Kinetics - Where Parkinson's Meets Parkour

A teacher who has recently been diagnosed with Parkinson's disease and a wayward student who has discovered Parkour are at the heart of a new film coming out this fall. Sue Wylie based the characters and story on her own experiences after she was diagnosed with Parkinson's. She wrote it first as a play and then, after the success of their performances, she began considering the possibility of creating a film, which would allow her story to reach a much larger audience. To give a teaser, here is a link to the trailer for the play: KINETICS.

Kinetics - where Parkinson's meets Parkour is a story about the desire to move through and past the obstacles in our path. In Parkour, the challenges are taken on voluntarily and consciously; getting past the obstacle on the path is the whole point. For those of us who have been diagnosed with Parkinson's, these challenges are not taken on voluntarily. Parkinson's disease is the obstacle we try to move through every day. When part of the sidewalk in front of me has been broken and pushed up by a tree root. I might not be as fast or as graceful as a freerunner, but getting over it, I can feel a sense of accomplishment as though I had leapt tall buildings with a single bound.

One of my former students is now doing Parkour. He's made quite a name for himself. Dylan Baker is not only really, really good, but he seems to have no problem with heights, dashing across narrow beams 50 ft in the air as if they were setting on the ground. I enjoy watching Parkour as I enjoy watching dance, gymnastics, and, well... any kind of movement accomplished with the human body. Perhaps it's because movement can be difficult for me, but it might be something more. I haven't seen this film yet, but I suspect we'll see that getting past obstacles on our path has to do with more than just our physical obstacles. 

I am so looking forward to seeing this film and sharing it with my family and friends. 

Health Labs Offer CoQ10 Test

And the nice part of this offer is.... it's free! As long as you mention that you read about it on my blog.

Health Labs offers direct to consumer lab testing. You don't have to have a referral from a doctor. This is a service they offer to those who want to have testing for allergies, heavy metals, hormone levels, anemia, or vitamin and nutritional testing. There's more, too, more than I can list. You pay online and your receipt (or ticket) allows you to go to any Quest Diagnostics Lab for the blood draw. They will send the specimen to Health Labs. We've used Quest Diagnostics numerous times. There's one not far from our home.

Generally speaking, I'd rather do just about anything than get blood drawn, especially if I'm paying out of pocket, but I can understand why some people would like to do this, if they can. For people who are trying to use alternative, holistic health care, their MD might not agree that certain tests are necessary. Others choose this because they have no insurance or are under insured. It's a choice that is out there for people who can afford to do this... many of the prices are very reasonable.

This last week, Health Labs came out with their list of the Top 100 Health and Wellness blogs. My humble blog showed up at number 28. I was surprised and somewhat bewildered to find my site on their list. Happy, too, of course, and I was honored to be included. I always feel like I should write back and say but.. but.. have you seen Meg's blog? or Jasmine's or Tom's or Yasmina's or any of the many newer blogs out there written by people I know? There are so many talented writers out there. I wish I had time to read every one of their blog articles.

Anyway, as part of being one of their top blogs and to introduce people to their services, if there is anyone out there reading this article who would like to have their CoQ10 levels tested, go to their site and mention my blog, Studio Foxhoven. Tell them you saw it here and the test is free. 

THE TOP 100 HEALTH AND WELLNESS BLOGS

Oh, and by the way, I was slightly embarrassed to find out my site was the only one without a dedicated facebook page and twitter account. So, I have updated my Studio Foxhoven Facebook page (originally meant for craft work) to reflect my writing. Anyone is welcome to follow me on Twitter (@TerriReinhart), but be forewarned - it's mostly political.

Finding Your Voice

Time for a re-run of an article I wrote six years ago. Speech is an ongoing concern for anyone with Parkinson's disease, but then, it is for many people and I don't think we are consciously aware of how differently we treat those who have challenges with speech. Even having a quiet voice can be a challenge in social situations. In a crowded room, it's hard to hear us. How much easier it is to start a conversation with someone whose voice is loud and clear! 

I have had a number of friends who have struggled with speech challenges. Though conversations with them will take time and effort, they are always worth it. For better or worse, it is all too easy to stop trying to communicate with others, especially when you are met with people who equate clear speaking with intelligence. 

So, here is my article again... titled:  SPEAK UP!

