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Wednesday, September 9, 2015

Time to tell and the new emotion coaster

It's been a day or so since the tentative diagnosis.  This gave me some time to figure out how I was going to tell my family and in what order.  I called my Dad first.  We talked for about half an hour about what was going on and he was reassuring.  It actually felt good to tell someone else what was happening. It's not that I was afraid of what he might say as I knew he would be helpful.  It's that I don't want people feeling sorry for me or for that matter, worried about me. Yes, it's a defect in my psyche and goes back to never asking for help, but I'm too old to change now. As I find out later, this is not healthy. (yes, more foreshadowing to future blogs).  I called my sisters next.  As expected they were both very sympathetic and helpful.  Now for the hard part, my kids.  I called my oldest daughter first as she was the one I was most worried about.  In a previous blog, I mentioned how she freaked out about how bad Parkinson's was when my sons eye twitched. I was worried how I would handle her reaction.  Growing up, she always seemed to think older than she actually was. This has helped her, I'm sure, become the excellent therapist she now is.  But, I was worried that a bad reaction by her might get to me.  She took the news as well as anyone could and offered tons of support and love.  Just what I needed, what a relief.  I called my eldest son next and again, nothing but help and encouragement.  This was going better than I thought it would by far.  Now on to my next son.  If anyone was going to get me to cry it would be him.  I decided I really wanted to tell him in person so I could show him my symptoms were not all that bad.  He asked a bunch of questions so I’m glad I chose to do it that way.  I got through all of this without shedding a tear.  I didn't want anyone, especially the kids, to think I was worried  I decided against telling my youngest daughter just yet.  She was only 10 and didn't want her to stress over something she couldn't see or understand.  As with most families, she, being the youngest, tends to listen a lot and pick up on family conversations. It didn't take her long to figure out there was something wrong with Dad.  We talked about it and I reassured her things would be fine.  I gave her a job to keep track when there were tremors in public.  It may have helped because now she was part of looking after me.  In retrospect, I'm not sure I handled it correctly by not telling her up front, but so far there seems to be no permanent damage.   I don't know if one way is better than another to tell your family you have an incurable, but non-life threatening, progressive, but more than likely a slowly progressing disease.  I guess every family is different and you'll have to judge each person by how you think their reaction will be.  I thought about a group setting but quickly ruled it out.  It sounded too formal for me.  No, I needed to downplay this as much as possible for my own sanity.  A good article on the Parkinson's secrecy can be found here.  If you get the chance to read Bill Geist's book, do so.  It's a fun read with a brief chapter on Parkinson's. 
 I still decided against telling work yet.  This is where I really did not want people feeling sorry for me.  I couldn't help but worry that Corporate would think "we can't give him that project, he has Parkinson's"  or "Lets not expand in his plant, we don't want to stress his Parkinson's." My symptoms were mild enough, I thought, that I had time to show them what I could do then explain that all that time I had Parkinson's.  That way I could show them there was no need to worry.  Over thinking this?   Probably, but it worked for me.  I did decide to tell my closest at work ally though.  I knew I could trust him to keep it quiet.  But, more importantly, I needed someone that would let me know if people were noticing my symptoms.  I highly recommend this because people will talk among themselves long before they will approach you.  Usually, by the time you feel the need to tell people, they have already figured it out.  This way, you can have some control over when its time to tell the people you work with.  Most likely won't work for everybody, but it helped me.
I received a call from the University of Rochester (U of R).  They confirmed my appointment with a neurologist but had this offer.  If I agreed to be in a Michael J. Fox trial (PPMI) I would be switched to the neurologist in charge of the study for the hospital.  I looked the neuro up and she had an unbelievable background including sitting on the Fox foundation board.  I could get top-flight care, for free.  All I had to do was submit bodily fluid samples two times a year and take some memory tests.  Seems like a no-brainer, right?  Oh, forgot to mention, some of the fluid they want comes out of your spine!.  In this study, I would end up getting up to five spinal taps.  Hmm, not real thrilled with that.  I'll have to think about it.  

