Closer to diagnosis

4 January 2023

Hello all,
Happy new year to you.

(This is Marc writing.)
Hanna visited a neuromuscular specialist today. A doctor named “Sun!” She was a kind listener, a good communicator, and took lots of time with Hanna. I sat in on the visit, which consisted of a lot of good questions, many taps in many places with a wee hammer, and a series of tests that felt like little games. “Lift your arms. Don’t let me push them down.” “Close your jaw. Don’t let me open it.”

Next steps: a round of blood tests that look for many different kinds of indicators, intended to support or eliminate possible diagnoses. And an EMG test—electromyography—which will happen next Friday (the thirteenth).

More soon: The doctor said (I’m paraphrasing from memory here), “With these blood tests and the EMG, I feel confident I will be able to make a diagnosis and discuss next steps for treatment.” So, not necessarily more certainty, but at least a near-term expectation for more certainty.

Warmth to you all. May the year bring buds, blossoms and fruit.


Gratitude 32

Gratitude despite dishevelment and poopedness

Gratitude 32/40

I am about to take a shower when I see the text on our chicken-chat: “I think one of our chickens has died and I need some help.” This is not how I imagined New Year’s Eve would begin.

We don’t know what she died of. Hendini was one of the younger ones. And one of the bullies. She was also a cunning escape artist. She would seek the chance to jump the fence and dash down the hillside while we ran after her, hunched over and worried about poison ivy.

Like Hendini, I too love to run. For most of my life I’ve been a stray chicken, often in my own company, often wanting more space in the company of others.

Over the recent frigid spell, the chickens stayed inside the coop for several days. Cooped up, I suppose. Maybe something went wrong then.

When I started to date my partner, I felt afraid of losing my freedom. This weekend was the first time in my life where I celebrated the holidays in the role of a “mom.” I loved being in this family, and I missed my days of entering the new year at a silent retreat. This is also the first time in my life where I can’t quite depend on my body.

When I woke up on the first of January I felt feral, like I too wanted to jump the fence. On the second of January I felt stranded by my lack of energy. On the third of January I felt worried about making a living with this life. Part of me feels disappointed with how disheveled I’m entering the new year. My energy is so low, my expectations scrambled, my house still partly unpacked.

And another part of me is rolling her eyes at me saying, “Girl, whatever! You too could be gone like Hendini—turning into a clay jug with feathers and stiff feet. No matter how disheveled you start the new year, you are here. Your lung sacks are functioning beautifully, exchanging Co2 for oxygen among other minor miracles. You be you. I love you in sickness and in health, productivity and poopedness”


Flamingo with wings spread wide

Gratitude 31

Flamingo with wings spread wide

Practice being in uncertainty

Gratitude 31/40

I resist the urge to check my email, check my phone, but I’m failing. In the last 24 hours I did two tests whose results should get me closer to a diagnosis, and very soon the results will land in my inbox. I don’t like this grasping feeling I have. And yet, here it is. I really, really, really want to know.

In a class Marc and I teach on social change, we underscore the importance of developing a capacity to dwell in uncertainty. When this health thing started to unravel, I lit a candle and placed next to it a ceramic bowl that my partner made. I wanted to enter this passage prayerfully. I placed things in the bowl that I might need along the journey, like the picture of a saint. And I surrendered things that might not serve me, like this grasping-way-of-needing-to-know-to-feel-okay.

But being intentional about accepting uncertainty is not enough for me. In this moment my body bristles with frustration only a test result will soothe. I want to, no, I need to know. When the email flashes in, I call my colleague Marc over and we open it. It’s not helpful. In short it says that this was the wrong CT scan to test for thymoma. And the blood test never shows up in my online portal.

In that moment I lose my composure. If I were a toddler, I’d head straight for the floor and fling my arms and legs around. I don’t. I stand and speak through my tears, “I just want the tests to tell me I have MG and then say, ‘take this medicine’ so that I can have my old life back.”

When things feel so out of control, many people seek certainty merchants—strong figures that offer a simple story and clear solution (thanks Sonia Blignaut). In this moment I too seek the comfort of certainty and it is a moment-to-moment practice to shift my attention toward what is still stable right here, right now.

I go for that second blood test, the one I hope would give me some certainty. On the way back I bump into a neighbor and we talk about the desire for certitude.

“Diagnoses are good,” she says. “I love them. It’s like feeling shitty thinking I’m bi-polar but then I realize it’s just PMS.”

We laugh. Ah, this thing of knowing and not-knowing, this thing of being human.


Orange flowers hang from tree branches

Gratitude 30

Orange flowers hang from tree branches

Gratitude for tenderness

Gratitude 30/40

An old television playing 1950’s Christmas carols welcomes me to the CT scan waiting area. The door to the scan room is wide and the steel door jamb looks like it belonged to a bank safe. The yellow “Caution Radiation” sign has me feel a bit uneasy.

