In 2010 I was attending my first PHA International Conference. I had been asked to sit on stage at a breakfast event, one speaker on a panel of "Next Generation of PHA Leaders", a request that left me rather surprised. At that time, I had no idea about the crazy ride I was embarking on with PHA, or the rolls I would find myself in, still to this day looking behind me thinking, "Don't you want someone else for this? It's just me here..."
Anyway, I was there because of my activity with Generation Hope. The young adult group I helped co-found. Others were there for their fundraising, advocacy, and awareness work. Near me sat a beautiful young lady named Lauren Johnson, just 17 years old. She was a fundraiser and worked to get her story in the media. She was articulate. She was effective in her efforts. She was full of life.
She died yesterday.
Still in college. Unexpectedly. The best I can gather, after a very rapid decline nobody could see coming. I hadn't spoken to her since that day in 2010, but that doesn't really matter. Because when this happens, it is always personal. Always.
I saw the news pop up on my Facebook newsfeed. The way I most often get word of a passing (totally bizarre). I just stared at her face. Numb.
Yes, this time it is just numb. I feel like I should feel something. And I can't, really. Because if I feel anything through the ones like this - the ones where PH just suddenly strikes and takes someone who seems fine, it opens up a shit storm I don't know how to face. It starts with the knowledge this will happen again and again, and it ends knowing that it could just as easily been me.
So many times, people say to me, "You do so much!"
My answer: She died from the disease we share. Every month it seems, I watch this happen. So, it isn't enough. Ever.
All I can say is that until I no longer have to feel (or try not to feel) the impact of person after person passing away from my disease, then my fight will never be enough.
Together though... if everyone kicks in more than they are able. Maybe these stories will no longer haunt my days.
In Lauren's own words, "It is hard, because we don't have... something everybody knows, like breast cancer, or diabetes, or tons of different diseases...we have something that nobody really knows, and we're the only ones that can fight for it... We're our own advocates."
This is the link to our video: https://www.youtube.com/watch?v=9cLrXGxsQ2c
Our section starts about 11 minutes in.
“My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style” ― Maya Angelou
Saturday, April 5, 2014
Thursday, January 2, 2014
Reflections on a Six-year Anniversary of a Disease That Gave Me a 50/50 Chance of Living Five Years
The title of this blog is complicated. But, then again, so is PH, right?
Each anniversary of my diagnosis has brought about a new wave of complex emotions. While the years are now somewhat blurred together, I remember the first year just being awe struck that a year since my earth-shaking news had already gone by. Subsequent years brought more and more hope, but my deep uncertainty for my well-being and even my life remained.
Conversely, year five was striking in just how un-striking it felt. Even though my chance of survival was said to be only 50/50 at five years and I had reached that point, I just felt how normal the year was (as in, very little medical drama) and was truly grateful for that sense of peace.
And now, here's year six. And, while a good one, this really has been a hell of a year! Truth be told, I still have a lot of sadness and uncertainty floating around. Right now it is centered on those I care for with the disease still struggling. I hate this disease and I hate the pain and anguish it causes. Even as I feel pretty good about my own future, too many people are not out of the woods. It can be paralyzing to be a part of. The pain of watching someone you care for suffer (and sometimes die... or almost die) from the disease you share is beyond words. You hurt for them, and at the same time, even though you try to fight it, you hurt for what your own future might be. This all sucks.
However, as PH is always a roller coaster, I am also struck by just what a crazy year of new milestones and celebrations this has been too. And, as always, while I give an honest nod to the hard parts, cry when I need to, and lower my head and ride through the storms when I have to, it is the celebrations I really want to stay focused on. So here goes...
I have just completed my third year on the PHA Board of Trustees and am looking forward to my next three-year term. And Generation Hope, the young adult group I helped start with PHA and some other patients, is turning four years old this month!
In 2012 I had traveled to the DC area to testify in front of the FDA in a bid to get them to choose PH as one of just of 20 rare disease states on which they would focus new patient-focused clinical trial initiatives. In April of 2013 we found out that the FDA had indeed selected us!
I also traveled to the DC area to PHA headquarters twice this year in order to meet with specialty pharmacy representatives. The goal - to implement a feedback system designed to improve patient care and medication delivery. This system is now FULLY IN PLACE and I still can't quite wrap my head around the idea that one patient who wrote a very polite but pretty pissed off letter, combined with countless phone calls and e-mails, and an incredibly dedicated organization for an incredible rare-disease community, has not only met big pharma head on, and then teamed up together, we ultimately made something that can have a really tangible difference. Now we look to the future where it could potentially become a model for other patient communities, and nothing would make me happier.
So... what else...
Each anniversary of my diagnosis has brought about a new wave of complex emotions. While the years are now somewhat blurred together, I remember the first year just being awe struck that a year since my earth-shaking news had already gone by. Subsequent years brought more and more hope, but my deep uncertainty for my well-being and even my life remained.
Conversely, year five was striking in just how un-striking it felt. Even though my chance of survival was said to be only 50/50 at five years and I had reached that point, I just felt how normal the year was (as in, very little medical drama) and was truly grateful for that sense of peace.
And now, here's year six. And, while a good one, this really has been a hell of a year! Truth be told, I still have a lot of sadness and uncertainty floating around. Right now it is centered on those I care for with the disease still struggling. I hate this disease and I hate the pain and anguish it causes. Even as I feel pretty good about my own future, too many people are not out of the woods. It can be paralyzing to be a part of. The pain of watching someone you care for suffer (and sometimes die... or almost die) from the disease you share is beyond words. You hurt for them, and at the same time, even though you try to fight it, you hurt for what your own future might be. This all sucks.
