One of the BEST daily emails I subscribe to is called Peaceful Daily.  Thank you Sandy for your daily wisdom, and especially for this story....a reminder to me of all the "shit" that's been shoveled my way.... it doesn't have to bury me, it can be a way up and out.  How are you shaking off the dirt and stepping into your freedom.  It's always a choice!

Peace


One day a farmer's donkey fell down into a well. The animal cried piteously for hours as the farmer tried to figure out what to do. Finally, he decided the animal was old, and the well needed to be covered up anyway; it just wasn't worth it to retrieve the donkey.



He invited all his neighbors to come over and help him. They all grabbed a shovel and began to shovel dirt into the well. At first, the donkey realized what was happening and cried horribly. Then, to everyone's amazement he quieted down. A few shovel loads later, the farmer finally looked down the well. He was astonished at what he saw.

With each shovel of dirt that hit his back, the donkey was doing something amazing. He would shake it off and take a step up. As the farmer's neighbors continued to shovel dirt on top of the animal, he would shake it off and take a step up. Pretty soon, everyone was amazed as the donkey stepped up over the edge of the well and happily trotted off!

MORAL: Life is going to shovel dirt on you, all kinds of dirt. The trick to getting out of the well is to shake it off and take a step up. Each of our troubles is a steppingstone. We can get out of the deepest wells just by not stopping, never giving up! Shake it off and take a step up.

Extra Hands

One of the serendipities that happened to us was a group called "Extra Hands for ALS", founded by Jack Orchard, an ALS patient who lost his battle way too young. The premise was to get high school and college students involved in specific volunteer work to help families living with ALS, and then educate the general public about their experience.  Help families, great ALS awareness/advocacy, and a great learning experience for young adults.  Win, win win!

I'm sure that the experience was different for every family involved in the program, and sadly, the group died out not long after Jack died.  Still, we had a wonderful experience with Matt and Julia, our "extra hands" and the nuggets of experience I took away could reasonably be applied today, without a formal program.  I think!  Here are some thoughts on how someone in an "ALS Tribe" could harness the energy and enthusiasm of students and young adults to benefit a patient/family.

Disclaimer....please, please, please, use good judgement and common sense!  If you are the primary caregiver for a patient, DO NOT attempt this.  You have far too many other things to worry about!  Do what makes sense for you, the group of young people involved, and absolutely respect the wishes of the patient and primary caregiver.  The idea here is to help them, not add unnecessary/unwanted stress, even if your intentions are honorable. 

Logistically, you will need

• a mentor
• a schedule
• a willing family with an ALS patient - or any other chronic/catastrophic illness actually!
• a few willing students
• tasks that the family feels comfortable delegating or having help with.

The MENTOR is the liaison between the family and the students.  This person should be strong in organizational, scheduling and diplomacy skills.  He/she will be the one to coach both the students and the family, help resolve disputes and to generally supervise the relationship.

The SCHEDULE is coordinated between the family and the student.  Kind of obvious...I know!  We found that once a week, for a couple of hours worked out really well.  It gave me time to organize tasks and think abouut any instructions that might be needed.  And, it gave Matt and Julia the structure they needed to plan for homework and other activities.  Depending on the task(s) and the time of year, your schedule could be different, e.g., more frequent, but less time; less frequent, but more time; more people, regular rotation, etc.  You will know what works for your situation.

The WILLING FAMILY.  If you are a relative or neighbor who takes on the mentor role, one of the biggest challenges will be to work with the patient and primary caregiver.  In general, my experience has been that patients and their families are pretty private and will insist that they are quite able to handle things on their own.  No one wants to be a burden to anyone else.  You may have to get creative in your approach to find the willingness!  It's a delicate balance between handling everything and delegating tasks to relieve the burden of caregiving.  And there's always the competency dance....no one does it like I do, or like I like it done.  We humans are funny that way!!

For example, it's pretty easy to suggest allowing a student to walk the dog(s).  Easy to do and not much instruction needed. And...somebody needs to do it!!  However, if the only respite the primary caregiver gets is the 30-45 minutes to take a walk and clear their head, they are probably not going to delegate.  If however, you know that the dog is getting a quick 5 minute "do your business" outing, a longer walk a few times a week will be good for the dog and likely relieve some guilt that the family pet is getting short changed!

Grocery shopping is another easy, but tricky to delegate task.  For Bill and me, shopping was always like a date for us, so it was hard for me to let go.  However, by having Matt and Julia become Bill's arms and legs at the local Safeway, he was able to get a change of scenery, feel like he was still contributing and he often managed to teach the kids something they wouldn't have learned otherwise!  They usually returned from these outings all smiles, and the 45-90 minutes of peace was a great gift for me.  It often meant I got more that a quick rinse off in the shower and I could "doll up" a little.  A pretty good trade off!

One of the most special events that came out of our EH experience was a dinner that the kids prepared for their parents, who hadn't met prior to the program. Under Bill's direction, they planned the menu, shopped for and prepared the food, set the table, provided the entertainment (we watched them cook/interact), and cleaned up the mess. I can't speak for the parents, but I was truly impressed by how well the kids worked together, as equals, to bring fun into our home and provide a brief glimpse into their futures. It was a truly special evening!


WILLING STUDENTS.  We were lucky!  The Extra Hands team recruited and screened the students in the program.  If you're working with family members or neighbors, you're probably familiar with their skills, temperaments and background.  I would NOT recommend organizing strangers, unless you have the background and resources to screen and insure these volunteers.  It's a HUGE undertaking.  Again, please use common sense!!!

One of the components I found appealing about the EH program was the learning opportunity for the students.  At the end of each 6 month segment, or at the end of a volunteer engagement, the students were required to formally document their experience.  Julia and Matt both did formal write-ups for school projects. Julia shared hers with me at the time of Bill's death and it was quite moving. I haven't seen her in 7+ years, but she left a beautiful imprint on my heart and I think of her often.

You might encourage your volunteers to keep a journal or diary of their experiences.  Record the day's events and their thoughts on the patient, the relationship, how they were challenged, what they had to overcome....really anything and everything!  Think about this as you set up your program.

