THE FACE OF AMD
AMD patients from around the world share their stories

• France – Jeanine Leroy
• Germany – Ingrid Hebenstreit
• Italy – Mario Petrucci
• United Kingdom – George McCulloch Kay
• United Kingdom – McDonald (Don) Curran, Immediate Past Chairman, AMDAI
• United States – Daniel L. Roberts
• Canada – Patricia Gill
• Canada – Charles Mossop
• Australia – Marion, Melbourne
• Australia – June, Townsville
• Australia – Frank, Sydney
• Brazil – Ronaldo Alfredo

FRANCE
Jeanine Leroy

Right away, Jeanine sought medical help and was referred to a specialist who told her she had a cataract in her left eye. The cataract was removed shortly thereafter, but once it was gone her doctor noticed something else. He told Jeanine she had wet AMD, a disease that causes rapid loss of central vision, usually over a period of a few months or even weeks.

Fortunately, within eleven days of her diagnosis, Jeanine received her first treatment for wet AMD. She was given an intravenous injection of a drug called Visudyne, followed by a cold laser treatment to activate the drug in her eye. Five months later she repeated the process, and together the two doses worked remarkably well and stabilized her vision.

During the course of treatment, Jeanine experienced two-months of depression, an experience quite common among AMD patients. She sought medical treatment for that as well, and it also helped immensely.

“AMD had a huge impact on my life,” says Jeanine. Because of the vision she did lose to the disease, she now has a difficult time with needlework, a hobby she is passionate about. When she reads she often has to go over a passage several times. She has mastered cooking and getting around her house, but she is no longer able to drive. “That’s my biggest regret,” she admits.

Jeanine thinks all wet AMD patients should have barrier-free access to the treatment they need, and notes that government health plans do not often cover the costs of laser therapy. “It would be extraordinary if governments would help people to get access to treatment for wet AMD,” she says. “I believe I would have lost much more of my vision without the treatment I received.”

GERMANY
Ingrid Hebenstreit

Ingrid went immediately to see an optician in her hometown in Germany. Two days later, she had a diagnosis - she was told she had the wet form of age-related macular degeneration (AMD). The condition, which typically develops in people over the age of 50, robs patients of their central vision by destroying the macula, a section of light-sensing cells in the middle of the eye’s retina. Even though wet AMD is known to progress quickly, over months or even weeks, few people experience its progression as rapidly as Ingrid.

With hardly any treatments available for wet AMD at the time, Ingrid’s retina was operated on in an attempt to stop the disease. The procedure was unsuccessful, and she suffered a retinal detachment and eventually a complete deterioration of the optic nerve in her right eye. “It was really hard losing my vision in that eye,” she says. “Little did I know there was more to come.”

Patients with AMD in one eye often develop it later on in the other, and Ingrid was no exception. But by 2005, when the disease began affecting her left eye, times had changed and many more treatment options were available. First she was given two photodynamic (laser) treatments, which had no effect. Fortunately, another treatment she was offered had better results, preserving the 15% vision that remained in her left eye.

“Wet AMD has definitely had a significant impact on my life,” says Ingrid, now 69. Although she has maintained her independence, she finds that most things take longer to do than they did before she lost her vision. “It gets tiring sometimes,” she admits. She used to walk a lot, visit many museums, and travel frequently. Now she does these things less often. Ingrid finds negotiating public transit particularly difficult. Since she lives on her own, and her sister (who also has wet AMD) and her niece live far away, she often feels a bit isolated.

But she has found vital support. Through a national peer group called Pro Retina, Ingrid has met a number of other people who have AMD. They get together every two months to share their experiences and learn from each other. “It’s a great comfort to me,” says Ingrid. “My friends have taught me that there is life after AMD.”

ITALY
Mario Petrucci

Mario went to see his family physician, and later was referred to an ophthalmologist, who diagnosed him with a disease he had never heard of before - age-related macular degeneration (AMD). The doctor told Mario he had wet AMD, the more aggressive form of the disease, which only affects about 10% of all AMD patients.

Mario’s ophthalmologist urged him to immediately get treated for the condition. He began receiving photodynamic therapy every three months over a period of two years. But unfortunately, by this time much of the damage had already been done, and he had lost vision in both of his eyes. Mario had to learn a new way of living.