One of my favorite scenes in the movie, "The King's Speech", is during a speech therapy session where the King starts swearing as he practices for the speech he has to give.  This pretty well captures my feelings about public speaking.

Even without a speech impediment, I was a quiet, shy child who would rather eat bugs than have to give a book report in front of the class. I was in a school play, once.  Well, twice, if you count my first role as a tree.  Trees don't talk. In my only speaking role, I was a bad angel and my one line consisted of three words, "Keep the money".  That the main character decided to listen to the good angel instead, may have had something to do with the fact that my lines could not be heard if you were more than three feet away from me. I came to dread the inevitable words from my teachers, my parents, and even my friends:  "Speak up!  We can't hear you!"  That's easier said than done.

As an adult, I worked hard to improve in this area, though I never was able to project well, because leading parent meetings and giving educational talks was a required part of my job. I eventually came to enjoy speaking to groups, as long as I was speaking about something that I was passionately interested in.

That changed when Parkinson's disease became a part of my life.  Even before I was diagnosed, I started having more difficulty with speaking.  My voice became quieter and I started stumbling over my words, sometimes freezing in the same way I freeze when I move.  This was my first indication that I needed to leave my teaching job.  Doing this once during a parent talk was embarrassing enough as I would totally forget what I had been talking about.  I would do this repeatedly.  I didn't want the parents to think I was totally stupid.  Before that year was out, I let my colleagues know that I would not speak to groups at evening meetings.  

Once I was diagnosed and my medications stabilized, things got better.  I don't freeze as often either in speech or while walking. As with most everything else with my Parkinson's, evenings are always off times. I am not articulate in the evenings. Difficulty with speech is also one of the symptoms that immediately comes back as soon as my meds begin to wear off at any time of the day.

I'm not teaching anymore and I'm not required to speak in front of groups.  My friends and family understand that it takes time for me to find the words I need and they are usually patient with me.  So, why, as the King would say, should I give a shit about how I speak?

There's a good reason to care about this.  My family and friends might be used to me but I've found that people respond to me very differently depending on how articulate I am at any one moment.  That includes my doctors, even my neurologists who specialize in seeing people with Parkinson's disease.  If I am having a good day and speaking well, my doctors are more likely to take me seriously and treat me as an intelligent adult.  If my speech is slurring a bit or if I stumble for words, it seems to me that my doctors are more patronizing. 

We tend to equate articulate speech with intelligence.  This is one reason I find writing to be so therapeutic.  I don't slur my words when I write, or at least when I type.  My handwriting I can't guarentee.  If I stumble over what I want to say next, there isn't anyone around to get impatient with me.  I can take all the time I need.  When my first neurologist started reading my articles, she suddenly began relating to me more as a person than a patient.  She treated me as an intelligent adult.  I'm not saying that she treated me badly before; it's just that when time is limited, we all tend to go with our immediate reactions and judgements.  I don't know many doctors who have the time to really get to know all of their patients. 

At the end of the movie, the King has given his speech over the radio, with his speech therapist standing nearby.  He does well, stumbling a bit at the beginning but ultimately delivering his message in a heartfelt and beautiful way.  Afterward, his therapist looks at him and tells him that he still stumbled over the w's. 

"That's okay", the King says, "I had to throw in a couple of them so they'd know it was me."

If a king can do this, I guess I won't worry too much about stumbling over my words from time to time.  Maybe one day, I'll take advantage of a speech study for people with Parkinson's disease. Until then, at least when I stumble, you'll all know it's still me.

Never Give Up

A year ago in April, a couple of things happened which would change my life; nothing monumental, but significant, nonetheless:

I became foster mom to a litter of 5-day-old puppies - and - I met Uncle Donut. Okay, I met a lot of other people, too; but who wouldn't be excited about meeting someone named Uncle Donut?

In this last year, we have raised a total of 9 orphaned pups from when they were brought to the Municipal Shelter to adoption age. Our grandson says, "It's not just a one time thing with Grandma, it's an ongoing habit." Yup. Who could say no when asked to save the lives of tiny, cute, adorable puppies?

And in the last year, I've gotten to know more of the "Never Give Up - Parkinson's and Dystonia" family. It has become an extension of my family as well. There is something special about an online group where, if I don't post for awhile, someone is going to check up and see if I'm okay. There is something special about an online group when they plan a meet-up in Denver and over 100 people show up from all over the country. 