You can also arrange a regular meeting with the family as a check-in session to share these types of insights.  I imagine that it would be a rich and rewarding experience.  It will also help with insights into additional opportunities to provide help.  A quarterly session to consider what is working and what can be improved, can also be rewarding.  If the patient progression is rapid, you might want to meet more frequently. 

The TASKS are limited only by your imagination and the willingness of the family. 

• If there are younger children, students can help with homework or help out with household chores.
• Yard work is an easy to manage project as well.  Consider basic mowing, raking, weeding, deadheading, or annual planting. This is also a good, one-time project for a neighborhood group to tackle!!
• Routine chores like folding laundry, making beds, helping kids clean rooms are tasks that are easily delegated.
• We had Matt and Julia help prepare meals, take Bill grocery shopping, build a kitchen island (3 week project), shop for plants/potting soil, and I'm sure there are more that I've forgotten!!  As previously mentioned, grocery shopping was a favorite.

A little imagination, some good organization and great communication can go a long way! Consider setting up an Extra Hands "like" program for someone you love and please leave a message on how it goes.  I'd love to hear about your experience!

 

Hospital Gown + Confidence = Oxymoron

Fifteen years in retail fashion taught me many things.  But the most important thing I learned is that when I feel like I look good, I honestly feel and "do" better.  To this day, if there is an important event - interview, meeting, presentation, date, etc., I will take the time to make sure I have the perfect outfit and all the correct accessories.  Then I only have to worry about what I'm going to say....not about how I look.  Why, you might ask, is this important to share with you???

In my opinion, going into the hospital, for any reason, is a time for making sure all of the confidence chips are stacked in your favor.  The night before my mastectomy, I laid out a cute, but comfortable outfit.  On surgery morning, I showered and got dressed.  Took time to do my hair.  No make-up, but made sure my face was clean and moisturized.  My friend picked me up promptly at 5:00AM with "wow, you look adorable!"  With my confidence boosted, I was ready for surgery!  

At 5:30AM, the pre-op nurses, put a quick and decisive end to my adorable-ness when they handed me a bluish-gray, standard-issue, one-size-fits-none, hospital gown w/unmatched robe, white compression stockings, gray slipper socks with white grippey stuff on the top AND the bottom and an over sized "hat" that most self respecting cafeteria workers would not be caught dead in!  In the span of 30 minutes, I went from confident patient, to just another patient to be operated on, and I was less than thrilled.  Now, before you start in, I can practically recite all the reasons for this change of garments, but does it really have to be that way?????

According to Rachel Zinney, the founder of Dear Johnnies, the answer is a resounding NO!  The tagline "the get better hospital gown", is true!  With a little pre-planning and some cash, I gave myself the gift of dignity and style, in a place where there is precious little of either!!  You can give yourself or someone you love, the gift of a hospital gown that is bright, stylish, improves the color in your cheeks, covers your assets AND meets the needs of your medical caregivers.  A win-win all around! 

It will probably take a little work to convince the nurses, that your hospital gown is not just any gown you brought from home to wear in the hospital - but I promise you, it is absolutely worth the effort!!  The minute I changed into my own gown, I started to feel more like Kathie and not "the patient in room 95W".  These gowns are the genuine article - open in the back as needed, but snap closed and tie in the back to protect your dignity as you walk around the floor, and have shoulder snaps to accommodate IV equipment or nursing.  Size matters....so these gowns come in a couple of sizes, including Plus for several styles.  Once my nurses were satisfied that they would not be inconvenienced, they were quick with the "oooohhhs" and "aaahhhhhs". Sprung from the hospital, I re-gifted my COCO gown to my friend Megan, an ALS patient who is in and out of the hospital....hopefully she will feel just as stylish!

Thank you Rachel for giving us confidence and dignity at a time when we feel especially vulnerable!

Props to Peter Shankman and HARO for sharing the Dear Johnnies link earlier this year!

Bringing Sanity to Mass Communication

Back in January, as I was beginning my journey with breast cancer, I quickly discovered that, one of the biggest challenges of getting sick, is that
my friends all wanted to know how I was doing, and more importantly....how they could help me. I found myself fielding lots phone calls at all times of the day and night, and I felt like I was always repeating myself...."haven't we already talked about this?"  I didn't know who I'd spoken to, couldn't remember what I'd said or who I'd spoken to, and frankly, it was tiring for me.  But I clearly understood the love and concern of my friends, and their need to know what was going on, so that I didn't feel alone.  

In frustration one day, as I chatted with my friend Patti, I remember saying that "I just needed an easy way to communicate with my friends and family, you know, post it once and let them log in to see what was going on."  I've been around technology long enough that I was sure there was a solution, I just didn't know about it.  Her answer,"why don't you just set up a CaringBridge site?"  My startled response, "I've never heard of CaringBridge."  Turns out this is the best kept secret on the internet!! 

It was easy to get started.  You can do this as a patient, or someone on your caregiving team can work the magic!  Once the basics were in place I could start typing my thoughts into the journal section.  I can share thoughts, test results, updates and more, once.  Then friends and family can log into the site with a web browser and get the exact same information, when it's convenient for them.  Did I mention that the best part is I only have to post it once!?  My CaringBridge journal has significantly cut down on the number of phone calls, which allowed me to get the rest I needed and heal.

I still get lots of calls, but now it's to offer good wishes, fill in some of the details on what I posted and catch up on their lives...it's the best!  Since I started using Dragon Naturally Speaking, I just speak my thoughts into their journal site and it's even quicker!  The guestbook section allows anyone to leave encouraging messages, which has proved invaluable over the past few months, helping to keep my attitude positive and strong.

CaringBridge is easy to setup, easy to maintain and more importantly it easy to share the login credentials.  This was a huge help when I was in the hospital, when everyone was the most worried!   No one had the burden of answering a million phone calls to find out how I was doing!

The most time consuming part of getting started was collecting all of the e-mail addresses of friends and family and sending the URL once I had the site set up.   This part requires a bit of advance work, but it's worth the extra effort.  To the Dev team at CaringBridge, if you're listening...it would be awesome if there was a built-in tool to import an address book!! 

