I have D-Y-S-T-O-N-I-A? No, it’s not a former Soviet Socialist Republic but a neurological movement disorder.
So what is Dystonia? Let’s set aside medical formalities and fast-forward to practical realities. Imagine you’re trying to jot down a grocery list and, quite inconveniently, someone jerks your elbow up and down, making it difficult – if not impossible – to control your writing. Or maybe you tackle something complicated like walking across a room. You lift your leg to begin that first step when a mischievous troll screws up your balance by pulling your foot inward, causing you to land on the side of your foot and desperately search for stability. Simultaneously, some imp twists your knee while your hip dips and swings in a motion that would swirl a hula-hoop.
Welcome to my Dystonia!
In the company of my pokey little puppy, I’m sure you can guess who’s been stealing the show! I’ve happily abdicated top billing to 12 pounds of furry delight while my metal co-star finds herself demoted to disgruntled supporting actress.
As life hairpins a 180-degree curve, I’ve discovered that those who notice my traveling crew assume my walker – purple and hot pink Sherpa ensconced snugly on the seat – serves at my puppy’s pleasure. Ironically, after a lifetime battling self-consciousness, I’m proactively advertising my need for a walking aid without a care.
Meanwhile, my Dystonia has taken a back seat to little Ellie as I traverse the miracles – and responsibilities – of motherhood. Housetraining poses a particular challenge when our summer strolls evoke the last leg of a marathon. As the thermostat ramps up, so goes my Dystonia. I trudge along the city’s streets drawing on every ounce of energy I can muster, braving sweltering weather I formerly shunned. When there’s no juice left, my walking devolves into a game of shuffleboard played out in a cloudy haze. Anything for my puppy, who stands infinitely more important than the “inconveniences” wrought by Dystonia.
The moral of my story: The very best pick-me-up is to step outside ourselves and divert our attention to the world unfolding around us, rising to the occasions life presents.
All too often, there’s a sideshow to chronic illness: our treatment regimen! Let’s take my pills. They’re small, white (or yellow) and round. They “control” (I didn’t say “cure”) my Dystonia but wreck havoc with my body. My meds require me to walk a medical tightrope juggling multiple balls in the air, engaging in a precarious – but common – balancing act.
My neurologist and I make all sorts of adjustments. We go down on one culprit with particularly distasteful repercussions until my walking worsens. Then it’s time to regroup. We add meds to address side effects, which in turn make their own statements. Understand, I’m an impatient person who rarely acts incrementally. I embrace BIG CHANGE. Not with my pills. The process of going up and down, not to mention trying new meds, is E-X-C-R-U-C-I-A-T-I-N-G-L-Y S-L-O-W. But I appreciate the need to drive with caution and intermittently engage the brake.
The “games” never end. I had to discontinue a long-standing drug that caused my blood count to plummet dangerously. Another regular exerts undue influence on my blood labs, rendering them confounding to everyone except my neuro. Then there’s the trial and error of “new” treatments. During a clinical study, I became convinced a med was making my Dystonia worse and hightailed my way off that highway. I speak from experience when I say serious drugs merit serious vigilance.
I reap the benefits of a highly knowledgeable and careful neurologist. However, responsible health care doesn’t end with a trustworthy physician. As patients, we’re the ultimate arbiters of the substances we ingest and interjecting a healthy dose of caution is prudent. Do the research, investigate your options, read the fine print, ask probing questions, and trust your instincts when it comes to side effects – after all, you know your body best.
With World Health celebrated throughout spring and summer, the American Recall Center has embarked on a campaign to promote medication safety (check out their tips below). The American Recall Center website is an invaluable resource for prescription drug and medical device recall information and other healthcare topics advancing informed medical decisions.
Posted in Life
Tagged American Recall Center, Anticholinergic, Artane, Chronic illness, Conditions and Diseases, Dystonia, Medical device, Medication, Movement disorder, Neurological disorder, Sinemet
A dashing speech therapist broke my heart. No, it wasn’t a torrid romance ending in tragedy but his sage words of advice: conversational speech is the last dam to break. Worse still, the coveted prize we were chasing was “communication” not “perfection.”
