Intrinsic Echoes

why is it that some things just never get said?

Me in my wheelchair. The only visible parts are pat of the footrest, a corner of the black cushion, part of the right arm rest, a view of the corner of a grey shirt and beige pants.
Description: Me in my wheelchair. The only visible parts are pat of the footrest, a corner of the black cushion, part of the right arm rest, a view of the corner of a grey shirt and beige pants.

This post comes mere moments after feeling like I had to defend my use of a powerchair as part of managing multiple co-morbid (horrible way of saying that it’s a chicken and egg thing trying to tease out what caused what problem in what order) disabilities and two neurologically based diagnoses. MS being the progressive disabling kind. The other just recently diagnosed based on genetic testing and putting a lifetime of cognitive dissonance into perspective – I am also autistic, but mask and hide very well in public – except when the great Fatigue wall and I slam into each other and then all bets are off because I do come undone in ways that horrify me after the fact.

The facts

My MS primarily presents in 3 ways. Increased muscle tone, and depending on which professional I’m seeing on any given day it’s either termed spasticity or increased tone. I think it’s clinically mild because I’m not yet rigid. I have mobility partially because when my muscles are at their most painfully tight – I am still moving them, stretching them out, massaging until I bruise myself on muscles that are hard as rocks, and massage therapists struggle to release – and sometimes they feel like they aren’t helping me because they didn’t manage to restore any movement to a muscle that feels like bone, but isn’t. It’s a constant, all day, move, stretch, release, masssage, try to ignore pain, take marginally effective medications and hope . I can now ignore a 7 on the pain scale – 8 is a slightly emotionless stilted conversation – 9 I can still speak tersely. A 10 and I have trouble speaking, my eye water on their own accord, My breathing is shallow but I can still force our words, but I’d really rather you shut-up so I can focus on not losing my shit because I’m really about to go catatonic, but I still won’t be wailing in pain. I don’t know what will make that happen, and I don’t want to find out. I only show up in an ER at a 9 (because maybe it actually is my heart when the MS hug is that crushing – it has never been my heart – at least not yet. The genetic anomaly I have is autism and cardiovascular problems, so I might want to consider going to the hospital earlier now that I’m 45 and my family history of heart issues means my genetics are against me.) The longer I am on my feet, the more tone (spasticity) creeps in and the harder my brain and body have to work to just move at all.

The second equally crippling is Fatigue. Fatigue is not tired. Fatigue is not momentary. It’s not fixed by a nap. It’s not touched by sleep. Fatigue rolls in like a thick pea-soup fog that I can’t think my way through. I can’t manoeuvre my way out of. It’s what I imagine swimming or walking through wet cement must feel like (not going to try it to find out.) My worst, and scariest moments with fatigue have lead to disorientation, confusion, and an inability to process my surroundings, and an complete failure to keep my masks in place and appear normal. All my practised smoke and mirrors vanish, and all the things I keep in check come out for all the world to see. It’s not pretty. This is the biggest what came first the life long struggle with Major Depressive Disorder and Generalized Anxiety Disorder? MS? Autistic burn-out from having to mask in the first place? I don’t know. I do know I never want to allow myself to ever get to the point of delirium ever again.

Lastly, at least in my books, is the coordination issues that might be a result of the spasticity – might be it’s own damned thing on top of the other things, but again it doesn’t really matter because it now takes thought to get my extremities to behave in a way that’s functional to do things like eat, cut thing up safely, walk in a reasonably straight line – not fall over and scare the crap out of other people. Me I’ve always been a little clumsy and uncoordinated – I’m used to laughing at myself. Apparently not everyone shares my humour with the wonkiness that is me. The coordination issues have just become more pronounced, and more funky weird as MS progresses. I’m semi-officially SPSMs (It’s been suggested only in my clinical records, but not in such a way as to exclude me from any new treatments )

I hope that all of this explains why I’m a walking wheelchair user, but if not, here’s the best way I can say it:

The longer I’m on my feet the more spastic I get. The more I’m fighting my body to move the more exhausted my brain gets, and then I can no longer regulate socially (autistic), the more I burn out, the more depressed I get (life long challenges with diagnosed Major Depressive Disorder.) The more I can’t read social cues the more social mistakes I make – the more anxious I get (Generalized Anxiety disorder.) Then the fatigue wall sets in and everything becomes an effort. The problem with the EDSS scale is it doesn’t take into account spasticity. It only takes weakness and paralysis into consideration. I’m heading that way (SPMS) I have major coordination issues. Everything takes more effort to control. My left side is a mess… so a manual wheelchair won’t work (I tried before the OT convinced me the effort was not in my best interest. 3 weeks in the Rehabilitation hospital in 2017 was an education in pacing that I am only now taking seriously.) Every day is an assessment: Is today a trekking pole day? A walker day? Wheelchair days are truly horrible days – or I have to be out and about on my own and need to take the cognitive load off so I can enjoy myself or have the energy to deal with whatever it is I have to do. The fatigue truly scared me when I started getting disoriented and confused because I was just that physically and mentally exhausted.

I “only” have an EDSS score of 4.0 – which by all means I should be a free walking person. I am not – not even close. It’s a measurement scale that really takes a very limited view of total disability. I used this scale as justification for a lifestyle that took no consideration of my overall disability load from multiple sources and I “ran” with it until that Fatigue day that shook me into the realization I had no ability to continue. I was done. A new way had to be found. I still don’t know what that new way is. It’s taken 1 year 6 months to get this much perspective. Reinventing myself is hard work. I can walk. I want nothing more than to put mobility equipment behind me. I am learning to be grateful for the tools I have at my disposal to live a happier, gentler, and more accommodating life for no-one other than myself.