The days were now turning into weeks of relatively minor symptoms.  There were no big changes and I was adjusting to day-to-day life as a new PwP (Person with Parkinson's). I did have what I'll call an ‘episode’ after a stressful Saturday morning at work then rushing around to get some major chores done.  I was shot the rest of the day. Absolutely no energy or even the will to move.  It became amazing how much stress fatigued me now. I think I could overcome the fatigue, but the apathy is another story.  Apathy, or the lack of desire, worried me the most because I have always been the one to say "let's get it done" and work as long as it took.  Now, I could be easily convinced to do nothing.  Not good.  This would be important to fight otherwise it could rule and possibly ruin my life.
 I’ve been spending too much time reading other parkie blogs too.  A few have been helpful, but there are a couple that have been rather depressing.  I keep telling myself to be optimistic and that everyone else’s symptoms won’t be mine, but it’s hard to read.  Some of the people have had it pretty bad. Then, there was a story at the end of the nightly news about a record producer with Parkinson’s. I cried at the end of it. Only the second time I cried because I have this disease but, as it turns out, not the last time I cried because of Parkinson's.  Slight twist of words there but you'll see what I mean in a moment.  What made me cry at the end of that news story was the guy takes 10 pills a day and yet he still LOOKS like he has Parkinson’s.  Shuffling gait, pan face and tremors.  Made me sad. I should be looking at the bright side, the guy is still walking, still working, still has a life, but it just hit me kind of hard.  Will that be me in 10 years? I tried unsuccessfully to hide my tears.  I didn't want anyone feeling sorry for me.   
Okay, so after all these years I am finally getting in touch with my emotions. This is a good thing, right? Then here we go as it's all aboard the emotion coaster! I got a card from my Mom and it was great!  She wrote me a very supportive and loving note that really made my day.  Everything was starting out well.  I was getting things done. I was in a good, no, great mood. I was happy. Then, just a few hours later and before I knew what was happening it felt like I could cry at any second. This sad feeling just overtook me.  It was gone by the time I left work, but it wouldn't be the last time I felt that way.  A whole new chapter had started and I had no idea, at that moment, what it meant.  If this was from Parkinson's, it is a very weird disease.
I never knew when my emotions would flip.  In a short amount of time, I went from someone that was always in total control of their emotions to someone that now cried at commercials.  I would cry while belting out an 80's rock song on my way to work. Who cries at Hagar singing "Can't drive 55?"   Watching a sad part of a cartoon with my daughter or an emotional sequence in a movie whether at the theater or at home produced HUGE tears.  They got difficult to hide.  I had no idea why it was happening and I couldn't control it.   The tears wouldn't last long and I wouldn't stay sad, but it started me looking at all the symptoms of Parkinson's... could this be my lead into depression?  Could it be I was approaching 50 and a mid-life crisis?  Time would tell. 

Up Next: On becoming a radioactive lab rat for Fox

Sunday, September 6, 2015

Superbowl meltdown plus the first of many

Okay, I just re-read the last post and I may have missed the point I was trying to make.  For those of you just going through the diagnosis phase or those that know someone that is the anxiety of not knowing what's wrong can be worse than finding out. There are a whole host of diseases that cause Parkinson's like symptoms and some of them are pretty nasty.  There is no definitive test to say you have Parkinson's so even being told you have it is still a guess until they can see how you progress.  At this early point in the diagnosis phase, the neurologist will tell you that you have Parkinsonism symptoms.  Basically, you have something that makes you look like you have Parkinson's.  Here a partial list I found of things, besides Parkinson's, that can cause these symptoms:
  • AIDS 
  • Corticobasal degeneration
  • Creutzfeldt-Jakob disease
  • Dementia pugilistica or "boxer's dementia"
  • Diffuse Lewy body disease
  • Drug-induced parkinsonism 
  • Encephalitis lethargica
  • Essential tremor
  • Genetics
  • Multiple system atrophy
  • Pantothenate kinase-associated neurodegeneration
  • Parkinson plus syndrome
  • Progressive supranuclear palsy
  • Toxicity due to substances such as carbon monoxide, carbon disulfide, manganese, paraquat, mercury, hexane, rotenone, and toluene (inhalant abuse: "huffing")
  • Vascular parkinsonism
  • Wilson's disease
  • Paraneoplastic syndrome
Yeah, that's what I thought when I first read through this list too.  If you are anything like me, you'll painstakingly go through each symptom for every disease listed and crosscheck against your own list.  Yes, self-diagnosis will drive you crazy.  I don't recommend it because it's like going to web MD and typing headache.  You either have a sinus infection or a tumor. That said, you know something's wrong, you don't know what and this list is in front of you.  Knowing that it could be months or years before they figure it out isn't helping. There is the DATScan test which does narrow the diagnosis down to a few possible diseases, but you still have to wait to see the progression. Bottom line, it's a waiting game no matter what you end with.
   I promised you a meltdown in the title so here goes.  It's Superbowl Sunday and as the day progresses, I feel worse and worse.  Every symptom is peaking at once including, for the first time, I think, my blood pressure.  It made enjoying the game impossible. Major tremors, pain in the muscles, stuttering, dizzy and as I mentioned it felt like my blood pressure was pounding,   By 9 pm I had about enough and actually got in the car drove to the only place I knew open that late that might have a blood pressure monitor, Wegman’s Supermarket.  I DO NOT recommend anyone that ever thinks their blood pressure is spiking or for that matter have a host of other symptoms climb in a car and drive anywhere.  I just couldn't take it anymore and had to get out.  Yes, I should have asked for help but, if you know me at all, that's not my specialty.  Everything in my body seemed to be against me or at the least, out acting on its own and not helping me.  I may never know if my theory is true but I'm still leaning towards your body is reacting to getting hit with lower levels of dopamine.  It doesn't know how to handle it which causes some strange symptoms.  I'm not a Doctor and don't pretend to play one on the internet, but something is causing these problems.   Well, after all that, bad news, as the pharmacy was locked up and I couldn't find out what my BP was.  By morning, though, I was feeling better, but it would have been nice to know if I was right and my BP was high.  I know I was told Parkinson's isn't supposed to affect things like blood pressure, but something was happening. What the heck could be going on?  It would end up taking a long time to find out. Yes, that's a tease for another, much bigger meltdown later.



