FROM SHOCK TO ACCEPTANCE

 By Anne Elizabeth Kinley

 One October day as I was hurrying
 from my car to one of mv classes at
 the College of St. Catherine in St.
 Paul, I felt my left leg give out, and
 down I went into a pile of leaves.  I
 told myself that I was hurrying too
 fast and was overly tired.
       Several davs later I took my
 daughter to her flute lesson, and on
 my way into the building I experi-
 enced difficulty in walking.  This
 time I couldn't find a logical excuse
 for my problem, and I decided to
 see my physician.
       The summer before, I had ex-
 perien@ a severe case of retrobul-
 bar neuritis in my left eye for which
 I had been treated with large doses
 of prednisone.  I had also been
 afflicted with numerous bladder in-
 fections in the past few years, but I
 didn't associate those happenings
 with what I was now experiencing.
       After giving me a thorough
 physical examination, mv physician
 sent me to a neurologist.  The neu-
 rologist saw me several days later
 and told me that he was 98 percent
 positive that I was suffering from
 multiple sclerosis and was in the
 moderate range of involvement.  He
 told me that I would have to be
 hospitalized for a course of treat-
 merit with ACTH, diagnostic tests,
 and phvsical therapy, but that I
 could return home first to make
 arrangements.  I had learned about
 MS in nursing school many years
 ago and pictured a chronic, incur-
 able, progressive disease, character-

 -------------------------------------------
 ANNE ELIZABETH KINLEY, R.N., is 2 staff nurse
 at the Childrens Health Center in Minnea-
 polis.  She was diagnosed as having multiple
 sclerosis in 1975, and now directs "The
 Hopefuls," an MS support group.
 -------------------------------------------

  ized by a loss of independence, neu-
  rological degeneration, and a
  wheelchair.  I drove home in a state
  of shock, crying so bad that I won-
  der how I arrived there at all.
       When I pulled into my drive-
  way, I jumped out to move a toy
  that one of the neighbor's children
  had left in my path and forgot to
  engage the parking gear.  My car
  kept moving forward and knocked
  the bricks out of the corner of our
  house before it stopped.  I ran into
  the house, histerically, phoned my
  husband's office, and ordered him
  to come home.  From then on I
  managed to control my emotions
  outwardly.
       To accept a diagnosis of multi-
  pie sclerosis and adapt successfully,
  during the past two years, I passed
  through four stages: shock, denial,
  regression, and acceptance.  Mv re-
  cent experiences have proved to me
  that traveling through each of the
  four staues, however painful emo-
  tionally, has played an important
  role in my present state of adjust-
  inent.
       When Earl took me to the hos-
  pital, I assumed the role of the good
  patient and cooperated fully with
  everyone. After four weeks of treat-
  ment, I was sent home on intramus-
  cular ACTH and with a 'quad"
  cane.  Walking was most difficult
  for me, and returning to the hospi-
  tal three times a week for therapy
  was all I could cope with.
       I became tired very, rapidly
  and needed to spend many hours
  resting.  My vision was blurred
  much of the time.  I had difficulty
  controlling my bladder and often
  awakened several times durring the
  night to go to the bathroom.  I
  found Myself unusually agitated
  from the'effects of the corticoste-

   roids, had problems with sleeping,
   and became emotionally upset over
   the smallest frustrations.
       My physician, family, friends,
   and minister thought I was adjust-
   ing beautifully, but my internal
   emotions were in a state of constant
   turmoil.
       My neurologist told me my
   life-style of attending school, work-
   ing, and homemaking would have
   to be altered, because MS patients
   do not get along well when sub-
   jected to many pressures.  Even
   though I knew I no longer had the
   physical and emotional stamina
   that I had once enjoyed, I couldn't
   believe that this was a permanent
   situation.  Thus, I went from a state
   of shock into a period of denial.
        During the next two months, I
   worked hard at rehabilitation, with
   the goal of returning to work part
   time at the Childrens' Health Cen-
   ter and Hospital in Minneapolis.  I
   returned to my job, but problems
   developed immediately.  We were
   short staffed and had a concentra-
   tion of seriously ill children to care
   for.  Even though I was only work-
   ing six days in each two-week peri-
   od with a day off between working
   days, I was exhausted, and it was
   extremely difficult for me to carry a
   full load while being so dependent
   upon a cane.
         I became more and more over-
   whelmed and fatigued, and before I

