ALS

Ohana Means Family- Who is Yours?

At this time of year, when I think about the upcoming anniversary of the day that Ben left this world, the notion of family comes strongly into focus and reminds me of how my definition of family has changed over the years. Although I love the film, Lilo and Stitch and its messages about family, love, acceptance and grief, I used to be troubled by its very famous quote, “Ohana means family. Family means nobody gets left behind-or forgotten.” Unfortunately, to a large degree, this has not been my experience and that makes me sad. For various reasons, and sometimes on the grounds of religion, there has been conflict in my family, and caregiving for my grandmother magnified our issues after my mom died. I learned the difficult lesson that, with rare exception, aside from my dad, I could not depend on the love of my family to provide the support that was needed. When I lost my dad, I lost the sense of family that I always thought of as my anchor. Family frequently let Ben down, too, and usually, it was not something that I could prevent, though I could support him through it. I was someone who always said that family was important- it was also what I was taught- but I didn’t feel the unbreakable bonds that I believed should exist. In addition to grief over the loss of my dad and Ben, I was grieving an overarching sense of family. As with all grief, I learned to co-exist with it despite reminders that still do make me feel sad and alone. However, reflection has lead to new perspective, and the Pollyanna in me has enabled me to expand my view of Ohana. (Click here for Pollyanna’s instructions on how to play The Glad Game.)

Ben and I were Ohana, with or without a marriage certificate. When Ben was diagnosed with ALS, we were not legally married but, of course, there was no question that I would be his caregiver. I had friends and relatives who told me to leave him because we were not married, which was absurd to me, because I loved him and Ohana means nobody gets left behind. His family members were certainly upset by his diagnosis, and there were many promises made of visiting and helping him. For the most part, those promises did not materialize into actual visits or even regular expressions of concern about how he was doing. He reached out to people and then they usually responded, with what became to him empty proclamations of love and caring, but they rarely took the initiative to reach out to him. It hurt him and frankly, angered and shocked me. Ben witnessed my devotion to my dad–he listened to our countless daily phone calls, watched me cook and shop for him, visit him on weekends, accompany him to his doctor visits, make follow-up calls to doctors and companies treating his cancer, just as I did for Ben. That was not happening for Ben with his family, with rare exception. There was, however, a lot of drama that was unnecessary, ridiculous, and selfish.

I am grateful that while Ben was in the hospital, one of his daughters frequently visited him. She was also with him at the end. She and I had a lot of time to talk in those weeks. We were close for a time, but that seems to have disintegrated, which is, for me, yet another disappointment in the experience of family and not really unexpected. I try to focus on the few nice surprises that occurred along the way, in the form of the few family members that expressed genuine caring and concern. We shared a love of Ben and respect for each other that continues today.

I found in caregiving that the people who are least involved have the most opinions and make the most judgments. I will admit that it was, at times, difficult to put aside the drama and just focus on Ben’s needs. Family came to the hospital and talked to him about his going home, getting his hopes up without asking any questions or having realistic information, but with plenty of judgment, especially of me. A friend of his visited and tried to dissuade him from separating from the vent on religious grounds after giving me a hard time about the issue. While visits can be a good time for a caregiver to take a break, I could not leave people alone with him because communication itself was challenging and discussions were often inappropriate and inaccurate. Mostly, they were not much of a comfort to him. This is not the way I want to define Ohana.

Just as I have found ways to reshape my life, I have also reshaped my perspective on family. As I have said before, I am eternally grateful for an incredible group of friends. Though they do have families of their own, these supportive and loving people embrace me and are my Ohana.

