9.12.2007
sweet setup
Sharon is the nurse practitioner in Geisinger's neurology dept who specializes in MS. she's been the crusader for offering Tysabri at the clinic, and truly passionate about helping her patients. we walked into bad news, which is never a good start to a long day. i was not going to be able to receive Aloxi, an anti-nausea medication that lasts an entire week. since its re-release, there isn't a lot of data on Tysabri's side effects, and i have found that even doctors and nurses that are trained to disperse the drug are not educated on this aspect of the medication. (there seems to be a "wait and see" approach.) i get many of the minor side effects- itching, fatigue, joint pain- but the worst is the violent cramping and persistent nausea. after the first infusions in march and april, i demanded an anti nausea medication. i didn't care that "most people don't suffer from nausea." i was, and dammit they were going to help me get through it! hence my relationship with Aloxi, which has proven a life saver.
i still have my private insurance through Arnold- BCBS of Massachusetts- but it is cobra based, so we're handing over $550/month just to keep the benefit. (medicare won't pay for Tysabri, but don't get me started on that.) BCBS refused to pre-authorize the drug. they said i had to have cancer to fund the prescription (Aloxi is used primarily for chemo patients.) this was at 3:30 last friday (yeah, good luck getting in touch with anyone after noon on Friday, no matter where you work!) so on monday, surprisingly, medicare said they would pay for the drug, BUT here's the catch. Geisinger (the hospital) requires you to sign a waiver saying that you will pay for the drug out of pocket if the insurance doesn't go through. guess how much this out of pocket drug costs? $1750. um, no way in hell was i signing that slip of paper. luckily, i have Zofran tablets that i use for the persistent nausea my GI problems cause, so i was able to pre-medicate with that. (while it has taken the edge off, i am still suffering from painful cramping and persistent nausea that has left me curled up in bed with a pillow padded against my poor stomach.)
even with the news about Aloxi, i had managed to hold myself together emotionally. that flew out the window when sharon asked "so how have you been feeling lately?"- i promptly burst into tears. the past week had been difficult, both emotionally and physically. it is typical for my body to start falling apart as the next infusion approaches. all of my symptoms decide to come out and play, wreaking havoc on my daily lifestyle. but this time things were different. i have had some new symptoms, plus a resurgence of some i haven't had in over a year- intense, daily migraines. when i raise my arms, they go numb. i'm constantly dizzy, and peeing just as frequently. in addition to the MS symptoms, my GI problems are persisting, if not worsening, and i'm being ping ponged from my internist to neurologist to gastroenterologist and back again.
we talked at length about the situation, and her suspicion is that a new lesion could be forming in my neck, and that i'm most likely in the beginning of a flare. when she said this, i was oddly calm. when it comes to my body, i'm pretty intuitive- i think we all are. and it felt good to fess up to what was going on physically- i had been bottling it in, nervous and wary of what this could mean, what would happen to me. Sharon said "you know, Tysabri isn't for everyone." and she's right. i had looked at Tysabri as this golden drug, this miracle cure. and there are other options. even with all this drama, there was some good news at the pre infusion appt- to quote Sharon, my brain MRI looks "beautiful." no decrease in lesions, but no increase either. (unfortunately, the lesions alone don't provide an accurate picture of a person's severity of MS, it's just one of the diagnostic tests.)
after our lengthy meeting, she loaded me up with paperwork and sent me off to Knapper Clinic, on the other side of the medical campus. she advised us to be patient, and warned us that things may not go too smoothly when we first arrive. let me tell you- that place is quite the operation! not only did things go smooth as silk, but i almost forgot i had a needle sticking out of my arm and a machine beeping my blood pressure and pulse every 30 minutes. beep. beep. beep. (god i wanted to throw that machine out the window.) the nurses were super sweet, and they hooked me up with a corner room with a view. (i guess i'll settle for a hospital partition since the corner office isn't in the cards anymore!)
here's the best part- the chairs had a massage button option, AND various levels of heating. all at the click of a button! my mom got the guided tour (i was too wiped out, i basically passed out in the chair once we got settled) and came back with snacks. there were sandwiches, chips, drinks, hot chocolate, coffee- anything you can think of. oh- and your own personal TV (with headphones) that extends out from a huge arm attached to the wall, wireless internet, and even portable DVD players you can check out. out of nowhere came a nurse with a digital camera (damn those paparazzi- they never leave me alone!)- they wanted my picture so that they can learn who i am, and identify me in the future. i was so impressed!
so now i'm back at the ranch, where poor mom has 2 patients to deal with. dad had surgery last week to take care of the prostate cancer- he came home from Fox Chase Cancer Center in Philly on saturday evening. his recovery continues, but he's not very comfortable and is having some unpleasant side effects from the operation. i'm acting as a drug consultant and medical specialist, much to his appreciation ;) thank you to everyone who was praying for him (and us), and who have requested an update on the situation. we'll find out officially on tuesday if the docs got all the cancer, but the prognosis is positive.
