FES shows that foot drop isn’t my only problem

img_0820The physiotherapist I saw in December at my three monthly fampridine review referred me to try FES. FES (functional electrical stimulation) is used a lot with MS patients or those who’ve suffered strokes, and applies electrical signals to stimulate the nerves in the leg, so that the foot muscles contract and lift. The logic is that although nerve signals don’t fire from my spine due to central nerve damage, the peroneal nerve along my leg works and can be triggered further down. I definitely suffer from foot drop, that is my toes sticking to the floor and blocking my foot from swinging forwards, and I compensated with weird swinging hip movements to kick my leg out sidewards, so FES prevents that.

The fact I was even referred to try it is really exciting, but I’m definitely at the less mobile end of those at the clinic. On the afternoon of my second visit to the hospital I was too fatigued to even stand up at the frame, and I think the therapist was wondering how I got there…

It is a massive hassle to set up, sticking the electrodes to your legs (I’m still drawing their positions onto my skin as half a centimetre move kicks my foot in a different direction). I’ve bought a bumbag to hold the power box in (luckily they’re in fashion and asos have loads), and the foot sensors are stuck in one pair of my traniers, which don’t go with every outfit. All the wiring fits fine under loose bottoms but I don’t think skinny jeans would be an option (I’m sure it could all be bluetooth…). Each electrical signal for each foot lift is a tangible buzz to my legs which is a weird feeling. But of course, if I was walking again, even with crutches or a frame, it’d be worth it, and make moving around friends’ homes or going to any bar/hotel with steps or non disabled loos so much less complicated.

It’s been three weeks, and it’s really hard. I arranged to cut my hours at work to 2.5 days a week during two months to allow myself time to trial it. After work I’m often too fatigued to eat, let alone try walking. I thought two months would be plenty of time; maybe I’m impatient or maybe it’s not going to happen, but I’m only managing a few short walks around the house about three times a week. It’s exhausting. I’ve been so tired which then knocks on to the next day at work where, come 3pm, I can barely type and have had a fall in the office whilst transferring chairs (everyone else was more alarmed than me). It’s still early days and hopefully I’ll get past this but it’s pretty counter intuitive. Walking is easier for sure, but it’s not easy, there are other issues like stiffness in my hips and weakness in my core that hinder me beyond the foot drop.

The FES will not fix the damage in my spine or allow me to walk freely again, but being upright even a little strengthens and stretches you. After I walk my feet feel so much looser, they’re less puffy, and the most dramatic change is the reduction in clonus (legs shaking).

I’m going back for my review in two weeks – each power box has a memory, like a fitbit or phone, so my physio will be able to see my use and whether it merits continuing the treatment. Even if it is, I then need to make a call on whether the positives outweight the negatives here. The only constant of MS is difficulty. The FES is no smooth fix but for now I’m giving it a go.

 

Advertisements

The new year

Another year, time flies, can’t believe it, etc etc. Always true, but I have a particular problem trying to bookmark my health. MS is such a gradually shifting illness that, when I sit down in front of my nurses and doctors and they ask me if anything’s changed, it’s true that in the past few weeks or months, nothing dramatic has. But when I remember specific past events, I know that my disability has massively progressed. So I’m really trying to evaluate the past year…2018My right arm and fatigue have definitely worsened. I don’t know when exactly, but I know that they are now daily obstacles which limit my ability to function, and I don’t think this time last year I would have rated them so high a problem.

  • I often have trouble extending my right arm and fingers now, my hand writing is very limited, and I’m worryingly relient on my left hand. This isn’t a new symptom, a sudden relapse in 2011 damaged my right hand, temporarily halting its dexterity (in the middle of my accountancy exams, and everyone else thought they were stressed…). It recovered, but has been weaker since, and has worsened.
  • The fatigue is a new unwelcome addition. I think I’d always understood it as tiredness before. And to be honest thought there was an element of weak willed laziness wrapped up in it, although obviously I never said that out loud. 2017 gave me my first real smack of it in a solid block. I now also recogise on a daily level the physical impact of fatigue. Come the end of a day at work I have less strength than a bowl of jelly, it’s all I can do to close my eyes in the cab commute home and hope that a power nap will recharge me enough so that I can get into my flat at the other end.

