn’t know there were other options, that even without a cure I could fight.

My fantastic ALS clinic connected me with the local chapter of the ALS Association and suddenly I had a power wheelchair, a Tobii eye gaze computer, and a cough assist machine, and I was trained to use it all. I had many long conversations with my neurologist, pulmonologist, social workers, husband, and family, and decided to go on a ventilator when the time came. I’m now a bedbound quadriplegic on life support and survive on a feeding tube. I’m very lucky because I live at home despite my high needs. My husband Evan works tirelessly, seeing to my every need. He is the reason I fight. I would do anything to stay by his side.

When I was diagnosed, we were about to start a family. I can’t have kids so we were researching adoption agencies. We decided to adopt siblings because they are hard to place. I even made a Pinterest board with resources for adoption and raising creative, resilient, grateful, vegetarian children. I also had a list of 27 parenting books we were planning to read together. We were going to be READY, but you know what they say about the best laid plans…

Eight years in, I’m starting to forget what it was like to speak and move. I guess it’s for the best since I will never talk or walk again. I remember certain things, though, like playing Who’s the Judge with my family at the kitchen table after dinner. We would sit in a circle and when it was your turn, you said a silly phrase in an even sillier accent. Everyone else had their eyes closed and would try to guess who the speaker was. Looking back, it was a ridiculous game. It was only my parents, sister, and me so it was easy to tell who had spoken by location alone. Plus, we always took turns in the same order. We all had fun, though.

I remember the first time I spoke Russian in Russia and someone understood me. It was like the best magic trick ever. My first words were to the taxi driver bringing me from the airport to my new home for the summer.

“I’m afraid,” I told him.

“Why?” he asked.

I explained I was worried the door to the apartment wouldn’t open. He promised to stay until I got inside. The magic trick worked.

I remember dancing with Evan with my Walker between us in the living room, his strong hands firm on my hips keeping me safe as we swayed softly, softly to Frank Sinatra. No more swing dancing for us. In our first Ice Bucket Challenge, Evan said, “I’m doing this so I can dance with my wife again!”

I remember dancing with dad on his feet in a living room across the country 30 years ago, usually to something loud like Eric Clapton. “Layla” was my favorite because every time it came to the part where Eric Clapton sings, “You got me on my knees Layla!” dad would set me down and fall on his knees in front of me.

These losses don’t hurt anymore unless I focus on precise moments I’m able to fish out of the murky depths of my memory. I have learned better than to do that. They only ache now.

I miss my old self, the creative, playful teacher, the fossil hunter, the singer, the traveler. I’m reminded of the lyrics to “Summertime Sadness” by Lana del Rey: “Think I’ll miss you forever like the stars miss the sun in the morning sky… Even if you’re gone I’m gonna drive!”

On the Other Hand

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It can be hard to “live my truth.” Just because I have had a revelation or realization does not mean I can instantly incorporate it into my lifestyle.

Especially because my hope just got a kick in the teeth. The latest bump in my pump did not work. This means more time on oral baclofen, which, remember, is heavily sedating. Being sedated is different than being fatigued because I can’t fight it. Chemicals overtake my body and my will. They rush through me, making me heavy, blurring my thoughts. I take baclofen four times a day. It knocks me out for two hours. Being unconscious so much hurts my mental health, relationships, writing, and hope.

I say “being unconscious” because being sedated isn’t always the same as sleep. I sometimes wake up fully rested, ready for an hour of activity before it’s time to pass out again. However, sometimes I wake up feeling like I have only been out a second. It’s disorienting to say the least.

Everyone, from caregivers to family, is overjoyed when I am awake, and they all want to see me. I should be flattered and feel loved. Instead, I feel pressured. Imagine if, as soon as you wake up, whoever is near you is full of energy and ready to play. When I wake up, all I want is a few minutes to myself to check my email, catch up with Evan, maybe send a few texts – all the things you do to slowly come back to the world in the morning. Because it is perpetually morning for me. In an ideal world, whoever finds me awake would express their joy, then ask if I need a few minutes. I think that would help reduce the pressure I feel and make me ready to fight through my discomfort like I decided to in my last post in order to be present for the people who love me.

I’m beginning to fear I will always need the baclofen, that the pump will never work. I honestly don’t know how much longer I can handle this. Choosing hope is harder with each failed bump.

But I know I will go on because I have no other choice. I have up to three years before my lungs fail, and even if I live like this, the time I steal with Evan makes any amount of suffering worthwhile.

For the Love of Dog

 

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I have become a tobii wizard. It’s true. Once upon a time, it took me fifteen minutes to type one paragraph. Now, I glide across apps, carrying and adding to my content, dipping into shortcuts to rearrange my words into uniquely crafted messages that sound authentic to yours truly – all at a speed that constantly wows clinicians. Despite my skills, though, using the tobii is still taxing work. I will never be fast enough to keep up with the natural flow of conversation. Still, I hurry and exhaust myself in the process.

However, there is one individual who eases the tension of the race to communicate because she is also nonverbal. For five years, Malka (introduced in “Someone to Watch Over Me”) has been my faithful, furry companion. On the surface, we don’t have much in common: she has four legs and I have wheels, she swallows her kibble whole and a gravity bag slowly drips formula into my stomach. I am becoming  more mechanical, and she remains pure, divine animal. But when we lay down side by side, we speak our own secret language. Eye contact and perked ears or my raised brows, touches, wiggles, and wags… There’s nothing we can’t say, and our talks are just my speed. She’s a source of solace like no other as I fight the monster inside of me, and sometimes when she looks at me, I swear she understands what I am fighting and her role in the battle. I am endlessly grateful for my silent soldier.