“It’s not easy to live with AMD,” he says. “I am now very dependant on my wife. I can’t drive anymore, and it’s hard for me to watch TV the way I used to.” Mario finds he sees better in the dark, and that sunlight can be uncomfortable. He still reads, but only with assistance. And when he goes outside, he has to move about carefully.

“I still have some vision anyway, and that’s fine,” he says. Like most AMD patients, Mario has use of his peripheral vision. With three children and six grandchildren that he visits with often, Mario is glad for the vision he does have.

While he admits he has experienced sadness over his vision loss, Mario often reminds himself to keep a positive attitude. “Psychologically, I feel okay,” he says. “I tell myself that there are people who live in worse situations than mine.

UNITED KINGDOM
George McCulloch Kay

Only 56 at the time, he still had years to go in his career, but the disease put an end to all of that. Since the disease affects central vision (in an area of the retinal called the macula), George found that he could no longer recognize faces, read the numbers on his clients’ front doors, or drive his car - all essential tasks in his profession. “Unfortunately, because of AMD I had to give up my career. If that wasn’t bad enough, it also had a significant impact on my finances,” he says regretfully.

But George’s luck changed after he got help. His vision had deteriorated badly prior to his diagnosis, particularly in his right eye. He received laser treatment, and the therapy stopped his condition from worsening. It even restored some of the vision he had lost in his left eye.

Today George gets along well with the vision he has. He gardens by splitting his yard into sections to keep a mental picture of where everything is planted. He often can’t see the grass he is cutting, but he can see enough to finish the job safely. George lives with his wife, and they have two sons, a daughter and seven grandchildren. His family and friends help him to get around for shopping trips, medical appointments and outings.

They have also been very supportive and have helped him to remain positive over the years. “I’ve learned to adapt to AMD and make the most of it,” says George. Now 74, he has become chairman of the Edinburgh branch of the Macular Disease Society of the United Kingdom.

“I’m happy to spend time raising awareness and funds for this cause,” he says. “If I can help others going through the same experience, I will.”

UNITED KINGDOM
McDonald (Don) Curran, Immediate Past Chairman
AMD Alliance International

EYES WIDE OPEN : a story of dawn in the dark of night
By Patrick Tudoret

It began in 1999. D. was sixty-one, at the peak of a brilliant career, the Vice President of United Airlines for Asia. He lived in Hong Kong, and played golf every weekend at Shek-O, a club well known to the local aficionados. One Saturday, his friend Brian, as nearsighted as he was, seemed to have suddenly developed an eagle's eye; he could see and distinguish their golf balls at a distance of more than two hundred yards. There had been a miracle; he had had a laser treatment. D. was impressed. He thought the fountain of youth would run like a waterfall at the mere falling of his glasses into the wastebasket, and when he later investigated, he was told that an operation that took minutes would suffice to give him perfect vision, or at least improve it considerably. But being a careful kind of guy, he got a second opinion, a third, and a fourth. On the 22nd of April, unanimously reassured, he was operated on by Dr. L., a reputed Chinese specialist.

When he awoke from the operation, he was in heaven. From his home high on the Peak, he could see to the farthest horizon, from Aberdeen to the green spine of the outlying islands. This explosion of landscapes made him so happy he felt like a new human being. But it lasted only two weeks. His right eye began to see things hazily, then there was a distortion, then a blinding glare. His physician gave him explanations, but he remained very worried. He went to consult an American doctor practicing in Birmingham, Alabama, whose diagnosis destroyed every trace of his brief exuberance: "wet" macular degeneration. He would lose virtually his entire visual acuity; nothing would remain but peripheral vision, which meant he would not be able to perform such fundamental tasks as reading, writing, or driving. In an attempt to slow the condition in the left eye, another laser operation was performed, but to no effect.

Questions tumbled over each other. Had it been the laser operation that had caused this condition? Probably not. It was however certain that it had accelerated its development by five or maybe even ten years. Statistical data tend to indicate that this type of operation should be limited to patients aged fifty at the most. D's priority became the conservation of a normal life for as long as possible, but in spite of his ferocious determination not to give in, depression gradually overtook him, along with intense pain in his stomach and chest. The only relief came from long walks every morning around the Peak, and of course every morning he was aware of how much less he was seeing, and growing more and more panicky. His two weeks of glittering visual contentment had ended by plunging him into an absurd - but real - world in which he could no longer see the faces of those he loved, in which he was becoming more and more despondent. A German psychiatrist recommended by a friend prescribed antidepressants, and D. became virtually comatose. When he consulted Dr. L, he was quickly shown the door. Operations that cost $4000 US must not suffer this kind of negative publicity.

