Monday, March 7, 2011

One Last Kick at the Can

Thank you for the wonderful outpouring of support after putting my last post out there! It wasn't an easy one to write, but now I'm certain that it was the right thing for me to do.


I've heard from a few readers that the process to leave a comment is a bit awkward, and for that reason I'm changing the parameters on my blog. I tightened up the security last year when I was getting lots of spam, but I'd like to try to make things easier for you if you feel so inclined to add your thoughts to the blog! The simplest way to leave a message to use "anonymous", or you can use your Google account if you wish.

We're waiting on the REALLY final decision from the insurance company. They themselves initiated an appeal on their decision last week and the final piece of information that they were seeking was sent to them late this afternoon. Keeping our fingers crossed for a positive reply tomorrow. We did go ahead and bite the bullet, purchasing a one week supply of Kineret today (I have two days left of my donated stock, and I didn't want to miss any doses with a special event happening later this week!)

We've noticed a correlation between my diet and my "bad days", maybe it's just a coincidence but it would appear that perhaps I have a sensitivity to gluten. It seems that every Saturday night lately I've been awake all night with bad chest pains and trouble breathing - but I couldn't understand how the pericarditis could tell which day of the week it was!

For the last few months we've usually had company on Saturday night. Nothing fancy, usually just an extra setting at the table -but being one who loves to cook I can't help myself by trying to cook something a little different than the everyday fare. And lately I've been turning to some sort of pasta dish on these Saturday nights (something we don't normally eat, it's mostly salads, veggies and fish around here). And then hours later I'm in bad shape. I'm not lifting anything especially heavy, I'm not missing my naps, not doing much out of the ordinary for which I could otherwise blame the added discomfort.

It finally occurred to me that it might be gluten, after all I was supposed to be tested for celiac disease a few years ago and just put it on the back burner when I got my ECD diagnosis. So, I'm going gluten-free this week to see if it does indeed help. I had no idea that gluten was found in many foods beyond the pasta, bread and baked products you might think of first!

I have lots of cookbooks but none that feature gluten free recipes - so, if you happen to have someone with a gluten sensitivity in your family and have a favourite recipe, please do share! Oh, and one complication - no poultry or egg for me - yes, I'm allergic (anaphylactic shock for the poultry, I always have my Epi-Pen with me). Not much left for me to eat, eh?

Thursday, March 3, 2011

What Was I Afraid Of?

When I began writing this blog almost two years ago I'd decided to keep it anonymous. I feared that I would lose clients, that I'd be looked at differently if people knew that I was ill, and worst of all that I'd be pitied.

I feared that friends, colleagues from the past, acquaintances, neighbours would all give up on me and leave me to survive the rest of my illness alone.


Little did I anticipate how things would go.

Little did I realize that it would actually be clients who would be among my strongest supporters (there have been cards and email messages of support that have reduced me to a puddle of happy tears), that clients that I'd photographed would become close friends who over and over again ask if they can do anything to help. To tell me that they'd look forward to me getting back behind my camera to photograph their families (this belief in me getting better has helped more than they'll ever know).

I didn't know that friends (and even more so my husband's friends) would be in frequent contact to ask how they could help us out. That they would feel as helpless as we often do in our trek through our medical system.

That a neighbour would become the person that I felt I could be most honest with when it came to talking about how scary this all can be (a huge hug for you J., I don't know if you realize how much you mean to me).

That a dear friend of my husband (who has also become my dear friend) would offer to ride his bike across the province to raise funds for my drugs (L., you are too much and I can't thank you enough for your incredible offer!)

That a client, now friend would realize that I need some stress relief despite me insisting that I'm fine (truth be told, I'm not always upfront about how I'm really doing). We have a date when the weather improves to do some paintballing in her backyard - guess what three letters will be written across the target. Thank you S., can't wait to pummel the heck out of ECD!

That a dear friend who used to be our family doctor when we lived in the city would help me get through this with her loving and supportive words of advice to help my amazing daughter find some sense in all of this.

That an old friend whom I needed more than just about anyone else to stay in my life would continue to be there for me without question. Always without judgement (and the many miles between us have never mattered). And who will always be there for my daughter after I can't be anymore.

There are many of you who lift me up just by putting a "Like" on my recent Facebook posts to let me know that you're there for me.

It's been a polarizing experience. There are those dear friends who have rallied around, but there have also been those that I've not heard from in quite some time. I do understand. Really. This all sucks and I'm not very exciting to be around. I wish that I could go to dinner with the girls, meet up for coffee or have you over for dinner - but that isn't my reality anymore and those invitations have long since dwindled away. I've come to terms with it.

My status as an "ill person" is very likely to soon become public. This is a good thing, it looks promising that I'll have a chance to speak up on behalf of Canadians with rare illnesses and I'm proud of this opportunity.