I use Outlook.  I used the export feature and created a master list of friends and their phone #/e-mail addresses.  From there, I created about 10 logical categories, based on a common thread (e.g. church, relatives, colleagues, belly dance, etc) and asked one friend in each group to be the point person.  I gave each point person a list of close friends associated to that group and then gave the master list to my friend Cindy.  Several friends sent out an advance notice, pointing their list members to the site early!

The best part of all this, in my opinion, happened on surgery day.  Cindy made about 15 calls and one posting to the site to start the communication tree; notifying about 450 of my friends and family members, scattered across the world, that I had made it through surgery with flying colors. It was awesome!

To get started, go to www.caringbridge.org.  Have fun, pass the word about this cool resource, and let me know how it's going!

Off the Bench…Back in the Lineup Again!

I am a huge baseball fan! And…even though they regularly break my heart, I remain true (29 years and counting) to the orange and black jerseys worn by the San Francisco Giants. My brother, an equally devoted Oakland A’s fan, and a few other friends have offered to pay for therapy! Hopefully, this bit of insight into my psyche sets a context for this post.

I’ve missed writing. I’ve been on the bench for 6 months after taking an “I found a lump” curve ball to my left breast on January 21st. Four little words that have significantly changed my strategy to playing this game called life. Turns out, I was lucky to get a “brush back” which allowed me to assess my life and make some changes, so that I have the stamina to stay in the game.  Here are just a few of the life lessons I’ve learned from baseball and my time on the bench:

• In January, when it’s still gray and icky, my heart leaps hopefully when I can start counting the days to spring training, along with all of the sports pundits. Hope springs eternal in January – it’s a new season and this could be the year we go all the way!  Every 365 days, I get to be hopeful - to start over to reach my personal dreams.
• There’s a lot of strategy to baseball. Pitching rotations and match-ups; hitting lineups; officiating; home or away; number of days on the road, and so much more. Same as life. Lots of things to consider when making changes, but it helps to know my team, how rested I am, am I on my home turf or on the road, what/who can I always count on?
• It’s a team game that takes 9 players, plus a cast of back-ups. And…any one player can be the hero or the (scape)goat for any given game. I’m only as good as the people I surround myself with.
• One game does not a season make. One has to shrug off a bad break or performance and mentally get into the next game fast. There’s never a lot of time for boo hoo-ing or second guesses. Equally important, a good performance today, does not guarantee a good performance tomorrow!
• Each player is a specialist, but there are times when opportunity knocks and one needs to abandon specialty to get the job done.
• 168 games makes for a long season, so players must have endurance and be resilient to make it through a full season. Health, training/preparation, attitude, support and flexibility, all play into one’s ability to make it through a long season.
• The game is on the field! Fans and coaching makes a difference, but in the end, the coach and fans are not on the field, the players are. If it is to be….it’s up to me!
• For a variety of reasons, players can spend a lot of time on the bench and not on the field. No one wants to be on the bench any longer than they have to! Time off is good. Too much time off is not good – at least for me!
• From a purely biased perspective, San Francisco has the cutest little ballpark in the league, and where else but a ballpark, can you enjoy beer, friends, and the smart crack of a line drive? It’s good to remember to stop and smell the roasted peanuts!

Six months has brought many changes and insights which are great topics for a blog about meaningful giving. For now, I am ready to play ball, so I’ll see you on the field - or in this case - on this blog!!!  For all the baseball fans, what are your favorite ballpark memories? What life lessons has baseball taught you? Please comment and share your stories!!

If you are interested, my CaringBridge online journal chronicles much of my personal journey with my breast cancer diagnosis.

Photo by Backpacker.

Rock on Carla Z!

If you've not discovered and/or taken the time to read the blog Carla Muses, you are seriously missing out.  Just my opinion.  Carla Zilbersmith is sassy, smart, and wicked funny.  Oh...and she just happens to have ALS.  I didn't know her bALS (before ALS) - my loss I assure you - but I suspect the disease has only served to sharpen an already razor-sharp perspective on everything...from the world, politics, dating, self care and quite literally, EVERYTHING in between.  She is a gifted writer, gamely sharing her ALS journey in full, out loud, living & breathing, color.  Late to the game, but yes....I am a fan!!

With that in mind, you should not be surprised to hear that she's written an informative and (it wouldn't be Carla's if it wasn't!) irreverant guide to living (with a capital "L") with ALS instead of waiting around to die from it.  While the Vain Girl's Guide to Living with ALS is clearly targeted to women living with the disease, never fear.  With and open heart and an open mind, there is something for everyone.  There are quite a few take-aways for me!!!

Once your laugh muscles are warmed up, the next step is to check out the film "Leave Them Laughing - a Musical Comedy about Dying".  Treat yourself to a full, "Carlaful" experience.

Enjoy!!

Bill turns 49 1/2

In January 2005, in the midst of building a ramp for the house, getting Bill ready for his wheelchair and who even remembers what else, our friend Connie asked, "Bill will be 50 this year, right?"  Indeed, his odometer would turn to 50 in October.  Always up for a party, Connie suggested we start planning!

A couple of weeks passed and it became pretty clear that Bill's ALS was progressing much faster than any of us were prepared for.  I called Connie and suggested that we hold off on the planning.  Based on his progression...it didn't look like we'd have a guest of honor for this bash and I didn't want to put anyone through a lot of trouble or heartache.  She said she'd get back to me!

Within a matter of days Connie had decided that waiting was not an option.  She delivered the new plan.  We would we quickly organize and still throw the party to celebrate Bill's 49 1/2 birthday!  I told you....she's a party girl!!  She and her husband Eric organized all of the details.  Bill and I had just 2 assignments.  Put together the favors and show up to enjoy some snacks, cake and the good wishes of friends and family.

Every picture tells a story!  This one tells of an amazing group of friends, who quickly organized before ALS could snatch their friend, to celebrate a milestone birthday - 6 months early!  Bill is smack in the center grinning, and Connie is in the lower right corner, with the bright, beautiful smile in the black, floral dress. I've told them personally, but this tells the world how grateful I am for the friendship I enjoy with Connie and Eric.  I will ALWAYS appreciate their thoughtful, unselfish gesture. 