Depression led to suicidal obsessions, and in the depths of these sufferings, D. decided to write his own "Ten Commandments" for life - and they were nothing less than those closest to him: his wife, his children, and his grandchildren. His lethargy moved his wife to action. She insisted he go to Chicago's Northwestern Hospital, where three doctors gave him the understanding and competent counsel that he needed. His return to the land of the living actually began when United Airlines took the initiative and gave him early retirement. He would have to get used to it. The "sighted" world can be irrationally ill at ease when confronted with the unsighted, as if their handicap had somehow affected their intellectual capacities. In any case, the handshake was negotiated, and D. would effectively leave the company at the end of the year.

By that time, his decision was made: a return to the land of his birth - Scotland - seemed the way to to adapt to this new life, to focus the force around him that was his family. It was time to assess the situation: D. had become legally blind in the space of four months; gradually he had learned to deal with the depression that had crushed him; he was condemned without appeal to the loss of his professional life; by his own volition he had decided to have the laser operation, and there was no one else to blame; and last, his inability to see embarrassed those around him, and they treated him as if he were mentally defective. He determined to adapt to this new reality. He would no longer be able to distinguish colors, to enjoy the scenes of daily life, to read people's body language, which was such an important element in communicating with them, to see what he was eating. Thousands of things that are taken for granted were taken, period, and the enjoyment they lent to life would be taken, too.

It took D. more than a year to return to "normal" life. His determination began to be restored around the beginning of 2000, and with a courage that has never failed her, his wife took on the move to Ayr, Scotland. What her husband needed now was a reason for living, for restating his commitment to life. The first step in this 'rebirth' was the stabilization of his illness in February 2000; the second was the assimilation of new techniques of communication, particularly email and voice recognition, which allowed him to connect with others again. Long walks on the beach, accompanied by the voice of Andrea Bocelli, and the unconditional support of his family did the rest. Life began to seem livable again, and as he relearned elementary things like taking a bus or train, eating in a restaurant, it began to seem as if a new dimension had been added to it. His introversion, his implacable solitude, his self-pity, so valid and legitimate at the outset, would never again feel appropriate. A Scottish practitioner's therapy made three problems clear: this unacceptable handicap would have to be accepted; retirement, and the sense of futility and social uselessness that accompanies it, especially for a person who has been in a fairly powerful position, would have to be adapted to. And third, had he not forgotten during all his trials that his wife was suffering as well? Had she not seen the world she lived in shaken to its foundations? And had she not been uncomplaining and courageous throughout?

This long year of self-improvement and survival had pointed up one basic truth: there is no medical assistance to the blind, once the diagnosis is established. Any other physical handicap is followed up. D., who was financially secure, was conscious of how privileged and favored he was: he imagined the suffering of those who had no support structures, who were cut off by their inability to see from any link to the world, and condemned to a hopeless and vegetative existence.

And yet, a life of dignity, happy and productive, is possible if you have the means to achieve it. Medical research has a lot to contribute, of course, but other rows must be hoed as well, such as psychological supervision and technical apparatuses developed for the unsighted. And information must be much better disseminated, so that any person who finds her- or himself in such a traumatic circumstance knows in advance what the effects of the illness will be, and is able to face it with dignity. When he speaks of his own case, D. always mentions how lucky he was. His encounter with the Rosenberg Group not only enables him to bring his experience to the development of companies and of the men and women who constitute them, it has also allows him to pursue his 'internal dialogue,' as he likes to call it, and to exercise his capacity of choice, each day, of the world in which he wants to live. Constantly aware of the need to assist those in similar circumstances, he joined the Council of the Macular Disease Society and became Vice-Chairman, and boosted a whole new dimension of activity which promotes medical research, as well as the development of technical aids and the psychological assistance that is so vital to patients.

If D.tells you with a radiant smile that his life is happier in many respects than it was before, make no mistake. It goes without saying that nothing can replace so essential a sense as that of sight. And yet, as D. demonstrates and confirms each day, there are "compensations." Never before was his ability to learn, and to reflect on his life so keen; never has he coordinated so fully the echoes of philosophy, history, or music, for example. A rich intellectual life has opened up new horizons, a new way of understanding the world. The age-old stress, the old insistence on immediate success, are things of the past. What counts for him today are his ability to help others and his newfound capacity for happiness.

