Welcome to the Helicarrier

Warning: Excessive Marvel references ahead.

This is not the story I wanted to write today. I planned on sharing something emotional and joyful. It was going to be a bigger piece, and I looked forward to a long stretch of appointment-free hours to get it done. However, ALS doesn’t care about plans. Like Loki in “The Avengers,” it lives for chaos.

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When I got out of bed, it was like stumbling onto the Helicarrier when Thor and the Hulk used it as an arena. The stress had my heart racing and made my speech even messier than usual. Evan was marching around the apartment on the phone trying to get an explanation for an unexpected and rather staggering medical bill. My theory is that marching keeps his energy up during marathon conversations about insurance and durable medical equipment – not naturally thrilling topics. Laura was on the phone at the table hunting down the right type of medical mattress for the hospital bed being donated to me (!!!!). I settled in beside her and she started spooning yogurt and pills into my mouth while on hold. Things must have been going well for her since she still in Bruce Banner mode. God help whoever tried to blow her off; she’s secretly the Hulk, and she’s on my side. Between her fierceness and Evan’s Captain America-esque determination, I felt plenty loved.

I also felt useless.

We finished with the pills, and Laura took the dishes to the sink. Then, as she dialed another number, she slid a piece of paper my way with notes about what she learned so far to catch me up. She went into her room to continue her work, and Evan parked himself next to me, hanging up and diving straight into a summary of where he was in his investigation. I made some notes about emails I could be writing to help, and noticed my voice getting stronger. His phone rang, he kissed my head, and he was off.

Laura’s door flew open at that moment. She raced to the table, skidding across the floor in her rush to get more scratch paper. I laughed hard, and she struggled to remain calm and polite to whoever was on the other end. Business now; laughter later.

Good caregivers can make people with ALS feel like Helicarrier leader and superhero guide Nick Fury. We can’t always speak or even hold a pen to write a phone number. If we are having a really bad day, yeah, we might be wearing an eye patch. Our minds are still sharp, though. There are days when we need rest, but there are also days when we like commanding the Helicarrier by pitching in, being informed, sharing our opinions.

We are grateful to the caregivers who know how to let us take back some control, the ones who remember that every now and then, even the weakest among us likes to stand at the helm, if only to remember how it felt to fly.

 

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Far From FDR

Lately, I’ve been worrying a lot about my identity. So much is changing at what feels like breakneck speed. My body in particular is alien to me. I swing between thinking I am an ALS research guinea pig, a robot incorporating new mechanisms to extend the life of what is clearly a junker, or, most recently, a plain old invalid.

My sister is not OK with this.


Me: Am I an invalid?

Laura: Rachel, what are you talking about? They haven’t had invalids since FDR. Besides, I don’t we are supposed to use that word anymore.

Me: Oh… then what am I?

Laura: What you’ve always been. You’re a woman with pursuits.


It was pretty unexpected, a little Victorian, and a lot perfect. I remembered then that I’m more than braces, machines,  and physical therapy exercises. Maybe I’m not exactly what I’ve always been like Laura said, but I’m also not less than I was. And as far as pursuits go, I still chase dreams. Now, though, I’m racing after them in a 400 lb vehicle… I like my chances.

 

 

 


Disclaimer: No offense intended towards FDR, who, according to my grandma, totally rocked.


 

Don’t Talk-A-Thon: Part 3

“You do not need to leave your room. Remain sitting at your table and listen. Do not even listen, simply wait, be quiet still and solitary. The world will freely offer itself to you to be unmasked, it has no choice, it will roll in ecstasy at your feet” – Franz Kafka.

Those of you who participated in the Don’t Talk-A-Thon are sharing such a wide variety of stories with me. I must thank you again for being both involved and open about your experience. Like any well-designed activity that includes thoughtful people, the results were not entirely what we expected. I heard two main opinions of the hour of silence.

First, the most predictable and popular opinion: silence is uncomfortable! I know this is what I expected to hear, and I imagine the event organizers did as well. Being silent in a checkout line when a clerk is asking questions and you are fumbling for your credit card is awkward to say the least; you can practically hear people behind you wondering what is wrong with you. Or when you see your dog eating garbage and you are too weak to stop him and unable to call to your husband in the next room… that’s enough to make a person panic. Believe me. I’ve been there. Forced, unbreakable silence makes you dependent faster than you can imagine. Your position shifts to observer rather than actor in your own life, especially in a culture that values talking incessantly, quickly, and loudly. In conclusion, silence sucks.