Oh...and the party favors?  A CD of Bill's favorite songs.  No small task for a 15 year DJ'ing veteran!  Volume I was such a hit, he immediately received requests for Volume II.  But that...is another story!

Here's the playlist...You'll probably scratch your head and determine that my husband's taste in music ran to the extremely eclectic.  And you would be so right!!  Enjoy...and let me know what's playing on your iPod!

1. Fox Fanfare
2. Beach Boys - 409
3. Disney - A Pirates Life
4. Eagles - Hotel California (w/acoustic intro)
5. Free - It's All Right
6. 3 Stooges - Hello (sound clip)
7. Jump in the Saddle - Curly Shuffle
8. Los Lobos - Mustang Sally, Slow Your Mustang Down
9. Michael Franks - Inside You
10. Star Wars Quote - "I find your lack of faith disturbing" (sound clip)
11. Ray Charles - America the Beautiful
12. Santana - Samba Para Ti
13. Sara Evans - Suds in the Bucket
14. Animal House Quote - "Fat, Drunk and Stupid is no way to go through life son" (sound clip)
15. Shelly West - Jose Cuervo
16. Southern Comfort - Liquored Up, Lacquered Down
17. Steppenwolf - Born to be Wild
18. THX Movie Opening Theme
19. Vivaldi - Concerto in D Minor, Allegro
20. Toby Keith - Courtesy of the Red, White, and Blue
21. War - Low Rider (remix)
22. Tracy Byrd - The Truth About Men
23. AD/DC - Back in Black
24. Backdraft Sound Track - Fahrenheit 451
25. Braveheart Sound Track - Amazing Grace

Patients with Pluck!

From the Yahoo Education dictionary, I found the following definition for the word "pluck"

"Resourceful courage and daring in the face of difficulties; spirit."

And PLUCKY would be the best one-word description for 3 ALS patients, each far too young to have this shitty disease, whom I have come to admire and consider as personal heros.  They have truly taken the lemons life has handed them, added some salt and tequila (the 100% Agave GOOD stuff!) and done shots!  While they are still around to read these words, I offer the following tributes.

Carla Zilbersmith is a singer, actress, mom and a hell of a funny woman!  She lives her life out loud and ALS is just one of the many facets of this extraordinary woman.  Read Carla Muses regularly for a funny, irreverant and emotionally engaging look at her life, which just happens to include ALS.  I often wish that our paths had crossed when Bill was still alive.  I can only imagine their friendship and possible collaboration.  Maybe....in heaven!?  Her latest post "A Cripple Danced at a Gay Cowboy Wedding" is not to be missed.

Jason Picetti is young, smart, a self proclaimed nerd/former math teacher and writes the blog Adventures of ALS Boy.  Jason teamed up with Carla and was photographed, wheelchair and all, surrounded by a bevy of very sexy looking young women.  All in the name of raising awarenss for ALS.  "We're Bringing Sexy Back" is his account of the recent photography session.  Jason, like Carla writes from the heart.  "Last Call" is just one of a hundred+ gifts of insight that will allow his baby girl Emma to know the dad that will be taken from her too soon.  His wife Fehmeen is gracious and shares Jason's ability to look at the funnier side of life. 

Last, but certainly not least is Sarah Ezekial who has made it her life's work to raise ire and eyebrows, as well as awareness for ALS or MND (Motor Neuron Disease) as it is known in the UK.  Sarahville is one of my new favorites for a variety of reasons....but mostly because, like Carla and Jason, Sarah doesn't flinch.  She tells it like it is and isn't afraid to shake up the status quo.  Please take the time to read "MND is..." including the embedded link to "Is my pain really too shocking for television?".  The advert (in America we say commercial, but advert is so much cooler!) "Sarah's Story" is brave, direct and has created a lot of conversation...proving once again that one person can indeed make a difference.

Who are your ALS heros?  Cheers!

http://www.flickr.com/photos/sheeprus/ / CC BY-NC-ND 2.0

ALS patients are not babies...

I've become a fan of Carla Zilbersmith.  Which actually kind of sucks for me because I didn't know her before ALS and would have really liked to.  My loss.  My only consolation is that I am able to read her blog, admire her joie d'vivre and truly appreciate the tremendous effort that goes into each of her narratives. Her recent post, Big Baby on Carla Muses had me laughing AND crying as I recalled some of the caregiver/patient moments I experienced with Bill.  My post today is from the opposite end of the continuum.

For the record, we did not have babies, we had a three year stint as legal guardians for three 16 - 19 year olds.  My skills were just as limited and impatient as Carla described, so you can only imagine the conversations between the two control freaks living in our house!  To Carla's point, it is painfully frustrating (even without factoring in the potential humiliation) to be an adult who is no longer capable of operating independently.  It is all too easy to treat an ALS patient or an elderly relative as if they are a small child, even when we are fully conscious of the fact that they have learned full well how to dress, bathe, drive, and more.  Please repeat after me:

It is not ok to treat an ALS patient like a baby, not even when or if they are acting like one.  ~William Neil Lichtig

Each and every day some bit of independence is stolen from these loved ones, and deposited into the hands of a well intentioned caregiver.  And it happens of necessity, not because you and the patient came to some sort of mutually agreed to arrangement! 

Take a minute to reflect on what it might be like if the circumstances were reversed.  Would you be a "good" patient?  Would you trust and allow your spouse, child, parent to be your caregiver?  How would you negotiate the boundaries and know when to speak up or shut up? 

Think about it.  When you are rushed, it is much easier and certainly more efficient to put the shoes and socks onto a pokey toddler who is learning to dress on their own.  However, we cheat them of the opportunity to learn independence. It's natural to yell "hurry up" when someone is dawdling. After all, there are place to go and people to see and we're on a schedule.  In the same way, it's easier and much faster to do everything for the ALS patient you are caring for, ultimately shortening the dwindling thread of their independence and cheating you of some much needed respite!  I am not for one minute suggesting that you allow anyone, child or adult, do anything that is dangerous or will result in serious injury.  But I am suggesting that it is in your best interest to slow down and work to encourage/retain independence for as long as possible. 