I’m a self-admitted practicing perfectionist. “Good enough” is never good enough when my life’s work is a perpetual pursuit of Eden. I aim to scale mountains and then chastise myself for the slightest blunder. So, surprise, surprise, I embarked on speech therapy with abundant determination to nail that bull’s-eye. In my estimation, I’d practice, practice, practice until my speech issued perfect, perfect perfect. While I might not scale tall buildings in a single bound, I’d surely conquer them with a rigorous daily regimen. Then reality hit. Those darn “Ks” and “Gs” continued to pose a battle, median “Ds” and “Ts” relentlessly evaded me…and shall we discuss my lip sounds? Further, if I reduced my life to working on my speech when would I actually use it? I needed to modify the recipe.
Most people coast through sentences blissfully unaware of the verbal gymnastics they perform with every word. The tongue effortlessly careens from venue to venue in fluid motion while the lips execute deceptively simple maneuvers. The veritable clockwork programmed by our brains and slickly engineered by our orofacial muscles enables us to focus on the dynamics of conversation rather than the specifics of location. As if on autopilot, we register our speed, then sit back and relax as the flight conveniently navigates itself.
Until I began speech therapy, I pounded out my speech in appalled ignorance of the mechanisms of my physiological inefficiencies. I’d no idea of the muscular precision required to orchestrate individual sounds and master conversational flow. Further, little did I know co-articulation demands we pronounce our sounds in units – in other words, our forward-thinking brains work a step ahead of us – granting undue influence to the banes of my existence. Certain sounds manageable in isolation “malform” when coupled with anticipated sounds looming in my future.
Focusing on my wealth of articulatory challenges simultaneously – a feat of multi-tasking – poses overwhelming, particularly if I seek to partake in productive listening. Adjusting my lofty aspirations, I slow the party down and divert due attention to the dynamics of the discussion. After all, the turtle bested the hare with a slow and steady pace.
Posted in Life
Tagged Anxiety, Aphasia, Dysarthria, Dyskinesia, Dystonia, Involuntary movement, Language, Neurological disorder, Speech impairment, Speech impediment, Speech therapy
Now this is an interesting exercise. Why don’t you give it a shot? Here’s the beginning of my list of challenging “multi-tasks:”
- Walking and talking on the phone.
- Maintaining my balance going down steps.
- Playing Twister. Won’t happen again…last game I tore my meniscus!
- Laying inside an MRI machine and holding still.
- Articulating individual words while speaking in sentences.
- Any exercise that involves my legs and another body part.
What are your fiercest multi-tasks?
Within my neighborhood, I rule the sidewalks in the company of my slick, 4-wheeled sidekick. Venturing onto public transportation pitches me into the world of “handicap accessible.” To my utter dismay, the 86th Street subway, a hub of activity and my home base, fails to accommodate. The “convenience” of the express train perpetually looms a foreboding 3 flights of stairs away.
So what’s the problem? Isn’t this where the dashing knight in shining armor comes galloping onto the scene to rescue the damsel in distress struggling with a precarious descent while juggling 5+ pounds of folded metal? Plenty of burly armed men bustle past me…not to mention a choice selection of NYC yuppies. Adamant about requesting assistance, I’ll patiently await my gallant to little avail. Seems this dystonia damsel requires a megaphone to motivate an endless supply of walking testosterone pursuing their destinations with single-minded focus.
Life is a trade-off and my solo adventures arrive bundled with a steep price. I find myself recalibrating my notion of “independently mobile” to accommodate the human and technological assistance I’m helpless to escape.
We all need role models who fuel our desire to make the world a better place. Mine is my dad, who’s passing this week has left a huge gap in my immediate family and also in my extended family: the Dystonia community.
Back in the 1970s, when my strange movements began, Dystonia posed a mystery scarcely understood by medical professionals. In the absence of specialized foundations, patients and their families had nowhere to turn. The movement disorder neurologist who diagnosed me could only offer utter lack of hope but that didn’t reside within my parents’ vocabulary and they determined to find a brighter tomorrow. If there was no way forward, it was time to construct a road.