Summer is now become a time when I travel to visit some of my friends. I’m beginning to see it as the time I travel to see my family. A few weeks ago, I visited my friend Dorie, which came with wonderful revelations (click here for that post.) Last week, I visited my college friend Monica and her family in Chicago. She’s got two absolutely fabulous daughters, one of whom is my namesake! I love them all. We did fun things like go to a Cubs game (Cubs won!), visit a zoo and discuss the plans for our upcoming trip to Walt Disney World, which will be a tribute and celebration of Ben and my cat, Disney. For me, the best part of the visit was just sitting around on the sofa and talking or watching videos. It’s a beautiful thing to feel like I am part of the lives of these children and to feel like family, accepted, understood and even appreciated for all my quirkiness. I could continue to lament Ben’s and my lack of caring relatives, but I am no longer under that cloud of grief. Instead, I am so very proud and fortunate to be surrounded by people who have been more family than family.

Monica, my namesake, Abby and I getting splashed at the dolphin show at the Brookfield Zoo.

With Monica at Wrigley Field- Cubs win! August 2019

In caregiving, if the people whom you’ve defined as family are not supportive, of course it is hard not to dwell on it. As someone who is emotional, I won’t suggest that you ignore your feelings. So, what can you do? If you’re a primary caregiver, as long as you keep family informed, express needs and set boundaries for what and when you will dispense updates, you will have some level of control of, and grasp of, your caregiving responsibilities and scenario. Family members will have to live with their decisions and you will be able to plan accordingly. It doesn’t mean that you won’t be disappointed or saddened, but you will have a keener understanding of your circumstances and interpersonal relations. This is likely to allow you to detach a little bit as family interactions happen, or don’t, drawing attention to the positive aspects of visits (or not) on your caree.

For your own self-expression and reflection, things you might consider are: keeping a journal, seeing a therapist, venting to friends who are good listeners, attending a support group or, if it is difficult to arrange to leave home, there are online and phone support groups. But, please don’t lose focus on the important, loving and invaluable work that you are doing for your caree.  As I have sorted through the many memories surrounding Ben’s care, I have learned to let go of (or at least work hard to fight) anger and resentment, and I have begun to recall incidents more as a matter of fact and sequence than with emotional attachment to the people who let us down. I can look back and feel grateful that I was able to show Ben so much love, though I also wish with all my heart that we never had to go through the experience.

If you are a family member of a caree, please be honest with yourself about the relationship that you have had with this person and the caregiver. Be realistic about what you can and are willing to do. If you want to help, ask questions about how you can help and also before judging. Remember that this is not about anyone but the caree, and that the primary caregiver does have the greatest perspective, knowledge of and responsibility to the caree.

As you move through caregiving, grief, and life, it is so important to have a clear understanding of the people in your life who are reliable and truly devoted. This does not necessarily mean cutting people off from your life, but rather knowing who will be there to have your back. Lip service is irrelevant. Ben and I learned that we could not rely on his family. Fortunately, we did have friends who stepped in and helped without needing to be asked. I have indulged in and expanded my family of friends. Maybe they are not the traditional definition of family. Yet, they are. Like Stitch, I am grateful to have them in my life. Know who your Ohana really is because they will not leave you behind. That is truly something to celebrate.

Stitch gave Ben some extra love! July 2014

Halloween with my buddy in 2010. Ben could still take photos at this point, which makes this picture especially sentimental.

 

What Mary Poppins, Bert, Walt and Merlin Knew About Life’s Ups and Downs

Disney, Mary Poppins, Grief, ALS

“Mary Poppins”
Disney and Cameron Mackintosh Musical Based on the Film

This is a time of year that I simultaneously eagerly anticipate and dread, and I find that am more reflective about my past, my present and my future. As a teacher, who doesn’t love time off from work!? However, this is also the time of year filled with memories of time spent in the hospital with Ben as he succumbed to ALS. Mary Poppins and Bert said, “Open different doors.  You may find a you there that you never knew before. Anything can happen.”  I see that I am the ever-evolving product of all the good and bad experiences, and although it took me a few years to get to this point, I have been following their advice, opening new doors, doing new things, rediscovering myself and considering new paths.

Last weekend, I visited my good friend, Dorie, whom I have known since high school. We had lost touch for a while, but the magic of Facebook brought us back together. For the past few summers, I have gone to visit her upstate and she and her husband have come to NYC to visit me and enjoy some theater. Last weekend, we went to a place called Animal Adventure Park. I love animals, and here you can pet and feed most of them, which is great fun for me.