However, as PH is always a roller coaster, I am also struck by just what a crazy year of new milestones and celebrations this has been too. And, as always, while I give an honest nod to the hard parts, cry when I need to, and lower my head and ride through the storms when I have to, it is the celebrations I really want to stay focused on. So here goes...
I have just completed my third year on the PHA Board of Trustees and am looking forward to my next three-year term. And Generation Hope, the young adult group I helped start with PHA and some other patients, is turning four years old this month!
In 2012 I had traveled to the DC area to testify in front of the FDA in a bid to get them to choose PH as one of just of 20 rare disease states on which they would focus new patient-focused clinical trial initiatives. In April of 2013 we found out that the FDA had indeed selected us!
I also traveled to the DC area to PHA headquarters twice this year in order to meet with specialty pharmacy representatives. The goal - to implement a feedback system designed to improve patient care and medication delivery. This system is now FULLY IN PLACE and I still can't quite wrap my head around the idea that one patient who wrote a very polite but pretty pissed off letter, combined with countless phone calls and e-mails, and an incredibly dedicated organization for an incredible rare-disease community, has not only met big pharma head on, and then teamed up together, we ultimately made something that can have a really tangible difference. Now we look to the future where it could potentially become a model for other patient communities, and nothing would make me happier.
So... what else...
I completed my third 5K race (and second Warrior Dash... and signed up for a third) and my friend Heather and I raised $1800 for the PH cause. When I was diagnosed I couldn't climb a flight of stairs without nearly passing out. What a difference a few years of the right medications, a holistic integrative approach, and a good dose of faith and miracles makes.
PHA launched the Chapters, and I attended the first NYC gala in honor of Dr. Robin Barst, a pioneer and hero in our community who was unparalleled in leading the fight for better treatments and at saving lives. Without her, none of us with PH would be where we are today and listening to her colleagues, patients, and family pay her tribute was an honor indeed.
And finally, this year I launched Willow Tree Wellness, my holistic health coaching practice. At first glance, this may not seem PH related, but to me it very much is. PH stole my teaching career, and I hated that. Mourned it in fact (Yeah, I cried when I got rid of some teaching supplies!). I left the classroom (ah-hem, that's a nice way to say I was covertly "let go" because sick teachers are inconvenient), and while I'm doing great, it is abundantly clear that a full time high-stress job with germy little kids is not in my best interest... so I went back to school and became a health coach. The irony of the sick girl helping people to find wellness does not escape me at all (in fact, it makes me laugh)... but I really cling to the fact that our bodies are meant to find wellness (which is different than total "good health" or a cure), and you can certainly always work to feel and do better. I truly believe that an integrative approach has saved me, and I know I can teach others to find the same. Add to that I get to work with families and children as well and... life is good. Very, very good.
Oh, and just for fun, I noticed this blog has 13,000 hits as of today. Thanks for stopping by. :)
Happy six years to me. Here's to the next six... I wonder if I'll be a long-term survivor by then or if the bar for years that make up "long-term survival" will just keep going up and up as things get better and better for us. It's kind of amazing to wait and find out.
Wednesday, December 11, 2013
Big News. Really, Really Big News!
Drum roll, please... after years of hard work, the
Pulmonary Hypertension Association and
Caring Voice Coalition are rolling out something that will address a challenge that has been at the forefront of patient concerns for far too long.
Introducing: The Specialty Pharmacy Feedback Form.
What is this thing and where did it come from? Well, for me, it started back in October of 2010. At that time, I was in a deep battle with my specialty pharmacy company. They were having serious issues with getting my life-sustaining medication to me as promised. And then there was the pivotal moment I will probably never forget.
At the time, I had to sign for delivery for my medications. When the meds didn't show up one day and I had to wait at home again the next day, I missed an event at my son's preschool. I was livid. I was on the phone with a department manager (having long since given up on working with the call center reps) and sputtering out my frustration. I'm usually articulate - I was too upset to be at the moment.
Then the manager said, "I understand your frustration, I'm a mom too." And in that moment I knew how much she didn't get it, and clarity returned. I replied something to the effect of, "Yes, but you are pretty well promised you will see your children grow up. I'm not promised that because with this disease I don't know if I'll live long enough! This mistake made me miss a moment in his life, and I can't get that back."
Then I hung up the phone and sobbed. To express that fear aloud was more painful than anything else I had to deal with regarding PH or the pharmacy company. It still is.
Well, we eventually got the delivery issues straightened out, and while I still lived in slight unease as I had completely ceased to trust the company, things seemed okay.
Then a new mess surfaced. I started a new medication and had an adverse reaction. The way you track an adverse reaction is simple: get the lot number and report it to the manufacturer, which is exactly what was requested by the drug maker. But as it turned out, the specialty pharmacy's distribution protocol at the time was ineffective in that they did not track such things. In other words, I had no way of reporting my adverse reaction to the manufacturer, and thus there was no way to track a potentially dangerous situation for other patients.
To be fair, tracking lot numbers at the point of pharmacy distribution is not an FDA requirement. But I would argue it should be considered best practice and done anyway - especially when the medication in question has the power to save someone's life or quickly kill them if something goes wrong. And as I knew the pharmacy's competitors were tracking lot numbers, I saw it as industry standard that absolutely should have been practiced.
Every time I tried to talk to someone to deal with this issue, I got vastly conflicting information. In short, I felt I was either being lied to (probably not the case), or literally no one had a clue what they were talking about... although I do believe they thought they did and had good intentions, there was clear disconnect between information I was being given, and what was actually happening.