With iron resolve and a heart full of love, my father scoured a barren landscape for information about my little-known disease. From his research at the local library, he located a rising neurologist – Dr. Stan Fahn – to help him forge the way, beginning with a much-needed medical conference opening a gateway to scientific discussion. My father’s fundraising gave birth to the first International Dystonia Symposium. It was a crucial step forward but the work had just begun.
Intent on his mission to secure me the very best care, my father helped build a thriving community that supports patients and their families while propelling forward medical advancements. The Dystonia Medical Research Foundation owes its strength to the steadfast determination of families like mine, the Belzbergs, the Kesslers and countless others.
Serving as the initial Treasurer, my dad worked tirelessly on behalf of the Dystonia Medical Research Foundation, earning a lifetime position on the Board. He never sought accolades, just a better life for me, in the process touching the lives of hundreds of thousands. He’s truly one of the unsung heroes of the Dystonia community and he’s my hero. My dystonia blog is a continuation of my dad’s vibrant spirit and can-do attitude. I’m eternally grateful for the life he made possible and the hopeful future he paved.
In loving memory of my father, Martin Sloate.
Donate to the Martin & Roberta Sloate Dystonia Research Fund here: Dystonia Research Fund.
I can’t think of a more distasteful task than listening to my answering machine message. There’s the shock of an alien voice even I strain to understand, followed by the dawning realization this is how I sound to friend and foe. Thankfully, this chore is only required when I tape a new message or forget my phone number and conduct reconnaissance in the form of a confirmatory call.
Recording my message is a disheartening comedy of errors. Accessing my inner thesaurus, I play out a maddening search for “perfect” words that don’t exist in a limited field of vocalization, discarding phrases faster that you can enunciate Jiminy Cricket…all the while stubbing my finger on the re-record button as I keep giving it “one more try.” By the time my word elimination game concludes, my message is reduced to the barest of bones and I can only hope callers will exercise their logical reasoning.
However, I staunchly refrain from resorting to a pre-recording, refusing to tender my surrender to the “luxury” of digitized speech!
In 2013, I took a summer “vacation” from Dystonia! This year, I packed my Dystonia – along with my cane and walker – to head to destinations north of the U.S. border. In case you’re wondering, I left my ego and my pride safely tucked away in my apartment. This was my first travel adventure with walker in tow and I was determined to serve patriotically as the penultimate trooper. Certainly, I’d no intention of defining this sojourn by my special needs.
The advance forecast was smooth sailing, my only trepidation the scents that threatened to assail me. Little did I expect a daily roller coaster ride rife with spine-tingling bumps and spur-of-the-moment curves.
Old Montreal offered a charming tangle of narrow cobblestone streets and squares lined with bistros and shops inhabiting the shadows of a modern city. Calling the terrain challenging is an understatement when my walker bounced over every square inch of cobbled friction. Swallowing my fatigue, I plodded along at my own measured pace, feeling a bit like Moses parting a sea of pedestrian traffic.
Unbeknownst to me, Montreal was merely my “practice run.” Our next destination, Old Quebec City, presented a veritable bobsled track snaking along the bank of the St. Lawrence. I found myself chasing my walker down descending routes, then huffing and puffing the upswings. Rain showers forced me to navigate single-handedly, a swift kick to my stability. I wasn’t the only one aching: my poor walker survived worse for the wear, even requiring an impromptu French Canadian repair!
A series of small victories over an endless obstacle course taught me an important lesson about weathering life’s bumps and bruises. While my sojourn was physically daunting, I brokered a treaty with my limitations and adjusted my future travel expectations.
