Tuesday, August 6, 2013

DEAR NEWLY DIAGNOSED PATIENT

Although it is now almost 3 years since I've been diagnosed (6 Sept 2010), memories of that traumatic time flood back easily to make me relive that devastating period in my life.  Not only the patients, but also their families and friends are hit hard when receiving a diagnosis of an incurable, terminal disease.

Like many of you, the day I was diagnosed was the first time we had ever heard of this disease called Multiple System Atrophy (MSA).  Back at home we looked it up on Google. I glanced only very briefly at the symptoms listed, and quickly closed the lap top. That was too much information too soon. Some people can take the whole bitter pill in one go, but I was far from ready to face all those symptoms.

My mind was racing with thoughts and questions: Will we be able to cope with this? How fast will all of this happen? Why did this happen to me? Did I do anything wrong? What do I do now? Where do we start? The only prayer I could manage was the desperate cry; "Oh God, please help me!"

The neurologist said we would need all the help we could possibly get and referred us to a psychologist.  Faced with the diagnosis of a dread disease that would require drastic changes in our lifestyle, we went through many emotions and all the different stages of grief.  This can, and did put strain on relationship. My husband’s patience was tested to its limits during my ‘angry stage’ and he often had to bear brunt of my frustrations.  He’s still here supporting me.  Bless him!

My emotions roller coasted from sadness, extreme guilt, and fear and uncertainty of what the future held.   Grief is a natural response to loss, and I was going to have to face many losses in the future. 

On the psychologist recommendation I started writing down my feelings and experiences.  With my friend Karin’s help and encouragement I started my first blog post in my mother tongue Afrikaans, ‘Sonja se Griffels’, wondering whoever would want to read my first humble posts.  Writing however did help me to see my problems in perspective.

By the time of the final diagnosis I was fortunately past the first stage of denial.  This however didn't mean that everybody in my life was past denial.  Some took longer to get past denial and others never did.  They were consequently unable to deal with me and the disease and were left behind.  Perhaps facing my physical frailty reminded them too much that, in the blink on an eye, it could happen to them.

At first I isolated myself from other patients, fearing that those in a more advanced stage would only depress me further.  Grieving has no time limit, it’s a very personal experience, and there is no ‘right’ way to do it.  It took me the best part of the first year to digest the diagnosis, the changes taking place in my body, and what I would have to face in the future.  This is an ongoing process as the disease progresses.
 
Before all this happened, I was fit and healthy.  When the first symptoms presented, I tried to fight it by becoming fitter and living healthier.  I bought organic foods from farmer’s markets, distilled our water, and juiced vegetables and fruits.  I still believe in, and reap the benefits of a healthy lifestyle, but going to extremes didn't stop the disease from progressing.  I therefore concluded that life is best lived balanced. 

Many well meaning friends have over the years suggested many therapies and ‘cures’.  If I had to try them all out, we’d be bankrupt.  I have come up with the following question for such suggestions; has the product/therapy been subjected to double blind clinical tests specifically for MSA?  I have yet to receive a positive answer.  There are currently dedicated researchers trying to solve the mysteries of MSA, but this is a process that takes time.  You’ll have to decide if there is anything out there that seems worthwhile to try.  

I found the love and support of my family and friends, and avoiding stress as far as possible, to be the best medicines.  The support of my kind, and always available neurologist, who regularly attends conventions on movement diseases, has gone a long way in keeping me satisfied that I'm receiving the best care currently available.

Sometime before the diagnosis the doctor prescribed an anti-depressant, which I still take.  Some may not agree with this - I however don’t believe in unnecessary suffering.  I also found humour and laughter helpful the ward off the blues.

Attitude can make a huge difference in how we cope with difficult situations.  I have adopted Viktor Frankl’s philosophy from his book, ‘Man’s search for Meaning’, as my own;

“Everything can be taken from a man but one thing: the last of human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.” 

