Saturday, April 29, 2017

Communicating

Communication is one of the most important things in life. How would we learn anything? No communication would mean no books, no computers, no phones, no hearing, no speaking, no writing letters. You've got it, it's a pretty simple concept to grasp, but it would not be a simple concept to live without.

Communication with FTD can be difficult.  Aphasia is a symptom of several types of FTD. Aphasia steals the ability to understand words, but usually still allows at least close to normal speech. Dysarthria is another language disorder that impairs or takes away the ability to speak properly. This can include anything from slurring to no verbalization at all. There are other forms of FTD whose primary symptoms are not speech related. However, all forms of FTD can lead to language and comprehension difficulties and make communication extremely difficult.

I do have some speech issues. I stutter quite a bit.  I often get stuck on the first syllable of what I am trying to say. If you are old enough to remember records, it is like when the needle would get stuck on the record. I realize it is happening, but have difficulty stopping. When I do stop, I can pause, change the first word and get the thought out. Irritating and puts people off, but not serious.

It seems that many, if not all, with FTD eventually lose abilities to communicate, even if their primary diagnosis was not that of Aphasia. This makes communication between one with FTD and their care partner difficult.

These speech issues are not the only barrier to communication. Some of us, myself includes, attempt to cover up the symptoms of the disease. I cannot speak for others here, but for myself, I think it is an intense desire to be viewed as normal as possible. Another issue, for me, is the inability to clearly explain what the disease does to me and the limitations that it puts on me.

I keep telling others, especially my husband, that I can no longer do the things I used to be able to do. I will try to explain that I can not do the household chores that I used to. It bothers me that my house is not as clean as I like and as I used to keep it. My husband, being a man, does not understand this. Yes, I know some men are just as serious about keeping things neat and clean, but not mine. The other problem with this is that he has no clue as to how much energy it actually takes to clean a house. Plus, this exhaustion, particularly the mental exhaustion is extremely difficult for me to explain.

Yesterday, I gave my bathroom a good cleaning and dry mopped the wooden floors in the hallway and a couple rooms. I was exhausted. The physical exhaustion is not the worst part. It is the mental exhaustion. Figuring out how to clean everything, even trying to remember what products to use and where they are located, is exhausting. I discovered I was out of the cleaning product I usually use to clean our bathrooms. It took me at least 20 minutes of staring at my cleaning supplies to decide what I could substitute. Mental exhaustion is even more debilitating that physical exhaustion, at least to me.

When it came to dinnertime, the last thing I wanted was to attempt to cook something. Instead of admitting that this little bit of cleaning wore me out and I didn't trust myself to cook and to make it edible, I simply said I didn't feel like cooking. I suggested several carry out options, but my husband balked at them. Being the stubborn cuss that I am, I said "Fine, I'll figure out something." I made Philly cheesesteak sandwiches, something I often make. Not too difficult and not too much mess, but certainly more than I wanted to deal with. I substituted flatbread for the rolls and it ended up tough. It was obvious that he was not thrilled with the meal. I have always taken much pride in my cooking talents. Cooking and baking were two of my favorite things pre-FTD.

His displeasure hurt angered me something fierce, but I kept it in. I even apologized for the fact that he did not seem to enjoy the meal. Great way to communicate, right? I let it stew inside me for hours. I could not sleep. I finally got up at 3:30 a.m. and wrote him a note explaining how it had made me feel.  If I had tried to explain this to him verbally, it would have been a disaster. When I am upset, I stutter even more. I would not have gotten my thoughts out properly. Yet it was important that I got them out. It was an opportunity to provide him an example of what I mean when I say that I just cannot do it all anymore.

My psychologist is always working with me to improve communication, but I keep falling back into my old habits of not communicating. This morning, when I walked into the kitchen for coffee, I was greeted with a huge apology. Later, I was cleaning the kitchen floor and when I was more than 3/4's done, he asked if he could help. Wait for it... I actually got the word "no" out, then stopped and said, "But if you would run the vacuum in the family room and the bedrooms, that would be awesome."  He did it, no grumbling and suggested that I ask him more often. It's a step in the right direction. I was so proud of myself for communicating my need and admitting I need help. I was very appreciative that he communicated his willingness to help. My instinct, though, is to wonder how long it will last. I am doubtful, but maybe it will, if I can learn to say what I need.