I have always loved animals. Ben became enamored with them after enough time with me. We shared a love of penguins, and he became very attached to my cat Tiffany (she was not so attached to him!) and to our cat, Disney. It was on a whim last summer that I followed a dream to visit the Georgia Aquarium and participate in special encounter programs with sea otters, penguins and dolphins. During those sessions, I realized how much I truly love being around animals and I feel a tremendous sense of fulfillment when I interact with them. I admit that it broke my heart that Ben could not be at the Aquarium and meet the penguins with me. Still, the animals were a huge source of comfort, joy and inspiration to me.

When I researched the Animal Adventure Park after Dorie mentioned it, I discovered that they have a sloth encounter, in which you learn about, feed and pet them. Sloths are among the animals I have been so eager to meet, and fortunately, Dorie and her husband were also enthusiastic about it. I then discovered that they have a river otter encounter. I am kind of obsessed with otters- river and sea otters. I could not resist the opportunity to shake paws with an otter and thankfully, Dorie was willing to accompany me!

The encounters did not disappoint! They were both wonderful. The animals each have their own personalities and preferences, which is fascinating and delightful. I was in heaven. I knew that Ben would have enjoyed it and I felt good about acknowledging him. This time, I didn’t feel angry or guilty about enjoying it without him, I was proud and happy to keep him with me in my heart and thoughts. I felt the closest to myself that I have felt in such a long time. I was with people I care about doing things that I absolutely love.

Afterwards, I posted photos on Facebook- after all, a large portion of my news feed is dedicated to otters and sloths, and now I’ve actually met them! Several friends commented that I looked so happy and that my smile was huge. I feel grateful to have friends who are always cheering me on and who want to see me thrive. I had to smile and laugh just seeing how positively gleeful I was. Looking at myself in those pictures, I saw that I have once again truly found my smile. I even fantasized about possibilities of working with animals in the future.

Walt Disney said, “We keep moving forward, opening new doors, and doing new things, because we’re curious and curiosity keeps leading us down new paths.” As usual, Walt was right. I am a shy person by nature, yet I am also friendly, reflective and interested in so many things. After I lost Ben, I had to reinvent and reshape a social life. Of course, as I have always said, I am so grateful to have incredible friends and to have friends that go back to my childhood. Still, I had to take a more active role in socializing. When Ben was ill, I got very used to doing things on my own. I am comfortable on my own, which is a good thing in many ways, though it can be lonely and isolating. I have opened doors and done things like taking the opportunity to reconnect with friends like Dorie. Next week, I will head to Chicago to see my college friend Monica and her family, which has become a favorite annual tradition. Although I am a huge klutz and do not generally follow sports, I have become a devoted Cubs fan and love going with Monica to Wrigley Field- another new side of myself! I am also heading back to the Georgia Aquarium. It simply gives me so much joy to be with the animals in that absolutely spectacular place. This time, in addition to the sea otters, I will meet sea lions and even get into the water with beluga whales! Donning a wet suit is something I wouldn’t have imagined doing, but curiosity has taken me there! I have also opened new doors to build new friendships. It hasn’t been easy, but I have indeed met many lovely people and learned new things about myself in the process.

In Disney’s The Sword in the Stone, Merlin explains to young Arthur that, For every to, there is a fro. For every stop there is a go, and that’s what makes the world go round. In life, there are ups and downs. In grief, there has been progress but there have also been setbacks. I have discovered that I am a person who wants and needs to open doors, but I have to do it in my own time. I feel like I have established a more consistent balance of keeping Ben in my heart while delving back into my life. I still do things that I know he would like in order to experience them through his eyes, and for him, but I also allow myself to venture forth on my own terms, being less of an observer and more of an active participant in my life. I know there will be tos and fros and stops and gos, and I am getting better at letting myself feel them all without getting angry at myself or judging myself harshly. I would not have expected that summer would be a time that I would find my smile, but I do believe in pixie dust, so maybe it’s Disney magic that’s clearing my path.