I consider myself pretty fortunate that Bill was able to adjust quickly to his circumstances and remind me ever so gently (...not!) of what he was still capable of doing.  He could no longer manage the wash, but he could handle the dryer.  He couldn't carry groceries with his hands/arms, but if I could hang the bags onto the handles of his wheelchair or the boxes of soda onto his lap tray, he could zoom up the ramp into the house while I secured the van and he would keep me entertained as I put things away.  He could still carry his share of the load, and sometimes all of it!  

I learned to make myself scarce but stay within earshot so that I could protect myself from the heartache of watching my husband struggle to button his shirt, brush his teeth, walk any distance or any one of a hundred other little tasks.  I learned to tell him he had to do the best he could while I took care of something else.  And I learned to ASK him first, to see if he really needed my help to complete a task.  We learned to build more and more time into the schedule to accomodate his needs and capabilities.  And just as the world doesn't stop spinning when the kid goes out in mis-matched socks because everyone was rushed, it didn't stop when it took us an hour and a half to complete the grocery shopping instead of  45 minutes!

Caregiving is a full-time gig.  It's demanding and generally exhausting work.  Change is not easy. Work together and do not willingly make this job any tougher, any sooner, than you have to.  It would be great to hear how you manage this delicate dance.

Calendar Girls (and Guys!) for ALS

Carla Zilbersmith is extraordinary. And...she has a great idea!  I am posting this to help her find the 11 patients she is looking for!  Please contact Carla directly if you are game to join her!

TO FELLOW ALS PATIENTS:

My name is Carla Zilbersmith and I was diagnosed with ALS in December of 2007. I have been thinking about something I would like to do to both raise awareness and raise funds for ALS research but I need the help of 11 other bold people with ALS.

I would like to create a cheesecake calendar using ALS patients as models. I’ve seen calendars like this to raise money for cancer but they have always used friends and family members instead of the actual people living with the disease. I don’t know about you, but I don’t like to be marginalized because of the fact that I’m in a wheelchair or that I slur my speech a little. I feel like I’m the same person inside and I am forever looking for ways to remind people of that fact.

Here’s what will happen: If you’re even remotely interested in participating in this project, you will email me at carlazilbersmith@yahoo.com with your questions as well as any concerns that you might have. I will arrange for a photographer or photographers to take our pictures and wrangle someone to help with hair, make-up, and clothing (Obviously, men won’t need make-up and bald people won’t need hair styling). The photo shoot should take no more than 2 hours of your time including make-up. None of the pictures will involve nudity but they will be provocative. You don’t have to consider yourself “hot” to participate and ideally people at all stages of the disease from not even needing a cane to using a ventilator will be part of this. I want to show the world that we are more than a disease. I have been in the entertainment business for over 20 years and I know what I’m doing, so you can trust me when I say I promise you will not be embarrassed by the picture we choose and you will not have any pictures taken that you aren’t comfortable with.

I will find a printer and a graphic artist to donate their time to creating the calendar, which ideally should be ready by Thanksgiving so absolutely everyone can buy several as Christmas/Hanukah/Kwaanza presents.

I hope you will consider being a part of this project. We won’t raise millions of dollars but we will cause a stir, make some money, and let people know that we are alive and kicking until we’re dead. Thanks for your consideration.

Carla Zilbersmith

Dignity, Self Sufficiency and Safety...PRICELESS!

Earlier this week I posted Why does fundraising for ALS matter...really? I received some feedback that the story got lost in all of the gadget photos. So I decided to separate them. I just adore technology!!!


Dignity, Self Sufficiency and Safety may be priceless, but they DO come at a cost. That's where each and every donor hero comes in! Yep...you are (or can be!) a Donor Hero. And trust me...that too is priceless! Please understand that ANY donation, no matter the size is put to good use by any number of organizations serving patients and families with ALS, such as Augies Quest, ALSTDI, ALS of Michigan, or the ALS Recovery Fund. Bill and I were blessed to be associated with the ALS Association Greater Bay Area Chapter. But there are many others - use GoodSearch or Google to find an organization near you. BTW, GoodSearch is a great way to donate "passively" to the organization of your choice! 

Here are a few of the zillions of ways your donations and fundraising efforts can help a family living with ALS:


A $25 donation allows a patient DIGNITY and SELF SUFFICIENCY.

Built up utensils, straw holder, scoop plate and a grip cup allow an adult to feed themselves

 
A Button/zipper pull and a key turner allow independent dressing and access to the home

A $50 donation purchases SAFETY...Bathroom grab bars and a shower chair retain independence and safety around the toilet and shower. A Gait Belt allows a caregiver to safely transfer a patient from bed to chair and back, protecting their back and retaining safe control of the patient.

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  $1 per day Provides speech amplifiers for those whose voices are now too faint to be heard. or Helps a family transport their loved one to a clinic visit. or Offers an hour of a Chapter Care Manager’s expertise.
  
  
  
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  ALSTDI estimates that it takes $100 to fund 1 minute (60 seconds!) of ALS specific research. Remember we still don’t know what causes ALS which means we cannot begin to find a cure for ALS.
  
  
  
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  A $500 donation allows an ALS specialized Regional Care Manager to do their job for 1 week. Every day, our Care Managers assist patients by recommending community resources for financial/emotional support, securing appointments for power wheelchairs, providing recommendations for in-home care, recommending speech devices, reviewing physical therapy techniques, checking in on a patient who lives independently, delivering educational presentations to a wide variety of audiences, coordinating equipment loans/transfers between patients and vendors, and so much more.
  
  
  
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  $1000 supports specialized care at an ALS certified clinic, where patients see a battery of specifically trained medical professionals – Neurologist, nurse, occupational therapist, respiratory therapist, speech pathologist, physical therapist, social worker, augmentative communication specialist, and physical therapist. Consider that these costs are not always covered by insurance!
  
  
  
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  $2000 supports the MDA's Durable Medical Equipment program - specifically the grants for motorized wheelchairs, enhancing mobility and independence
  
  
  

How have you been supported by an ALS organization?  Please give a shout out to the heros that help make each day a tiny bit better. Thank you in advance for your generosity. Together, we can make a difference. But it WILL take all of us. 

Calm in the midst of a storm.