I am the type of person who tries really hard to accept people at face value. What I mean by this is I take you as you present yourself on a day to day basis. I try not to make snap judgments, especially when I hardly know you. I know that one meeting is just one meeting. Many meetings over time are necessary for me to get a “baseline” expectation for how you and I are going to work (or not work) together. Before I decide that we won’t work, though, I’m a questioner. “I see this happening between us. I’m curious as to why this is happening? Here’s what I need…. how can we work together to do this? What do you need? Where can we find common ground to work together?” I try very hard to recognize that we all have stuff to work through. I also try hard to recognize that everyone has a place around the table if we just learn to work together. It’s why I find any sort of -ism so challenging to wrap my head around. I am very aware of my privilege, and work very hard to throw myself into someone else’s shoes when I don’t understand their point of view until I get it or at least a reasonable facsimile of understanding between us. I can’t truly understand what I haven’t lived. Compassion is my strength.

Before I was visibly disabled and a wheelchair user, I had a bunch of invisible challenges that were disabilities, and it was a huge uphill battle for recognition. I was involved in my workplace’s Disability Committee to ensure that the work I was doing made things accessible for a wide variety of visible and invisible disabilities. I was the person responsible for making sure that all the projects I touched met the accessibility standards, and improved as technology improved. Then my disabilities became, not so invisible and much more restrictive, and now that I am so very – Other. I am smacked hard in how Abelist society is to an often cruel degree, and at worst not only am I now excluded, Able bodied people think I should be grateful for the access I have. I should just accept that I am on the Fringe, and be happy with what I have. I mean seriously now that I’m in a powerchair I can’t honestly expect equal equitable access to everything – you’re a minority after all. Yes actually I do expect equal and equitable access everywhere. It’s the law and you’re supposed to be compliant by 2020 which is 4 months from now, but what do I know?

There is abelism in health care. I am constantly having to educate new PSWs because it’s like a revolving door of new people.

It’s been a terrible few weeks with muscle spasticity. It’s not charlie horses; it’s muscles so tight and hard that they sometimes feel like bone on the really bad days. No muscle in my body is left unaffected. It’s the reason I don’t sleep more than 2 hours at a time. It’s the reason I am currently not at work like I want to be. It’s also the thing I try to limit my complaining to “It’s a bad day” because I’m already doing everything I can to deal with this nonsense and there’s nothing I can do until I see another specialist in a few weeks. I’m managing it the best I can.

PSW: There’s got to be some medication you can take to fix that.

Me: I’m already at over maximum dose for one medication, and they’ve added a second and no – if medication, exercise, physio, massage and accepting PSW Care hasn’t dented it – It’s just part of MS and it sucks.

PSW: That doesn’t make sense.

Me: 🤷‍♀️ It is what it is.

PSW: Well you’ll have to find something so you can do care on your own eventually

Me: Chronic degenerative illness doesn’t work that way, and if it did you’d be out of a job. (It’s been a really bad week. My filter broke)

I cannot deny ableism because it is part of my lived reality.

Friday I went out to lunch with work colleagues that I haven’t seen in over a year partly because I was such a wreck health wise, physically and mentally last year and partly because losing my ability to work and seeing them crushed me so completely because they represented what I could no longer do. It was such a motivating, soul affirming, fun, enjoyable lunch. It also shone a big ol’ spotlight on exactly the reason I worked beyond my physical and mental capacity and still went down kicking and screaming “Please don’t take my career from me.” I forced myself out of bed each day when I should have stayed put because these people made going to work worth it – it some weird way.

I’m on LTD (long term disability). I worked in IT. When I say I loved my career, I mean I lived and breathed it. I never really worked a day in my life (except those few positions where I just didn’t fit, but I just moved positions to something I did fit.) The stress lit fires in me that made it a game – exciting, fun, challenging! There was no problem so big or obstacle too wide that I couldn’t find a solution or way around, and that was affirming. I really thought that sheer force of will could hold my broken body and mind together while I did what I loved most – this career that I had built from nothing to one where I actually felt competent and comfortable and energized – until it couldn’t because MS yelled louder and restricted my thinking in ways I didn’t think was possible, but it did it anyway. My last few years were in the most mission critical, core business highest stress possible in my organization. Even good stress, so I’ve learned, can be way too much for the MS brain – my brain.

A year later I have perspective now. I also have an idea on how I could approach my job healthier, gentler, kinder to myself and my constant dictator: MS. I know I could do things differently. Not today. I just swallowed the 2 tablets that will make me feel off and exhausted. Day 1 of 5 for this final year of Mavenclad. Next month I will have 5 more days of tablets and then I’m done and we see what happens until 2021. I joke with my nearly grown children that the pills are radioactive because the handling instructions come with decontamination protocols should they touch any surface outside the packaging. It’s extreme. I can’t take myself too seriously (in spite of the somber posts.)

My goal right now is to find a way back to my desk – somehow. I don’t know what the least financially damaging way that would be right now. I also don’t know how to convince my medical team to let me. They’ve been trying to get me to stop working for about 10 years. They won’t even entertain the notion at the moment. Their response is actually reasonable (as much as I want to stomp around and deny it.) I have to learn how to live outside of work. I have to find activities that provide counterbalance to the frenetic pace and provide enjoyment and relaxation that I can also look forward to when I am not in the office that are just as fulfilling. I haven’t done this piece yet. I also have to find room for the therapies that will support going back to work, and really be aware of how much time and energy really is available to work in an office setting again. If I go back before these are in place, I will end up right back where I am or worse, and that’s no way to live. However, the end goal of getting back into my career has me glowing with possibility, and this is something I haven’t felt in a really long time.