It was a dream come true to hold a little otter’s paw!

 

I found my smile!

 

 

Yesterday- Memories, Grief, And Looking Towards Tomorrow

On Friday, I saw the film Yesterday. It’s not a Disney film, but I see those, too! It’s a fun film about a glitch in time (the one everyone worried about, which never occurred, at the stroke of the year 2000) in which all memory disappeared of the existence of The Beatles. It’s hard to imagine. I saw the film largely because of Ben’s love of The Beatles. As I frequently do, I wanted to see it through his eyes. When I attend Disney films, I often sharply feel Ben’s absence, and sometimes I do feel his presence, but this time I wanted to be his eyes, enjoying it as he would. It had emotional moments for me, and, even without the obvious title, made me think about “yesterday,” and the concept of time as I’ve journeyed through caregiving, watching Ben battle ALS, coping with the depths of grief and the adjustment to co-existing with it.

If I travel back enough yesterdays, I remember that the first song I ever danced to with Ben was The Beatles’ Twist and Shout. We met at work and at a gala, before we were actually dating, when that song came on, he grabbed my hand and took me to the dance floor. I learned how much of a fan he was of The Beatles and developed more of an appreciation of them. Now, I listen to the albums more often and with more love. During the yesterdays of Ben’s ALS struggle, when we were fortunate to travel to Walt Disney World several times, at Epcot’s England pavilion, I loved watching Ben watch and play the air guitar along with the live bands as they performed music of The Beatles. During the yesterdays of Ben’s time in the hospital, and even on his very last day on this earth, musicians visited him to play Disney music and some of Ben’s favorite Beatles songs, including his favorite, In My Life. On his first day in the hospice unit, Ben had a visit from one of the very kind residents who treated him early on in the hospital, before his tracheostomy and feeding tube. They spoke for quite a while about music and which was their favorite Beatles album. It wasn’t easy for Ben to communicate, but the resident did a great job reading Ben’s lips and I was there to help translate. This resident did not have to visit, but he was a lovely, compassionate soul, and he had to deal with one of Ben’s crises on his very first day as a resident. I know that he will be a wonderful, caring doctor. A lot of yesterdays. A lot of memories. A lot of sadness. But, a lot of love and even laughter in the darker times.

Walt Disney World, 2011.
Ben’ in one of his many Beatles tshirts.

The lyrics of Yesterday start with

Yesterday
All my troubles seemed so far away
Now it looks as though they’re here to stay
Oh, I believe in yesterday

In the film Yesterday, some of the past is erased. It’s a flawed plot, but it did make me think. Imagine if The Beatles had not become The Beatles. Imagine if John Lennon had not been shot. And, more to the point, imagine if Ben had never been diagnosed with ALS. Imagine if there was no ALS? How would life play out? Thoughts like that do at times drift through my mind. It happens often when I see elderly couples walking hand-in-hand, because Ben used to always comment that we would be a couple like that.

2010- Shortly after Ben’s ALS diagnosis and still standing, albeit unsteadily. In his favorite Beatles shirt at a fair with my Pets en Voyage products.

The concept of time is fuzzy when I think back to my days taking care of my dad and Ben. I measure time by significant events in the progressions of their disease and then “firsts” without them and, of course, milestone dates like birthdays and anniversaries. February is a month I dread because it was my dad’s birthday, Ben’s birthday, the month when my dad died and, most recently, the month that my cat Disney died. Summer is the marker of when I lost Ben. The start of each school year reminds me of the insanity I felt when I returned to school a couple of weeks after Ben died, feeling the drastic change of not having the same caregiving responsibilities, which only magnified the feelings of loss and the accompanying grief. They say time heals all wounds. When it comes to grief, I think time helps you adjust to and learn to coexist with the grief. Sometimes my experiences feel like yesterday, sometimes they feel like further in the past.