I have often joked, "pick your own natural disaster and call it home".  Me...I live in earthquake country.  It's crazy I know, but a small price to pay to be within 4 hours of any kind of weather I want, exquisite dining and culture, the Golden Gate Bridge and a short drive to some of the best wines in the world!  For you, it may be floods, hurricanes, searing heat, sub-zero cold, tornados, or humidity (that acts like MiracleGro® to blood-sucking mosquitos!), but we all brave the elements, wherever we live. 

Because there is generally no warning before an earthquake, there are measures I have taken to be prepared for when the "big one" hits. I check my supplies at least once a year, but for the most part, I don't have to think much about it, because I can physically go to that spot whenever I am feeling anxious, touch the supplies/check my list and ground myself with a measure of confidence. In addition to regular fire drills (stop, drop and roll), evacuation drills (remain calm and move quickly to the designated area) and earthquake drills (drop, cover and hold on), I know that if the time ever comes, I can go my spot, take a deep breath and remind myself that whatever else happens, at my core, I have the basics covered, I've practiced and I'll be ok. 

Friends who know me well, know that I am a great believer in the natural order of the universe.  Everything happens for a reason.  There are no accidents.  Most of the angst in the world results mostly from our own perception of words, circumstances or specific situations.  Life and its experiences (good and bad) come at us thick and fast.  We just catch our breath and we're on to the next "adventure".  For me, it's not what happens, it's how I handle or react to what happens, that ultimately makes the difference in whether an event bends me, breaks me or catapults me forward into something infinitely better.  My reaction ultimately determines my resiliance and perception of the event. 

And...I can hear you all loud and clear!  "Hey Kath...wouldn't is be just ducky if there was an emotional disaster preparedness kit?"  A great question and there is!  Today's post from the DailyOM - one of my favorite websites - reminds me of exactly why I subscribe to their daily newsletter to help me stock my psychic supply box with everything I could possibly need to weather life's storms.

This site is an online fountain of inspiration and practical tools to help each reader find his/her own center in the midst of the crazy, fun, chaos we call life.  Their tagline is "Nurturing Mind Body and Spirit" and for me that is exactly what they deliver.  Day in and day out the writers at DailyOM deliver a thoughtful and positive message, complete with practical suggestions, that reminds me of the emergency/disaster preparedness kit I have for the times when Mother Nature gets fussy.

Today's message is literally about taking a deep breath in the midst of all of the swirling and noise to touch base with our inner source, as a way to safely anchor myself to the universe and remember that I have everything I need to weather any (perceived!) threats to my emotional stability.  I also subscribe to their daily horoscope and am frequently amazed at just how targeted the message for the day is?!  I am regularly reminded that it is in my best interests to listen to and value the thoughts and opinions of others, and patience is a virture for which I will always strive!  Some days I'm quite sure there's a secret satellite webcam following me so the writers will know EXACTLY what message I need to heed!! 

So how about you?  What do you do to keep your balance when the inevitable storms hit?  Please share your stories here.  In the meantime, "Cool Runnings" Peace be the Journey!

The Tentra Totem - A Rx for Living

The key to getting over a case of the blues is to get out of my head. I mean, I have to literally take steps to stop THINKING! About me, about my troubles, about my blues. It's not ALL about me!! One of the best lines from the baseball movie Bull Durham is when Kevin Costner says to Tim Robbins “Don’t think ‘meat’, you just hurt the team.” Not so easy to do, but when the student is willing, the teacher arrives!

Over the weekend, I came across one of those chain emails (the ones where you almost reflexively hit delete!) that I read and then copied/saved, thinking at the time I suppose, that it might come in handy some day. Re-reading it yesterday, it seemed more like a “bucket list” for everyday living. And then it hit me! I can follow the suggestions on this list as kind of an antibiotic for the blues! So...it is my intent to follow this "Rx" for the next 30 days, as a gentle reminder of how much abundance I currently enjoy and practice some good, old fashioned gratitude! I'll keep you posted on my progress!

This Tentra Totem has arrived from India and was sent to you for good fortune. It has already circled the world 10 times. Whether you believe in superstitions or not, devote a few minutes to read the Tentra, good
fortune will reach you within four days from receiving the Tentra. Share the link to this post to whomever you think is in need of good fortune.

• Eat plenty of whole rice.


• Give people more than they expect and do this willfully.


• Learn by heart your favorite song.


• Don't believe anything you hear and do not sleep as much as you would like to.


• When you say "I love you," say it truthfully.


• When you say "I'm sorry," say it with eye contact.


• An engagement period of six months is crucial before marriage.


• Believe in love at first sight.


• Never mock other's dreams.


• Love deeply and passionately. You may get hurt, but this is the only way to live life at its fullest.


• Deal with discontentment, fight fairly, but do not offend.


• Do not judge others because of their relatives.


• Talk slow, think fast.


• When someone asks you a question you do not want to answer, smile and ask, "Why do you want to know?"


• Remember that the greatest love and the greatest success also hold many risks.


• Bless a person who has just sneezed.


• When you lose, do not lose the lesson.


• Remember: respect for yourself, respect for others, and respect for your actions.


• Do not allow a small disagreement to hurt a great friendship.


• When you notice that you have made a mistake, take the appropriate steps to correct it.


• Smile when you answer the phone. Those who call can "hear" your smile.


• Marry (or be with) the person you love talking to the most. When you get old, conversation will be more important than anything else.


• Spend some time alone.


• Accept change with open arms; yet do not give up your values.


• Remember that sometimes, silence is the best answer.


• Read more books and watch television less.


• Live a good, honorable life. Later, when you grow old and remember the past, you will enjoy it once more.


• Believe and trust God, whomever/whatever you conceive God to be, but securely lock your car.


• An atmosphere of love at your home is most important. Do all that you can to create a calm home full of love.


• Do not bring back the past.


• Read in between the lines.


• Share your knowledge. It is the way to live forever.


• Be gentle with our planet Earth.


• Pray. Prayer has incredible power.


• Never interrupt someone who flatters you.


• Take care of your problems.


• Do not trust a man or woman who does not close their eyes when you kiss them.


• Once a year, visit a place you have never seen before.


• If you make a lot of money, channel it so as to help others while you are alive. This is the greatest satisfaction a treasure can reward you.