When the door swings open, a platinum blonde woman waves me in. She wears dark blue scrubs with penguins dressed in winter attire, skiing all over her body. On her headband are four oval-shaped light bulbs glowing red, blue, green and yellow. If her attire isn’t enough to disarm me, her language is. She says a sincere, “Welcome honey.”

I can tell I feel more relaxed (or is it relieved) than my previous CT scan because this time I notice that the tree in the sky-blue ceiling tiles is the same as my neighbor Ed’s tree. The picture was taken in early spring after the leaves unfurled and before the blossoms wilt.

This time I go feet first into the donut-shaped machine. Once the scan starts, the blonde woman’s voice reaches me through speakers. “Lie perfectly still and don’t swallow,” she says. And goodness knows, in that moment a tiny bird lays a warm hard-boiled egg at back of my throat, pressing onto my vocal cords. All I want to do is to swallow it away. So I wiggle my toes. I hold the urge in loving care. I think of kittens. But nothing works. In a quiet machine moment, I succumb and swallow.

When she helps me up after the scan, I say, “I’m sorry, but I swallowed.”

“You did good sweetheart,” she says. “Don’t worry about it.”

When the heavy door closes behind me, a grey-haired gentleman stands under the TV fiddling in with his faded hospital gown. Our eyes meet and he says, “These are so hard to close.”

“Would you be okay if I close this for you?” I ask. He nods and turns around. His back is bare and his skin, sprinkled with sunspots and freckles, feels strangely close. I take the cotton laces between my fingers and turn them into bows.

There is a tenderness we can experience in vulnerable moments and I feel lucky to be in its flow.


A large alligator

Gratitude 29

A large alligator

Gratitude for care I cannot offer myself

Gratitude 29/40

The day after the MRI I meet with a neurologist who suspects I have Myasthenia Gravis – a chronic autoimmune neuromuscular disorder. She subscribes a slew of tests to get us closer to a diagnosis: two blood tests, a swallow study, another CT scan and a breathing study.

It has been more than a week and I still do not have an appointment for the swallow and breathing study.

“Why?” asks a friend. “Just pick up the phone and make the appointment.”

I shake my head. “I wish it was that easy. The day after the neurologist visit felt like an old arthritic dog and did nothing. The day after that I did make those appointments. I made them for next year, because I’m trying to be wise with my money. But then, after making the appointments, I started to, or imagined that I were, experience the same tardiness of my mouth in my hands. I dropped a jar full of pickles, I had a hard time peeling an apple and typing felt forced. Then I panicked, thinking that my symptoms might be getting worse and that it’s irresponsible to wait. So I cancelled the appointments for 2023 and shifted them to 2022.

And then I called the estimation line to find out what my co-pay would be. Two hours later they called back; the two tests will cost as much as a new bike. And so I thought, “It’s only a week later and it’s really going to help me financially if I move it out.” So then I called to move it out to 2023, but the breathing office was closed. And the swallow study could only schedule me in the afternoon and I’m not sure I’m up to having nothing to eat or drink for fifteen hours.

And so here I am still—no appointments.

“I see. It’s not a task, it’s a spider reaching into many tender places,” Says the friend.

But today another friend did help me schedule the tests. I feel grateful for help with things that seem so simple, that I believe I should do by myself, but that I am not quite able to get done in this moment.


An art installation with rubber fists on cable arms suspended in a boxing ring

Gratitude 28

An art installation with rubber fists on cable arms suspended in a boxing ring

Gratitude for choosing back

Gratitude 28/40

The MRI was much less scary than I thought. For one, I imagined it to be dark around me, but the inside of the MRI feels less like you’re in a coffin, more like you’re in a light box. I was also much calmer than I imagined I’d be. There is a lot to do while lying motionless.

During that time, a question came to me. “If I had a choice, would I choose to have some type of illness or be healthy?” Without missing a beat, I knew I would like to go back to being healthy in the way I was before.

Whatever I have, is most likely an auto-immune disorder. From what I understand this means that I have a genetic predisposition that has been activated by my lifestyle. I come from a mostly healthy family, and I’ve really tried to live a healthy life. I didn’t see this coming.

At first I found myself racing up and down the hallway of my past choices, trying to find a way in which I clearly messed up, a way in which I deserve this. Others have helped me find a reason too – believing the COVID vaccine is the cause and sending me COVID detox regimens. Or sharing with me that the Lord revealed to them that this is an attack of the devil.

There is a strange logic that seeks something to blame, as if fighting that is a better use of energy than sitting with the unsettling knowledge that my world, our world, is changed. I don’t want this change, I don’t want this thing I have no name for yet. And yet it has chosen me. And it has, most likely, chosen to be with me for the rest of my life.

With the limited choice that I have, I would like to choose this back. To say, “Welcome, this is weird, but maybe we can figure out a way to co-exist. Maybe we can partner up and aspire to thriving lives and vital worlds.”

. . . . . .

Image: An picture I took at one of the the art houses on Troy Hill. Please comment if you know more about the artist/artwork!