This is my life and I had a choice how I could respond to this.  I have an incurable disease and it will only get worse, but I wasn't going to spend to rest of my life being miserable as well.  I had plenty of people to love and to live for, and I am blessed with their love in return.

It took me the best part of the first year before I tentatively started reaching out to others with the disease.  My first step was to register on ‘Patients like Me’, where I searched for others who were more or less at the same stage as me.  I found plenty in a far worse state than me.  Their plight triggered deep feelings of compassion, and I stopped feeling sorry for my self.  

Concerned, I wondered how I could help them. When I first heard projects to create awareness for MSA, I was ready and eager to put my name and face to this disease and join these campaigns.  With plenty of help from my supporting friend Karin, we organised our first local awareness event.  This added new purpose to my life.

I have since been privileged to make contact and get to know many patients and/or their families from all over the world, as well as a few locally.  From them I have not only learned a lot about the disease, but also how to cope with it.  We support each other, and they have enriched my life. Now I can not imagine my life without my compassionate MSA buddies.

Being a fiercely independent person before, accepting the help from others was very difficult initially.  I have since learnt the valuable lesson that in accepting help you give a gift to the giver.  Don’t underestimate the value this can add to the lives of others, and the new depth in friendships/relationships this can lead to.  In turn, reaching out to fellow patients in their darkest hours has added value to my life.

Living with an incurable disease has caused my life to take on a new intensity.  I love more deeply, have more compassion, value friendships deeply, laugh more joyously, take more joy in music, and appreciate the beauty of nature more.  I live in the moment, savouring every beautiful moment.  The awareness that my earthy life, like all life, is finite has made it more precious.  
   
One can never be fully prepared for the expected diminished capacities, but I hope my mental  and spiritual preparation will soften the impact.  Concentrating on what I have left has made what I have lost easier to endure.  I now see my physical body as only a part of the real me.  This allows me to look at the disease objectively, to accept it, but not succumb to it.  Coming to acceptance is an ongoing journey, a destination to aspire to.  I now often experience the inner peace that comes with acceptance.  At times I cry a little, but it is no longer tears of desperation for I am not without hope. 

Dear fellow patient, you are at a cross road in your life now. Your journey will not be the same as mine.  It will be unique to you and how you respond to this extreme challenge.  The road ahead will be rough.  Open your heart to see the beautiful flowers along this road.  They will be there. 



  
Blessings for your journey,

Sonja
                                                                                                                                                                    Psalm 10:17 - You, Lord, hear the desire of the afflicted; you encourage them, and you listen to their cry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     





Sunday, June 9, 2013

TREVOR


In Memory of Trevor Allen Pengelly - 13.5.1959 - 8.6.2013



In my search to find other patients with MSA in South Africa I, by chance, found Trevor’s email address on a blog.  I immediately wrote to him, and since that day in November 2011 our friendship had grown from strength to strength.

We started off by sharing our MSA experiences with each other, comparing medications, and laughing at the fact that words like zimmer frame and commode had prematurely become part of our vocabulary.  His great sense of humour, despite the difficulties he suffered, had me in stitches on many days, and I could always depend on him to see the lighter side of the darkest days.

When he picked up that my friend Karin and I were involved in creating awareness for MSA, he encouraged us.  The two of us enthusiastically made plans to find other patients in S.A., but this was not to be; the dictator MSA proved to be stronger than both of us.  Although the disease didn’t allow him much, he remained keenly interested in our activities and supported our efforts right to the end.

I never had the privilege of meeting him, but my friend Nola Dippenaar did visit to share her vast knowledge of health with him.  These were her words after that meeting; “Sonja you will just love him!  The two of you are so alike.”  According to Nola, with whom I agree, it was easy to love him.

He also proved to be a generous friend too when he sent me his mobility scooter.  A useful  gift I was very thankful for.



It was a special privilege to share these last years of his life journey.  The loss of my friend is a blow and I will miss him dearly.  His positive attitude with which he bravely confronted the disease will stay with me forever.