It would take me pages to explain what this particular battle entailed. In short, I ended up on the phone with everyone as high up in the company as I could stalk, my doctor's office wrote a strongly worded letter of protest, I filed complaints with HR for my husband's company urging them to drop this specialty pharmacy from their insurance plan, contacted the biomedical company that distributes the drug and complained, and so on.
Still, I felt I was getting nowhere. The misinformation persisted, and I never did get to report my adverse reaction in an effective way.
And then the next pivotal moment. There I was sputtering on the phone again - this time with people like corporate pharmacy managers and the head of global patient safety for a drug company. And I was repeatedly told, "You have my phone number, you call me if you have more issues." And I finally replied, "That's all well and good, but what is the next patient with problems going to do? They don't have your number. And I don't want your number. I want your company to do their job."
And I knew - even if I somehow got my own issues straightened out, odds it would help anyone else were slim. And the idea that other patients were going through this same mess was unacceptable to me.
As luck would have it, this was around the time of a PH related conference in Boston in 2011. I was in attendance, along with the PHA president, Rino Aldrighetti. I told him what was going on, and that I was having trouble getting a certain key person to return my call. He picked up his cell phone and made the call himself - and he lit that person's voicemail on fire. My jaw hit the ground, as I had never heard a sharp word from him before, and this was an entirely new side of the PHA leader.
Rino then asked me to begin to track the time I was spending on these issues, and to write a letter to the Corporate Committee for PHA and express my concerns. This is a committee made up of representatives from many of the corporations involved with PH care, including drug companies and the specialty pharmacies that distribute their medications. I did so, and what became known as THE LETTER went out. I guess it caused a stir... or so I am told.
We have continued to do hard work on this issue in in the two years since. I have flown to PHA headquarters twice and, along with PHA staff, a doctor, and members of the Board of Trustees (dialed in by phone) met directly with leaders from one of the pharmacies. Countless e-mails and phone calls have gone on.
A Specialty Pharmacy Advisory Board has been launched, comprised of: a patient (me), a caregiver, representatives from specialty pharmacies, representatives from drug companies, The Pulmonary Hypertension Association, and The Caring Voice Coalition. We've discussed in detail the issues at hand, and I have been forwarding individual patient concerns to those directly involved for months.
We see issues and trends. We see areas of strength. And now, we want to hear from YOU.
Please, please, use this form to offer feedback to the specialty pharmacies. When you have an issue, be it small or large, report it. When you have a praise or accolade, we sure want to hear about that too. I continue to believe that change is best made when we build on strengths.
Your comments will be accessed regularly by both PHA and the specialty pharmacy for whom it is intended, and all entries will be tracked carefully for trends and areas of ongoing concern. I have worked really closely with these people over the last several months. I am entirely confident that those on the ground care a great deal about these issues and are making sure changes are made. The Advisory Board will continue to meet and discuss as well.
And if anything, I want you to remember... PH has dealt us a really lousy hand. But we are never victims unless we allow ourselves to be.
Three years ago as I sobbed in my driveway after slamming off my phone, I never would have dreamed that such progress and change could happen. But it has.
And now you have to use it to make it work.
It is here: The Specialty Pharmacy Feedback Form
Introducing: The Specialty Pharmacy Feedback Form.
What is this thing and where did it come from? Well, for me, it started back in October of 2010. At that time, I was in a deep battle with my specialty pharmacy company. They were having serious issues with getting my life-sustaining medication to me as promised. And then there was the pivotal moment I will probably never forget.
At the time, I had to sign for delivery for my medications. When the meds didn't show up one day and I had to wait at home again the next day, I missed an event at my son's preschool. I was livid. I was on the phone with a department manager (having long since given up on working with the call center reps) and sputtering out my frustration. I'm usually articulate - I was too upset to be at the moment.
Then the manager said, "I understand your frustration, I'm a mom too." And in that moment I knew how much she didn't get it, and clarity returned. I replied something to the effect of, "Yes, but you are pretty well promised you will see your children grow up. I'm not promised that because with this disease I don't know if I'll live long enough! This mistake made me miss a moment in his life, and I can't get that back."
Then I hung up the phone and sobbed. To express that fear aloud was more painful than anything else I had to deal with regarding PH or the pharmacy company. It still is.
Well, we eventually got the delivery issues straightened out, and while I still lived in slight unease as I had completely ceased to trust the company, things seemed okay.
Then a new mess surfaced. I started a new medication and had an adverse reaction. The way you track an adverse reaction is simple: get the lot number and report it to the manufacturer, which is exactly what was requested by the drug maker. But as it turned out, the specialty pharmacy's distribution protocol at the time was ineffective in that they did not track such things. In other words, I had no way of reporting my adverse reaction to the manufacturer, and thus there was no way to track a potentially dangerous situation for other patients.
To be fair, tracking lot numbers at the point of pharmacy distribution is not an FDA requirement. But I would argue it should be considered best practice and done anyway - especially when the medication in question has the power to save someone's life or quickly kill them if something goes wrong. And as I knew the pharmacy's competitors were tracking lot numbers, I saw it as industry standard that absolutely should have been practiced.
Every time I tried to talk to someone to deal with this issue, I got vastly conflicting information. In short, I felt I was either being lied to (probably not the case), or literally no one had a clue what they were talking about... although I do believe they thought they did and had good intentions, there was clear disconnect between information I was being given, and what was actually happening.
