The evolution of ALS and socializing…

A glimpse at life with ALS.

Hey folks I have something to share with you as my closest friends; I have ALS…

~What the hell is that?

Well it’s…

~Dude, I’m so sorry, we are here for you. Whatever you need! Let me buy you a drink. This ain’t gonna stop you! We are going to fight like hell!
~
Hey good to see you, how you been? Thanks for joining us, we wanted to meet somewhere your wheelchair could access. Let me get us a round of drinks.
~
Hi, how’s it going, been a bit. You’ve modified your home, is it working out for you? We brought a meal. Oh, I’m so glad you’re still able to eat. Yeah we’re doing good, you know busy and all. How’s the new experimental medication working?

It’s not experimental anymore… just new. Won’t know how it’s working for a while.
~
FB Post: Hey there, sorry we haven’t been by, went on vacation then a huge project at work, you know how it is. Will drop by soon.
~
FB Post: Great seeing you at the walk! You’ve really gotten good at that eye computer of yours. You looked good.
~
FB Post: Dude the pics of your trip are amazing. So glad to see you’re not letting ALS slow you down.
~
Um, hi, I hope you can hear me brother. We are all here…

It’s not anyone’s fault, it is the disease to be honest. Life for all of us continues at the pace our lives require. Friends and even family have a harder time seeing us so vulnerable as our ALS progresses.

In the end we are all just here for each other and that’s all we can do, be present.

If you are a friend of someone dealing with a terminal condition, please visit them. You may just sit in the quiet company of a dear friend. You know what… that’s enough…

TJO

It’s Okay to feel the way you do…


(Based on observations of others comments on social media)

ALS takes so much from each of us; those of us living with this disease and our loved ones. At some point, as our eyes are all we have left, they express our desire to be free of this cruelest of afflictions. We each reach this point on our own terms and time. When the time comes our families have to walk the extremely sharp edge of grief and relief, the innate duality that is ALS.

The desire to be present ultimately gives way to the need for rest. It’s not a surrender to ALS. It is in fact our body simply finishing its arduous fight, a fight that took every ounce of our being, every ounce. A battle that our loved ones fought at our side, giving us the strength to endure as long as we do. We must all rest when our time arrives, every single person, regardless of who we are, ALS or not.

Our families don’t ever want us to reach this point, but we do. It’s okay to feel this way; when you feel in your soul that it’s time to rest.

I hope this is not distressing, I only put my thoughts down to help others understand. ALS is a beast, having the strength to endure any of it is a monumental feat. But I (we) and you (loved ones) are so worth the fight!

However you feel, at any point in your journey, that’s OK.

TJO

I Am Not What You See

I have ALS, but I am not the disease, nor is it me. My body is in a wheelchair, but my mind and soul are not!

As I reflect on my physical abilities, now dis-abilities, I realized I am still the same irascible, stubborn husband and father. So what has truly changed? My perspective, both physical and mental.

The able bodied world accommodates where it can, most often at our urging. The greatest accommodations though have to come from within. Even from our closest family; those that can accommodate us do stay with us, those that can not, leave us.

Ultimately we have to allow ourselves to accommodate our ALS. Accommodate, not surrender. Because we are not our ALS, we are “Us”, still us, just with ALS.

J Reyes

ALS: Pulling Back The Public Veil

Recently I’ve come across those in the ALS community that feel the ALS public conversation is filled and represented by super-resilient personalities. A quick browse of the major SM Outlets (IG, FB, Twitter etc…), will prove this to be true, somewhat. For the most part these are individuals and families willing to put their life out there; primarily to generate awareness and catalyze treatments. I’m in this very category, my lane is more emotional support through creative writing… I’m ok with this.

Does this truly represent the destructive, unrelenting ALS toll on the body, family and the global ALS community. I have to agree it does NOT, if I must be honest.

So what does?