In the beginning we used to end our letters with, ‘stay strong’, which progressed to, ‘lots of love’, but for some time it had been, ‘love you lots’. 

For the last time; love you lots, always, my friend,

Sonja

1 Corinthians 13:2; if I have a faith that can move mountains, but do not have love, I am nothing.




Monday, May 6, 2013

CARER IN TRAINING



Me and Lilian 2010, photo by Laurette's photography

After a recent fiasco when the nursing services forgot to organise a substitute carer for me, we decided to look at other options.

A local service, Strand Dienssentrum, was recommended to us and Karin went to investigate.  This service centre is situated around the corner from us and is run without profit for the community.  Karin came back very impressed with what they had to offer; a tea garden, daily meals which can be delivered, a hairdresser, foot care, transport to shops, and a nursing/caring service. 

We made an appointment and the nurse who runs the service came to see us to discuss my current needs and what the options were to run my caring more seamless.  The option we all liked best was to send my current housekeeper/cook/unofficial carer on a carer training course.  During the time she is in training one or two other carers can then be trained to take care of me.  They can then serve as substitutes when Lilian is ill or on leave.

Lilian the cook in action

Lilian, who is very proud of her newly acquired cooking skills (taught my moi), was very keen to further her education to be trained as a carer.  I was very lucky to get Angie, who cared for a local MSA patient for 3 years, as a substitute.  She was shown the ropes by Lilian before her course started to make the transition as easy and stress free as possible for me.

Lilian, who still helps out on Saturday mornings, came in beaming with pride with the good results of her first test.  The course is in English, which is a bit of a problem for this dominantly Afrikaans speaking lady, so she left armed with my Afrikaans/English dictionary to help with translations.  Her uniforms are hanging ready for when she starts the practical side of her training at a retirement home soon.  In a couple of weeks I'll catch her pride smile on camera when she walks in here fully trained and in uniform.

Although Angie is taking good care of me, her cooking skills are not so hot.  Because of my back problem I am no longer able to sit for long stretches in the kitchen to train and supervise her.  Until Lilian’s return we’ll have to make do with ready cooked meals from Woolies, depend on the occasional pizza delivered by Mr Delivery, meals cooked by our son on weekends, and braais (barbecues) by hubby and friends.  I think we’ll manage!

Saturday, April 6, 2013

OUR MSA TEAM AT THE ARGUS CYCLE TOUR

Here at last are the photos of our MSA Cycle team who had completed the Argus Cycle Tour successfully.  The past month has been a trial and error struggle to find the right medication for my ever painful back and this has kept me from sitting at the pc for the long stretches of time needed for blogging.

All fresh and eager to start are: left front to back; Mari, Michelle, Gary, Zarier, Maahir. Right front to back; Margarheta, Amanda, Charlotte, Adri:



 

After many months of hard training, and I suspect some butterflies in the tummies, they could hardly wait to be on their way.  Seen here at the back from the left; Anton, Maahir, Zarier, Amanda, Charlotte, Gary.  Front, left to right; Michelle, Adri, Mari;






Amand Erlank, the organiser of this group, and Adri van der Merwe;









Gary and Charlotte;






The Behardien brothers, Maahir and Zarier;





On their way with food for the road!  In the top left is Abdul and on the right Gary.





Amanda and Mari taking the turn;





Amanda and Charlotte






Congratulations to our team with a successful Argus tour!  I dare to hope this will become an annual event!  After 109 km at the finish are; Mari, Amanda, Charlotte and Gary.




And some great times too! 