It would take me pages to explain what this particular battle entailed. In short, I ended up on the phone with everyone as high up in the company as I could stalk, my doctor's office wrote a strongly worded letter of protest, I filed complaints with HR for my husband's company urging them to drop this specialty pharmacy from their insurance plan, contacted the biomedical company that distributes the drug and complained, and so on.
Still, I felt I was getting nowhere. The misinformation persisted, and I never did get to report my adverse reaction in an effective way.
And then the next pivotal moment. There I was sputtering on the phone again - this time with people like corporate pharmacy managers and the head of global patient safety for a drug company. And I was repeatedly told, "You have my phone number, you call me if you have more issues." And I finally replied, "That's all well and good, but what is the next patient with problems going to do? They don't have your number. And I don't want your number. I want your company to do their job."
And I knew - even if I somehow got my own issues straightened out, odds it would help anyone else were slim. And the idea that other patients were going through this same mess was unacceptable to me.
As luck would have it, this was around the time of a PH related conference in Boston in 2011. I was in attendance, along with the PHA president, Rino Aldrighetti. I told him what was going on, and that I was having trouble getting a certain key person to return my call. He picked up his cell phone and made the call himself - and he lit that person's voicemail on fire. My jaw hit the ground, as I had never heard a sharp word from him before, and this was an entirely new side of the PHA leader.
Rino then asked me to begin to track the time I was spending on these issues, and to write a letter to the Corporate Committee for PHA and express my concerns. This is a committee made up of representatives from many of the corporations involved with PH care, including drug companies and the specialty pharmacies that distribute their medications. I did so, and what became known as THE LETTER went out. I guess it caused a stir... or so I am told.
We have continued to do hard work on this issue in in the two years since. I have flown to PHA headquarters twice and, along with PHA staff, a doctor, and members of the Board of Trustees (dialed in by phone) met directly with leaders from one of the pharmacies. Countless e-mails and phone calls have gone on.
A Specialty Pharmacy Advisory Board has been launched, comprised of: a patient (me), a caregiver, representatives from specialty pharmacies, representatives from drug companies, The Pulmonary Hypertension Association, and The Caring Voice Coalition. We've discussed in detail the issues at hand, and I have been forwarding individual patient concerns to those directly involved for months.
We see issues and trends. We see areas of strength. And now, we want to hear from YOU.
Please, please, use this form to offer feedback to the specialty pharmacies. When you have an issue, be it small or large, report it. When you have a praise or accolade, we sure want to hear about that too. I continue to believe that change is best made when we build on strengths.
Your comments will be accessed regularly by both PHA and the specialty pharmacy for whom it is intended, and all entries will be tracked carefully for trends and areas of ongoing concern. I have worked really closely with these people over the last several months. I am entirely confident that those on the ground care a great deal about these issues and are making sure changes are made. The Advisory Board will continue to meet and discuss as well.
And if anything, I want you to remember... PH has dealt us a really lousy hand. But we are never victims unless we allow ourselves to be.
Three years ago as I sobbed in my driveway after slamming off my phone, I never would have dreamed that such progress and change could happen. But it has.
And now you have to use it to make it work.
It is here: The Specialty Pharmacy Feedback Form
Thursday, December 5, 2013
Meet Justin: When Giving Back Also Inspires
The final installment for 2013 for PHers who inspire... the previous editions are HERE
Justin is a recent high school graduate with a story to
tell. This past June, I was lucky to hear that story first hand. It is a story of incredible ups and
downs, of defying the odds, of uncertain times, and of triumphs.
Born in Colorado, Justin is one of triplets, and he also has
Down syndrome. At birth, the family learned he had pulmonary hypertension.
| Surgery |
As can be
common with Down syndrome, Justin underwent open-heart
surgery at just four
months old. Because of complications, he spent a subsequent
five weeks in ICU.
By age 2 ½, Justin was on oxygen constantly. Doctors told
his family that the elevation in Colorado was too much for him, and that the
family must re-locate somewhere closer to sea level. They chose Connecticut,
within distance of Dr. Robyn Barst at Columbia in New York City, and that is
when Justin’s journey with pulmonary hypertension really began.
Dr. Barst was the preeminent physician addressing pulmonary
hypertension at the time, for the general patient population, but especially
with pediatrics. Justin and his
family went through a lot as they tried to fight the disease, and Dr. Barst was
with them every step of the way.
Justin has had two pace makers and been on many PH
medications. For a long time, Flolan saved his life. Being a child with a
backpack that carries a pump attached to an IV into your heart is not easy by
any stretch, but Justin persevered for 12 years. The family tried him on
Remodulin too, although that was not as successful. Then, on a second attempt
with Flolan, Justin hit a critical point. The drug is extremely powerful, and
it can also be extremely toxic. For Justin, this meant a severe drop in
platelets, which led to lung bleeds, amongst other multiple complications.
And then, the miracle came for Justin. An inhaled medication
called Tyvaso had just hit the market, and it was decided that Justin should
try it. Tyvaso, combined with Adcirca, turned things around. Justin’s health
started to improve. He competes in the Special Olympics – and medals. He
graduated high school in June 2013,
and is now in a transition academy. His parents tell me they hope that someday
he will attend college.
So, when to everyone’s happy surprise, Justin reached his
senior year in high school and the time came to choose a senior project, Justin
chose “Giving Back to the Organizations that have Shaped My Life”. He chose the
Pulmonary Hypertension Association and The Special Olympics.
| Fundraising |
Justin worked tirelessly on his project. Two bake sales, and
a pasta dinner, were all smashing successes. Through his efforts he was not only able to raise money for
causes so important to him (an impressive $3,000 in total), but he was also
able to spread a great deal of awareness as well.