Indeed, before Ben’s diagnosis, it’s not that life was perfect- it never is- for one thing- my dad had cancer, but an ALS diagnosis sent us into a tailspin. There was always the wish of going back to yesterday.

The narrator says this in reference to Cinderella’s grief over the loss of her mother.
Cinderella © Disney 2015

The narrator (Fairy Godmother) of Disney’s 2015, live action Cinderella said, “Time passed, and pain turned to memory.” This is one of the Disney film quotes that always gives me pause. I can look back at my yesterdays and say that after nearly four years, I still feel the pain of losing Ben. Pain has not turned to memory, but I can view that pain as part of sixteen years of so many memories with him, only the last six of which involve his life with ALS and mine as his caregiver. There has been a gradual shift from continuing to live within the pain of suffering and loss, to embracing the wide range of memories, and the feelings they bring, but also defining and diving into my new “present.” Pain, sadness, joy, anger- a bevy of feelings and emotions related to my yesterdays- are all part of cherished memories and I see that they continue to shape me and lead me towards a bright tomorrow. I even made sure that I visited Abbey Road when I returned to London in 2016- it was a way to honor Ben, have him present with me, and see London, one of my very favorite places but one I never saw with Ben, through his eyes. Yes, I wish I could erase ALS, but this was our unique story. It did not have a Disney happy ending, but it did have love and even some pixie dust. I will carry in my heart all of those yesterdays as I face today and tomorrow.

Feeling like a Beatle, as Ben would have wanted to do.

On July 4- Thoughts of Independence, ALS and Aging

Today, here in America, we celebrate Independence Day. In our challenging political climate, I cannot help but reflect on how our independence seems so fragile. I think about my dad on holidays such as these, and how he, the proud Marine, lamented that less and less families displayed a flag. As much as I miss him, I am relieved that he is not living through these times because I firmly believe that it would make him physically ill. He would be worried about my future, but at least now he is watching over me.

I also can’t help but think of independence as it relates to ALS and to aging.

My dad was used to being the tough guy- after all, he was a Marine. As he got older, it was hard for him not to be able to manage the tasks that required physical strength. It was a hard thing to admit that aging has taken some of his independence. Even things that he could do independently, he wanted me to take care of. He wanted his independence but he wanted to depend on me. He wanted to know that I was there for him. I navigated his pride as I, the consummate klutz, and a pretty weak one at that- lifted and schlepped for him. He worried about my back but he did not want to have groceries delivered. I shopped in the city, cooked for him and brought everything to him by train. I know that he was comforted in the knowledge that I was going to take care of him. He was coping with fear of being alone, fear of his cancer progressing, fear of dying, and even fear of leaving me. Whatever it was, my dad had cancer, he was more than eighty years old, and I loved him. I was his caregiver and I was his daughter. Actually, anyone I met during his doctor appointments or visits to the neighborhood told me that I was his life. I knew that and he wanted me to know that.

Daddy loved to visit the Cradle of Aviation museum and relive his USMC days.

Ben dealt with a loss of independence as ALS stripped more and more of his abilities. ALS, or amyotrophic lateral sclerosis, is a progressive neurodegenerative disease that ultimately results in the loss of voluntary muscle action. Patients are affected differently in terms of progression, but people may lose the ability to speak, eat, move and breathe in any order of events. Ben’s initial symptoms were weakness in his legs and lack of balance. Next, he struggled with the use of his arms and hands, then his ability to chew and swallow. His speech was impaired though he did not lose it until he had a tracheostomy, and he got a feeding tube at the same time.

Imagine the loss of all of those abilities that we take for granted. People with ALS cannot independently take care of daily life activities. That is a physical and emotional struggle. I was always struck by Ben’s sense of humor and determination to devise strategies for managing on his own. He was quick to purchase things like adaptive zipper pulls and computer accessories that allowed him to function at least somewhat independently. He loved his scooter and electric wheelchair because they gave him the freedom to get around and be outside. As he lost dexterity in his hands, it became more difficult for him to steer, but he could be out and about.  He tried hard to avoid, for as long as possible, his loss of independence.