In the meantime, I am still looking to hire someone to clean my house. He has physical limitations as well and I think it would take a huge load off both of us.  Hopefully, I can communicate to him how important I think this option is and... I hope I can communicate with the cleaner what I need.

Saturday, April 22, 2017

Something To Look Forward To

I have mentioned the AFTD before, but just in case you missed it, it is the Association for Fronto Temporal Degeneration. I have also mentioned that their annual education conference is coming up. Right now, it is 12 days away. Okay, it is actually 13 days away. The difference is that the online support group for those of us with FTD happens the evening before and it's only 12 days till that.

The get together is just for those of us with FTD and the caregiver that has accompanied us. Someone asked me a couple days ago how can I enjoy something like that. After all, it is in a pub/restaurant, is most likely crowded and noisy with lots of commotion. Often, when faced with similar circumstances, I become extremely stressed and need to leave. Good question! The fact that it is one of the rare instances during the year that I consume alcohol, that definitely might explain part of it. I think the primary reason is that we, like everyone else, can be in an "up" state. This is probably excitement, adrenaline or whatever you want to call it. Think about it, when you are relaxed and having fun, isn't it easier to keep going?

The other day a few of us with FTD were video chatting and we all said pretty much the same thing. We go to conference and have a great time, make it through a couple very active days as well as the travel days. Then, we crash. I have the week after the conference blocked out for recovery time. Also, the AFTD provides us with a "Quiet Room" where we can go and recharge ourselves or calm ourselves as necessary. No activites, just quietness, in that room.  Just like in our everyday life, we do get sensory overload which triggers so many of the bad aspects of FTD such as agitation, cognitive decline, anger and the list continues on and on. By giving us a place where we can go off and be by ourselves, we can make it through the day. Since it is held in a hotel conference center, most of us can go back to our rooms for a bit if necessary as well. I know last year, my daughter and I took our lunches back to our room so I could decompress for an hour.

It is not just because we look forward to the conference so much, it is the joy we find in being surrounded by people with the same disease, the same symptoms and the same frustrations. We don't feel like we have to pretend, we can let out hair down and not worry about what the others are going to think about us because we all understand. If we are stumbling around after having an alcoholic drink, we don't have to worry about others thinking we are drunk, we know it is the FTD.  If we are speaking to someone and start stuttering or can't think of words, we know we won't be judged. We share information.  There are questions anywhere from symptoms to help with getting Social Security Disability approved.

This conference is also for professionals, in fact in the beginning years of this conference, those with FTD were not invited.  So, I'm sure you can understand that there is a lot of information presented on everything from the latest research to care decisions, ways to communicate and so much more. Those of us with FTD are also welcome to attend those sessions as well.

One of the sessions this year is a panel discussion with three pairs of someone with FTD along with their primary care partner. I am so honored that my daughter and I have been asked to be part of this panel. If you regularly read my blog, you know how important it is to me to share any and all information that I have in the hope that it just might help someone else. As I say repeatedly, I have experienced dementia from both sides... as a care partner and with FTD. I don't have any more information than the next person, but it does make it a bit easier for me to see the frustrations that both sides are experiencing. I know I will also learn from hearing the stories of the other pairs.

Throughout the conference day, there are break out sessions to provide everyone choices to sit in on the subjects that interest them most. There are also break out sessions for those of us with FTD to cover subjects that are more interesting to us. The nice part, for me, is that it is only us. You have to have FTD to  join in these sessions. Again, no threat of judgement.

I will admit, that despite all the information we will hear and share, the part of the conference I look most forward to is the camaraderie. I look forward to meeting, face to face, those I talk with online. I look forward to all the hugs, all the laughter and all the understanding that we share. This will be only the second conference I have attended. Others have attended many more than that, have more knowledge than I do and know more of the people. That does not matter though, we all are on common ground. It is the only place I have found where I feel totally comfortable to let my hair down and have a good time.