The group was founded by Erika Snider-Jimison after she had been in another, larger group, and she wanted something more personal. Now, she and 7 others (including Uncle Donut - Keith McCoy) are administrators for a group with over 1700 members. Not everyone is very active in the discussions, but that doesn't matter. Some people are more comfortable just reading what the others write. The important thing is everyone is welcome; you can ask whatever questions you want; you can vent, be silly, post video blogs, or eat donuts. 

I'll let some members speak for themselves:

From Erika - "Seeing the love and support this group has for one another online and in person is a testament to why support groups are so important. Starting this group has been my most rewarding achievement to date. When I think of NGU I smile."

From Terry W - "Some say I inspire them to do better of themselves. I say each one of you are an inspiration to me. To see the different ways that a person can deal with all the negative issues of these afflictions and still be a light to all around them. My hat is off to all of you.. You are the blessing that has renewed my heart and brings a smile to my face every day."

From Keith - "Parkinson's Disease is not an "old persons disease", it affects all ages, genders, races, etc.... There is no cure and it's a terrible disease to have, especially if Dystonia sets in. These diseases are painful and I don't wish them on anyone. I have both plus fibromyalgia, edema, osteoporosis, etc.. We struggle every day to do what used to be easy tasks, like brushing our teeth, eating, getting dressed and more. It's a degenerative disease that cripples you. It not only affects you emotionally and physically, but it affects those you love. Don't feel sorry for me, but laugh with me. I'm known as Uncle Donut in my support group and they're amazing people We need a cure."

Keith asked, "What stuck with you from the Meet and Greet?" Some of the answers are below:

• The true warmth and genuineness of everyone! From the greetings to the hugs, to the offers of help! It was humbling!
• It would be how comfortable it all felt.
• How I wasn't self conscience about how I walk or movements I make, because, everyone understands.
• I still try to hide it, especially at work. It's so exhausting.This weekend I was able to just let the tremor do its thing.
• How real and genuine everyone is. The warmth of the hugs. The feeling of having known each other for so long. The generosity. The willingness to help each other without blinking an eye. The strength, courage and laughter through struggles.
• The thing that stuck with me the most was "no fear". Through storms, dystonia, nOH, for the first time (in public) there was no fear from those around me. I had no fear of people not understanding. It was a wonderful feeling! I cannot thank you all enough for giving that to me!!
• Beauty. Erica's video celebrates the beauty of NGU members. You have to see them in person to appreciate it. Gorgeous. I felt attractive myself in their company. (my note - when the people around you can see the beauty in every person, it's easy to see and feel the beauty in yourself)
• The comfortable feeling to be around folk that understand! No explanations - NO hiding symptoms - HUGS instead of DRUGS!! And no one expects or suspects anything...WE CAN JUST BE!!
• By only being there virtually through all the wonderful posts, it is family. A sense that we are not alone, and among others that understand the daily struggles and accomplishments. I will be there next year!

Look at this photo - these are the faces of people with Parkinson's and Dystonia. Yes, there are some family members in the picture, too, but our youngest group member is 3-years-old and has Dopamine Responsive Dystonia. Okay, her parents are active in the group for her. We have other children with DRD. We also have young people in their teens and twenties with juvenile onset Parkinson's disease. The oldest member of the group is 82. I'm almost 60 and in many PD groups, I have been the youngest. Not so in this group and it's not just because I've gotten older! 

The Meet and Greet included a catered lunch, T-shirts, and two keynote presentations. The first was given by Jasmine Sturr, who has juvenile onset Parkinson's disease. She spoke about the non-motor challenges with Parkinson's, making a good argument for not describing Parkinson's as a movement disorder, redefining our language to describe PD as a "Systemic Neurological Disorder". Her entire talk is on her You tube channel.

The other speaker was Navin Kumar. Navin has Parkinson's disease and he also has a partially mechanical heart because of a congenital heart defect. He has had 5 open heart surgeries. He is also a champion table tennis player and is, right now, in Germany to represent the US in the Paralympics in table tennis.  

Online, the group is growing every day. This will be a challenge for our administrators and all of us. Can we keep the personal, community feel with over 1700 members? For those who cannot come to the Meet and Greet, how can we include them during this special time? As the numbers grow for the Meet and Greet, how do we reach out to all the new folks and not just hang out with those we know and are comfortable with? Can we have some fundraising to help members who would like to come, but can't afford the trip? Or use some of us who are in town to provide host homes?