So at this point, what is his dearest wish? That proper, useful information be diffused to persons suffering from this disease, to help them recognize the symptoms and developments. It was in a plane, when he was reading his last book, his sight fading from one hour to the next, that D. understood what he would have to face. Yet there are audio instruments, and they are easy to use. What a quantity of depression and suffering could be saved by the availability of an appropriate supervision as the disease develops, and a few simple technical devices.

Hallucinations frequently occur, especially on awakening, at the early stages. The head of a bear fading into one's "line of vision" - or the map of Africa, or a sheet of endless rain, can have a devastating effect on a person who is unprepared for them. Yet it would be so simple to inform people. Isn't it criminal to leave people in despair when the medical community has easily the means to let them know what is happening to them? In the ever-lengthening life expectancy of our modern world, in which visual techniques make ever greater demands on our eyes, eye diseases such as macular degeneration will occur more and more frequently. It is essential to know in advance how they manifest themselves, how they develop, and what can be done about them, and to help people who become their victims. We could well be called upon.

A writer, a journalist and a researcher, Patrick Tudoret contributes to several publications. He has also written three novels published by Editions de la Table Ronde.

UNITED STATES
Daniel L. Roberts

The visual spots that I first thought were caused by temporary “burn-in” from the bright light of the copy machine turned out to be much more. When the spots didn’t go away and I started noticing cars on the highway disappearing into them, I decided it was time to see a doctor. The next bright flashes were into my dilated eyes as the examiner took photographs of my retinas. The diagnosis that followed was the most difficult news I have ever received. My central vision was deteriorating. To help slow down progression of the disease, the doctor injected a steroid into the tissue around my worst eye and told me there was nothing more that could be done. I asked him if my vision might last until retirement. He gave me my answer by smiling sympathetically and crossing his fingers as if to say “good luck.” Then he left the room, making that the last time I saw him, because I chose to look elsewhere for the answer to my problem.

The Internet was still new, but I thought perhaps I could find help through that strange invention called the World Wide Web. After weeks of searching through the tangle of disorganized information and dead ends (I was sure that’s why it’s called a “web”), I discovered a little group of about a dozen people who had found one another and formed an e-mail support group called MDList. They had all lost central vision from macular degeneration, and they took me under their wings.

Daniel Roberts is the founding director of MD Support, Inc., and the National Low Vision Support Group. Mr. Roberts wrote the book “The First Year”, an essential guide for newly diagnosed AMD patients.

CANADA
Patricia Gill

She woke up one morning in 1998, opened her eyes and realized something was very wrong. “I had a black cloud over my left eye,” said Gill. However, it was not until 2000 that she was finally diagnosed with AMD, and she was even more alarmed to learn then that 35 years of smoking might have been a contributing factor in the disease development.

Since getting AMD, she has been very involved in making people aware of this disease by making numerous television appearances, speaking on radio talk shows and giving speeches to people who have AMD. Patricia has also been in most of the newspapers across Canada

CANADA
Charles Mossop

It was not for another two years that I realized that small incident with falling snow heralded the onset of my sight disability. In 1964 I was told I had macular degeneration, and two years after that the diagnosis was refined to Stargartd's Macular Dystrophy: a condition that results in the loss of central vision almost identical to the effects of age-related macular degeneration (AMD). Stargartd's usually appears in early life, is a genetically based inherited condition and is very rare. There are only about three thousand Stargartd's patients in Canada.

By the time the diagnosis was finally made, I had lost enough of my central vision that I was no longer able to drive and was having trouble reading. I was half-way through my second year of university, and I felt as if my future, if not my life had been taken away. My parents were in another country, and although I had other family members relatively close, I did not see them often and they were unable to offer much support. I felt confused, afraid and utterly alone.

My ophthalmologist recommended that I register with the Canadian National Institute for the Blind (CNIB), and although I was mortally afraid of the word blind, I eventually went and saw the people at the Vancouver CNIB office. Things improved markedly. I no longer felt so isolated, and I found that I had a new network of friends to whom I could turn for help, support and advice. My ophthalmologist had advised me to leave university and seek training more appropriate to the sight he said I would have - he estimated that within ten years I would be unable to do any of what he called normal work - but my CNIB contacts rejected that idea altogether and strongly encouraged me to stay at university. That proved to be the best advice I was ever given. I did stay, and after a total of six years I left with a Bachelor's and Master's degree in the Social Sciences and Humanities. Throughout my post-secondary studies my sight had continued to deteriorate, but had stabilized by the time I left graduate school. I sought and found employment in the newly emerging community college system and obtained a teaching position in 1970.