Posted in Life
Tagged Balance, Conditions and Diseases, Disability, Dystonia, Health, Independently mobile, Mobility, Montreal, Movement disorder, Neurological disorder, Old Montreal, Old Quebec City, Quebec City, Walker, Walking aid
The latest experimentation with my meds sent my walking into a funk, leading me to a newfound appreciation of why I tolerate their medical mischief. It also rendered me significantly less independently mobile – in need of what I shall call a “new friend” – landing me smack in the middle of a vigorous debate between my good sense and inner stubborn mule. Seems my resistance to special assistance is alive and kicking. Notwithstanding 40+ years living with Dystonia, I cling to a foolish insistence I’m no different from everyone else.
As a cantankerous attitude sought to assert itself, complications immediately ensued when I discovered the surprising rewards of life with a walker. Let’s start with my ability to perch comfortably at random street corners – not a bench in sight – for a much-welcomed respite. It dawned on me, not only needn’t I fear wiping out from an unruly twist of foot…or exhaustion…but I now enjoy a custom seat at any outdoor venue. Further, thanks to my visible aid, New Yorkers have become more generous with their assistance.
Where I expected shock from friends, I encountered awe over the creature comforts at my fingertips. Indeed, they quickly jumped on the bandwagon, appropriating space for handbags and parcels – triggering an onslaught of speculation about the moneymaking potential of my new adventure. Inject a flash of ingenuity and my walker may very well present a portable gold mine.
As for me, I often mistake myself for a mother out for a spin with stroller in tow…only this femme is walking herself!
Every Spring, individuals with Dystonia from throughout this vast country lend their enthusiasm, personal struggles and impassioned advocacy to advance mission critical policies aimed at eradicating Dystonia and improving patient care. The power of advocacy is nothing more – and nothing less – than the power of people banding together in pursuit of a common cause. The collective wealth of the experiences we recount illustrates the importance of the policies we promote. Our participation reminds those inhabiting halls of power in Washington that Dystonia is on the map…to stay…until we find the means to whip this debilitating condition.
On the flip side, we gain tremendous gratification from the knowledge we’re actively pursuing a cure, not merely awaiting one. One of the most difficult aspects of living with chronic illness is the degree of helplessness we exercise over the villain holding our bodies hostage. Participating in research studies, raising needed funds and advocating for important policies are direct and meaningful contributions that imbue us with a sense of purpose. Remember, no one chef bakes this cake. The search for a cure is a team effort reliant upon medical and research professionals, healthcare partners, patients, fundraisers, advocates, and all who support us. The accumulation of efforts we undertake propels us forward.
Those who can’t make Advocacy Day should take heart. Flocking to DC for a day of oral combat is by no means the only way to muster our numbers. The strength of our platform is fueled by the collective resonance of our individual appeals, assembled piece by piece. We needn’t travel great distances or endure a whirlwind of meetings jam-packed with issues. Advocacy can be as simple as a call or email to your local politicians introducing your health challenges and policy agenda. Time-sensitive “action alerts” requesting specific communications offer additional opportunities for participation “from a distance.” Sweeping displays of strength are composed of thousands of “tiny” efforts. We need every available voice raising our concerns as it’s impossible to know who or how many will tip the balance.
By no means are we building castles in the air. Health activism conducts serious business. Washington is steeped in special interests strong-arming policy and politicos jostling for position. Everyone with an interest in tangible outcomes bears responsibility for expressing an opinion about the actions – and inactions – of our government and reminding elected representatives why we entrusted them with their authority in the first place. Only by telling our stories and asserting our legislative programs can we be heard. Dystonia’s continued eligibility for DOD research funding is one potent example of the tangible outcomes our sojourns to Capitol Hill produce. I urge patents, friends and families to heed an imperative for action that yields concrete results. Armed with determination and an email program, you can even make a difference from the comfort of your home.
Dystonia Advocacy Day, April 9, 2014
Capitol Hill, Washington, D.C.
Dystonia Advocacy Network Legislative Agenda, FY15
- National Institutes of Health (NIH) appropriation of $32 billion to allow continued funding of important research programs.
- Active support for the Dystonia research portfolio at NIH including the Dystonia Coalition.
- Inclusion of Dystonia as a condition eligible for study in the Dept. of Defense (DOD) Peer-Reviewed Medical Research Program.