Let’s pull back the curtain for a moment.
Potential Triggers
The road to diagnosis is extremely frustrating, long and ultimately devastating. This is but the beginning of the assault. So insidious and heterogeneous (different case by case), that one has better luck in Vegas than guessing how progression will happen: fast, moderate, plateau or slow. This simply adds unbearable weight and stress on the person with ALS and the family.

Regardless of the onset, arms, hands, legs, speech, swallowing or breathing, the outcome is still the same, terminal. Let me be blunt, ALS kills everyone that gets it, every single person! The wake of destruction created by ALS is felt by the family for ever; some for generations.

This is what every person with ALS will experience, in no specific order:

Loss of limb function, total loss. You sneeze, you can’t lift a tissue to blow your nose. Walk today, with assistance, to being unable to bear any weight the next day. I believe the term is paralyzed, not a little, but completely.

Breathing, you know that thing we all do without thinking, yeah that disappears also. Some slow, some abruptly, oh and did you know this, the majority of us will die of respiratory failure. ALS literally takes our breath away, our last breath.

Until this happens, we and our families have to endure loss of privacy, modesty and dignity. As much as all those around try to protect our dignity, to the best of their ability…ALS is utterly undignified. Diapers, catheters, feeding tubes, personal accidents. Ok, full transparency… if we live long enough, we will piss and shit ourselves, did you expect a quadriplegic to not poop and pee? Well shit! Some will lose so much muscle tone that they are unable to bear down. Did you know that, probably not.

Do you enjoy food, so do we, ALS takes that also. Prior to loosing the ability to swallow, we experience episodes of choking, not just on food but our own phlegm. Did I mention our diaphragm stops working, essential for pulmonary toiletry. You know…coughing shit up. This in turn leads to weight loss, accentuated by atrophy. Making most of us gaunt, emaciated, skeletal, how’s that for a visual? Not pretty, well ALS, in my opinion, is one of the ugliest diseases.

I will leave you with this.

The person who is diagnosed with ALS, is not the person the family says goodbye to. Not in appearance, perhaps in mind and spirit but not the body. Long gone is every physical attribute that was the loved one. Except the eyes, our eyes will always convey our love for you, my (our) family(s), our world. We can’t live without your love and support, we simply can’t.

This is ALS, but I’ve only scratched the surface; there’s so much more, gross, ugly, uncomfortable, painful. To be honest you can’t handle the truth, you can’t handle ALS, neither can we, but we live in spite of it. My
— Continued —
quad·ri·ple·gic
/ˌkwädrəˈplējik/
adjective

  1. affected by or relating to paralysis of all four limbs; tetraplegic.
    “quadriplegic patients”
    noun
  2. a person affected by paralysis of all four limbs.
    “a car accident left him a quadriplegic”

Paralyzed from the neck down. This is what a person living with ALS will experience; if they live long enough to reach this inevitable conclusion. So please forgive us if your well intended wishes are occasionally rebuffed. Or we may simply smile…graciously.

Many paraplegic persons are a result of injury to their spine. ALS on the other hand is a progressive degenerative disease, where by some unknown trigger, motor neurons die. Translation – the nerves that control movement die. The general public believes that arms and legs are the principle muscles that move. Once diagnosed with ALS you learn there are oh so many more.
• Diaphragm
• Neck
• Tongue
• Soft palate
• Swallowing
• Lips
• Eyelids

All of the above can be affected in too many variations and sequences. The typical prognosis for us is 2 – 5 years. So if it can take up to two years to be diagnosed, how much time does one actually have. Again you have better odds in Vegas than guessing anyone’s prognosis.

Okay let’s get into some of the odd things that ALS causes to our bodies, again some experience these some don’t. Sialorrhea! What the heck is that!? It’s the medical term for excessive saliva, drooling. The drooling isn’t the major issue, although uncomfortable socially, the real problem is choking. Many persons with ALS often aspirate drainage and end up with life threatening pneumonia. Paralyzed and choking on your own saliva, ALS is simply brutal.