This song reminds me of my fur baby every time I hear it. It also reminds me of Evan, but pretty much everything does. “We laugh until our ribs get sore, sharing beds like little kids” even though everything outside of them grows scary. At least we have each other.

https://www.youtube.com/watch?v=os13bj4x

The Sun’ll Come Out April 19th

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I haven’t written a lot about the problem that has rendered me bedbound for quite a few months now. You may think you understand the severity of the situation. However, what you know is the tip of an iceberg that you soon discover is actually the edge of a glacier that is moving inevitably into the sea to raise and heat the ocean around you. In other words, you don’t know the full story. Yet.

The first two minutes of this video offer an explanation of what has been happening to my body.

The spasms affected me first in predictable ways, like decreasing my mobility and flexibility. Then my caregivers began to struggle to dress because of the extreme rigidity of my joints. Bye bye to my fitted retro clothes. Hello baggy sweaters. Maybe this doesn’t sound like a real loss, but when you have ALS, or even just live in a wheelchair, there’s already so little you can control about the way you present yourself to the world and the impression you make. A teal camisole under a blue tunic topped with a gold 1960s cardigan was my way of telling new people, “I may look kinda funny, and yeah, I need a computer to talk, but I’m happy and playful!” Those clothes made me feel like my old self. Losing the clothes was a stinging paper cut type of hurt: sharp, yet invisible.

Soon, the effects of my spasms took unexpected, dangerous turns:

– I spasmed in my shower chair and nearly fell. I would certainly have broken a bone since my limbs were locked.

– My jaw clenched so hard that I can’t brush my teeth anymore. This put me at risk for more than cavities. Dental hygiene is a first line of defense against pneumonia, which is all too often fatal for people with ALS.

– I became bedbound because moving me became too risky with how violently I shake. As a result, I am vulnerable to circulation problems, bed sores, and serious mental health issues.

I am now officially on every antispasmodic and pain medication my mind can handle. I had another one, but it causes nightmares so violent about the pets, I am haunted by them. I can’t even tell Evan, that’s how bad they were. Still, despite all the medicines, my spasms are so bad that I even sense them in my dreams and wonder why my dream body is shaking. Other people in my dreams avoid me because they are afraid or judgmental. The new medicine disturbs me. I wake up suddenly because, for example, I hear a crow and see it rushing at me out of the dark with the face of a human. I also have a black owl with raven feathers who guides me through the dark forest that is now my dreamscape. (clearly, I’ve been reading too much Rosamund Hodge). I wake up in pain, exhausted, and breathless.

I wasn’t supposed to get to this point. My doctor recommended that I have a Baclofen Pump implantation eight months ago, which my insurance denied immediately. So began an epic struggle with my insurance on one side and my doctor, the amazing team of nurses at the clinic, and my mom fighting valiantly on my behalf. Guess who finally won? Are you guessing the good guys? I can’t see you. You should be guessing the good guys.

BUT BEFORE THE SURGERY… I needed to do a successful Baclofen Pump trial.

The trial will look like this. No needles are actually shown in the video, only syringes, the tubes that hold medicine at the top of a needle. There is no blood. You can safely watch this while eating lasagna and your weak little tummy won’t so much as turn.

The trial was four hours of pain, but I got through it. Evan was with me, and Evan makes all suffering 50 – 75% better according to the latest study in the Harvard Medical Review (2017 Nov. Volume 4). The pain wasn’t caused by the needle in my spine – been there, done that – but by the fact that I can’t have any baclofen – my main antispasmodic – before the procedure, and it took four hours for the baclofen pumped into my spine to take effect. That meant four hours of spasms so intense that my whole body shakes and cramps, my jaw rattles, my teeth start chattering so wildly that I actually chew skin off my lips, and I beg Evan to cut off my limbs (usually starting with my right arm).

It was worth it, though, because it worked. The trial worked.

I forgot how luxurious it is to feel comfortable in my own skin, and after April 19th, the date of the surgery, I will feel that way all the time. the other side of the surgery…

I imagine that’s where sunshine lives, the daylight outside my bedroom window that I so long for. It’s where holding hands with Evan on the back porch watching the dogs play has been waiting for me, and so too the quiet scent of the poetry paperbacks in the last aisle of the Blue Room at Powell’s City of Books.

On the other side of the surgery is everything I love and live for, and I am overjoyed that I will have it again.

I will keep you posted on the events around the surgery. For now, start around minute two where the pump first shows and stop before the explanation of side effects to gain a better understanding of how the implant works.

https://www.youtube.com/watch?v=IeS-Wr4iz

Gross True Love

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At my most recent clinic, the nurse pulled out my mic-key – the feeding tube that allows access to my stomach – so they could give me a fresh one, and all of my breakfast came out like a volcano. Before the nurses could even react, Evan dove in and covered the hole with his bare hands. Remember, my feeding tube version of vomit was pouring out. Nothing grosses him out when it comes to me. Nothing. And that is true love in all its gross glory.

Please enjoy the illustration below, and have a happy Valentine’s Day!

J/K about the illustration. I love you too much to do that to you. (insert adorable, mischievous grin)

Xoxo,

Rachel “The Volcano” Doboga