- Long-term solution to the Medicare Sustainable Growth Rate (SGR) formula that adequately reimburses physicians and ensures patient access to quality care.
The Dystonia Advocacy Network’s legislative agenda is found here: http://dystonia-advocacy.org/agenda/
Those with Parkinson’s can join forces with the Parkinson’s Action Network: http://www.parkinsonsaction.org
Posted in Musings
Tagged Advocacy, Capitol Hill, Congress, D.C., Dystonia, House of Representatives, Legislative policy, Medical research, Medicare, National Institutes of Health, Neurological disorder, NIH, Senate, Washington
Too often, I find myself apologetic over hurdles that come with Dystonia: I’m sorry it’s difficult to understand me…I can’t walk across the park…I need more time to finish this form. Worse are the silent apologies I make to myself. Why do I perpetually raise excuses for my condition as if responsibility for this annoying hoopla falls squarely on my shoulders? I possess greater control over my runaway temper than my speech or my stride. Dystonia arrived as an intruder on my doorstep, robbing me of some of my dearest possessions: clear speech, even gait, smooth handwriting, contraction-free enjoyment of life.
The perpetrators of this medical crime lurk deep inside my brain committing all kinds of chemical mischief. I’ve participated in a bunch of “line-ups” – ironically, I’m the one who’s scrutinized – but while a culprit surfaces in a blood test, the actus reus can’t be captured in a pretty picture and my “head shots” are dead-end streets. We know Mr. DYT1, my uninvited houseguest, orchestrates a mutant ninja protein – Torsin A – who’s ostensibly a key player in a conspiracy of neurological proportion involving a perplexing hoist of my brain with a modus operandi stumping even the most seasoned investigators. To complicate matters, a host of suspect genes orchestrating their own villainous behaviors are implicated in different forms of Dystonia.
On the bright side, I function as my own “neighborhood patrol,” doing my best to combat an ongoing bodily offense. I undertake every effort to keep the crime labs busy, proffering skin and blood samples, funky PET scans, functional MRIs…accompanied by eyewitness accounts of the damage inflicted on my landscape. Meanwhile, I remain a walking crime scene apologizing for acts I can’t explain. Perhaps my amends are best bestowed on the objects of my temper…
Posted in Health, Life
Tagged Conditions and Diseases, Dystonia, DYT1, Genetic disorder, Genetic mutation, Involuntary movement, Medical research, Movement disorder, Muscle contraction, Neurological disorder, Torsin A
Last week I experienced health care at its finest in my own peculiar version of one-stop shopping, heading to the hospital for a day of consultations flowing from Psychiatrist to Fellow to Attending Neurologist to Physical Therapist. Now that’s what I call patient-centered care, yours truly the star of the show! With Movement Disorder, one’s neurologist is often the tip of a medical ice-burg floating down a river teeming with doctors and therapists. Why shouldn’t treatment resemble a “power trip” to the mall to score a broad swath of retailers?
Pushing our “main squeeze” to the side, chronic illness ushers in a host of ancillary issues shaping quality of life. We confront side effects from our meds, the practical repercussions of a body gone wild, a seesaw of energy and fatigue…not to mention those emotional highs and lows. Assembling our go-to team requires us to work as our own Offensive Coordinator, searching out appropriate therapies – hopefully with providers who take our insurance – in an effort to quarterback a game plan aimed at gaining elusive yards as we journey up the field. The big “Hail Mary” may lie outside our control but we gun for those small victories.
Getting to the nitty-gritty of my “medical spree,” what a treat to bask in the rays of a professional crew evincing an understanding of a slew of complicated relationships – Dystonia the hub driving the wheel. They proffered care with concern, proactively addressed side effects rather than prescribing recklessly, and showed due respect for the knowledge I contribute…after all, I qualify as my own expert witness! Meanwhile, I enjoyed a bout of medical room service where the farthest I strayed was a jaunt down the hallway to display my decidedly Dystonic swagger. If only I could coax this symphony of place and time out of follow-up therapy appointments. When health care gets things right, it’s really rather incredible how much “simpler” our lives could be.
