ALS

April 8, 2024

April 12th

It’s strange. One would think that at the start of the worst week of my life I would have something to say. Something to impart on how I am feeling… But I have nothing. Genuinely nothing. I feel numb. As if I have hit pause on my entire body. I imagine if I were to pursue some answer it would say that it is some sort of trauma safety response… However I don’t have the time or the energy to do it. And in the end… what would this answer serve?

For some context, this Friday (April 12th) my husband will go to bed without his breathing mask. It is this mask that has kept him around as long as he has, and without it he will most likely pass way in his sleep. We have spoken with his hospice nurses and they will be there to help keep him comfortable as he “transitions” into the next stage of his existence.

I have known that this day was coming since he was diagnosed with ALS. It’s not like that this was sprung upon me out of the blue. I knew. I have known. It’s just weird to know the exact day. Prior to this I would wake up every morning and see if he was still here, or whenever he took a nap. I have been convinced for sometime that he would go while we slept. Primarily because that was what the doctors had told us was most likely to occur, and even before he had been diagnosed I would wake up in a panic throughout the night and see if he was still breathing. It’s weird. It was as if I knew.

All I want to do is open up my heart and pour out all I feel… I am craving some semblance of vulnerability but I have none. Is this shock? Maybe it is denial, until I am there to see and feel the reality.

For so long I have lived with the “not there yet” attitude. It was the title to our weird little video blogs we would do on our trips. It was literally the words I would say to myself in the early days of diagnosis, when my mind would spiral into all of the gory/overwhelming possibilities. To calm myself I would repeat “we’re not there yet” so I could focus on where we were in all of this. Well… we’re here.

The thing that is keeping me together is what Charlie said the other day, when I asked how he was feeling: I’m excited to see what happens next.

March 5, 2024

Scheduling “Farewell”

My sister-in-law said it best when she stated that all of this is very surreal. She was commenting on the fact that my husband has decided to stop using his breathing machine at the start of April. He had randomly asked my thoughts on it one evening. As usual, I told him that it is entirely up to him on what we do regarding his care. He didn’t respond to me in that moment, but he answered later that week when he announced “the plan” to his mom.

For context, my husband uses a breathing machine about 90% of the day. The only times he doesn’t use it is when we’re transporting him from one room to the next or getting him into a bath. Then once he is situated we put it on him. This is a bi-pap machine, not to be confused with oxygen. It’s used to assist in the push and pull of air out of his lungs. It never occurred to me how much heavy-lifting it was doing until we had to take a trip to the ER. He was so anxious about the whole event that we had to bump it up to the “emergency” level. I watched Charlie’s chest rise and fall with every pump of the machine. Usually his breaths are so diminutive that I have to stare at him for a solid minute or two to see if he is in fact breathing. More often than not I give up and look to his neck or face which have more prominent signs of… y’know.

As my husband explained to his mom, and not so much myself or Tony, is that he has gotten to a poor quality of life and he is putting too much strain on the two of us. He wants to do it in April after both my nieces and Tony’s birthdays.

My own perspective on the issue is that once he stops use of the breathing machine, that will be it. I told him as much last night, regarding his breathing. He again didn’t respond until later when he told me the next morning that he had started to focus so much on his breath that he began to panic. He hadn’t noticed how small of a breath he takes.

At least giving everyone a heads up kind of takes the initial sting out of it. It’s different dealing with loss when you know it’s coming. It doesn’t make it any less painful, but it does make it easier to compartmentalize.

One may want to know, how do I feel about all of this… Well, when charlie was first diagnosed, literally the next day, we were sitting silently in the hot tub on our patio. He was staring off into the middle distance thinking.

“I need to ask you something,” he said, fighting back tears. (He refuses to cry.) “I want you to promise me that when the time comes that you will help me.”

It took me a moment to realize what he was alluding to…

“I promise,” I said.

I’m such an idiot… I end up giving more than I am willing. Especially in the moment. I’m a people-pleaser and will do anything for those that I love. Even at the cost of myself.

I am also a man of my word… Which makes this complex and complicated in this scenario. However, he has made it abundantly clear, in very clear and precise words, that he isn’t committing suicide. He is not doing that. He is just attempting to “speed up the process.” He, rightly, assumes that if he stops using the bi-pap that it will happen sooner rather than later. Since the nature of the disease is to take away the muscle strength to speak, swallow, breathe, and move.

As it stands, on April Fools Day we will no longer rely on the assistance of the breathing machine.