As Ben’s caregiver, as he became increasingly dependent on me, I, too, lost independence. This was an emotional battle for both of us. Even within couples and families, each person maintains a certain level of independence. Ben and I lost that independence, albeit in different ways. I could no longer take time for myself. And, I witnessed Ben’s struggle and was consumed with trying to accommodate his efforts to maintain some level of independence. Ben and I were dependent on each other in this world in which our relationship was shifting beyond our control and we desperately wanted to maintain some semblance of who we were at our core, before ALS. After I lost Ben, I was frequently told that it was good that I could now reclaim my freedom. Only now, nearly four years later, am I becoming more comfortable with my independence. Still, I blog and maintain my deep connection to people who are experiencing ALS, as patients or caregivers. My experience left me with some battle scars, but it also left me with a tremendous appreciation of and perspective on independence.

Walt Disney, Walt Disney World

Walt Disney said that “Mickey Mouse is, to me, a symbol of independence.” This was said in the context of the success that it brought him and his company, and the freedom to pursue his dreams. “Independence” is vital to our existence in many literal and figurative ways. On Independence Day, we honor this country and its founding principles. Let’s be grateful for independence. Let’s fight to preserve those values that are currently under attack and being chipped away and could potentially impact on the medical care and research that strives to help make ALS more manageable and, ultimately, to eradicate this cruel disease. In my practical way, I contribute, through donations, volunteering and the raising of awareness about ALS. In my Disney way, I continue to wish for and dream about a cure for ALS and all other diseases.

Happy and Hopeful Independence Day.

Disney Pixar “Up” Helps When Grief Has Me Down

Up Copyright © Walt Disney Pictures, Pixar Animation Studios 2009

Today was the last day of school. I eagerly anticipate this day throughout the entire school year. Today, however, I felt terribly sad and lonely. This is the fourth summer that I have approached since Ben died. I guess that I may never enter summer without remembering that summers were difficult for me when my dad and Ben were ill because I juggled caring for both of them. Just as I didn’t get excited about weekends, summer didn’t really represent any kind of freedom or fun, other than being away from the school building. Ben died in August 2015, having spent the summer in the hospital.  I still feel twinges of guilt and sadness that I was so angry that, without talking to me first, Ben made the decision to let go his home health aide because he said that I could do everything since I wasn’t teaching. It ended up being  only a week before he ended up in respiratory crisis and in the hospital. I don’t like remembering the anger and resentment, though it was an honest part of our experience with ALS. I also remember the days and nights spent at his side in the hospital, when there were terrifying, devastating, frustrating and also many loving moments.

I relate so much to this scene from Up. I like to reminisce about my time with Ben. But, there are times like today, when I want to share the celebration of the end of a school year with him. Like Ellie’s, Ben’s chair is empty. He’s not at home. I’ve gotten better at planning my own adventures, but on days like this I am too keenly aware of being alone.

Every summer has come with melancholy and anxiety, and a regression in grief, but this seems to be the first time I have had a very tearful last day of school. I don’t really know why. I guess I will always be thrown by the unexpected tears and clinging sadness and loneliness. I don’t fight the feelings. I acknowledge them and let myself have the moments. I know that the profound loneliness and loss that I am feeling will fade and I will get back up to speed. I’ll use this time to spiritually commune with Ben, try to work through that difficult summer, and try to balance his  absence and presence. Maybe part of my sadness is the change of routine. With school, Ben was part of my structure- I listened to my “Ben playlist” on the way to school every day. I have not firmly organized my next few days. That was probably a mistake. Without structure, I might be able to distract myself, but I might flounder. I’ll have to see how it goes. I’ll try to remind myself that I am going to have new adventures this summer and he will still be with me, just in a different way. That will never be enough, but it is a lot.

Ben and I at Walt Disney World, July 2014. A good summer memory.