8.30.2007
test tubing
tomorrow it's yet another trip to Geisinger Medical Center at 7:15am for my 6 month MRI tests. the actual test doesn't begin until 8:30, but they require me to check in at 8:00- not sure what we will do for the extra 30 minutes.... freshly flipped omelets in the waiting room? doubtful. a quick game of Simon Says with the lab technicians? um, no. watch the Today show and drink steaming cups of hot cocoa? definitely not. reviewing the same insurance information they reviewed last time? totally.
the MRI (magnetic resonance imaging) is an extremely important testing device in the world of MS. i just tried to count how many i've had in the past few years.... at least 17, but i lost count after that. MRIs are used in both the brain and spine, showing areas of demyelination (big white blobs on the x-rays- these are bad). by inserting a contrast into the patient's IV, the MRI can then show if any of those plaques are active (if the plaques "glow" this indicates active and usually a flare, which is also bad.) it's already obvious why this test is unique to tracking this disease- it can show both existing and acute plaques. most people with MS will have dr. ordered MRIs at least every year, if their disease is manageable and/or in remission. but if you have a more active form of MS, or have a treatment that requires frequent MRIs, or have a relapse, you will have more than 2 or 4 each year.
so tomorrow will be somewhat of a big day for me. yes, it is one day before my birthday, but i meant something even bigger (you didn't know there was something bigger than my birthday, did you? good answer.) the MRIs i have done tomorrow will be the first since i began the Tysabri medication. i did some quick search on the 'net to refresh myself with the results from the Tysabri trials. they are below:
"...an 83% reduction in the development of new or newly enlarging MRI-detected brain lesions. Tysabri also reduced the mean number of enhancing (active) MRI lesions by 92% after the first and second year."
obviously i'm not into a second or even first year, but the stats seem wildly successful. i always feel a bit nervous when i am put up against such proven success possibilities. what if i'm not? what if i'm the one patient who Tysabri doesn't help? what if i ruin others' chances to get Tysabri @ Geisinger? all b/c i didn't improve? but, it's normal to have those feelings, right? i want more than anything to be a success case for them, because that means they will allow more people to benefit from the medication, and that would be the biggest success of all.
so. i will go strap myself into that elongated tube and shut my eyes super tight for 2 hours. and i will keep everyone posted, although we won't have the results until early next week, esp with the Labor Day holiday. too bad they don't allow iPods in there- i could be brushing up on my French skills. so far, all i have mastered is "we are not Canadians."
8.24.2007
so ya wanna be a human guinea pig?
alrightyyyy folks, step right up to the newest attraction at the Geisinger Medical Center in Central PA. that's right it's the kind of creature you have never seen before, a breakthrough for science and mankind alike. never before this moment has one been observed from within their natural habitat. that's right folks we have it right here, right now. all for the price of.....
possibly contracting progressive multifocal leukoencephalopathy (PML) through a compromised immune system, an opportunistic viral infection of the brain that usually leads to death or severe disability.
yes, you guessed it- i'm talking about the "T" word. the same word that usually sends medical professionals, ms patients, and health insurance representatives scurrying for cover, shielding their eyes with the new york times and turning their iPod headphones up to MAXIMUM. well, i have some great news for everyone- i have been on Tysabri for 6 months and have not died. does anyone have a bullhorn? I'd like to borrow it for a bit while I scale the tower of one liberty place in philly, and exclaim "I, MEG MORGENSEN, HAVE NOT DIED FROM RECEIVING THIS TREATMENT."
don't get me wrong, i completely understand that doctors, hospitals, pharmaceutical giants and health insurance companies have to be extremely careful about these things. after all, they are usually the first to be blamed when a medication goes from bad to worse. so don't worry, i'm not on a soapbox today against the medical society. but i do feel strongly that if you are not being helped by your current treatment, you have the right to fight for one that works better. it is your disease, your body, and your informed decision.