For instance, last year, at the reception following the conference, I spilled a full cup of coffee all over the buffet table. It happened because I was trying to fix my cup of coffee and hang on to my cane at the same time. I was mortified until I realized people were laughing with me and several told me about similar experiences. They didn't care one bit that I am so clumsy that I spill things, because they do too!

As I said, 12 days and counting!

Friday, April 14, 2017

It Doesn't Take Much to Become Too Much

I usually take time each day to visit the online support groups that are for both caregivers and those with FTD. There is one complaints and/or questions that are posted by caregivers way too often. This is the complaint that the loved one they are caring for "just wants to sleep all the time." That one, or "just wants to sit and do nothing" all the time. I cringe every time I read these types of questions. No matter how much I, and others with FTD, try, we cannot convince them that it is not that they "want" to sleep all the time or "want" to sit and do nothing. It is more like they "need" to sleep all the time and "cannot" be doing things. The loved one is not being lazy or uncooperative just to irritate the caregiver/s, I assure you.

I can really only speak for myself, though I see others with FTD saying the same thing. There are days that we cannot seem to get enough sleep, or that we have no motivation or energy to do anything. These things can be made worse by their surroundings or the previous day's activities or just about anything that requires brain power. That includes everything!

This past Sunday was a "down" day for me. I played on the computer, wrote a blog entry and just goofed off all day. The dinner I fixed was super easy. It was a good day to recharge myself. Unfortunately, every week, Monday always comes next. I really wish we could change it around once in a while. Monday is our grocery shopping day. We found out from the store manager that it is their slowest day, so that is when we shop. I make the grocery list on Sunday, just to soften the load on Monday.

This past Monday was no exception. I was already feeling stressed that morning, so I actually took a .5mg Ativan. Shopping actually did go a little bit better than usual, so when we got home and got everything put away, my husband and were still speaking to each other and I hadn't locked myself away in my quiet room. So, he suggested we make a run to Sam's Club. We only needed six things so it shouldn't be too bad. Wishful thinking!

It was a fairly quick trip through the store. The downfalls were the noises of the forklifts running and beeping, people diving in front of me with their carts, just too many stimuli. Plus, who told them it was okay to move things around to different locations? Sure wasn't me, I don't do change! But we survived and made it home just fine.

The problem was that I was totally exhausted, both physically and emotionally. My brain had to work itself much too hard by the end of that second shopping trip. The next day, Tuesday was spent trying to figure out where my husband had lost his ring of store discount cards. I don't know if this exists everywhere, but here in PA, every store has a discount program for you to join and you need to have a card or key tag to get the discounts. We were trying to figure out where he was the last time he remembered using it and it had been five days. He did the running around trying to hit all the stores he had visited since then, but the ordeal taxed my brain and again left me exhausted.

Wednesday, a friend took me to lunch. It was a gorgeous day, so we went to a park to walk off the lunch. It was fun, two "old" ladies walking along an uneven path with their canes. It was quite nice, truly. Thursday, is our usual "appointment day." I went to the doctor's office for a shot and to the chiropractor, then we stopped at our favorite diner-style restaurant for lunch. When we got home, I realized I did not have my cane. Plus, a package we were to leave at the chiropractor's office was still in the car. So we retraced all our stops again. I had left my cane hanging on the counter while paying our lunch tab and they had recognized it as mine, so it was easy to get it back. Then we had to stop for gas and go to the ATM for some cash.

None of these things, by themselves, are too much for my FTD-raddled brain to handle. Start bundling together like we did, and my brain becomes a disaster. My head was spinning, I couldn't focus on anything. I couldn't think about dinner. I ate half a piece of pie we had brought home from our lunch and a cup of tea. I was in bed by 7 p.m. I needed peace, quiet and darkness to survive.

I am still feeling the effects of the brain overload today. I slept almost 12 hours, but my brain is still in what I call it's "spin cycle." That is what it feels like to me when it becomes overloaded. The brain is spinning, trying to figure things out... what to do, how to do it, trying to not scream. I tried to do the puzzles I normally do in the newspaper, but I just sat there and stared at them. I just couldn't do them.