PBA, Pseudobulbar Affect; emotional incontinence, uncontrollable crying or laughing. This is a little side hustle ALS has, although this condition can be triggered by a number of neurological conditions and head trauma. So what does PBA do to the person? It literally makes one think they’re loosing their mind. Total emotional breakdowns for no reason or caused by emotionally charged triggers. PBA also causes laughter or giggling for no reason, most often at inopportune moments. Luckily there are medications that can help suppress or control the intensity and frequency.

ALS, three letters that can be expressed in so many four letter words, expletives just don’t do it justice as to how devastating it is. So if you encounter a person living with ALS and their family, consider what they are enduring and realize how strong they are.

J. Reyes

Dignity

This is a term that for general purposes we use to describe appropriate interactions/actions with and to others. Modesty is frequently associated with dignity, when discussed. We are all familiar with it’s use under this premise. I would like to share another aspect of this term as it applies to ALS, end of life.

Although this dignity or dignified end of life concept has been present throughout all human history, it continues to be taboo. My question is, Why?

Death is very much an integral aspect of life itself. Yet as a society we shy away from this very real and unavoidable eventuality. Fear, narcissism, ego and many other factors feed and add life to the taboo public perception.

Recently the ALS community experienced the loss of two incredible human beings, who defined their dignity. I am not here to discuss anything other than the strength and courage needed to make such a truly personal and difficult decision.

Take a moment to reflect on the many hours of reflection, conversations with loved ones and the tears shed leading to this. Just imagine.

Given that ALS takes everything, dignity is totally dependent on others. I ask that you also take to heart the amount of love and respect for the individual by the family. That is true and selfless love, which is essential for dignity.

I won’t even venture to say “ I can imagine “ the discussions had. Ultimately each person defines their dignity and we who remain cherish their lives and memories, with DIGNITY.

J. Reyes

Family

sponsored#MTPApartner I’m proud to be partnering with Mitsubishi Tanabe Pharma America (MTPA) to help newly diagnosed pALS and cALS navigate their diagnosis.

#EmbraceYourNow

Imagine having your life turned upside down with the words, “you have ALS”. Imagine losing everything that gave you security, comfort, and support. This, in fact, happens to many people dealt a terminal diagnosis, abandonment. Losing your entire support network, all of it! It’s an insidious occurrence around the world, hidden in plain sight.

What then? Where to turn?

ALS has a tendency to do one of two things; rally your family and friends around you or bring the worst out in them. This is just a simple fact of life. Sadly, there may be many pALS who are abandoned and left to navigate this journey alone. How can these individuals embrace their new challenge as their body and family turn against them?

There simply is no solution. Each case requires a tailored approach for that pALS’ needs. Some resources are available through ALS clinics, various nonprofits and government agencies.

Considering the degree of care needed may be a challenging experience depending on what resources are available. I have found that in these challenging instances, it is the ALS community that must come together and embrace the pALS to show support.

Personally, I am blessed to have a very supportive family. I can’t fathom living with ALS and also being abandoned. My heart goes out to anyone dealing with this very situation.

Having experienced a medical emergency a year ago, I experienced firsthand the sense of helplessness. Unable to move and completely dependent on others. Given the current state of health staff shortages, it took some convincing to allow my family to help me. Without them I would have been miserable.

It’s not just a matter of who you embrace but who embraces you – “Embrace Your Now!”

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This information is intended for U.S. audiences only 18 years of age and older. RADICAVA ORS and RADICAVA are available by prescription only. Talk to your doctor.
IMPORTANT SAFETY INFORMATION
Do not receive RADICAVA (edaravone) or RADICAVA ORS (edaravone) if you are allergic to
edaravone or any of the ingredients in RADICAVA and RADICAVA ORS.