Teri, Terri, Terry, and... Teri! 

I believe this group can do it. We have amazing leaders who really believe in this community. In Denver, Keith Uncle Donut McKoy made sure to greet every person in attendance and he had his picture taken with each one of us. This year, we added a picnic after the Parkinson's Vitality Walk, just to give everyone more time to get to know each other. 

Nearly everyone came. We even brought the puppies.

When Do You Call It Quits?

My friend, Ed Sikov, recently wrote a wonderful article about writing. With the title, "How Do You Know When Your Writing Career Is Over?", I was almost too scared to read it, wondering if I'd find out my writing career should be over. It's way too easy for me to believe. Scared or not, I read it anyway. Ed's a friend. He's also someone I consider to be a real writer, he has written books and articles and gets paid to do it. Any advice he gives, I'll take seriously.

Soon enough, Ed reassures his readers. All we have to do to be a real writer is... write. Write consistently. Don't say we're going to write, just do it. Don't stop because we get rejection notices or because someone thinks it's a silly thing to do (Ed words all this much better than I do). I would encourage any and all writers to read this article, more than once. Print it out and keep it handy for those times when you get discouraged.

Then, about halfway through his article, he speaks about his diagnosis of Parkinson's disease and how this affected his writing. What he had been doing for years as a professional writer didn't work anymore. He didn't call it quits; he changed how he was writing. This article of his is proof he still is very good at what he does.

I would also encourage any and all people with Parkinson's disease or other chronic health challenges to read this article, print it out, and keep it handy. It's easy to get discouraged when it's harder to concentrate, harder to find the fine motor control, harder to find the energy to do things we used to enjoy so much. We have to learn when to take a step back and change how we do things, not call it quits.

Craft work was a huge part of my life for a long time. It's not that I cannot do it anymore, but the end product of my art work was no longer up to my standards. So I called it quits on a few things, like felting and artistic books. I couldn't think art anymore; couldn't get into that special art zone. I called it quits on broom making too, but that was for another reason; it's just too hard physically. I'm cleaning out my studio and giving a lot of art supplies away.

I still make simple books from time to time and I knit. I don't think I'll be tackling any complicated lace patterns, but I can still do the basics. It's enough and it's very satisfying.

I also write. Oddly enough, I didn't really start writing until after I was diagnosed with Parkinson's. This blog began as articles I wrote simply to help me process this new direction my life had taken. I finally put them on the website because I wanted to make sure I wouldn't lose them if my computer crashed. I didn't really expect anyone to read them. Perhaps this made it more exciting to hear I made the top 15 Parkinson's blogs of 2017, chosen by Healthline. 

I've made the list for a number of years now, but I never expect it. I've run across some wonderful new blogs by people with Parkinson's disease and, if there is a year I am not chosen, I won't be the least bit offended. I won't call it quits, either. Writing seems to be in my DNA. My father wrote his first novel at age 85. Our son, John, is becoming well known for his poetry, and our daughter, Emma, has had two of her short plays chosen to be performed. I'll do my best to keep up.

And before I sign off, here's my new favorite Parkinson's blog:

Small Girl With Parkinson's by Meg Bernard

Oh, and if you haven't done it already, read Ed Sikov's article. 

Healthline

A Journey through my Dad's Heart

It was a wonderful privilege for my sister and I to sit in on Dad's echocardiogram this morning. An echo cardiogram is an ultrasound of the heart and is often done after someone has had a heart attack. Ever since Dad's mild heart attack on Good Friday, he's been concerned and curious about what the doctor will find. 

We sat down and watched as the technician put the leads on his chest and turned off the light to start the test. Gray, fuzzy images came on the screen. That was Dad's heart? I kept trying to understand what I was seeing. The darkness started to make me sleepy. Dad's arteries, valves, the atria, the ventricles; all were fading in out in grays, whites, blacks. Half asleep, pictures started forming from his heart images on the screen.

It was like seeing pictures in the clouds. What was that? It looked like a small gray man playing a clarinet. Funny... Dad played clarinet. A three leaf clover? An elf playing piano? A hippo eating biscuits? An exotic dancer? 

"Hey," said my sister, "was the dancer upside-down?"