I didn’t get this story from an adult well versed in medications and PH. Justin told it himself. As I sat in an auditorium at Shepaug Valley High School, I don’t think I ever stopped smiling or shaking my head in wonder. Justin is a remarkable person. He had clearly put so much into his project and presentation, and presented it with a level of articulation more seasoned speakers can lack. And I would be remiss if I didn’t mention that he gives the best hugs too.
He told his whole medical story with such fineness. His pride in his
accomplishments beamed through, as well they should. Justin has defied every
odd. He works to give back to the communities that supported him in his fight.
We can all learn a thing or two from this remarkable young man.
| Justin presents me with the check for PHA |
| Justin's Family: Sister Lindsey, Justin, Dad Russ, Mom Lori, and Sister Jenni |
In closing, the funds Justin raised for the Pulmonary
Hypertension Association will go to the Robyn Barst Pediatric Research
Fund. As Justin said, “ Because of
Dr. Barst and her incredible work I am alive and able to graduate! Thanks to
Dr. Barst, I and thousands of others with PH are living longer and better lives.
She is gone but her work will live on forever!”
Wednesday, November 27, 2013
Meet Diane Ramirez
For PH Awareness Month 2013 I'm bringing you stories of people in the PH
community going the distance. Each in their own way, they have found a
path that takes control around the disease and makes our community a
better place. You can read the other installments HERE
“I went through the hell that everyone is still going through today.”
Diane credits her ability to persevere with doing everything she could to stay healthy: eating well, keeping the house clean of irritants, wearing oxygen, and exercising. She’s also quick to point out that there is absolutely no reason for people to forgo medicine today. There are so many options out there.
Around 2002 -2003, a family member gifted Diane with a computer. She was so excited to have access to the Internet from her home. She found PHA online and the first patient she ever chatted with was Alex Flipse. They exchanged phone numbers, and started calling. She began to meet more patients and eventually found the local Piedmont support group, with Cindy Pickles, who still leads the group today and also sits on the PHA Board of Trustees.
Diane’s first PHA Conference was in Texas in 2006. That was it for her – she was in! She says, “It was like somebody threw me the football, I caught it and started running… and I’m still running. Meeting all the patients was overwhelming, hearing the doctors talk about the research… it was really motivating, and meant so much.”
Diane also heard Carl Hicks speak that year, and learned from him that “Hope is
a Verb.” She spent time with Katie Kroner, PHA Director of Advocacy and
Awareness, and learned about the 435 Campaign. Katie also gave her the
confidence to begin advocating for PH specific legislation. Today, Diane leads
the way nationally on advocacy work, and is supporting patients who are
mobilizing and reaching out to their representatives, specifically now for the Pulmonary Hypertension
Research and Diagnosis Act of 2013.
Her first up close and personal experience with PHA was a wonderful thing. Of the experience she remembers,“Talking to Katie and hearing Carl… and realizing I needed to take action. I can’t wait for somebody else to fight my battles. This is mine.”
Well, battle she has. In 2011 Diane also joined the PHA Board of Trustees, where she has continued to lead the way in advocacy work, and is helping to meet the needs of patients, particularly long term survivors who need their own unique spin on support. She says, “It’s so cool to see stuff coming to fruition and take off, and know that I was a part of that.”
I asked what gives Diane her motivation today. She laughs deeply and says,
“To be a long term survivor with this illness, and to be a part of the group of people who started with nothing, to being a part of PHA today, you have to be a little “touched”, a little fragmented part of your brain that helps you get through it. It is so challenging, so extremely overwhelming… it has been an incredible upheaval, and major change, and extreme positives… one end of the spectrum to the other… you have to have a little insanity in your life to make it through.”
“I went through the hell that everyone is still going through today.”
![]() | |
| Diane and me at "The Kitchen Table" where PHA was first brought to life. |
Diane Ramirez is a name many in the PH community may
recognize, and with good reason.
As a 26-year survivor of pulmonary hypertension, she is perhaps one of
the longest living patients we have in our community. And what she has done in
her time with the disease is nothing short of amazing. It is my pleasure to
bring you her story.
It began, likely, around 1984. Diane had asthma from early childhood, but around this time, her shortness of breath and difficulty with breathing began to increase. For three years, she searched for answers. Changing medication wasn’t helping, in fact it was making some things worse. She went from being told that her asthma was worsening, to that she had a mitral valve proplapse, to being referred to a therapist and being put on meds because the symptoms were supposedly all in her head.
As Diane put it, “I went through the hell that everyone is still going through today.” And she’s right… even so many years later, patients still struggle on average 2.8 years searching for a diagnosis.
It began, likely, around 1984. Diane had asthma from early childhood, but around this time, her shortness of breath and difficulty with breathing began to increase. For three years, she searched for answers. Changing medication wasn’t helping, in fact it was making some things worse. She went from being told that her asthma was worsening, to that she had a mitral valve proplapse, to being referred to a therapist and being put on meds because the symptoms were supposedly all in her head.
As Diane put it, “I went through the hell that everyone is still going through today.” And she’s right… even so many years later, patients still struggle on average 2.8 years searching for a diagnosis.