A great big thank you to the Bachmann-Strauss Dystonia Center of Excellence at Beth Israel, putting a capital “P” in Patient-Centered Care and addressing our multi-disciplinary needs!
For more information on Dystonia and Parkinson’s Centers of Excellence, check out the following links:
Posted in Health
Tagged Chronic illness, Dystonia, Health, Medication, Movement disorder, Neurological disorder, Neurological examination, Parkinson, Parkinson's disease, Tardive Dyskinesia, Tremor
We’ve all read inspirational stories of triumph over physical or mental challenge…or met people who believe they were given their illness for some higher if unknown reason. While I undertake the utmost admiration for these points of view, I don’t find a grand design in my circumstance beyond writing this blog…and I wish I’d never encountered Dystonia in my bout of chance in our family’s genetic lottery, whether stronger for this experience or not. One of my greatest battles is the “Useless Why” that relentlessly besieges me.
Over a span of 40+ years living with Dystonia, I’ve frequently traveled to the Land of Why: Why me? Why Dystonia? Why the unnecessary obstacles? Of course, these are dead-end detours in pursuit of unanswerable questions, pointing me in the useless direction of life’s random unfairness. My daunting “whys” deliver a knock out left hook to productive focus as I grapple with comparisons serving no practical purpose.
I’m not alone in a wasteland that swallows more voraciously than quicksand. The “Useless Why” game is intrinsic to human nature. Our instincts compel us to seek explanations for senseless adversity or what we perceive as worldly injustice. Check in with your internal barometer – “Useless Why” plays out on many levels: Why is my hair insistently frizzy? Why can’t I find a more satisfying job? Why doesn’t my child behave? Why haven’t I met Mr. Right?
Amid my searing search for answers to life’s more perplexing questions, I’ve found the antidote for “Useless Why” resides in “Useful How” – the tactics we embrace to dig ourselves out of our holes and lead purposeful lives. So make a plan of action and trash those Useless Whys!
Nothing like a massage to tense up those muscles!
Now, I’m not talking about a rough and tumble sports massage but one of those coveted Swedish gigs that cost upwards of $150 at a fancy spa…
During breakout sessions at a patient symposium, a massage therapist offered her services to our group, hoping to bestow a haven of relaxation. She was utterly baffled by the dearth of volunteers for a free massage until I explained how our muscles react to stimulation. After all, I port a history of educating massage therapists about the Mexican jumping beans in my legs at the touch of their fingertips.
Aaaah, we achieved clarity. Perhaps she could work on locations that relieve sinus congestion, avoiding contact with my upstarts. Didn’t do much for my aching muscles but I went home breathing easy!
Posted in Life
Tagged Chronic illness, Chronic pain, Dystonia, Health, Massage therapy, Movement disorder, Muscle, Muscle contraction, Neurological disorder, Relaxation, Spa, Swedish massage
Did I say that? Certainly not, Ms. Dystonia Muse is no Ebenezer Scrooge!
The Holiday Season is the perfect time to reflect on all the year has brought for which we can express gratitude. Yes, our health may pose a constant struggle but we must believe in those flip sides. The friends and family who make us smile and support us constitute treasures beyond compare. As for my New Year’s Resolution, I shall leave behind 2013 – the good, the bad and the ugly! – and take heart in 2014. New year, new opportunities, new hope.
I’ve shared so much of my life with Dystonia on this blog and so many have graced me by reading. I urge readers to give me the gift of your details – all health conditions welcome! Chronicles Of A Dystonia Muse embraces everyone who contends with medical issues or feelings of “difference.” I’m proud to showcase Dystonia BloggerMania on my sidebar – fellow troopers blogging their real life stories week in and week out…all set for a visit!
Wishing you peace, love and joy in 2014! May you experience the miracles residing within your heart and share them with the world.
Posted in Musings
Tagged Blogger, Christmas, Conditions and Diseases, Dystonia, Health, Holiday, Holiday Season, Movement disorder, Neurological disorder, New Year, New Year's resolution