So I make the leap to letting you know who is behind "Sessa". My name is Sandy. Sandy Trunzer. An ordinary 46 year old wife and mother with an extraordinary illness. The names of my husband and daughter remain private (they both have different last names than myself ), you know how much they mean to me and they deserve whatever privacy that they wish to maintain.

The photography business that I've mentioned numerous times in this blog is "The Intrepid Lens" - I'm proud of my work and if you'd like to check it out please visit my website at http://www.theintrepidlens.com.

This wasn't so painful after all.

And I'd also like to thank you for reading my blog. This blog gives me an outlet when I feel like talking, and I thank you for listening! (and for contributing with comments, I love getting them!)

With warm regards, and the knowledge that I have blessings in my life beyond what I ever thought possible,
Sandy

Tuesday, March 1, 2011

Moving Forward

What a whirlwind the last few days have been.

First of all, I must say what incredibly supportive friends we have. I put a request out on Facebook asking if anyone had contacts in the media to help spread the word about the issue of drug funding for rare diseases here in Ontario and didn't they just go all out! I don't want to jinx anything by being too specific just yet, but we're hopeful that we'll be able to share our story as part of the big picture of the challenges that patients with rare diseases face. Keeping our fingers crossed!

A bit of good news today at my oncology appointment. My leg tumour is the same size as it was this time last year. I'm not sure if we have ten months of prednisone to thank for that (for all the nasty side effects it had better have done something positive!). It's been over two years since I had a full body bone scan, I must admit even with today's good news I'm a little anxious about what that might show. It's unusual for an Erdheim Chester patient to have the bone involvement on only one side, it's most often mirrored on the other half of the body.

It's funny how things come around in life. When we first moved to Burlington almost six years ago I wanted to jump into being a part of my new community. A local clothing store was holding a fundraiser for the Juravinski Cancer Centre in Hamilton and asked if I'd be willing to donate a portrait package as one of the silent auction items. I happily did so, and through this donation met a wonderful family who subsequently referred me to several of their friends for portrait sessions. I count several of these families as good friends today (and they bring tears to my eyes when they tell me to hurry up and get well so that I can photograph them again!)

Today I was able to see the Juravinski Cancer Centre today for the first time as a patient (even though ECD is not classified as a cancer, an oncologist is often part of the patient's medical team). My oncologist had transferred from Mt. Sinai in Toronto, and I happily followed him to his new hospital. After all, he was the one who diagnosed ECD and for that we share special connection. His first ECD case, and I do hope his last.

And lastly, it would appear that our insurance company may have caught wind of our efforts to contact the media. I received a call yesterday asking for proof that the pharmaceutical company had indeed limited my trial to three months (I was able to get that document from my doctor in Toronto), and were willing to reconsider their decision. Hmmm, let's see what the next few days brings!

Saturday, February 26, 2011

Time to Bust Out

Yesterday was a tough day.

Our appeal to the insurance company went down in flames, refused once again. And our other option of applying to the Ontario Drug Assistance Plan really isn't an option since another ECD patient was recently refused coverage for Kineret, after an appeal as well.

We're hoping that the manufacturer of Kineret will help us out, but I'm not terribly optimistic since they made it very clear at the beginning of my three month trial that it wouldn't be extended.

I have just a few vials of Kineret left, and have started alternating my shots every other day in order to stretch it out. I wonder how soon after that last vial I'll be again hobbling around and in significant pain? The thought scares me silly. Although I still don't have a lot of energy, being able to sleep (mostly) pain free and being able to get up and down the stairs for the last couple of months has been a huge blessing. Just being able to go to another floor of our home has helped me to stay positive.

The sad thing is that if we (myself and the other Ontario ECD patients) had cancer or other prevalent serious illness this wouldn't be an issue. This denial of treatment is down to one thing and one thing only. There is no drug anywhere that lists on its label "for the treatment of Erdheim Chester Disease". A few words keep us from getting treatment coverage.

When I first started this blog almost two years ago I explained why I was using a pseudonym, being self-employed I didn't want to scare away clientele. The reality is that it looks far less likely that I'll ever get back to work and all I'm looking for now is a bit of mobility and pain relief for whatever time I have left.

So we launched one of our big guns yesterday. A letter was sent to a reporter of a major Toronto newspaper who had recently written a series of articles about a young patient refused access to an expensive drug that was provided to another patient elsewhere in Ontario at no charge. We're hoping that International Rare Disease Day falling on Monday will open the door to conversations about treatment coverage for rare illnesses. At the very least shame our insurance company and the government into helping us.

We're well aware that the prognosis for ECD is not good. Kineret and other drugs being prescribed around the world for ECD are not a cure. I'm just looking to spend the rest of my life in a bit more comfort rather than constantly be battling for the opportunity to get some relief.

Thursday, February 17, 2011

Let's Play the Good News/Bad News Game

The Good News:

Last week I went back on some heart meds that didn't work out well for me last year, but in combination with Kineret things are looking up! It's taken some experimenting with dosages and the time of day that I take this new drug but I've had two good days in a row. I even felt well enough today to drive for the first time in about a month. Just to the pharmacy (to pick up more drugs mind you) but it felt wonderful to get out of the house.