Before you take RADICAVA or RADICAVA ORS, tell your healthcare provider about all of your
medical conditions, including if you:
• have asthma
• are allergic to other medicines.
• are pregnant or plan to become pregnant. It is not known if RADICAVA or RADICAVA ORS will harm your unborn baby.
• are breastfeeding or plan to breastfeed. It is not known if RADICAVA or RADICAVA ORS passes into your breastmilk. You and your healthcare provider should decide if you will receive RADICAVA or RADICAVA ORS or breastfeed.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the possible side effects of RADICAVA and RADICAVA ORS?
RADICAVA and RADICAVA ORS may cause serious side effects, including hypersensitivity (allergic) reactions and sulfite allergic reactions.
• Hypersensitivity reactions have happened in people receiving RADICAVA or taking RADICAVA ORS and can happen after your medicine has been given.
• RADICAVA and RADICAVA ORS contain sodium bisulfite, a sulfite that may cause a type of allergic reaction that can be serious and life-threatening. Sodium bisulfite can also cause less severe asthma episodes in certain people. Sulfite sensitivity can happen more often in people who have asthma than in people who do not have asthma.
• Tell your healthcare provider right away or go to the nearest emergency room if you have any of the following symptoms: hives; swelling of the lips, tongue, or face; fainting; breathing problems; wheezing; trouble swallowing; dizziness; itching; or an asthma attack (in people with asthma).

Your healthcare provider will monitor you during treatment to watch for signs and symptoms of all the serious side effects and allergic reactions.
The most common side effects include bruising (contusion), problems walking (gait
disturbance), and headache.

These are not all the possible side effects of RADICAVA or RADICAVA ORS. Call your doctor for
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INDICATION
RADICAVA and RADICAVA ORS are indicated for the treatment of amyotrophic lateral sclerosis
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Broken Hearts Keep BeatingBroken People Keep Fighting

We live surrounded, orbited by those that come into our lives. Most on the periphery, some fly close, even less shift our trajectory. But a few collide with us, forever changing us. Their impact leaving a lasting and enduring impression. When they leave us it hurts, yet we carry on, we must.

Recently we, our ALS family, lost two such persons. Each having left an incredible void in their families lives. Both fierce advocates, more importantly fierce mother’s . Both willing to fight not just for themselves, but for everyone afflicted by ALS.

Sandy, you altered the ALS research landscape by demanding and implementing accountability. Allowing those living with and affected by ALS to contribute directly to the impenetrable research machine. Your voice and presence never diminished by your failing body; when you spoke we hung on to every labored word of yours.

Taya, we met over zoom, and your energy and smile won us over. As we came to know you it soon became glaringly obvious, you were a force of nature. A fierce ALS advocate in your own right in Canada, and an avid fan of the Toronto Blue Jays. We were always in awe of your efforts and your candid perspectives.

I know my life is better for having met both of you. So with broken hearts and broken bodies we keep fighting. Our hearts continue beating with a broken cadence, having lost two resounding notes in our ALS song.

J Reyes

Dear FDA:

I am waiting for you to practice what you have promised… regulatory flexibility toward ALS treatment’s. I know and understand you have so many priorities, but I hope you understand that it’s very much a priority for me. You see it’s very personal to me, my family and every person afflicted.

I get it, although we are dying, you hold true to your practice of protecting us from potential deadly therapies. I snicker, well because as you know… we are already dying. I’m being polite, obviously.

In the turbulence of delay after delay, the wake takes it’s toll on our hope, bodies and minds. Not to mention our families hearts; so we wait.

However while you deliberate and decide our fate, we will continue to live in spite of ALS. We will continue to encourage, press and help you understand the human price of the science. We, the person with ALS, are the currency; what value do you assign to us?
As Lord Farquaad once said…
“Some of you may die, but it’s a sacrifice I am willing to make.”

I jest of course, I can because I’m on the inside.

I truly respect the very difficult task you have been charged with, but could you try being a bit more flexible, maybe just a skosh.