when i first began tysabri, i was at the end of my time in washington, dc, where cutting edge healthcare is the norm. with such facilities as NIH, Georgetown University Hospital, George Washington Hospital, and Washington Hospital Center a mere cab ride away, i had many options on where to receive treatment. unfortunately, that wasn't the case when i moved to Central PA. for the past 4 months, we have been driving to harrisburg for the infusion treatments, an hour and a half commute each way. for me, travel is similar to stuffing your body in a barrel and rolling off one of the niagara falls. extreme comparison, but you get the picture.
although there is a top national hospital, Geisinger Medical Center, with an internal ms clinic, located in nearby danville, there has been a turf war over use of the infusion center. in addition, there is an overall uneasiness in regards to offering the controversial medication. for months, the hospital seemed to be siding with the oncology department, who has control over the infusion center. that mere fact that a debate had ensued over whose healthcare matters more- ms patients or cancer patients- is not only absurd, but seems to go against the ethical practice of medicine itself!
through a long laundry list of credits, the infusion center grudgingly agreed to do a trial phase of providing tysabri. depending on the success and ease of the first patient, they would expand the program to one patient at a time. and YOU are lucky enough to be looking at (ok, reading from) the ms clinic's official tysabri guinea pig. mom & i spent the majority of the afternoon with the nurse practitioner, sharon, and my new MS specialist, dr. carl. (i cannot pronounce his last name due to my lovely ms induced speech slurring, so i asked if i could be a bit informal- he gave his permission!)
besides the pre-tysabri clinical exam (including my favorites- the safety pin and finger to nose exercises!), scheduling upcoming MRIs, visiting the local vampire club (aka getting blood work), and reviewing medication lists, we had to have the "frank PML discussion". this is where i have to look each person in the eyes (the NP, the doc, my mom) and state that i understand there is a chance i could contract PML, and that i am aware that PML is fatal and incurable.
and to be honest, it's easy to get the "it can't happen to me" false sense of security since i have already been on the medication. except the usual nausea, headache, vertigo and minor allergic reactions that are short lived after the first day, there have not been any adverse reactions. but when you have to be completely serious, and say out loud that there is a chance you could, well... die. then it becomes real.
however, i still feel the same way i felt in february when we began this journey. i want to have a life worth living, and until the scientists and researchers cure my disease, this is the only chance i have. and i'm going to take it, risks and all.
8.23.2007
MAJOR ANNOUNCEMENT: Meg Conquers All

8.16.2007
Meg's Summer Guestbook Expands!
i have to give her kudos for expertly managing one of the worst weeks i've had in 2007- and wanting to come back! she survived a visit to the ER, multiple trips to the doctor, just as many phone calls to the nurses, daily treks to CVS, my hysterics (let alone what mom was going through), dad being on drugs (he had his wisdom teeth out), and nothing touristy or cultural whatsoever. (although i'm sure she saw an amish buggy or two at some point!) at the end of her trip, dad arranged an evening road trip to state college, where they discovered photos of my grandfather and his '38/'39 baseball team on the wall in one of the gymnasiums on campus!
okay, on to the wedding activities. we had lunch with the bride on friday afternoon, kim & i set off to the rehearsal at the chapel of the cross friday evening, we hooked up with the rest of the bridal party for the rehearsal dinner at the weathervane, i had my makeup done with sandy & patty early saturday morning, the ceremony was at 10:30, and the reception immediately followed at the carolina inn's main ballroom. (i did have to sneak in a nap after cake but before dancing!) before heading out of town on sunday morning, the kendalls (ralph & carol from high point, ben & leanna from chapel hill) and patina joined us for breakfast in the carolina crossroads. oh- random inclusion!
8.12.07 (evening) lindsay casteel, mclean, virginia
an emma woodhouse moment
here's the thing. as much as i don't want to face it, and upcoming birthday avoidance aside, i'm 98.66666% sure that I have become a grown-up. this most likely occurred when i was in one of the stages of denial, but regardless of that fact, i should be thinking more maturely, right? i should be living my days in line with the number one priority in my life- taking care of my health. it should go without saying that i should be disciplined, that my thoughts should focus around increasing my strength, conserving my energy, performing the MS yoga routines, being vigilant about taking my medications, yada yada yada.