   had managed even two full months
   back on the job, I was ordered by
   my neurologist to take another
   leave of absence.  My condition was
   deteriorating.  After checking me
   over, he decided that I was suffer-
   ing from a hysterical reaction and
   referred me to a psychiatrist.
       While waiting a couple of
   weeks for an appointment with the
   psychiatrist, I spent much time try-
   ing to analyze my behavior.  I real-
   ized that I had been going through
   the textbook stages of adjustment-
   shock and denial-and had
   branched off into regression.
       My problems became clear.  I
   had become hostile over how rude-
   ly this disease had taken over my
   life and had totally ruined the plans
   I had made for advancing in nurs-
   ing.  My neurologist had been my
   scapegoat.  He, by diagnosing my
   MS, had given me a punishment
   that I wasn't able to accept, and in
   my irrational state of mind, I had
   decided to regress and show him
   and everyone who was close to me
   how helpless I was becoming.  I was
   slowly slipping into a state of de-
   pendence upon him, my family, and
   friends.  There is a large measure of
   comfort and security in such behav-
   ior, but I realized that in order to
   adjust and get the most out of my
   life, I would have to face my illness,
   accept my new body image, and
   reorganize myself.

      I had hit bottom physically
   and emotionally, but I felt that I
   could make it.  I turned to my reli-
   gion for guidance.  I became active
   in my therapy program by trying to
   live each day for itself.  I incorpo-
   rated regular periods of rest into
   my schedule.  My husband and I
   spent more hours communicating
   with each other, and he became a
   whole new source of strength to
   me. Life slowed down and I began
   to see, feel, and enjoy things that I
   had been too rushed to notice be-
   fore.
       I now accept the fact that I
   have multiple sclerosis.  I'm still
   new at it and make some mistakes.
   Sometimes, when I feel tired and
   experience increased symptoms, I
   continue with my activities instead
   of resting as I should.  I have found
   that when I do interrupt my normal
   pattern and decrease my activity
   for a couple of days, my condition
   improves rapidly.
       I have learned to set aside such
   activities as handwork, reading, and
   writing during these periods of rest
   and recovery.  I work part time at
   the Childrens' Health Center and
   have discovered that if I don't over-
   schedule other activities, I can still
   perform my nursing role quite suc-
   cessfully.  On days when I have been
   under increased stress, I compen-
   sate by getting off my feet when I
   return home.  Then I devote the
   next day to quiet pursuits.  My hus-
   band and I have started to attend
   meetings of the Minnesota North
   Star Chapter of the National Multi-
   ple Sclerosis Societv and have bene-
   fited from contact with others who
   share with me their problems of
   coping and adjustment.
        At this point I can honestly say
   that having MS is not all that bad.  I
   am gaining from it the ability to
   live my life in a lower gear and am
   seeing much beauty along the way.
        I thank God for each day of
   sight and movement, and pray that
   I will have the grace to accept
   whatever new problems to- 
   morrow might bring.      
   
   American Journal of Nursing/February 1980

----------------------------------------------------------------
  In her book, The Pursuit Of Hope,  Pulitzer Prize winner
  Miriam Ottenberg tells of her first symptom after being
  pulled out of the way of an onrushing car: "Too shaken to
  speak, I could not tell him the car appeared to me to be
  half a block away. Certainly I would not admit that all
  the cars now stopped for a light looked like those two-
  layered, over the road car haulers.  I did not know then,
  would not know for many years, that I had temporarily
  lost my depth perception, that the two-layered look of
  the cars was a mirage created by double vision, and that
  ?????? of it was mulitple sclerosis."
  ----------------------------------------------------------------