• Remember that sometimes, not getting what you want is very lucky.


• Learn all the rules and then break some.


• Remember that the greatest relationships are the ones in which the love between two people is greater than the need one has of the other.


• Judge your success in light of what you had to give up to obtain it.


• Relate to love and to the kitchen completely. (All the reason you need to see the movie Julie and Julia!)

I hope you enjoy and are inspired!

100 things, leading to a single choice

Last week, the LA times published a beautiful piece written by Martin Welsh, who is the cousin of Jared Gill, one of my fellow ALSA board members. I was truly moved by the piece and asked Martin if he would agree to be a guest writer for DFTALS this week. He agreed and I am thrilled to share his thoughtful essay.

By Dr. Martin Welsh July 26, 2009

I am a 55-year-old retired family doctor with a large, loving family and innumerable friends and former patients whom I see often. I am an extraordinarily lucky man. For the last five years, I have also been a patient. I have ALS (or Lou Gehrig's disease), a cruel neurological illness in which a normally functioning intellect becomes trapped in an increasingly weak and eventually paralyzed body. Soon, I will die from it.

Through my career, I tried to honor my patients' end-of-life wishes. But after a quarter-century as a firsthand witness to death, I've developed my own perspective. It's not that I'm a quitter. I have struggled against adversity of one sort or another all my life, and those challenges have helped prepare me for what I face now. I still delight in accomplishing difficult things, and I always wear a bright red ALS wristband that says "Never Give Up. "That said, there will come a limit. I have made it very clear to my wife, my family and my doctors that I want no therapy that will prolong my suffering and lengthen the burden on others. I do not want a feeding tube nor a tracheotomy when the time comes that I can no longer eat, drink or breathe for myself.

Physicians and families sometimes feel an obligation to do all that can be done to keep someone alive. I believe this is based in equal measure on a fear of death and on Western medicine's increasing ability to prolong life near its end. I was able to diagnose myself at a fairly early stage of the disease. My case was slower to progress than some, and so I was able to keep working as a physician for nearly two years. During that time, I was enormously grateful -- for my patients, for sunsets, for golf games with good friends. Life has been truly wonderful, even as I have slowly lost the use of my hand, then an arm, then both legs and my speech. But as much as I have stayed focused on what I am still able to do, it has become harder to ignore the things I am losing. Today, my guitars sit idle. I haven't used my stethoscope in years. My jogging shoes gather dust in a closet as I watch my belly grow from lack of exercise. I remember the last time I tried to shoot a free throw with a basketball and I was five feet short of the rim.

Today, I find myself facing the kind of "quality of life" issues I discussed innumerable times with my patients. Answers vary from person to person. But the fundamental question is always this: At what point is the quality of life no longer worth the emotional and physical costs of maintaining it? I am not afraid of dying or death, and that is a wonderfully comforting thing for me right now. I have seen so many "good" deaths in my time as a physician that I know this passage can be peaceful, spiritual and even comforting to those left behind. I hope for such a death.

I have also started to think about how I will know when I am ready for it. To that end, I often think about what I call the "100 Things." Here's how it works. Imagine a list of 100 things you do most days. Some are routine, some are "chores," some are pleasurable. Get out of bed and walk to the bathroom. Kiss your wife. Answer the phone. Drive your car to work. Go play golf with your friends. Brush your teeth. Write a letter, lick and seal the envelope closed and put a stamp on it. Hug your child. Of course we do many more than 100 things each day, but for now, just imagine 100 that are essential to the life you live. Now if you take away one, you can still do 99. Is life worth living without being able to smell the rose in the garden? Of course it is! How about losing two or seven, or 23 -- is life still worth living? Of course!

But suppose you get to where you've lost, say, 90 things, and now with each thing taken away, a bad thing is added. You can no longer walk well, and you start falling, and it hurts. Your grip is gone, and you also suffer the ignominy of wetting your pants because of bladder spasms. You can't turn over in bed, and that also means you will get bedsores unless someone turns you frequently. Life is still worth living, but you're getting tired. At some point, no matter who you are or how strong, you can lose enough things that matter -- and acquire enough negatives -- that the burdens will outweigh the joys of being alive. This is the stage when, as a doctor, I would reassure my patients and their families that they had fought the good fight and it was now OK to accept moving to the next phase.

I know I will one day reach that point. And that's why I worry about feeding tubes and ventilators. It has been my experience that these things are at times started almost automatically, and once they are started, they are next to impossible to stop. I have seen too many unfortunate people kept alive for years in hospitals or nursing homes, beyond all quality of life. Sometimes it causes untold stress in a family. Some of these cases even have made national news, and, unbelievably, our government and some national religious leaders even weighed in, as if they had a right to do so. I worry that at some point a feeding tube, or other artificial substitute for a basic body function, will be medically "indicated" in my case. Intervention at that time might seem to make sense to those around me. But the result may be that I am kept alive only to count off the remaining things on my list of 100, such that I am forced to live well past where I would want to say "Enough."

I like to know where a road leads before I set out on a journey. Right now, one path I could take leads to a place I don't want to go. I am determined not to start down that path, even if others think I'm being premature in my decision. In short, I may well be ready to die before my family and friends are ready to say goodbye. But they know that, as I face my diminishing list of the 100 things that make life worth living, the choice of quality over quantity has to be mine to make.

Reprinted with permission, this article was first published by the L.A. Times, July 26, 2009. Martin Welsh grew up in Los Angeles and graduated from UCLA Medical School. He now resides with his wife in Camino, Calif.

Gratitude

I learned a very valuable lesson earlier this week and I want to thank you for taking me on as a willing student...and teaching me! In the past, I haven't been good about sharing my progress and setbacks in the process of grieving. I'm not too excited by my own company, so I certainly don't want to burden my friends! "The Funk" post was the first time I'd really been honest, even with myself, about how hard it is to grieve.

By reaching out, sharing my experience and asking for feedback, I received a wealth of warmth, personal sharing and encouragement, from places I never expected. Just like when I was a full-time caregiver, I am once again humbled by the lessons ALS has managed to sneak into my consciousness! THANK YOU!