Uh, yeah. I'm not sure whether to be relieved or worried that we both saw an upside-down exotic dancer in Dad's heart. We were both pretty sleepy. 

After the test, the technician was quiet for a minute and said, "Well, if he was a lot younger, the doctor would see all sorts of problems, but probably, he'll want to see your dad in a year." This was not surprising. Will he still be here in a year? I know there's a lot wrong with Dad's heart. I also know there's nothing wrong with his heart.

That's because there's a lot more to see as we take this journey through my father's heart:

such as a small sheet of paper with the names of all four of us kids and a space to mark when we came home from an evening out with friends. Theoretically, this was to make it easier for Dad to get some sleep and be assured he would know who is home. He still got up to check.. every time one of us walked in the door.

A paperback book with a $20 bill stuck inside, handed to one of us whenever we needed a little cash, with the words, "don't lose the bookmark" said quietly.

A brown paper bag containing peanut butter and butter sandwiches, which meant Dad had surprised one of us by making lunch for us.

His heart is a little sloppy now and it's getting crowded in the veins. If anyone ever grumbled about our house being sloppy or crowded, Dad would laugh and say, "you should've see the house I grew up in!"

There are stories and stories and stories - about his time in Africa, his time on board ship during World War II, about his imaginary friends, Mr. Brown and Andy, and about attempting to play his clarinet with false teeth.

And there is our mother. They've been married 62 years and he's been in love with her the whole time. Even through the most challenging time of their marriage, when side effects to her prescription drugs caused psychosis, Dad would say, "I just want to live one day longer than Mom, so I can take care of her." 

Dad and I share a few things. We've both been diagnosed with Parkinson's disease. Because of this, we've been able to have our DNA testing done through 23 and Me. I perused our reports to see what we have in common and found: we share 49.9% of our DNA, we both consume a lot of caffeine, we're both light sleepers (hmm), we both have dark eyes and detached earlobes, and we both have straight dark hair.

It doesn't say anything about our hearts, but regardless of how it's working now, I hope I inherited a heart like his; even if it comes with an upside-down exotic dancer, clarinet playing guy, hippo, piano, and three leaf clover.

But it's just a headache!

We didn't go to the doctor very often when we were growing up. Unless we needed stitches, a cast, or had strep throat, we pretty much made do with home remedies... or just simply waiting it out.

We didn't go to the doctor for the simple stuff like ear infections or childhood illnesses. An earache meant getting drops of warm vegetable oil in your sore ear. Mumps, measles, or chicken pox meant letting your siblings drink out of your glass so everyone would get sick at the same time. A headache? Lie down with a cold washcloth on your forehead. Rest. It will go away eventually. Stomach flu? Just try and get to the bathroom in time; when we could eat again, we got warm jello water. 

A few weeks ago, my dad was having some pain. "It's okay," he grimaced, "it'll go away in a minute. It always does." When we finally got him to the emergency room, we found out he was having a heart attack. He expected a heart attack would have been more painful and obvious. 

Somehow, I got the message that going to the doctor, the emergency room, or even being in bed sick for days meant I was being lazy. I don't think I was taught this, it was just something I picked up on my own.

via GIPHY

In my 20's, I started having migraines. I didn't know they were migraines. They were headaches, albeit rather severe headaches.. that lasted 3 to 4 days. Who goes to the doctor because of headaches? Who stays home from work because of a headache? Still, over the years, I mentioned my headaches to the docs now and then. Some brushed it off, one suggested I take Ibuprofen every 4 hours - indefinitely. One told me I wasn't having migraines. I didn't find the docs very helpful; but then, I wasn't articulating my concerns very well, either. It was just a headache. 

I've learned a lot in recent years. Migraines may be an early indicator of Parkinson's disease. I've found out that a lot of people who have Dystonia have migraines. My three day migraine parties are not unusual. The nausea and sensitivity to light adds to the festivities.  Then, after the major headache is gone, along comes the Migraine Hangover. That's the day when your head isn't pounding anymore and you don't feel like throwing up; your head just sort of aches here and there, and your body feels like it's been rolled down a rocky hill, through a creek, and left overnight to dry.

Some people get an "aura" (seeing lights, smelling something, etc) that tells them a migraine is coming. I get cravings for certain foods, which I will never crave, ever again. Last week, I suddenly just had to have hash browns. I ate a lot of hash browns. I now hate hash browns.