It wasn’t until 1987, at the age of 24, when she passed out
going up a flight of steps, that answers began to emerge. When she came to, she
was in the ER. Still in her sharp business suit, surrounded by doctors who were
as confused as she was. A medical history, blood work, x-rays, CT scan, and
finally a cardiac cath finally yielded the answer – Pulmonary Hypertension. The
diagnosis came as a relief of sorts, finally an answer to the issues that had
plagued her, and validating her concerns. However, at the time, there was
nothing they could do for her but put her on blood thinners and begin the
process of being worked up for a transplant.
In addition to no medications, there were also really no other patients to be found. PHA didn’t exist yet. Flolan trials had not yet begun. And the people taking care of her weren’t PH specialists. They didn’t really exist the way we know them now yet either. Instead, she was under the care of the transplant team at Yale.
“His story is a part of my story.”
Finally, Diane “met” another patient. It was her own brother, Ariel Ramirez, diagnosed at age 18 in 1992. It turned out their particular form of PH was familial. Even at that time, there were only about 190 diagnosed patients in the country, mostly women, and Ariel had struggled to get a diagnosis as well. There was much loneliness in this rare disease, and the two bonded over their shared experiences. Ariel had a wonderful sense of humor, with a contagious laugh, and he was incredibly brave. During a trial to try to transition him from IV to oral meds, he suffered a massive heart attack and passed away at the age of 36. His efforts and his ultimate sacrifice are a part of PH history.
In addition to no medications, there were also really no other patients to be found. PHA didn’t exist yet. Flolan trials had not yet begun. And the people taking care of her weren’t PH specialists. They didn’t really exist the way we know them now yet either. Instead, she was under the care of the transplant team at Yale.
“His story is a part of my story.”
Finally, Diane “met” another patient. It was her own brother, Ariel Ramirez, diagnosed at age 18 in 1992. It turned out their particular form of PH was familial. Even at that time, there were only about 190 diagnosed patients in the country, mostly women, and Ariel had struggled to get a diagnosis as well. There was much loneliness in this rare disease, and the two bonded over their shared experiences. Ariel had a wonderful sense of humor, with a contagious laugh, and he was incredibly brave. During a trial to try to transition him from IV to oral meds, he suffered a massive heart attack and passed away at the age of 36. His efforts and his ultimate sacrifice are a part of PH history.
Staying the Course
Throughout this, Diane had her own journey with treatment.
She had originally met with doctors in Providence, RI who were starting the
Flolan trials, but she did not qualify because she lived too far away. In
addition, the idea of IV meds was so overwhelming, that it was almost a
relief not to go on them.
By the time Flolan was FDA approved, she had started to
stabilize, and opted to stay off the only treatment for PH at the time. This
might sound crazy to some… but the idea of a permanent IV in the chest, with
all it entails, never mind it was such a new medication at the time, was too
much.
Diane credits her ability to persevere with doing everything she could to stay healthy: eating well, keeping the house clean of irritants, wearing oxygen, and exercising. She’s also quick to point out that there is absolutely no reason for people to forgo medicine today. There are so many options out there.
Still, in 2001 she had started to go into heart failure, but
remained, as she says, “mule headed” about IV medications. She happened to
visit Duke University during a vacation to North Carolina and learned that
clinical trials for Tracleer had begun. She relocated to North Carolina to
start a new life for herself, a life that would include this new drug Tracleer.
At this point she was on oxygen 24 hours a day. The first months were difficult. She slept a lot, with very low blood pressure. And then, six months into it, something changed. She was at the mall with her sister and turned from window shopping to see her sister crying. Confused, she asked what was wrong… and was told she had just walked the entire mall without getting short of breath or needing to sit and rest, and she hadn’t even noticed. Slowly but surely, things were turning around, and it was truly a blessing.
A little while later, Diane started Ventavis as a precautionary measure. She did that for two years, before embarking on the Tyvaso trial and now has been on Tyvaso for five years. She’s tried Revatio and Adcirca as well, but they have not proved to be a good match with side effects. Still, she thinks she might try again sometime.
PHA
At this point she was on oxygen 24 hours a day. The first months were difficult. She slept a lot, with very low blood pressure. And then, six months into it, something changed. She was at the mall with her sister and turned from window shopping to see her sister crying. Confused, she asked what was wrong… and was told she had just walked the entire mall without getting short of breath or needing to sit and rest, and she hadn’t even noticed. Slowly but surely, things were turning around, and it was truly a blessing.
A little while later, Diane started Ventavis as a precautionary measure. She did that for two years, before embarking on the Tyvaso trial and now has been on Tyvaso for five years. She’s tried Revatio and Adcirca as well, but they have not proved to be a good match with side effects. Still, she thinks she might try again sometime.
PHA
Around 2002 -2003, a family member gifted Diane with a computer. She was so excited to have access to the Internet from her home. She found PHA online and the first patient she ever chatted with was Alex Flipse. They exchanged phone numbers, and started calling. She began to meet more patients and eventually found the local Piedmont support group, with Cindy Pickles, who still leads the group today and also sits on the PHA Board of Trustees.
Diane’s first PHA Conference was in Texas in 2006. That was it for her – she was in! She says, “It was like somebody threw me the football, I caught it and started running… and I’m still running. Meeting all the patients was overwhelming, hearing the doctors talk about the research… it was really motivating, and meant so much.”
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| Diane snags not one, but two, North Carolina Congressmen during a recent advocacy visit to Capitol Hill. |
Her first up close and personal experience with PHA was a wonderful thing. Of the experience she remembers,“Talking to Katie and hearing Carl… and realizing I needed to take action. I can’t wait for somebody else to fight my battles. This is mine.”