January 26, 2024

A New Member of the “Lollipop” Guild

I entered into the Midnight Madness short story competition and have had a week to concoct a short story. Have I started? Not really, other than planning and plotting in my head. So, I’m finally sitting down to bang out a rough draft. In the past I have done it day of the deadline so at least this is some progress. However, to get the engine purring before I dive in, I thought I would write a blog. It feels like so much and nothing at all has happened.

My husband has definitely progressed. But I think it’s a subtle change that isn’t as obvious to it’s broader implications. For some reason he has become OBSESSED with his mouth. He has explained to us that it feels like he has a tapeworm that is trying to escape through his mouth. Like this parasite is reaching up through his esophagus to escape. We called the hospice nurse and she assured him that “that” isn’t possible. (However I was told a story from my grandmother that her mother had a tape worm and after a bite of horse radish it crawled out… but I guess that was a ‘tall tale.’)

The nurse’s suggestion was to provide us with these little “lollipop” sponges to moisten his mouth and try to break up that dried phlegm at the back of his throat. Now every 20 minutes I’m dipping in these little sponges and swabbing his gums and tongue. This isn’t that much of an ask, except for me it comes with past trauma and lots of emotional baggage.

When my mom had lost the ability to swallow and was heading toward her end, the hospice nurse provided these exact “lollipop sponges” to moisten her mouth and lips. Seeing these again has brought up the feelings attached to them. I shared my feelings with him and he assured me that they are unrelated. This is not a sign of things to come. At least not in the immediate future. Yet… aren’t they?

With ALS he will eventually lose the ability to speak, breathe and swallow on his own. It’s just a natural progression of the disease. The muscles involved in these bodily functions atrophy and he is left kept alive by machines. He has already shared that he doesn’t want that, and I do not blame him. Neither would I. So… we have entered into a new waiting game, in my mind, of whether this is a sign of that or not.

I hate all of this. I hate this for me and for him. He feels so much guilt for how much he is relying on and asking of Tony and I. And I feel bad because in the face of this new task I am overwhelmed with it’s overall meaning. So I respond by being short and cold when he asks. It appears that I’m angry at him for making the requests, when in fact I’m mad that this is happening and don’t properly know how to process this change.

It’s further made worse because I generally don’t know how to process my feelings. I never learned healthy coping mechanisms or how to unpack my feelings in a way that I could handle them without flying off the handle. My go to response for most things is anger/rage. I think it makes me appear “tough.” Yet that couldn’t be further from the truth.

November 29, 2023

If there is no flight, then we shall fight

I never truly understood the concept of “fight or flight” until recently. And when I say that, I mean within the last two weeks. Prior to two therapy sessions ago, my comprehension of the saying was: either “fought for their life” or “ran away to survive” in life threatening situations; like being held up at gun point or rape. It never occurred to me that these moments could occur at any time. It’s a trauma response.

The last few months I have been at home. It began at first as a way to cope with the panic and anxiety I had that my husband was starting hospice care. Since then I have not left the house. For the most part, I stay at home and care for my spouse.

At the start of October I returned to work doing miscellaneous jobs from home, only leaving for (at most) 2 hours to do an inspection. It started off fine, but it has since become a sort of prison. I can’t escape when I want and I can’t do what I want because I have my husband who needs me. The worst thing that could happen is for something permanent to occur while I’m gone.

It is here where the “psychological response” became vividly clear.

My tendency is to run away from situations. I’ve done it since I was a kid. If I was feeling uncomfortable I would just escape to my room, go on a walk or just drive for hours with no destination. Now that I cannot do that because of circumstances and my own unwillingness to leave for fear of what may happen… I have become angry. I fight, but not in the way one would expect. I don’t pick fights verbally or otherwise. No. I just get cold, quiet, passive aggressive or redirect it into something unrelated. It’s the way I alleviate the feeling.

Lately I have started to “fight” with my husband. I try, as quick as I can, to remind myself of the reality, how I really feel. Most of the time it works. Sometimes… it takes a little bit. I will bring up long since dead fights, grievances or misdeeds to justify my rage. Essentially I’m picking a fight. Fortunately it’s just with the shadows of the past, in my own head. The guilt I feel after these response moments is so heavy.

I have yet (and universe willing) have done so only in my head. I know, without a shred of doubt, I would forever hate myself if I were to ever let my thoughts leave the safety of my mind.

There is no conclusion or real resolution I can impart. Just wanted to share this clarity in the hopes of helping someone else. Maybe another reader has yet to get the basic principle. The one that sounds so simple, but lacks any specifics to its deeper meaning. Well, it’s an oversimplification for me at least.