The biggest thing I've learned is that headaches can be a big deal and docs actually take you seriously when you seriously ask for help managing them. There's medication, even some I can take, that will knock out a migraine in progress. Of course, there's the possibility of a "blow-back headache", and I can only safely take the medication so many times per month, but it's something.

I'm getting a little bit better at figuring out when to go to the doctor.. and.. there's no such thing as "just" a headache.

Take it to the limit

April got away from me. It's the first full month of spring, so I guess it's appropriate. This year, trees are leafing out already and the first daffodils started blooming almost a month ago. Our world is bursting with life and activity. We get the urge to do and create and .. well... sometimes the energy is a little crazy.

When I got the first call, I looked at the calendar. During the month of April, I had only 4 important events: Easter (and hosting our family gathering), speaking on the women's panel at the school of pharmacy, Emma's square dance graduation, and staying with our grandchildren for 3 days at the end of the month. Not bad. I figured I could balance activities with rest and be just fine.

So I said yes, I'd participate in the clinical study. It was to be just one morning of cognitive testing; lots of cognitive testing. I like to support these endeavors. Two hours later, another call came. Since I'm participating in this study, would I consider staying a few more hours to be in another study? I would be getting a MEG scan to record my brain's activity. Why not? I'd be there anyway, and hopefully they'd find my brain was doing something other than playing hopscotch or reading comic books.

After the MEG scan, I had a wonderful conversation with one of the doctoral students whose thesis was looking at brain activity to test the theory that our brains become more active and more capable when we stretch out limits, at least to a certain point. When tasks become too difficult and our answers required too quickly, we make more mistakes. We also make more mistakes when the tasks are too slow and not challenging enough. Our brains just get bored and go back to reading comic books. Fascinating!

Then the next phone call came. This was two hours after finding out how much better our brains do when we are pushed to do a somewhat more difficult task. It became my argument and justification (rationalization?) to say we'd take the 3 orphaned puppies and foster them. I'm not sorry we did, I never am. Even at 2 am, looking down at a nursing puppy drinking his formula from a sponge, I am always in awe of this tiny life in my lap. I just had no idea our lives were about to become even busier than I had imagined. 

Easter - we've always told our kids they are welcome to invite friends to our holiday celebrations. We've tried to make all our holidays welcoming to friends, family, friends of family, family of friends, and others. My mother-in-law did this exceptionally well and my husband grew up with large gatherings of very diverse people. This year, everyone got into the spirit and at one point, I had 27 guests on the list with a possible 5 more. WONDERFUL! 

Among the guests were my two brothers and my sister-in-law. They arrived on Thursday evening. Friday morning, Good Friday, we took our dad to the emergency room and found out he was having a heart attack. We didn't bring him in for heart attack symptoms, but thankfully he was in the hospital and being cared for when they discovered this. Our whole focus was on Dad. As heart attacks go, this was a mild one and Dad did very well. Something like this brings up lots of emotions and lots of questions: 

Are we doing enough to take care of Dad? Why didn't the staff at the facility recognize how ill Dad was? Will he need more care now? How do we make sure he gets the help he needs? If he has an angina attack, will the staff get the nitro pill to him in a timely manner, as in right away? Should I be going over every day to check on them? ..and making sure the facility is doing its work? Do I need to cancel our Easter plans?

I didn't have any control over Dad's health and I was so very grateful my brothers were both in town. I decided to go ahead with Easter, partly because I didn't know who all was coming and partly so we could at least provide food for my parents and other family, too. Together (it was potluck) we fed 25 people. 

Dad came home on Saturday, before Easter, feeling very tired and weak. One thing we found out is that he has an artery which is almost blocked, but not quite. At 92, they will not do anything invasive unless we insist; something we will not do. And because it is not quite completely blocked, it's possible his heart will find a way to reroute the blood flow all on its own. Our bodies really are amazing.

A week later and I'm crashing. On day 3 of a migraine and in the migraine "hangover" stage. Like everyone with chronic health issues, I am constantly trying to figure out how much I can do. I think the migraine is my brain's way of saying ENOUGH already. Time to rest for awhile. Tomorrow I'll get up and face the daily dilemma: Take it easy or take it to the limit one more time? 

Sometimes we make the choice. Sometimes life makes the choices for us.