JR

ALS, Behind the Public Veil, P2


quad·ri·ple·gic
/ˌkwädrəˈplējik/
adjective

  1. affected by or relating to paralysis of all four limbs; tetraplegic.
    “quadriplegic patients”
    noun
  2. a person affected by paralysis of all four limbs.
    “a car accident left him a quadriplegic”

Paralyzed from the neck down. This is what a person living with ALS will experience; if they live long enough to reach this inevitable conclusion. So please forgive us if your well intended wishes are occasionally rebuffed. Or we may simply smile…graciously.

Many paraplegic persons are a result of injury to their spine. ALS on the other hand is a progressive degenerative disease, where by some unknown trigger, motor neurons die. Translation – the nerves that control movement die. The general public believes that arms and legs are the principle muscles that move. Once diagnosed with ALS you learn there are oh so many more.
• Diaphragm
• Neck
• Tongue
• Soft palate
• Swallowing
• Lips
• Eyelids

All of the above can be affected in too many variations and sequences. The typical prognosis for us is 2 – 5 years. So if it can take up to two years to be diagnosed, how much time does one actually have. Again you have better odds in Vegas than guessing anyone’s prognosis.

Okay let’s get into some of the odd things that ALS causes to our bodies, again some experience these some don’t. Sialorrhea! What the heck is that!? It’s the medical term for excessive saliva, drooling. The drooling isn’t the major issue, although uncomfortable socially, the real problem is choking. Many persons with ALS often aspirate drainage and end up with life threatening pneumonia. Paralyzed and choking on your own saliva, ALS is simply brutal.

PBA, Pseudobulbar Affect; emotional incontinence, uncontrollable crying or laughing. This is a little side hustle ALS has, although this condition can be triggered by a number of neurological conditions and head trauma. So what does PBA do to the person? It literally makes one think they’re loosing their mind. Total emotional breakdowns for no reason or caused by emotionally charged triggers. PBA also causes laughter or giggling for no reason, most often at inopportune moments. Luckily there are medications that can help suppress or control the intensity and frequency.

ALS, three letters that can be expressed in so many four letter words, expletives just don’t do it justice as to how devastating it is. So if you encounter a person living with ALS and their family, consider what they are enduring and realize how strong they are.

J. Reyes

They Just Can’t Help It

I have ALS, you do not, so why are you so awkward around me? I’m the one enduring the jail cell that is my body, as I lose every bit of my independence. I wouldn’t behave this way if it were you…or would I?

As a person living with ALS I am very aware that I am in a minority with slow progression. If one can ascribe “lucky” to ALS, I and my family are lucky. However I too experience the distancing of friends and family, I have siblings that simply can’t see me in my current state. And I’m still mobile and active.

Many families experience extreme isolation due to the immense focus required to care for us. No time to entertain guests, regardless of the good intentions of those guests. Yes it’s painful to see us bed ridden, emaciated, gaunt and sustained by technology; beep, hiss, click…

Think of it this way; if we can endure living with ALS, you can endure a fly-by. Better yet! Stay and learn to care for me. This way my spouse/child/parent/friend (AKA caregiver) can comfortably go to the bathroom or have a bite to eat.
“ But I’m squeamish, and I can’t stand to see you like this. It breaks my heart, I just can’t.”

Okay, honestly, if I may be blunt, that’s a “you problem”. I don’t have a problem with you seeing me in such a vulnerable state, I would love a visit. [Some with ALS do want to quietly and privately live their life, respect this.]
So if you as a person living with ALS receive company or run into acquaintances while out, don’t hold it against them if they say…

…how are you?
…you look good.
…hope you feel better.
…I’ll pray for you.

There’s absolutely nothing wrong with these statements. Yes we know full well that at this point in time nothing will help us. So don’t alienate others by chastising them for their awkward greetings or goodbyes. They just can’t help themselves.

TJO