February 10, 2011
MRI today of my head and neck.  Looking back it was the first of more than 10 that I have had.  Admittedly, I'm in a research study where I get two different kinds every year plus I had some back issues requiring more imaging.   In the tube I go, as we've got to make sure it's not anything other than Parkinson’s. So not only do I have to come to grips with the fact that I may have a degenerative, incurable brain disease but, now have to worry about tumors, lesions or a host of other things. I did learn something about myself during my first MRI though.  I'm lying face up on the table about to be slid into the machine. As I start to enter, the roof of the tube comes into view.  It's about 2" above my nose.  I felt instant panic, threw my hands up grabbing the machine and said "nope, can't do it."  The technician was nice and asked if I was claustrophobic.  I never had been before so why now?  What to do, I need this test!  I'm tired of waiting for answers, but I knew I wasn't going to be able to go in there.  The solution?  The technician loosely placed a small towel over my face so, if I opened my eyes, all I would see is towel above me like I was in a little tent.  No idea why it worked, but it did.  I've used the same technique ever since.  Of course, like everything with this disease, I have to wait for results from the MRI.  Nothing seems to be in my favor in this whole process.  Another week of waiting.
I still haven’t told anyone what is going on yet.  Well, Rachel told her parents, she felt she had to.  I’m going to wait until I see the Neurologist again because by then, he’ll have the results of the blood tests and MRI.  If they are all clean, then confidence is high that it's Parkinson’s.  Then I’ll have to figure out who to tell and when.  Also, I’m going to transfer to Rochester, Strong Hospital to be precise.  The specialists up there are getting quite a bit of press lately.  It would be good to have them look at me.
It's now Thursday and finally time for Doctor's analysis.  This visit was killing me as the nurse asked question after question.  I know she was just doing her job, but she is not who I came to see.  Enough with the under-card, BRING ON the main event, I want to see the neurologist!  Finally, he arrives. reviews the notes and asks questions about what the nurse wrote.  All the while, I’m dying inside wondering what the results are.  After minutes that felt like hours, he starts to read the report and asks if I brought the disks of my MRI.  Disks??  What disks?  Weren't they supposed to send the information over automatically?  I’m freaking out on the inside now thinking that I’m not going to get results today.  He said he had the notes and wouldn't need the MRI's but would follow-up to make sure he had a copy for the file. So I start thinking again about the list of other possible things it could be except Parkinson's.  Weird how you start to root for the incurable, degenerative disease because other things on the list are worse. "Come on Parkinson's!"   Then he says it, test results were negative. Great, I got my wish, it's the incurable one.