They’re the negatives. A sad part of MS is that things just staying the same is a positive, but even beyond that I think there are some highlights:

  • I actually think my legs have strengthened. The introduction of fampridine and more regular/intensive physio have gone hand in hand – each enabled the other. I can walk (i.e. wobble along on a zimmerframe) as well if not better than I could 12 months ago, transferring is easier, and I’ve noticed my thighs (while still a source of disappointment, a lingering vanity) have actually toned up a bit.
  • My bladder control has been pretty good compared to a few years ago, I’ve cut my bladder urgency meds to a half dose, and I’m racking my brain but I don’t think I’ve had a single UTI. My 2015 self wouldn’t have thought it possible.

Becoming more used to, and so confident, being disabled has led to more proactivity, and ultimately to my involvement with the MS Society and MS Trust – speaking openly about my least favourite part of my life to a filled room was my biggest achievement of 2017.

And in non-MS life I’m still living independently in my flat (/with carers twice a day), still working, still swimming, seeing lots of friends and family. Most of the bad parts have been out of my control. This is the first time in about 5 years where there have been no significant changes. I’ll probably complain about boredom another year, but for now, I’m pretty happy with that.

When plans change

img_0723When I woke this morning to snow covered empty roads, I initially ran through my day plans and reassessed which were possible. Swimming and brunch with a friend? No. Even getting from my parents house, where I’d spent the night, to the pool in my hometown would be hard, let alone my friend and I then navigating the pavements. I know I was disproportionately upset by that, but I’m too tired to swim on work days so my weekend swim is really important to me as the little exercise I can do.

The knock on effects were bigger though: snowed in, could I get back to my flat tonight? And then how to get to work tomorrow? ‘Wait and see’ doesn’t exist for me anymore. I have to organise my carer visits, my taxis to work, even my work laptop is at my flat should I need to work from home. My life is constantly scheduled with military precision. I know this, I’ve commented on it before, and keeping on top of all the moving parts has become an ingrained feature of my daily admin. But it’s only now, when plans unexpectedly fail, that I realise how much this way of living has infiltrated my mind too.

I was irritated, short tempered, and actually finding myself getting upset at my parents, like a toddler who expects grown ups to control the skies. I really only relaxed once all weather forecasts had been checked, a new plan made, and I’d contacted my carer, taxi company, and checked work emails. There’s so much scaffolding holding my life together, undoing it isn’t a quick job. Then followed some harsh self judgement.

I’ve long accepted that disability has robbed me of freedom. The luxury of being able to wake up, get up, go out and do whatever I fancy is an old memory, a richness you only appreciate when it’s lost. The correlation in rigid thinking has crept up on me though, my physical health dragging down my mental health in new ways. I’m a little embarrassed by how stressed I became. The big question, which I don’t have an answer for, is what the heck to do about it. By definition, you can’t plan spontaneity. Maybe learn new things, go to new places – just keep my brain fresh. But still, this will inevitably be within allocated timescales on fixed days, and there’s no changing that.

Berlin (round 2)

img_0576A long weekend in Berlin: my second time to the city, but first time post disability. ‘How accessible is it?’ my cousin asked as we booked. I don’t know, who notices disabled access when you don’t need it? I haven’t been on the brink of dehydration recently, so couldn’t tell you where the nearest well is. As it turns out, I’d say similar to London infrastructure wise, just with super helpful people.