CONTESTANT
RACE NUMBER
TIMES
Amanda Erlank
53019
6:25:32
Mari vd Merwe
53020
6:25:33
Gary Evans
41162
6:25:32
Charlotte Kriel
53200
6:25:30
Adri vd Merwe
53441
4:11:31
Zarier Behardien
53135
5:32:02
Abdul Atta
53234
4:45:00
Margaretha Steyn
53184
6:07:17
Anton Titus
53292
5:28:49
Michelle van Rooyen
53381
05:59:57
Maahir Behardien
465228
06:22:26





Thursday, March 7, 2013

THE LAST PREPARATIONS FOR THE ARGUS CYCLE TOUR





Here in the Cape hardly any conversation goes by without a discussion of the ARGUS CYCLE TOUR.  You don’t have the drive far before running into cyclists doing their last training at all hours of the day.  The weather forecasts are being studied and best diets and drinks to take before and during the race are being discussed. 

One our MSA TEAM cyclists, Gary Evans, wrote the following to give us an insight into a recent early morning training session;

“Woken by the alarm at 5 am on a Saturday morning is not the way to wake up in a happy and stimulating mood, but the thought of training for the 109 km Argus road race and riding for MSA is enough to get anybody out of bed in a hurry…..

Bicycles on the car-rack, energy bars and juice packed, we leave for Delvera wine estate near Stellenbosch to cycle the Dirtopia route.

The day is dawning, with the sun peaking behind the mountains and the silence in the car on the way there tells a story of tired bodies and tired legs. We unpack the bikes and head out into the mountains.

The energy and enthusiasm comes back the further we ride and the saddle starts to feel like the lounge chair, legs pumping the pedals, and we reach our first drink-stop. The view is awesome and getting out of bed early is a distant memory.

The fresh air is our “drug” for the day.

We rode 12 km, but climbed 534m. Great strength training for us novices, and as we returned to the car the thoughts of a coffee and a muffin were in most our minds.  Isn't that what we get out of bed for?”

Thank you Gary, this made me realize how much dedication and perseverance goes into training for a race like this.

Traffic on all main routes towards the Cape will increase over the next couple of days, with many vehicles coming from all over the country, all with loaded tell-tale bicycle racks.  Airport personnel will have there hands full dealing with boxed bicycles that need to be reunited with owners.  Restaurants and guest houses will be filled with excited cyclists awaiting race day with trepidation.

Organising a race of this magnitude (an expected 35 000 cyclists) takes expert planning and Cape Town will come to stand still on Sunday 10th  March to accommodate all the participants and the spectators.  Physiotherapists will be on hand to treat strained muscles and cramps.  First aide personnel and doctors will stand by for more serious injuries and ailments.  Water points along the route need ample amounts of water, coke and ice, with enough volunteers to keep the race running smoothly, eliminating unnecessary bottle neck delays.

Amanda Erlank, the organiser of the MSA CYCLE TEAM, and the rest of the team, has been invited to the Woolworths hospitality tent at the finish where they will be pampered and spoilt after the gruelling race.

The funds raised were donated to the MSA Trust in UK, and Amanda received the following note from them;

“Dear Amanda,

I just wanted to drop you a line to thank you for your kind donation of £180 to the MSA Trust, in aid of the South Africa Argus cycle tour…it sounds fantastic!

As you are aware, as a small charity we rely entirely on voluntary donations to continue our vital work, supporting all those affected by the devastating disease MSA. Your generosity will enable us to continue growing our support group services, expand our specialist nurse programme, and reach more people touched by MSA. Thank you.

Please do not hesitate to contact me should you require any further information on our work. 

With best wishes,

Katie”

It’s heart warming to know that this team’s effort is recognised and will make a difference to the lives of patients.

The race begins at the Cape Town Civic Centre in Hertzog Boulevard. Depart from the N2 and M3 and follow the False Bay coast past the entrance to Cape Point, then the Atlantic coast and the Chapman's Peak road to the Cape Town Stadium. 

Our MSA CYCLE TEAM will start their race at 9.16.  We wish these brave cyclists the best of luck on race day and will be cheering for you and willing you up Chapman’s Peak and the dreaded Suikerbossie hill!