This brings me to the second opinion of the hour of silence, the one that caught me off guard: there is peace in silence; why don’t we embrace it more often?

I know I said that I no longer find peace in silence, largely because choosing when to be silent is a luxury I hate losing. It makes every silence a tiny prison. Still, when a friend wrote the following, her words resonated with me the more I thought about them:

I’m silent a lot of time, between reading, writing and gardening. I wish we lived in a culture that didn’t value talking, incessant talking, so much. It’d be easier to hear what matters.

My first, sleep-deprived, frantic thought was, “This is not about gardening! It’s about my life!” I wrote back to her in what she would probably generously call a snappy tone.

And that’s the thing that got me thinking in those guilty minutes after clicking send… My friend is generous, and wise, and infinitely kind. Her ideas have always been worth hearing, her words respectful, so what was I missing?

I read her note once more and remembered her passion for gardening. Whether she is working alone or with family, it is clear she is most in her element when quietly nurturing precious little things. She’s got wit and sass – plenty of it – but she knows the value of balance. She understands what Franz Kafka meant when he said the world will unfold for those who wait for it quietly. However joyful a chatty dinner with friends can be, revelation and wonder don’t live there. They live in sitting side by side watching a sunset together, letting yourself feel deeply in another’s presence.

This is such an important reminder for both pALS and their loved ones. Those of us with ALS who are losing our speech will continue learning new ways to “talk” and asking for better technologies to give us our voices, but healthy people will always talk faster and louder than we can manage. We will still be in an endless race to keep up. So maybe, every once in a while, give us a rest. Take us to your garden. Put our stiff, curled hands in soil, and for once, let our breaking bodies be a part of creation. Join us every now and then in the silence until we forget to think of it as a cage. After all, the greatest, freest things are silent…

“See how nature – trees, flowers, grass- grows in silence; see the stars, the moon and the sun, how they move in silence… We need silence to be able to touch souls.” – Mother Theresa

Don’t Talk-A-Thon: Part 2

Hello all! I’m already impressed, touched, and overwhelmed by your stories of how your hour of silence went today. I would LOVE to share your stories of silence; it would be amazingly powerful to have them all in one place. Please consider sharing your experience below. If you are not able to spend an hour in silence today, go ahead and share what you would miss or fear if you were stuck in silence. Your empathy can move mountains and inspire ALS awareness!


I didn’t speak for an hour and it wasn’t all that easy… My mom and I were sitting at the kitchen table having coffee reading the paper and being silent. Every once in a while a word would almost come out and I would catch myself. I was mindful of the fact that this Made communication so difficult especially with someone else in the room. A lot of other emotions such as frustration and anxiety. Rachel is so brave and I grieve for her and for Evan every day but at the same time I remain hopeful that one day there will be a breakthrough, the one we all are waiting for.” – Renee (my mom!)


I had planned on taking the vow of silence, but my husband’s feed tube had an issue, and I needed to speak to our hospice team. But that then brings up they thought of, what if he needed to communicate the issues to the team? How frustrating and difficult it would be. So even without taking the vow, I know the horror he would have to go through. ALS may cripple one person’s voice, but thankfully, there is usually a village to roar for them!” – Glynis, author of Life After ALS: A Caregiver’s Journey


“I participated today. I occupied myself with reading a new book next to Harley on the bed, and to be honest it was hard. For one, I drifted off for 5-10 minutes, and it was hard not to talk to Harley, as I normally would, as I petted him with one hand and held my book in the other. At first, I was frustrated by my forgetfulness, but then I reassured myself the whole point was to think about what it would be like if I couldn’t verbally express myself. I was ‘trying on’ silence and checking myself in the mirror, so to speak. I did share my mission with a friend this morning at church, and it moved her. So I don’t win any awards today for successfully keeping silent, but my intention was pure.” – Mitzi


I wasn’t able to do the hour of silence today but if I did it would be so difficult to not be able to tell my family I loved them.” -Sarah

 

 

 

 

Don’t Talk-A-Thon: Part 1

Today is the Don’t Talk-A-Thon, a fundraising event in which participants vow an hour of silence in support of those who are forever silenced by ALS. In honor of this special event, I am sharing a very personal and painful story about the first time that ALS stole my voice. Remember, for me and countless others with ALS, our voices disappear permanently as a result of this awful disease.