So, I am in my quiet room and this is where I shall stay as much as I can today. I am giving myself the day off tomorrow as well. That is the only way for me to get re-centered and my brain to get back to where it can function up to its ability.

This is what I want those caregivers to try to understand. I am fortunate that my husband finally understand this concept and can tell when I need down time. It's not that I don't want to do some things today, it's that I can't. It wasn't that I didn't want to watch the baseball game with him last night, it's that I couldn't. A friend called today. It wasn't that I didn't want to talk to her, it was that I couldn't I had trouble understanding what she was telling me or how I should be responding.

Usually my weeks are not as hectic as this one became, thankfully! Those of us with FTD can only do what we can and we must remember to not push ourselves to the point of breaking down. This is true for the caregivers as well, but if they could try to understand that we do what we can, it might make it easier for them to deal with the exhausting days.

Sunday, April 9, 2017

Clinging to the Lifeline of the AFTD

I had already written an entire blog entry. When I finished and read over it, I realized it was all about me and my feelings. I was whining because someone had questioned my motives for what I do and hurt my feelings. My feelings don't matter, it is all about educating people about the disease and its ramifications and, hopefully, helping someone better cope with it. So I erased the whole thing and started over.

While dealing with this disease, I have met a lot of people, in person and online. It is awesome to have gotten to know so many other people who are dealing with FTD, those with the disease, as well as those caring for someone who has it. I have to remind myself that 99% of the people I encounter are totally supportive of one another, including me. It is these friends, most of whom I have met through online support groups, who have become a lifeline for me. After my diagnosis, I was feeling lost and hopeless until I found these groups and met these people. It is through many of their examples that I started to advocate for the disease.

The term "lifeline" is defined as a rope used to rescue someone who has fallen from a ship into the water or used to tie the sailors to the ship during rough seas. I often talk about my lifelines and find the term to be perfect. Without any of them, I would still be floundering around in the rough waters of FTD. I have often talked about having four of them: my daughter, my husband, my therapist and my online support groups. They are all equally important. Without any of them, I would still be wallowing in self pity and anger over being diagnosed with FTD. I think there should be a fifth lifeline, one that I often rely on, yet did not realize how important they are to me.

I am talking about the AFTD, The Association for Frontotemporal Degeneration. I learned about this organization when I first decided to learn about the disease and to not sit around and feel sorry for myself. Through them, I found links to much information about the disease and these links led to even more. It was through their online support group that I was invited to join a couple more. Without them, I would not have the online support from all these friends I rely on for advice, understanding, commiseration and laughter. I would also not have found a lot of the information that I have shared with my family to help them better understand what effect this disease has on me. I'll even be honest, they would not understand why I am sometimes royally difficult to deal with.

This organization puts in a lot of effort toward fundraising and supporting research from those funds. They also have a great system of outreach to help educate everyone about FTD and all the subgroups that make up FTD. One of the ways they do this is by holding an annual conference on FTD to educate professionals. A few years ago, they started including those of us with the disease and our caregivers.

I attended my first conference last year after much encouragement from my support group. This conference was just amazing! To be able to meet the AFTD staff and get to know their organization better was quite helpful. The conference sessions were quite informative and there was much printed information that could be obtained. The best part of the conference was definitely being together with so many people who are also dealing with the disease. We were able to compare notes, swap stories, share coping mechanisms and get to personally meet many members of the support groups. I was able to relax, let my hair down, and have fun. I knew these would be non-judgmental people who would not judge me if I said or did the wrong thing. I had not had so much fun since I had received my diagnosis. That my daughter attended with me made it perfect.

Do I sound excited about the AFTD conference? Oh, yeah! This year's conference is 3 weeks and 4 days away. I won't start counting in days until it reaches the 3-week point. Can you even begin to imagine party time with a whole bunch of FTD'ers? Believe me, it is amazingly fun.

This year, not only are we attending, but my daughter and I are participating in the program. We have been invited to be part of a panel discussion with 3 pairs of FTD'ers and their caregivers. What an honor and opportunity to share! Hopefully it is a day when I can speak well and don't keep stuttering, but I will have my daughter next to me to remind to pause and start over. In addition, these people know about FTD. If I have a problem speaking, they will understand why.