THE TEAM: Amanda Erlank, Abdul Atta, Adri vd Merwe, Anton Titus, Audrey Mallett, Charlotte Kriel, Gary Evans, Maahir Berhardien, Margaretha Steyn, Mari vd Merwe, Michelle van Rooyen, Zarier Behardien.

Some Argus Cycle Tour facts;
The fastest winning time was 2:27:29 (Robbie Hunter in 2008)
The fastest average speed was 47.48 km / h (Wimpie van der Merwe 1993).
The oldest person to complete the bike tour, was 92 (Japie Malan in 2012).
The race was cancelled twice in the past due to bad weather - heat in 2002 and strong wind in 2009.





















Thursday, February 28, 2013

MSA MONTH: SOUTH AFRICA’S FIRST FUND RAISING EVENT



Seweweekspoort; from the left, Mari, Charlotte and Gary

 It is most apt that our first fundraising event is happening in March; MSA Month.  My dear friend and fellow patient, Magda Erlank's daughter, Amanda Erlank, has taken the initiative to organise a group of cyclist to dedicate their ride in the annual ARGUS CYCLE TOUR to MSA.  This 109 km tour is the largest timed event of its kind in the world, attracts more than 35 000 cyclist from around the globe, and winds its way around our beautiful Cape Peninsula.  It takes place on the 10th of March.



Training for a mega event like this requires the discipline to spend many arduous hours in all kinds of weather conditions on their iron horses.  They do this because they can, for us who no longer do it.

Magda, on the right on her recent visit to me, left, with Karin in the middle

Amanda writes that she started cycling 5 years ago for health reasons.  Training for the Argus has transformed her into a healthier and fitter person, physically as well as mentally, and helps her to unwind from daily stress.  Struggling through training is often unpleasant but has taught her much about herself and her inner strength. 

Amanda training on the Dirtopia blue route


When faced with what seem like impossible hills to conquer, thinking of her mother’s impossible journey with MSA gives her the strength to carry on.  When an isolated mountain bike trail takes her to beautiful vistas, she is reminded that her mom can no longer share this with her because of this terrible disease.  Every breathless and torturous step is for her mom, a dynamic woman whom she reckons would have easily beat her in this race ten years ago.

Adri van der Merwe is a contestant from Upington in the beautiful Northern Cape, where hills for training is scarce in the mostly flat landscape.  This seasoned athlete participated in the Ironman race in 2012, swam the Midmar Mile in February, and won a 78 km road race in her hometown last weekend.

Adri on a early morning training session

Adri knows Magda, prays for her daily, so when asked to participate in this race, agreed immediately.  When recently reminded of her pledge she started training more seriously and rises at 5 am to do so in the company of other cyclists from her town.  A lot of sweat and the occasional fall have gone into training for what she regards as a worth while cause.  With her first Argus little more than a week away she is excited and hopes that her training was enough to make it an easy ride.   She is thankful for the privilege of being able to cycle and prays her effort helps our cause.

My therapist, Audrey Mallett, who has done the race many times before, is part of this group as well.  When she popped in today she told me she hasn't had any time to train and intends to wing it on a prayer.  This petite lady is a whole lot tougher than she looks (I have often suffered under her supervision!) and I'm sure she’s quite capable of finishing the race.

Gary and Charlotte taking a break on a recent training session


Zarier Behardien

I hope to bring you more news on these brave cyclists soon:

Amanda Erlank, Abdul Atta, Adri vd Merwe, Anton Titus, Audrey Mallett, Charlotte Kriel, Gary Evans, Maahir Berhardien, Margaretha Steyn, Mari vd Merwe, Michelle van Rooyen, Zarier Behardien.



Thank you Amanda for all the hard work you put in to make this possible. The best of luck and perfect weather on race day to all of you!  Although I can’t be there, I’ll be glued to the TV to cheer for you.  Hopefully those orange shirts will be easy to spot.



Because no research is being done locally, the funds raised were donated to the MSA Trust in UK.


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