The Sound and the Fury

Before ALS, I associated silence with prayer, reading, sleeping, being comfortable with friends. It was full of promise. Now, I know silence can be sheer terror. It falls like a knife from your hands to the kitchen floor, clattering around your bare feet. It paralyzes you with its chaotic power.

I knew it was coming. My voice is fading to nothing; that was established months ago. I hadn’t really imagined what it would feel like, though. I may have had a vague notion that permanent laryngitis awaited me, but I understand now that it’s so much more than that. I learned the truth when I spilled a glass of water by my computer (weak fingers). I couldn’t lift the computer out of the way (weak wrists). I imagined songs, stories, and photos being leeched out of the laptop into the puddle. Panicked, I called to my sister to come help me.

No sound came out. My tongue was heavy in my mouth. I felt like I had been slapped in the face, my breath stolen from my lungs. On the third try, I finally understood. This was my disease, a preview of what’s ahead. My horror rendered me motionless. My sister was in her room talking on the phone, but she might as well have been on another planet. I hit the alarm on my wheelchair, but Laura couldn’t hear me through her door. Malka raced to me, recognizing I needed help, but she couldn’t understand what was happening, and what could she have done anyway? I wanted to scream.

I broke into tears while Malka ran in frantic circles, panting hard in her desperation. A hot, fuzzy tingling sensation climbed the back of my neck, and all I knew was that I needed Evan. Despite my clumsy fingers, I managed to text him that I needed help. He was at work a few blocks away. He flew to me, his footsteps pounding down our hall faster than should have been possible. He crashed through the door and was by my side before I could blink away my tears, as if by moving quickly enough and wanting it badly enough, he could save me.

Evan held me and I sobbed for a while, calming down once I realized I was making a lot of noise with my crying. That was reassuring, but when I tried to speak, my enunciation was too messy to understand. My words sounded like a sad foreign language.

I resigned myself to the fact that I wouldn’t be speaking intelligibly until I recharged. A storm rolled in from the mountains, filling our valley with night dark clouds so it seemed far later than four in the afternoon. The lights in the living room became far too yellow and dim. My bird screamed then, and fluttered around his cage. I checked his food and water; there were plenty of both. His favorite nap area was clean. Laying back down, I felt awful that I couldn’t figure out what he needed. He chirped and squeaked, but it meant nothing to me.

I drifted off watching him flap around, never figuring out what he was trying to say. I remember thinking, though, just as I lost consciousness, that I had only narrowly escaped my own cage. My stomach rolled and I got dizzy imagining the door still open, waiting for me.

A Seat at the Table

Seeing my mom reminds me I am changing, though slowly relative to most other people with ALS. When she visits, there is always a lot for her to learn: the new way to help me dress, which silverware I can handle, what medicine I take at night. The list goes on. My sister and husband swoop in, explaining so much I didn’t even realize they thought about:

“When she says she’s thirsty, you have to grab the pillow under her feet so she can sit straight up. That way she won’t choke,” Laura says, pulling the pillow away and handing me my water.

“Hold the glass for her between sips so her wrists don’t get tired,” Evan says, taking the water from my hands while I swallow.

They must be thinking constantly about my needs. I can look at either of them and when our eyes meet, they burst into action, knowing automatically what I am silently asking. It is amazing, but it can’t be easy, and watching them train my mom, I keep wishing I didn’t need so much, didn’t change so much.

I need to be here in Portland. The care I am getting here is perfect for me, and I am so lucky I made it into the clinic. It is still hard to be away from my parents, though. It’s easier when I think of this time apart as an investment: I will live longer and ultimately have more years with them because of the care I receive here. Watching my mom learn to take care of me as though I am a very strange kind of infant will never feel OK. Neither will seeing my sister and husband throw their time and energy down the drain of my healthcare. I have to believe, though, as the three of them work together, the distance and effort will be repaid one day by my presence at their dinner table, when we all have gray hair and have grown old, just like we hoped and planned long before we ever heard of ALS.

Love and Dirty Dishes

It’s scary to show people just how sick I am. I let visits go way too long to avoid cutting people off or kicking them out, then end up exhausted with worse speech than ever the entire next day. I feel so guilty cancelling plans; after I do it enough times, I am sure I’ve become too unreliable to deal with. There are some people, though, worth being vulnerable for if it means keeping a friendship going and growing. They make it safe to be weak.