3 weeks, 4 days and counting!!! Look out Baltimore, we're coming!!!

Sunday, April 2, 2017

...so I keep on going!

Today, I received a compliment that "made my heart proud". The words came from someone who is very dear to me who is also dealing with a fatal disease. She said to me, "I keep hoping to die, but then I would miss you, so I keep on going." I suspect that to some people this comment would not be taken as much of a complement, nor that it is a good thing. I disagree.

The way I took it was that I am still making a difference in her life. Since most of us cannot or do not make the decision as to when we die, providing even a small reason to make her feel like there is still a little worth living for, is a good thing in my mind. Neither of us can drive anymore, so we do not get together nearly as often as we would like. I wish she lived next door so we could spend time together every day. We settle for phone calls. She says that I can still make her laugh. I love hearing her laugh!

Neither one of us gives the other those false platitudes of "You are looking better," or "I would never know you were sick." We also would never ask the stupid questions of "Are you feeling better?" or "Have 'they' been able to get rid of it yet?"

People mean well when they say these things, I am sure. However, these words are hurtful and/or discouraging. We have mirrors, we know what we look like. We know the disease has aged us very rapidly. Some days I look in the mirror and it seems as if I aged a whole year overnight. Just yesterday, I was looking in the mirror and was thinking about the annual Association for FTD conference coming up in 4 weeks and 4 days. (Yes, I am counting that closely!) I had just come across a picture of me at the conference last year and I realized that I look ten years older. I am not digging for complements, it is reality. Kind of sad, but I have two choices. I could think that "Gee, I really look bad." or "I don't look too bad for someone dealing with a fatal illness!" Guess which one I choose!

There are better questions to ask someone dealing with a fatal disease. Many are just a word or two different than the bad examples: "You look good today" or simply "I am glad to see you." Instead of the stupid questions you could say "Are you having a good day today?" or a very sincere "Is there something I could do for you?" What I wouldn't give for someone to offer to wash my windows or pull some weeds. Sadly, I would most likely answer the offer to help with an emphatic "No!" simply because I am stubborn. don't want anyone to see my dirty house or to do yard work that I, myself, hate to do. Even though I would decline, I would really appreciate that someone cared enough to offer.

What would be better is if someone just showed up one day, armed with some gloves and supplies, and said that I should find someone to take me to lunch because they are going to do (insert helpful chore here). I would be embarrassed most likely, but how can you politely refuse? I am not writing this to make anyone feel guilty enough to do this and I hope no one take it that way. I am fortunate that between my husband and me, we do keep the house clean enough, laundry done and meals prepared. It is only the bigger projects that fall by the wayside.

My friend's husband was just telling me this morning that both lights in his kitchen burned out last week, so he had to climb the ladder and change the bulbs. It scared the bejeebers out of me as he should not be on a ladder. I asked if there wasn't someone they could call to do that. He hem-hawed around, my friend said yes there is but he won't ask. I pictured him trying to get up the ladder while leaning on his cane and started giggling. I told him "You are such a man!" He admitted that asking for help would have made him feel useless. Useless? He spends several days a week driving her to treatments and/or doctor visits, does the cooking,plus keeps up with as much around the house as he is able. They are a tad smarter than I am because they do have someone come in to clean their home and have someone to do most of the yardwork.

In the meantime, she and I compare notes on how compensate in order to do things and what things we can still do to make us feel useful and our brains stimulated. She and I keep each other going and when one of us is feeling down, the other can usually brighten our spirits.

If you reread the first paragraph, it could also make a good argument for our country to allow assisted suicide. When faced with a fatal or debilitating illness, the time does often come when you know it is time to end your own suffering. That, however, is an extremely controversial subject and I do not care to get into the debate in this forum.

On a final note, I am reading a book, "What If It's Not Alzheimer's? A Caregiver's Guide to Dementia, Third Edition" and is very informational so far. It will take me quite a while to read it since any new information takes a long time for my brain to process. I have heard a lot of good comments about it. I have only read the first chapter and already have a better understanding of the brain. I'll keep you posted.