That position developed into a thirty-year career in post-secondary education which culminated in a management position that I occupied for seventeen years. Throughout my career, my sight went through periods of deterioration separated by periods of relative stability, but it seemed that as my sight became increasingly restricted, my horizons of activity and work became ever wider. My job called for me to travel extensively throughout the world, and particularly in Asia, and I developed ways and means of coping with the requirements of international travel. I was also required to do an increasing amount of public speaking and I worked out ways of preparing for those occasions through a system I devised of highly condensed speaking notes which I wrote or printed out in large, bold letters.

Whenever a new assistive device appeared I turned for help to CNIB and learned how to make best use of the sight I had left through the use of adaptive technology. Thus, I began to use video magnifiers (Closed Circuit Television, or CCTV) when they became available, and when screen magnification software came onto the market, I began to use a computer. The early screen magnifying programmes were not fully compatible with the old main frame computing that we used at the college at that time, but I used it notwithstanding and then when the age of the personal computer dawned I acquired new software and at that point the full benefit of the computer became available to me. When I retired from the college, which has now become a university, I established a part time consulting business, and the computer became the means by which I carried on that work. ZoomText is the screen magnifying software I use , and when I first installed it in 1995 I set it for 2x magnification for things like email and routine documents. I'm up to 6 or even 8 power now, . but I continue to do whatever I need to do, be it writing, Internet research or anything else. Such work obviously takes me a good deal longer than it would take a fully sighted person, but I don't find that a deterrent.

And speaking of writing, I published many articles and papers when I was at the college, but always promised myself I would try my hand at fiction when I had a little more spare time. I always loved reading good historical fiction and went from normal print to large print and then to audiobooks as my sight deteriorated over the years. I began writing fiction when I retired and have now developed a modest career as a writer of short mystery stories, and in July of 2007 my first novel was published.

After retirement I became a leadership volunteer with CNIB, and that has provided me with a marvellous opportunity to work with other people who are living with vision loss and to apply whatever skills I have in advocacy, public speaking and communications to assisting CNIB in bringing greater independence to its clients. CNIB did much for me over the years, and I am grateful for the chance to repay at least some of the debt.

For me, the most significant realization is that while I can't help what's happened to my sight, I am responsible for my vision: that is my vision of the world and my place in it, my vision of myself as a person and productive member of society. I am not my disability. It does not define me. I define who I am through my vision of myself. Limited sight does not have to lead to limited vision, and I have always found it invaluable to keep sight and vision clearly separated in my mind. No matter how limited our sight, our vision can be rich with infinite possibilities. I was told I would not be able to work for more that about ten years, but forty-four years later, I'm still going!

AUSTRALIA
Marion (Melbourne, Australia)

In the course of conversation Marion mentioned that she had experienced ‘overnight’ a dramatic change which included dark patches in her central vision. These were clearly symptoms of a ‘bleed’ indicative of wet MD.

The urgency of seeking immediate treatment from an ophthalmologist is critical in these situations. Marion later wrote to us and her following words convey an important message for us all:

“It was an expression of urgency that I sensed in your concern that motivated me to seek out a Retina Specialist on my return to Melbourne. He performed an angiogram which confirmed that I had Neovascular (Wet) MD. He explained that I needed the blood vessel treated immediately. Without the Photodynamic Therapy (Visudyne) I asked what would happen. My specialist promptly replied ‘you will go blind.’ So I agreed to go ahead. Had I waited and not sought treatment immediately, as I was advised to do, one can only imagine the possible extent of scarring and loss of vision. I am now using low vision aids including a CCTV in order to persevere with my Masters Degree through Macquarie University.”

Marion was lucky; she spoke to the right people at the right time, received advice and acted immediately. Marion’s story highlights the need for vigilance in detecting serious visual symptoms needing immediate attention.

AUSTRALIA
June (Townsville, Australia)

“The first time I heard of MD was when my optometrist diagnosed me with it,” June says. “Unfortunately there weren’t the treatment options there are today and I lost vision in my right eye permanently.”