Well, battle she has. In 2011 Diane also joined the PHA Board of Trustees, where she has continued to lead the way in advocacy work, and is helping to meet the needs of patients, particularly long term survivors who need their own unique spin on support. She says, “It’s so cool to see stuff coming to fruition and take off, and know that I was a part of that.”
I asked what gives Diane her motivation today. She laughs deeply and says,
“To be a long term survivor with this illness, and to be a part of the group of people who started with nothing, to being a part of PHA today, you have to be a little “touched”, a little fragmented part of your brain that helps you get through it. It is so challenging, so extremely overwhelming… it has been an incredible upheaval, and major change, and extreme positives… one end of the spectrum to the other… you have to have a little insanity in your life to make it through.”
With Diane, you should be prepared to laugh with her from
your core… and maybe cry from there once in a great while too. She’s right. This is a crazy, crazy
journey. I for one am very glad she is on it with us.
Her advice to long-term survivors is, quite simply, “Never give up.”
To the newly diagnosed, she says the same, but adds, “Get involved. Now that you’re diagnosed with PH, this is your battle. Get involved with it. Be a part of the fight.”
Her advice to long-term survivors is, quite simply, “Never give up.”
To the newly diagnosed, she says the same, but adds, “Get involved. Now that you’re diagnosed with PH, this is your battle. Get involved with it. Be a part of the fight.”
Friday, November 22, 2013
Meet the PH Peddler: A 3000 Mile Journey
For PH Awareness Month 2013 I'm bringing you stories of people in the PH community going the distance. Each in their own way, they have found a path that takes control around the disease and makes our community a better place. You can read the other installments HERE.
But this is Joshua – given six months to live three years ago, facing multiple critical illnesses, and experiencing things that would shut most people down, he could be sitting at home having given up. But instead of giving in, he bounces back every time, dedicates himself to the cause every day, and is impacting people around the country because of it. There is little doubt the Peddler will be back on the bike and more than make up for lost time in the future.
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| Post PH Fundraiser Celebration |
Today’s introduction is about a rather unique PH patient.
From his medical journey to how he chooses to live his life and dedicated
himself to the PH cause, Joshua Griffis brings something special to our
community.
Joshua’s journey with PH officially began in 2010. For some time, he had been experiencing shortness of breath, extreme fatigue, and general weakness. He was working as a corrections officer in a jail at the time, and one day after running to break up a fight between inmates, he blacked out.
However, it was really the fatigue that first led Joshua to seek treatment. Like so many patients, he was experiencing a feeling of being extremely run down, and unable to garner his energy. The doctor he saw wanted to rule out pneumonia, and it was during the chest x-ray that aortic aneurisms were discovered.
Joshua’s journey with PH officially began in 2010. For some time, he had been experiencing shortness of breath, extreme fatigue, and general weakness. He was working as a corrections officer in a jail at the time, and one day after running to break up a fight between inmates, he blacked out.
However, it was really the fatigue that first led Joshua to seek treatment. Like so many patients, he was experiencing a feeling of being extremely run down, and unable to garner his energy. The doctor he saw wanted to rule out pneumonia, and it was during the chest x-ray that aortic aneurisms were discovered.
Initially scheduled for corrective surgery, the doctor
wanted an echocardiogram prior to the procedure. It was then that the extreme
elevated pulmonary pressures were found. The doctor called and told him he had
pulmonary hypertension – and that he had perhaps six months to live.
The cause of these aneurisms which kicked everything off is still somewhat uncertain – rare diseases such as HHT and Loeys-Dietz syndrome have been tossed around, but a solid diagnosis continues to be elusive. Whatever the underlying cause, this much is certain, Joshua still has severe pulmonary hypertension.
The cause of these aneurisms which kicked everything off is still somewhat uncertain – rare diseases such as HHT and Loeys-Dietz syndrome have been tossed around, but a solid diagnosis continues to be elusive. Whatever the underlying cause, this much is certain, Joshua still has severe pulmonary hypertension.
Instead of surgery, Joshua found himself undergoing a right
heart catheter. He was immediately admitted to the hospital and started on
Flolan. However, before discharge, the doctors elected to try just oral medications,
starting with Adcirca.
As with so many PH meds, the side-effects were intense. Experiencing extreme headaches and heart palpitations added to the breathing challenges that were already present. Eventually, Sub-Q Remodulin was added, and finally IV Remodulin was settled on.
Fast-forward to the summer of 2012 and Joshua was presented with a unique opportunity. He applied for a job at the Pulmonary Hypertension Association and was selected, becoming the first full-time employed PH patient at PHA, and is currently the National Support Group Coordinator
I talked with Joshua about his experience there. What’s it like signing 10 – 20 condolence cards per week for patients who have passed from the disease we share? What’s it like to experience that kind of emotion, and to interact so personally with the ups and downs that come with this disease? He stresses that finding outlets are important, for him: reading, writing, and the support of close friends and family being chief among the strategies he draws on.
As with so many PH meds, the side-effects were intense. Experiencing extreme headaches and heart palpitations added to the breathing challenges that were already present. Eventually, Sub-Q Remodulin was added, and finally IV Remodulin was settled on.
Fast-forward to the summer of 2012 and Joshua was presented with a unique opportunity. He applied for a job at the Pulmonary Hypertension Association and was selected, becoming the first full-time employed PH patient at PHA, and is currently the National Support Group Coordinator
I talked with Joshua about his experience there. What’s it like signing 10 – 20 condolence cards per week for patients who have passed from the disease we share? What’s it like to experience that kind of emotion, and to interact so personally with the ups and downs that come with this disease? He stresses that finding outlets are important, for him: reading, writing, and the support of close friends and family being chief among the strategies he draws on.