The tube network throughout the city is hit and miss, with not all stations accessible. Maybe we were unlucky with the station nearest our hostel (Möckernbrücke) having only stairs, but when you don’t know the network, you’re forced to avoid it altogether rather than play russian roulette with each journey. We were rushed and underprepared in the build up to going, so arrived at midnight in the station to discover we couldn’t get out. We stopped a group of 20-somethings (‘Sprechen Sie Englisch?’ ‘Yeah of course, how can we help?’) who then grouped together and CARRIED ME UPSTAIRS. Mad. Even madder, on our return to the airport, when the lift at a connecting train station was out of order, it happened again, with people offering before we even asked.

img_0609Our hostel (Grand hostel Berlin) had good access, with a communal wet room/disabled toilet, and it was my first time using a wheelchair lift to navigate the stairs in the entrance. It takes a little longer, but 24 hour reception ensured I was never stranded, and meant than rather than five steps ruling out a whole venue, as is often the case, we could stay there.

In general, similar to London or Paris, the newer or public buildings in the city have good access, the older ones less so. Friedrichshein in East Berlin is a fun area full of bars and places to eat. With quirky areas I don’t expect great access, but most places had max one step to get in and then large enough ground floor toilets to be doable. It’s an awesome area and city, I love Germany full stop. The EU flags dotted around were a constant source of mourning (confusingly the more Brexit looms the more European I feel), but there’s a strong identity and great beer, and with such a short flight I expect I’ll visit again. A noticeable downside was that I struggled to keep up with the energy levels of my cousin, and felt guilty my fatigue held her back. But my main negative was the fact people still smoke inside bars. It’s so unfamiliar now, a decade into the smoking ban in the UK; we were leaving bars gasping for air, and as every neuro will tell you, smoking and MS aren’t a good mix. Passive smoking seems an unfair lose-lose scenario…

My unexpected favourite part of the trip though was the grungey Berlin style. For once not only did I feel that greasy hair was acceptable, but positively fashionable.

Care crisis

Ms society

Given my experience of establishing home care to move into my flat, which took an enormous amount of effort, resilience, and resulted in me writing to my MP, it felt like a moral obligation to submit my experience to the MS Society’s current campaign End the care crisis.

In sharp contrast to my involvement at the Savoy last week, it’s not glamorous. Seeking, organising, and relying on carers is at best effing tedious, and at worst, dehumanising, frightening, and distressing. To highlight the point I received a ‘consultation invitation’ from my council this week as they review their charging structures for home care, essentially looking at different ways to increase the amount paid by users. My answer to all their questions seems the same: no-one WANTS care, much less increases their visits or call lengths for amusement. This is not what we earn and save money for. It’s a necessity. My family and I have all paid taxes but have been unlucky, and now need help.

The campaign is live here including my case study. Please email your MP. Social care and local councils are struggling for funding and resource, and it’s not improving.

It takes two minutes, the MS Society’s template is ready prepared (although add in any personal experience you have).

  • In the past 20 years, we have seen at least 10 government consultations and reviews on social care, but with the system still underfunded.
  • Because social care isn’t working, people with MS have to turn to the NHS.
  • The government must put forward a long-term funding plan for social care in England.
  • We are asking MPs to write to the Minister for Care and Mental Health for a commitment to consultation on social care in the form of a Green Paper.

Do it, tweet it, share it with your friends and family to make an impact.

Speaking MS at The October Club

OctoberClub2017-002On Wednesday I spoke to a room of 400 people. About my experience of MS. At the Savoy. When I started this blog I did not see that coming…

The MS Trust were chosen this year by The October Club – founded in 1987 by a group of City workers, their annual dinner raises funds via a live and silent auction. The focus of the MS Trust was on advanced MS, that scary destination I’m likely headed to, having been diagnosed at 16, where you’re too disabled for drugs to make much difference, and need a lot of help. The dinner this week raised £500,000 for the launch of a new programme to fund six  Advanced MS Champions over three years.

I’m so hugely proud to have been a part of the evening, the biggest public speaking I’ve done by about 350 people, on a sensitive topic, for such a brilliant charity. I didn’t cry, one of my concerns ahead of the night. I had my speech on my lap to pre-empt the brain freezes. I guess one silver lining of being in a wheelchair is that I didn’t need to worry about tripping over. I, along with Yeoman Warder and Natasha Bunby, had filmed a short video to set the scene too – although as that was playing pre speech my right arm was having a complete MS breakdown and seizing up (stress is a trigger, I should’ve seen it coming). The evening is a bit of a blur of nerves and adrenalin, but speaking at the Savoy is definitely going down as a life achievement. And true to form, no amount of anxiety could put me off the incredible dinner.