Thanks to regular eye checks with her optometrist and ophthalmologist, June was diagnosed with Wet MD in her left eye before any visual symptoms had occurred. This meant that treatment was available to help her maintain the best vision possible in her left eye.

“I have now had six Lucentis injections and my ophthalmologist is very pleased with my results. I still have trouble reading some of the eye chart but I can read magazines and newspapers with no trouble and only use my strong magnifying glass to read very small print.”

“My husband says I don’t notice dust or dirt on the floor, but I can notice things I couldn’t see before, such as the microwave dial. I can even thread large-eyed needles and see lines to write on.”

June now maintains a healthy lifestyle to slow down the progression of the disease in her left eye.

“I eat fresh fruit and vegetables every day, especially spinach, to keep my eyes healthy. I take supplements to help prevent any further damage to my good eye and see my optometrist every three months for a check up.”

“I’m so glad I kept up my eye tests. It really has saved my sight.”

AUSTRALIA
Frank (Sydney, Australia)

“My vision isn’t good,” explains Frank. “I love to cook but can’t read the recipes, let alone the labels on the food. I only have the peripheral vision in my left eye, making it difficult for me to see anything - especially now that my right eye has started deteriorating.”

Frank tried using magnifiers but found that they weren’t strong enough for him to make out words and sentences.

“The magnifiers didn’t work for me. It was almost impossible for me to write something down and then read what I had written, which was so disheartening. I tried to put together a photo album for my grandchildren of their father when he was a boy, but I just couldn’t see the photos.”

Frank is one of many elderly Australians who experienced great difficulty after being diagnosed with Macular Degeneration and consequently was diagnosed with depression by his doctor.

“One thing I have found is that people are very understanding and helpful if they know I have low vision. There is one lass down at the chemist who helps me sign my prescriptions, and the pharmacist explains everything thoroughly. They know I can’t see them, so they make up for it by guiding me and giving me help where I need it.”

“I have also had an Occupational Therapist come to my house to help me adapt to everyday life with low vision. I now use a cane when I head down to the shops, and she has taught me some helpful tips on crossing the road safely and travelling on public transport.”

“It’s hard to think that there must be others out there who are suffering from MD. I want to help to get the message out there that there is nothing more important than having your eyes tested. It might just save your sight.”

BRAZIL
Ronaldo Alfredo

Estava em consulta para aumentar o grau das lentes, quando o médico tapou o olho direito. E vi com a vista esquerda um borrão, uma bola preta.

Que providência tomei? Consultei um oftalmologista amigo meu, e ele me orientou para procurar um médico neuro oftalmologista, resultado: no exame clínico foi detectada degeneração macular relacionada á idade. E ele pediu uma retinografia fluorescente e colorida, para confirmar o diagnóstico. E disse: “Você nunca vai ficar totalmente cego”. Isto aconteceu em janeiro de 2000.

Desta data em diante, comecei a conversar com meu coração. O primeiro conselho: aproveitasse o que restava.

Todas as experiências vividas... Neste ano eu completava 69 anos.

As primeiras deficiências: dirigir a noite ou quando está sol e entramos em um túnel, ou ao anoitecer, tudo isso incomoda. Até o dia em que você lembra de quem não se vê nada. Uma oração diz: “Seja feita vossa vontade”. Não posso mais dirigir e sai da concessionária com que restou? Afora sou um usuário do transporte coletivo.

Pergunto ás pessoas que estão esperando o ônibus: “Por favor, pode me avisar quando chegar tal ônibus?” Aí ela me responde: “Está vindo meu ônibus...”. E eu digo: “Não tem importância peço para outra.”

E a leitura de livros? No começo tudo bem, mais adiante o uso da lupa e por último solicitar ajuda. E hoje os CDs.

Para a TV, o teatro, o cinema? Hoje uso um binocular. Resolve? Quebra o galho.

E usar o cartão do banco para operações bancárias, ver o extrato de sua conta... Difícil.

Nos mínimos detalhes do dia a dia. Colocar um plug na tomada, Colocar pasta de dente na escova. Cortar unha.

E atravessar a rua... Por favor, pode me ajudar?

Enfim que restou? Restou a vontade de viver, de servir. Como a vida é bela, sinto o perfume das flores. Sinto que posso progredir.

Obrigado a todos que me ajudaram, que me ajudam e que me ajudarão.