but i have to confess something. my thoughts ... don't always focus on the responsible things i just mentioned. i mean, come on. they're hideously boring! would you be thrilled with such an agenda??? if i were to be perfectly candid with you, i'd say that some of my thoughts are incredibly materialistic and completely irrational. example? easy. my brother went out in the sweltering heat for a 45 minute run this morning, and i turned an unattractive shade of GREEN with envy. um, i HATE running. and i think sweating is abhorrent. but i'd like to have the OPTION of running. want to know something else? i really miss drinking wine, especially that delicious bubbly vinho verde we used to buy @ trader joe's for $3.99. how pathetic is that? i'm in the midst of a health CRISIS and i want to be guzzling booze and running a marathon.
while we're at it- how i miss shopping! put me in a target, macy's, the limited, banana republic, ann taylor loft, dsw, anthropologie- even those chaotic racks at forever21- and i'd be content for days. (especially when i'm with kate b/c she always insist we stop at auntie ann's for soft pretzels.) i miss the panicky thrill of checking my online account obsessively to make sure nothing is overdrawn before that piddly paycheck is deposited at 12:01am on the 2nd friday of every month. i miss those carb-a-licious bagel sandwiches at that place in clarendon, starbuck's chai skim lattes, chipotle burritos, bloomin' onions... ok, clearly i'm on a roll. i'll allow one more. i miss getting dressed up with the girls on a saturday night and ending up in a seedy beer bar dancing our asses off to a cheesy cover band. (ohhhhh, wait! i can't forget those super greasy slices of pizza at 2am in adams morgan.)
but now that i've put pen to paper (or finger to keypad) on my inner-most materialistic secrets, i guess i should try to put it all back in perspective. i've been trying to remake myself in my own image, and it's being proven that it was the wrong approach. i can't go running. 1/2 a cup of white wine makes me vomit. i am physically unable to walk around a shopping mall (and refuse to be carted around in a wheelchair at the age of 26, almost 27, by an unlucky pal who was guilted into it.) i the online account overdraw excitement is null and void bc i don't even have a paycheck. and to top it all off, i don't eat gluten so all of those deliciously greasy items i mentioned are banned.
ok, brain says, we'll find other things you can do instead! how the hell do i do that? it took me over 20 years to figure out who i was and how my "normal" fit into the lives of my work, my friends, my family. no one told me i'd have to start over. so today, i have no answers. all i know is that i solve these problems much better when i have a glass of red and a late night gab session with my neighbor candy. oh yeah, i don't live there anymore.
7.06.2007
people you meet
the same can be said for my ms world of influence-but it's multi-faceted and slightly more personal. i don't attend ms support groups. i hate the ever present question regarding my cane or my gait. i resist speaking to others afflicted with ms. i hate the "my cousin has MS and she's doing great" conversation starter. i look away when i see someone in a wheelchair or walking with a cane. to be totally honest, i can't articulate exactly why i behave in this manner, but i do know that it is an odd combination of fear and embarrassment. but, as we all know, life has twists and turns that puts you smack dab in the middle of situations you would normally go screaming from. (and there is a reason for it, at least 99.4295837% of the time.)
Robert Michael's jersey; Team Anglo-American post-ride
stacie & meg, 7.07
the second when was only a few months ago, when mom began attending the local ms support group at the local hospital. a woman she met there told her about another attendee, jane, who was going through an extremely similar situation. her daughter, the who, is stacie. she lives in boston, and Jane had taken many trips there helping out due to her daughter's limitations. mom reached out to jane, and they met one afternoon. i of course shouted to mom as she left "don't think i'm going to be friends with this woman just b/c you're talking to her mom!" turns out, one of our many similarities was that neither of us wanted to talk to each other in the first place! stacie had a nasty flare that left her vision extremely distorted, her walking is impaired like mine, and she struggled with major denial issues at onset. (sound familiar?) she likewise didn't attend any ms support groups and didn't like talking about her disease with others, especially others that have MS.
but we both changed our mind about that- and around the same time, too. her mother gave me her myspace information, and i spent a solid week clicking on her page a couple times a day, scoping out the situation. after hemming and hawing about what to say or when and how to say it, i finally sent her an email. the result has been a friendship that has been an outlet, a resource, a strength, a role model and above all, a commonality that i desperately needed. her favorite quote to me is "if don't use it, you lose it." and she truly does embrace that philosophy. she is using her love of fitness and certified knowledge in yoga & personal training to produce exercise videos for the disabled- the youthfully disabled at that. our people! ;)
Showing off some yoga moves...