As I said on the night, my approach is to always say yes to opportunities, as you don’t know if there’ll be another chance, and you have to do things while you can. Although that’s true for all of us, having MS makes it a more immediate reality, which I’m always conscious of.

Full speech here. (Ish… sure it changed a lot on the night)

The tiredness from the last few weeks is still there, but the lift from Wednesday stirred some proactivity in me and I’ve made a GP appointment to review it. I’m counting that as a (small) victory too.

‘I’m fine, just tired.’

‘Are you ok?’ ‘You look pale, are you well?’ ‘How are you?’… ‘I’m fine, just tired.’ 

That’s been my opening conversation now for a month. I’m exhausted. And I’m sleeping like a log, keeping weekends clear, eating well, and still just about carrying on. And I’ve been emotional, tearful and feeling low. Is that caused by the tiredness? Or the other way round? 

I tried to tackle one problem and looked up local counselling. My county neuro centre gave me really good psychology sessions about 3 years ago so I rang them: 18 week wait. I’m bloody hoping that in 5 months it’ll have passed. I contacted private psychologists, obviously they’re not wheelchair accessible. I don’t have time or energy for more, I’ll probably feel fine after some rest. 

‘Are you very busy at the moment?’ my MS nurse asked me. Well, I moved teams recently at work, but an internal sideways move isn’t exactly running a country. I’m super excited to be involved in campaigns with the MS Trust and MS Society at the moment, but as you’d expect, they’ve been pretty considerate and not imposing deadlines on me either. 

‘Are you sleeping enough?’. Last night I got into bed and put a podcast on for 15 minutes with a sleep timer. I didn’t hear the end. My care hours are fixed and give me 9 hours sleep a night. One day this week I was in tears just being forced out of bed after that. I can’t physically need more sleep, rest is making no difference. 

My email inbox, to do list, and WhatsApp are overwhelmingly unread. I’m struggling to do the minimum. I’m just run down. I’m writing this from my Tysabri hospital chair – my MS nurse has just sent a blood sample for a thyroid check. That would be an easy answer. But I know it’s probably going to be a more muddled MS/fatigue/seasonal/mood related effect which there’s no easy fix for, just giving it time. 

Why vampires don’t use wheelchairs

The home of vampires: Transylvania, Romania. Ideal location for a road trip holiday, not for the gothic links, but for the gorgeous landscape. I mainly love exploring places a bit less common and off the beaten track. The downside of this of course, is that these places are normally not the most accessible.

As always, my fantastic friends did a stellar job of lifting and pushing me round, but it wasn’t easy, and the 30+ degree heat obviously did wonders to any strength I usually muster. However, what Romania lacks in infrastructure is made up for by the people. Without a common word of English or Romanian between us, strangers would still join in to lift my wheelchair over steps or up steep hills (bonus, lots of them attractive guys, the man bun is big in Romania right now). One lovely English speaking girl wanting to visit the U.K. asked me if British people hate Romanians (hence Brexit), pretty heartbreaking, and as actually I think some do, my answer recommended she visit London, Manchester or Scotland.

Anyway, the sights:

  • Salina Turda – a salt mine with underground lake and light installations… so I’m told. The website describes a lift, the entrance has disabled parking and ramp, but turns out you still need to climb down 70 stairs to GET to the lift.
  • Sovata Bear Lake – gorgeous salt lake in the trees, pretty accessible to get lakeside – steps in and out though (again locals helped out). I swim once a week and assumed once in I’d be fine; swimming in salt water is waaay harder, my legs were being dragged about in all directions until a local lady (via mime) lent me her rubber ring float.
  • Prince Charles’ Castle – A fan of the area, Prince Charles owns a castle which has been converted into guesthouses. Shockingly, it’s not accessible. I wrote to his office to raise the issue and got no reply. Poor show.
  • Brasov cable cars – this town next to the Carpathian Mountains, a walled citadel, is worth the drive. We were also lucky to be there the weekend of a food festival in the park; really pretty town with a vibrant young atmosphere. To get the best views there’s a hillside cable car… with steps to get up to the base, it’s a no go.
  • Bran aka Dracula’s castle – I’d emailed them in advance, to which they asked when I was visiting and told me they’d help and that I could see some but not all parts. There is a long steep path up to the castle, impossible for me even without hoping to get into the rickety stairways inside. Not surprising really, I didn’t imagine Dracula living in an open plan penthouse with stair lift, their emails just missold it..