The Bad News:

On the way back from the pharmacy this morning I picked up the mail. I didn't expect to hear back from the insurance company so soon (the application for Kineret coverage only reached them Thursday evening) - but I could have waited a bit longer for this news. No, no and absolutely no. No coverage for ANYTHING that doesn't specifically state that it's for the treatment of Erdheim Chester Disease. No such thing. Not one drug in existence that states that it's for the treatment of ECD. For the icing on the cake, the letter was unsigned without a printed name of the bottom. An anonymous slap in the face.

So despite the fact that medical teams around the world are investing heavily in research to improve the quality of life, and hopefully the lifespan of ECD patients - their findings are dismissed by our insurance company. And our government also declines to help (a fellow ECD patient in Ontario already had to find this out the hard way, and I've been advised that it's not worth the effort to apply to the government after another patient has been refused coverage. Again because it's "off-label").

I have two and half weeks worth of Kineret left in my fridge. I try really hard not to dwell on this point, but the stats tell us that 60% of ECD patients die within 32 months of diagnosis. I'm at month 25. And I'm in the group (cardiac involvement) that usually lands in the 60%.

So I play that stupid mind game of "what would you do if you were told that you had six months to live?" Fight like hell with our insurance company and government for a drug that might improve those odds? Or save whatever energy I have to spend time with my family? There is no right answer to this one.

I'm not the only ECD patient (or person with a rare and serious illness) out there and many of us are dealing with this issue. Things have to change. Change so that we can stop wishing that we instead had a "common" serious illness for which drugs would be handed out without a blink of an eye because of what is printed on the drug label.

Tuesday, February 15, 2011

Where to Lay Blame

I feel as if I've been hit by a bus the last few weeks. What did I do to myself to set off this latest round? That shovelling from a few weeks back? One of my meds? Something I've been eating?

It's natural to search for a reason when things change. I have a difficult time admitting that it might simply be the natural progression of my illness; that I have to be more accepting of how I'm feeling and the limitations that my health places upon me.

Not quite ready to blame Kineret however. I'm nine weeks into this trial and it's still helping greatly with my mobility and to some degree with my bone pain. My heart on the other hand has been misbehaving. Badly.

It's been rounds of scans and other tests to see what might be going on besides the pericarditis. We're waiting for results of the latest CAT scans to see if my lungs and brain might have developed any problems. Nothing seems to be working right from the weird tremors that shake my hands, the numbness in my foot, and the continued breathing difficulties.

And I discovered yet one more medication that I'm allergic to - Pulmicort. I was put on this steroid inhaler to see if it would help with my breathing but all I got was a lovely rash from neck to knees for a few days.

It's hard not to feel beaten down and trodden upon by ECD when it's hard to do anything more than lay on the couch, occasionally getting up to do something useful around the house that doesn't require a lot of exertion. Every action is measured, is it worthy of how it's likely to make me feel afterwards?

Yes, I'm feeling sorry for myself right now. This just isn't me. It's me with ECD tugging at me every single moment until I want to kick it clear across Lake Ontario. If only I could muster enough energy to at least get it to the curb for a few days.

Thursday, February 3, 2011

Self Admissions

I detest admitting that I'm sick. But ECD has slapped me around a bit the last few weeks, and just maybe it's time to realize that I shouldn't push myself so hard. I think I've said this before but maybe it's high time I had a serious chat with myself. And actually followed through.

I'm eight weeks into my twelve week Kineret trial, and decided today that I definitely want to keep taking it beyond the trial period. Now comes the funding nightmare, but the upside is that the drug company is helping me this time. I suspect that their voice is much louder than mine!

Kineret has helped greatly with my mobility, and now with the bone pain (I've hardly had any the past week!) The cardiac issues are something else, but maybe Kineret needs more time. Or I need to stop pushing those boundaries so hard.

Although it felt great at the time, shovelling the snow a few weeks back seems to have set off weeks of misery. What the heck did I do to myself? I'd been doing so well in the first few weeks of Kineret, did I undo all that in just one hour?

I've made a promise to my family. No more lifting, no more "let me do it!", and most definitely no more shovelling. No more of anything that feels like it just might be more than I should be doing.

Give the inflammation in my heart a chance to settle down, to let Kineret do its thing. To hopefully breathe more normally again (talking on most days this past week sets off a round of coughing that leaves me gasping for air). Not to mention the tremors that have kicked in too. What an adventure one night last week trying to get food on my fork, and then fork to mouth. I came way too close to asking someone else at the table to feed me so I didn't leave the table hungry.

My doctor called this morning (on his day off no less) to let me know I'd be at the hospital longer than usual tomorrow. He didn't want to say just yet what tests were being lined up, but I'm ready to know more about the extent of the ECD in my body.

Not only ready, I need to know.