4 months ago today, a young man named Drew Schemera earned his ALS wings and is free from this stupid disease. In his ethereal wake, he left a wonderful BLOG with a comprehensive set of links to ALS related sites. Even better...a fabulous (encouraging, thoughful, uplifting) playlist of 147 songs from all music genres. I'm listening to it as I write. #80, "You Get What you Give" by the New Radicals has become my new anthem! I'm sorry I never had the chance to meet Drew, but I am very grateful to his family for leaving his writings on the web.

Lesson learned: Be honest and reach out. There will always be a hand to clasp yours and a hand out of the funk can come from some unlikely places!

The "Funk"

So....I haven't written for about a month or so. I've missed it, but the summer months are difficult for me. I go into a funk and climb into my "cave", a self imposed RIF (reduction in fun) to hibernate with my grief. I lost my dad in August. I lost my husband in August. I lost his brother in September. I can get through the routine stuff...you know, go to work, try and work out, pay the bills, wash some clothes, and the like, but that's about it. Every other bit of energy seems to be absorbed in this whole process of processing grief. It's a job!

In the year following Bill's death, I was completely numb. I went through the motions - 365 days passed and I could barely remember what had happened, let alone identify specific moments in time. The second year, I went into a dark place and couldn't identify what was happening. I couldn't shake the sadness. Just when I thought I would be OK, Bill's brother was killed in a freak motorcycle accident. I felt like I'd been pushed under water. The sadness in my bones lasted until after the first of the year and took the remainder of the year to melt away.

Year 3 approached and I really dreaded the summertime. I just knew that I was going to be sad, and sure enough... I received what I anticipated! However, my time in the cave didn't last as long and I was encouraged. Late last fall, during a period of intense introspection, I finally figured out (with much gratitude!) the source of my sadness. For me, summer and early fall are closely linked to loss of loved ones. To cope, my normally cheerful, optimistic self crawls to a place of safety (the "cave") and assumes the fetal position for whatever length of time it needs to sort through all of the feelings of anger, sadness, hopefulness and faith that are associated with loss, leaving the rest of me to cope with the world. For me, this period is now fondly referred to as "the funk". You might imagine that with the cheerful "me" on hiatus, the rest of "me" is not all that much fun - and you would be correct! I'm just not very good company during this period.

Coming out of "the cave" last year, I resolved to be more present with this period of time each year...to pay attention to what was happening to see if I might learn anything. It's odd paying such close attention to my feelings!? This year, I've noticed that the funk started a little later....and curiously it doesn't seem to be quite as intense this year. Good news! I'm hopeful that this hibernation period is brief and restorative!!

How do you handle grief? I'd love to hear your thoughts, so please post a comment!

Aftermarket add-ons for your wheelchair – Safety and Style

A while back, I wrote about the horn Bill and his brother rigged up for his motorized wheelchair. If you missed it, read "Aftermarket add-ons for your wheelchair - The Horn". Here is the story of a few OTHER additions made to the chair...

We got the wheelchair in early March 2005. To break in the new wheels, Bill decided to take himself to the barber for a haircut. It was a perfect spring day and his favorite Supercuts salon was only about 2 ½ miles from the house. We knew he had enough power, so I checked his wallet on a string, fastened his seatbelt, reminded him about looking both ways at the intersections, kissed his head and sent him off. Little did I know my admonition would come in handy! About two and a half hours later he returned with a buzzcut and a “mad-on”. Dear Lord…he wasn’t gone that long, what could possibly have happened? Through his wild eyes and keyboard banging, I learned that drivers could not see him, they often honked at him, and a couple of times he felt really terrified. For the record, it’s not easy to scare a guy who made his living by running into burning buildings!

Over the years, I’ve learned that there are times when it’s best to just listen and not try to do or say anything. This was one of those times. Once his blood pressure was back into the range of normal, he announced that we were headed to a bicycle shop and Home Depot, in that order. I grabbed my shoes, my handbag and the car keys, and loaded us up into the van.

We got to our favorite bike shop and he sped right to exactly what he wanted – a bright orange flag, the kind that parents generally add to a tricycle or the bike of a small child. Next stop…Home Depot. That part of the trip did not go as smoothly! He was having a hard time explaining to me what he had in mind. Never mind that he had to use “talky” to try and translate! We started to draw a small crowd! Frustrated for both of us, I told him to stay put and went to find a hardware guy! The universe was truly watching out for me that day, because the first guy I found turned out to be an angel in an orange apron! Within just a few minutes, he completely “got” what Bill was trying to accomplish. While he was looking at the chair, he noticed that Bill had strategically angled his walking stick between the chair seat and the handles. He asked if that was working and the answer was “only part of the time”. They had another quick round of discussions and our new friend set about making the necessary alterations. About 20 minutes or so later, not only was the flag attached to the chair, but so was a piece of PVC piping. Both the flag and the piping were mounted to the back of the chair with metal brackets. The walking stick fit neatly into the pipe and his baseball cap fit over the pipe, keeping both close at hand. The flag actually had a joint, allowing me to detach the top part of the flag so that he could get in and out of the van easily. When it was in place, the flag extended approximately 3 feet above his head. It was just enough to make him feel safer when he was out and about on his own. It was really quite ingenious!

A few weeks later, our good friend “Aunty Em” gave him a bouquet of bright yellow (his fave color!) silk daffodils. He loved them and immediately asked me to stick them into the PVC pipe to wedge the walking stick. Turns out, the rattling was making him a little crazy and this was a perfect, stylish solution! The daffodils were a small bit of sunshine wherever he went and never failed to draw a smile.

In addition to the normal wheelchair adjustments and equipment additions we made to accommodate ALS as it progressed there was one final bit of flair added. The chair we received came with 3 sets of removable fenders. So his best friend took the silver set and with the help of an artist friend who details fire engines, added some hand painted flames to the otherwise vanilla looking fenders. When all was said and done….it looked like he’d won a trip to the reality show “Pimp my Ride”!

The addition of the flag allowed Bill to feel more confident when he was out and about on his own – a true blessing which allowed him to keep his independence just a little bit longer. The flowers and the flames were the icebreakers that made the chair a little less threatening to strangers and children. For me….I just smiled and was thankful that ALS only got his body and not his spirit!