I knew I was feeling awful when I agreed to a cooking date with my friend Brandi last night, but I had already cancelled on her a few times and I hadn’t seen her in 2 weeks – the longest we’ve ever been apart since meeting last year. She came in, hugged me, got to work chopping, and I reclined my wheelchair while she updated me on her latest adventures. I ultimately could not eat the amazing food she made, but that was fine. We talked about books and listened to music while I dozed on and off.

Part of me hated that she was seeing me droop in my chair like a wilting flower too weak to speak, but the part of me worth listening to focused on the sounds of dishes gently clinking in the sink as she tidied up. It was so normal. This is my new normal. I am not the one washing dishes anymore, and I feel some shame over that. However, I have learned there is beauty in vulnerability. I know now that love can sound like familiar, gentle hands scouring a dirty pot.

Brandi, this song is for you.

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Woman, Woman by AWOLNATION

Another Point of View

ALS has not just changed my life. It has rocked the world of those who love me, especially my primary caregivers, my sister Laura and my husband Evan. My friend Glynis knows all about life with ALS as she cares for her husband. Read her blog, Life After ALS: A Caregiver’s Journey, to get a new perspective on the battle against this awful disease. Caregivers are warriors, too!

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Glynis and her husband, Vince

Deeper Than Bone

Since my diagnosis, I have come up with elaborate methods for convincing myself I am OK with losing the chance to be a mother. I have a list of why kids would destroy my marriage and sense of self. I avoid places where children flock and families are happy (Salt & Straw Ice Cream Shop down the street is off limits on sunny weekends). I even tell myself this story: Evan and I get our wish; we have a baby! However, from the very start, we know something is wrong. The baby looks at us with a wicked gleam in his eyes. Before we know it, he is escaping his crib and biting our fingers and toes in the night. At school, he puts slugs in the other kids’ jello and sets fire to his library books just to deprive his classmates of the joy of reading. Next thing we know, he is a juvenile delinquent. He kidnaps us, loads us up in a stolen car, and keeps us captive in an abandoned hacienda in Argentina. It’s not so far-fetched. Think about it. Every maniac and psychopath you’ve ever heard of had a mom and dad. It’s totally possible Evan and I have narrowly avoided creating the next Voldemort. I like to think that.

Every now and then, though, I’m caught off guard and have no time to conjure images of evil Baby Doboga. Like when Laura and I were watching “New Girl” and a commercial for a fertility clinic came on. A picture of an ultrasound drifted across the screen and I made this sound. I didn’t know humans could make a sound like that. It was instant and animal. I can’t even tell you what I was thinking. I’m not even sure I was thinking yet. My reaction was pure instinct. Then pain and fury rushed in, and I ground my teeth and shut my eyes to hold it back. I don’t want to feel that again.

Laura understood right away. She grabbed the remote and switched to “Broad City,” a show featuring the funniest and least maternal women I’ve ever seen. “It’s fine now,” she said. “What are you thinking we should do when mom visits next week?”

That’s how we erase it, or at least bury it. We have to. A person can only feel so much at one time. We have to pick and choose which hurts to feel. However, I still think of that awful sound. Whatever savage pain made it lives on in the shadows of my heart and the twist of my intestines, deeper and stronger than my bones.

Loud Mouth

I have a big mouth. I wasn’t always this way. Somewhere along the line, though, I learned to talk back, something I’m especially good at when sticking up for loved ones. Even though I’m in a wheelchair and my voice is fading, I just had to say something when a man catcalled my sister Laura from his car and made her incredibly uncomfortable. As loud as I could, I let him have it in what Laura later called a “fun mix of feminist ranting and light swearing.”

Suddenly, the man drove off and Laura grabbed my wrist. “Rachel, the volume is all the way up!” she cried. I must have looked at her blankly, because she tapped the microphone at my mouth and scrambled to turn down the sound on my brand new ChatterVox voice amplifier. I totally forgot I was wearing it, and with the sound up so high, I might as well have shouted through a megaphone!

We hid by a big hydrangea bush and laughed so hard while families heading to the park and people coming home from work looked around for the crazy lady broadcasting obscenities up and down the block. I was just catching my breath when Laura said, “Well, you’re definitely still a teacher… I know those kids just learned some new words.” I started laughing all over again. She was right; I never could pass up a chance to give a vocabulary lesson.