While Joshua is already dedicating his life to the PH cause,
this past fall he took it up another notch. The Race of Our Lives Campaign
has launched, and four women formed Team Phenomenal Hope to cycle 3000 miles
across the nation. In his own way, Joshua is joining them.
Inspired by what the team will accomplish and experience, he has created the PH Peddler in an act of solidarity. Launched on September 9th, 2013, he too will cycle 3000 miles, spread over the months between his start date and the race itself. The plan is to cycle a certain number of miles per weekday, with weekends either off or for make-up time in case of illness or set-back. With PH, we always have to have a contingency plan.
The goal – to raise up to $50,000 towards PH research, and to engage people at the community and corporate levels in meaningful ways. There has been a multistage roll-out, starting with social media on Facebook and Twitter and now it is time to take it to the next level and find corporations willing to join the cause.
Inspired by what the team will accomplish and experience, he has created the PH Peddler in an act of solidarity. Launched on September 9th, 2013, he too will cycle 3000 miles, spread over the months between his start date and the race itself. The plan is to cycle a certain number of miles per weekday, with weekends either off or for make-up time in case of illness or set-back. With PH, we always have to have a contingency plan.
The goal – to raise up to $50,000 towards PH research, and to engage people at the community and corporate levels in meaningful ways. There has been a multistage roll-out, starting with social media on Facebook and Twitter and now it is time to take it to the next level and find corporations willing to join the cause.
Joshua says he feels blessed that he can do this, although
it is not without challenges. As he wears a continuous infusion pump, he has to
be careful to not tug the pump, open the site to infection, or even over-exert.
Pacing and sometimes taking breaks mid-ride are key.
Following
the PH Peddler on Facebook gives you a glimpse into this journey. Miles
covered, feelings as he rides, and if you are paying attention…sometimes
inspirational quotes instead of miles. Why? Because when a PH patient gets sick
or travels, or overdoes it or just wakes up “off”, everything can come to a
halt. The PH Peddler has had a few unexpected breaks as of late – actually, not
totally unexpected, given the severity of the disease and reach of this
project.
But this is Joshua – given six months to live three years ago, facing multiple critical illnesses, and experiencing things that would shut most people down, he could be sitting at home having given up. But instead of giving in, he bounces back every time, dedicates himself to the cause every day, and is impacting people around the country because of it. There is little doubt the Peddler will be back on the bike and more than make up for lost time in the future.
Follow the Peddler on Facebook HERE
And on Twitter HERE
If you’d like to get
involved in the Race of Our Lives in your own act of solidarity, there are many
ways to do so, and they don’t have to involve a bike. Visit http://phassociation.org/RaceOfOurLives to learn more.
Wednesday, November 13, 2013
Meet Steve White
Well, it is PH Awareness Month, and truth be told I don't have a lot of pressing things to write about right now. Maybe that's because life is so full with other things... a nice problem to have. But still, I should spend the month doing something, right?
So, I thought it might be neat to bring you the story of others in the PH community who inspire me. I draw so much of my strength and drive from them... and it gets boring (and slightly self-indulgent) to write about my own experiences so much. The first is Steve's. The others are HERE.
So, without further ado, the first introduction.
Meet my friend and fellow Board of Trustees member, Reverend Steve White.
Steve is the chair-elect for the PHA Board of Trustees, and will take the helm this June at our 11th annual PHA International Conference (you are going, aren't you?)
Steve has been really important to the PH journey for many people. He lost his daughter, Christen, to the disease in 2002 and has turned their story into a way to help others (see why he is inspiring?).
More specifically and importantly, he often helps people understand and go through the grief process that is so often associated with the disease. When you have this disease, or know people who do, you loose people dear to you. A lot.
I remember when I first joined the Board, and realized how many people on there had lost someone they loved, and were carrying on the fight in their memory and honor. I often wonder if I would have the strength to do the same... it seems so raw. We have a lot to thank these people for, as they turn their grief and loss into strength and gain for our community.
You should know Christen's story too. But I should not be the one to tell it. Steve does it much better justice, and you can read all about her, and the importance of early diagnosis and pediatric research HERE.
And be sure to subscribe to the blog for more inspiring stories... I have some good ones on deck!
So, I thought it might be neat to bring you the story of others in the PH community who inspire me. I draw so much of my strength and drive from them... and it gets boring (and slightly self-indulgent) to write about my own experiences so much. The first is Steve's. The others are HERE.
So, without further ado, the first introduction.
Meet my friend and fellow Board of Trustees member, Reverend Steve White.
Steve is the chair-elect for the PHA Board of Trustees, and will take the helm this June at our 11th annual PHA International Conference (you are going, aren't you?)
Steve has been really important to the PH journey for many people. He lost his daughter, Christen, to the disease in 2002 and has turned their story into a way to help others (see why he is inspiring?).
More specifically and importantly, he often helps people understand and go through the grief process that is so often associated with the disease. When you have this disease, or know people who do, you loose people dear to you. A lot.
I remember when I first joined the Board, and realized how many people on there had lost someone they loved, and were carrying on the fight in their memory and honor. I often wonder if I would have the strength to do the same... it seems so raw. We have a lot to thank these people for, as they turn their grief and loss into strength and gain for our community.
You should know Christen's story too. But I should not be the one to tell it. Steve does it much better justice, and you can read all about her, and the importance of early diagnosis and pediatric research HERE.
And be sure to subscribe to the blog for more inspiring stories... I have some good ones on deck!
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