Next steps toward diagnosis

19 December 2022

Continuing to chase a good diagnosis…

The following tests are happening between now and the first week of January:

  • CAT scan
  • Blood tests for this and that indicator of this or that condition
  • An appointment with a neuromuscular specialist and a swallow and lung study

Feeling good about myself for all this adulting after so many late-night wakings!

x Hanna


Closer to diagnosis

16 December 2022

Good morning dear people,
How are you all today as this year comes to a close?

I had a good meeting with the neurologist yesterday and they suspect I have Myasthenia Gravis, a chronic autoimmune neuromuscular disorder. I am helped by knowing there is a possible diagnoses. Next steps are a slew of tests, scans and muscle studies to confirm and gain more insight.

After the call with the neurologist, Marc said it sounds like a Harry Potter spell and immediately made this picture:

Which made me laugh. I need to laugh now, I feel exhausted by this week and when I think future, I feel many other things. I woke up wishing I didn’t have to move and fearful that I’ll over do it and hurt my back/get ill again. And then I saw all your names on the list and received your messages and now I feel more hopeful. Thank you — and for those of you that has a cold / flue / covid — sending so many healing energy to you!

x Hanna


A turtle in a pond

Gratitude 27

A turtle in a pond

Gratitude for what we don't have

Gratitude 27/40

My goodness but the health system here can be so speedy quick! The result of the MRI arrives in my inbox before I get home from the scan, thirty minutes away. I don’t look, because right now I distrust my meaning making capacities. But then I get a call from the doctor’s office– and the scan is normal. So I feel so relieved! And I feel intrigued.

I wrote this in the summer. It feels relevant today.

J. takes a minute before responding to me asking him how he’s doing. He puts the pruning scissor down, lean on his knee to straighten up, places both hands on his hips and arcs his back. The august air is thick with humidity.

Then J. says, “I guess I am okay.” The sound of “okay” has a long and weary tail, ending like a question.

A. responds in a similar tone. “I’ve had better days.”

“What about Hanna?” J. asks as I snip the cerise chard stem. I still cannot believe how pink it is.

“Well,” I say looking up, “for the first time in my life – at least that I now of – I am the host of 52 parasites.”

“What?”asks J. “How?”

“We went to lake Erie on Sunday and swam for hours. But we weren’t alone in the waters. There were sneaky parasites looking to make their home in ducks. But because we are hot bodied too, they mistook us and burrowed into our skins. So now I have all these hungry parasites hanging out under my skin, making me itch much so much that I wake up in the middle of the night longing to I scratch my body on the bedside like a cat. There is nothing I can do but wait for them to discover that we are incompatible and die.”

“Ha,” says A. “Are the parasites transferable once they are in your body?”

“No,” I reply.

“Mine is,” she says.

“Your what?” asks J. with a bit more animation in this voice.

“I too have a parasite.” A. brings her left leg forward and there, halfway between her ankle and knee is a ring almost as bright as the chard stems.

“I have ring worm.”

“Seriously? How did you get it?” J. asks.

“You get it through skin contact or by sitting in dirt. I think it’s through the dirt, because no one else I touch has it.”

“How long will it last?” I ask.

“A month or so,” she replies.

J. straightens up again, his right hand filled with four tomatoes. “Well,” he says, “I guess I’m doing really great then!”
We laugh.

In this moment, I am grateful for all the nasty things I do not have.


Health challenges, and a move

15 December 2022

Hello dearly beloved Pittsburgh people. I hope you are doing well today.

I’m in an interesting time with my health.

I’ve been having trouble speaking — making words and using my voice and having enough air for it. I’ve had multiple tests: CT scan, bloodwork and yesterday and MRI which all looks normal. This is a relief and a mystery. Today I’m meeting with a neurologist to see what next steps could be. This is new for me — and it has consumed a lot of my attention.

I don’t feel very together.

Oh my dear damn — at this moment I feel proud of myself if I remember to eat AND put the food away. Smile. So I am not inviting you into a very organized moment of my existence.

I’m moving this weekend.

Yes! I am moving up! I’m moving from my current four room apartment to the one above mine. So it’s an easy move up one flight of stairs. And yet… there are things to build and many things to move.

Could you please help me move?

*If* you have capacity and energy, please lend me a hand this week-end. I’ve made a spreadsheet where you can see the times I’ve marked up and the two types of requests — one to bring us food (or drinks) and another for your time. I’m practicing healthy dependance (thanks for that framing Michelle King!) which means that I trust you not to give if you can’t. And I will love you all the more if you come and if you don’t come. You know it!

Help me make it a moving party by arriving with joy and silliness if it’s accessible for you. Bring a hat, bring music, be with me in the joy of living and moving and all the muck that comes with it!

Love you people.

Note

This did indeed turn into a three-day moving party, involving more than a dozen people in different ways. Lovely, and thank you by the heaping heap-full to everyone.