Surviving

When you have CF you spend your life waiting for the ball to drop on your health.  You live life as best as you can: you go to college, you get a job in your field, you stop when you need to and in between you fit in hospital stays, IVs and therapies daily.

But what happens when you hit your 30s, you can't work because your health is too precarious, and you have been evaluated for a double lung transplant, and then you learn that you MIGHT get a new drug that could push that expiration date to over 60?!

It sounds so exciting and amazing and just plan AWESOME.

But it also sounds scary and emotional and weird.

WHY???

Well that's because you spent your whole life up until this point thinking that you would never ever see 40.  That making it to almost 33 is a miracle in itself.  And that the thought of living to 60+ is just impossible.  I know to someone who hasn't had to deal with this it probably sounds ridiculous.  But let me explain.

I don't remember when I became fully aware of CF and its consequences.  I always knew my life was going to be shorter but I don't think I ever truly THOUGHT about it.  Not until 15 or so years ago anyway.  Then I began to think about my life expectancy.  I went to college right after high school and I got a job in my field right after college in the fall of 2001.  I worked in my field for 8 years, almost to the month (November 2001 to December 2009).  I participated in the 401k offered by all my employers but I don't have one anymore.  I took the penalties when I moved up to Boston and took that money to survive on until I was approved for SSDI. When we would have meetings in work with the 401k company I would tell them I was not going to live to retirement age so what were my options?  Just get it anyway.

I have never thought about burying my parents or living without them.  I have always assumed I would be buried first.  I have never thought about old age and spending 30 years with my husband.  I always assumed I would be dead by 40.  I never expected to see my niece and nephew graduate high school, college, or get married.  I haven't worried much about things because I was expecting to be dead by 40.

Now I am faced with the possibility of ALL of those things.  I might have to bury my parents.  I might spend the next 30 years with Peter.  I might see my niece and nephew grow up and get married.  I might make it to retirement age and I might not be prepared.

When you expect to die early you live your life completely different than someone who expects to retire some day. And not just in "living" life, but in preparing for old age.  Why prepare if there is no need for it?  I wanted to keep my 401k in a 401k when I "retired" in 2009 so that my family wouldn't have to be burdened with my funeral costs.  I was told by them not to worry about it, to take the money to survive on then.  You think differently.

How does one cope with this new prospect of life?  Especially for someone who likes to be prepared, how do you cope with the possibility of NOT being prepared to retire?  Kalydeco, when it comes out for DDF508 mutations, will change my life forever.  I will live to retirement age.  I will grow old with Peter.  I will be able to go back to work.  But its going to be like starting out at 35.  Those 14 years where I was working, and then not working, will be like they didn't exist.  I will have to start from scratch.  And let me tell you how scary that thought is.

I don't want anyone reading this to think I am being ungrateful.  Believe me, I am thoroughly ecstatic that I will get to do all that I wanted to do again without needing new lungs.  I won't have to worry about the threat of cancer being exacerbated tenfold because of immuno-suppressant medications. I might get the chance to be as close to normal as possible.  And that is amazing and exciting to me.

But I still have to deal with things I never thought I would have to.  I guess it makes me human and normal to now think about things that my husband and brother and friends think about.  To worry about retiring and having money to do it.  To worry if I will spend the rest of my life working somewhere I hate to get a good retirement, or if I will do something I love for 30 years.  The possibilities are endless, and though they are scary and exciting, they are inevitable.

I hear there are survivors groups for people with CF living over the age of 40.  Maybe we need more of these, for those who will be changing their life's outlook completely in just a few short years...or less...

Self Perception

Don't worry this isn't another weight related post.  This one is all about the inside.

With Kalydeco's wonderful results and the start of phase 3 for Vertex 809 (combo med for those with DF508)  with amazing results in phase 2, its a possibility that we could stop CF progression where it is right now in some patients and perhaps even reverse some of the damage.  This is a huge step in the right direction to make CF much more manageable.

But it brings into ones mind some thoughts that wouldn't be there otherwise.  For me these thoughts always played a part deep down in my thinking.  I have often wondered what a "cure" would mean to me.  Disclaimer Kalydeco is NOT a cure.  It restores function to a non working protein in the cell.  CF is still CF, this med just helps the underlying cause and helps to fix it.

I hover around 40-43% FEV1 when I am healthy.  My shortness of breath is daily.  My ability to function normally has decreased drastically over the past 4 years.  Yet this new med could help me gain some of that all back.  I could potentially go back to work before receiving a double lung transplant.  I could stay off that list for many many more years.

However, there is also the negative side to this thinking that we must dive into.  What if I don't last long enough for 809 to be approved and started?  I am not content where I am right now, feeling like my life is on hold until I get a transplant, whether that is 1 year or 10 years from now.  I feel like I have stopped everything and I am not truly living.  I struggle with wanting to take my meds and doing everything by the book because if I don't I would get sicker faster and then transplant could come sooner and I could start my life over.  But we all know that transplant is not a guarantee.  I might not survive the surgery.  Or I might not make it home after waking up and trying to learn to live with new lungs.

But having my original lungs offers more of a guarantee to life than transplant does.  What I need to do is change my perception so that I can become more comfortable with my life as it is now.

I need to look at what I AM doing and focus on the positives there.  I need to step back and realize that I AM living my life right now, in preparation for when I can breathe again and do everything I have always wanted to do again.

I am a stay at home wife/mother who goes to graduate school and takes care of her health on a daily basis.  I am doing what I need to do now so that in 5 years I can do what I want to do then.  My life is not on hold yet.  My life is progressing different than anticipated but it is still progressing.  And I need to focus on THAT and not the what ifs.

Kalydeco could allow me to finish my degree and get a job before I get transplanted.  Or it might do nothing and I will still need the transplant.  But I have to continue on as if I am going to live forever and one day live and breathe with shiny new healthy lungs.