Up next: Time to tell and the new emotion coaster

Saturday, September 5, 2015

D-day

February 1 – D- Day – well, God had other plans.  A MAJOR snowstorm hit with number two coming tonight.  The storm dropped a whopping 5 inches of snow (yes, sarcasm) but since it was supposed to be worse it caused widespread panic and cancelations including my neurologist appointment.  Yeah, everyone over-reacted, big surprise.  THE appointment has now moved to Friday.  I have to suffer through the rest of this week wondering.  My wife is right, though, chances are, I’m not going to find out anything definitive during the appointment, but I’m tired of waiting.  I keep reading blogs by people that have been diagnosed over the last 5-10 years.  Most are pretty upbeat.  I guess I’m searching for what to expect, but the great part of Parkinson’s (yes, more sarcasm) is everyone is different.  They have no idea how fast things progress or what progresses and what doesn’t.  Overall the consensus is that it still sucks no matter what level you have.  No one really talks about their bad days in any detail, though.  Makes me nervous.
Read some articles today about the benefits of exercise at slowing the progression of the disease.  Great, more of what I don’t want to do.  Why is it always more exercise?  Why can't it ever be more chocolate pudding?.  Maybe this problem is just God’s way of making me get into shape. Here is an article on the effects of exercise
February 2, Groundhog day (new D-2), and I hope I don’t have to live last night over again.  Felt pretty good going to bed, had a good day with minor symptoms so no drugs I decided (Advil or Advil PM is as hard as I go, …for now) and went to sleep. 
          1 am wide awake – started thinking about all the bad stuff that can happen with this disease.  Just what was late stage Parkinson’s and could I survive it?  By that point, would I want to?  I scared myself awake and now there was no fixing it.  I couldn’t get comfortable, no matter what I did.
          2 am still awake
          3 am still struggling then finally at 3:15am I took an Advil PM.
          3:30 am still nothing. 
          4 am – went downstairs and laid out in the recliner.  Dozed off after a bit and then, magically, it was 6 am. Time to get up.  Fell back asleep till 6:15 when my wife came down.  Ugh, getting up was hard – Never take Advil PM so late errr… early!  From what I read most of the meds for Parkinson’s don’t help with sleep.  Great, just great.  This so far has been the worst part. I've got to find a way.
I’ve done so much research on Parkinson’s that if I don’t actually have the disease I’ll be lost.  Not that I want it, believe me, I DON’T.  But, I keep looking up other things it could be and don't like the options.  Only time will tell, unfortunately.  With this disease, all you can do is wait and see.  Fridays appointment can’t come soon enough.  I hope it’s not a letdown.  It’s 6:30pm now, Wednesday, Feb 2nd and 3 hours till I take 1 or maybe 2 Advil PM’s to help, hopefully, make a restful night.  Oh, by the way, groundhog predicts early spring, yippee!
February 4, 2011.  The new D-day.  I’ve been praying this is something else but somehow deep down I have this feeling that I know.
My wife and I got to the Doctors office at 10 am, right on time, off to a good start.  Did the obligatory exchanging of the insurance info and only waited about five minutes before getting called in.  The Physician’s Assistant was a happy lady, too happy for the mood I was in, and we reviewed all my symptoms.  After a page full, I warned you that I am very observant, she did some quick tests and was off to get the Doctor.  He was nice and was very interested in seeing for himself what was wrong with me and not jumping to conclusions.  Standard tests, walk here, touch this, look over here.  He tested some reflexes and grabbed my arms.  At the beginning of the appointment he said he couldn’t be sure I had Parkinson’s but by the end he said it was better than 50% chance.  I could tell by the way he looked at me that it was higher than that.  We talked about other testing I should get and he wants an MRI to make sure there are no lesions or tumors, oh what fun this has become!  Blood tests were ordered to rule out anything with the thyroid. You've got to love a disease that has no real diagnosis.  "You might have this, or one of these 10 other things."  You start wondering what would be the least objectionable.  It surprised me he didn’t know anything about the new DaTscan approved by the FDA for detection of Parkinson’s.  But, it was just approved 2 weeks prior and Parkinson’s isn’t his specialty.  He suggested we go to Philly to the Parkinson’s center there, but I think we may go to Rochester.  Closer and they have the DaTscan.  I wonder how much that costs? (future blog coming about my many DaTscan’s and how I was almost arrested because of one).  On the way out I asked what we should do going forward and his answer stung me to my core.  “Enjoy life now while you still can,” he said.  Now how am I supposed to take that?  I know he meant well, but it felt like I was just given a death sentence.
We came home and my wife and I hugged and she cried.  Although I have no idea what’s going to happen to me or how fast it will happen, I feel the worst for her.  I read about these caregivers for Parkinson’s patients and I don’t want her to become one.  She is my wife not my nurse.  She shouldn’t have to be both. Oh, I’ve had that damn smell with me all day today too.  Sweet, antiseptic, Band-Aid smell.  Couldn’t shake it. This disease is just weird.
Couple things I didn’t tell the Doctor and will wait for the specialist.  I’m worried if there could be a transfer of symptoms over to my automatic reflexes like swallowing or even breathing. I’ve started to occasionally drool at night. I know, gross right, but it was like I forgot to swallow.  Scares the hell out of me if it can affect other things that are supposed to be automatic, like breathing. Update: I confirmed with my new neuro that it can’t – whew! Although, I did find this on autonomic dysfunction, hmmmm?

Next up – Superbowl meltdown plus the first of many

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