Great trip, beautiful country, but outside the city of Cluj in the real Transylvania, it’s not an easy ride.

 

 

 

 

3 0

I’ve entered a new decade, and crossed that point upon which so many expectations were balanced until now, the “When I’m 30 I’ll have life sorted” logic. I certainly thought I’d still be walking at 30, but was forced to accept otherwise 3 years ago. Re-reading my blog from my 28th birthday I realise how much harder my life was then. I was still hanging on to so many ideals and plans set for myself in my early twenties, and maybe it’s the wisdom that comes with age, or having moved to my own place, or just getting used to being in a wheelchair, but actually, 30 feels… fine.

Make no mistake, I still get unwelcome flashes of my parallel healthy self. The image of how she’d be living hits me like a plank to the head and can leave me in tears. I hate MS and it’s alterations to my life, from the constant compromises to the major life choices – it feels like being fished out of an ocean and dropped into a test tube: your scope is limited. I’m not sure that feeling will ever pass, but it’s not the constant turmoil of a few years ago. In fact, worrying about progression and losing the travelling/city life/marriage/kids was worse than the reality. Maybe I’ve just forgotten what I’m missing but whatever, being angry and upset every day is exhausting, and I don’t miss it. In hindsight I think I stayed living in London too long, constantly jealous of the young high-achievers surrounding me (disability aside the 24 hour opportunities force permanent FOMO). And the truth is that life, whether with a serious illness or not, is not as simple as it seemed 10 years ago. A lot of my peers with everything on paper find problems, and I’ve got perfectly able friends whose lives haven’t worked to plan either.

So at this moment, right now, things are okay, turning 30 wasn’t that scary, and I’m relatively pragmatic. But it’s MS, tomorrow I could be in tears, and my 31st birthday could hit me with a whole new set of symptoms. The illness forces you to change your expectations, and though I’m not totally there, I’ve got better at accepting it.

London Athletics, and nothing else

IMG_0093I appreciate that history and character are important… but if only we’d rebuilt the whole city for the London 2012 Olympics. I had a ticket for the IAAF World Championships in Stratford last night, a Sunday night so normally off limits as a rule, to avoid exhaustion all week, let alone infrequent trains and travel hassle. But this was easy, the Queen Elizabeth Park was designed and built for purpose, ahead of the 2012 London Olympics. It was so straightforward that I actually didn’t reflect on it until this morning. Normally disability related obstacles shadow all my outings, so the fact access was unremarkable is huge.

With a Blue Badge, you can drive and park onsite (by a quick email and dashboard print out beforehand). There are plenty of spaces, and volunteers on site to direct you down the lifts to one of the many accessible shuttle buses which drop you off right outside the stadium (they also run from Stratford station). It’s all step free from there to your wheelchair space which is a great one. You’re in the middle level of the stadium, no lifts, just in front of one of the disabled toilets, on the same level as the bars, and surrounded by people. As a comparable, at the Millenium stadium in Cardiff, the wheelchair spaces are at the back of the crowd, set apart from everyone else (lest you forget you’re different) so you’re not really in the atmosphere.

So my memories of the night are purely of the athletics, boring right?! I didn’t boo Justin Gatlin (I was going to stay silent but when people started boo-ing actually applauded in offset)… give the guy a break he’s still a devoted athlete. Discovered a love of the Pole Vault. Realised I need to carry my glasses around more. And was in bed pre midnight, brilliant.

IMG_0101