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Refined by Fire

Refined by Fire

At 10 months old, I was diagnosed with spinal muscular atrophy (SMA) type II, a recessive genetic neuromuscular disease. It increasingly robs me of strength and affects my spinal cord’s motor nerve cells. As the number one genetic cause of infant death, and with an average life expectancy of about four years, I’ve beaten the odds at age 21.

My medical file is about a foot tall, but let me summarize it. Please understand that I am not complaining or seeking your pity. I’m just telling it like it is.

I have had countless hospitalizations, nearly dying on numerous occasions from complications like pneumonia and metabolic acidosis. I had a spinal fusion at age 9. And now, in the past few years, I have lost the majority of my remaining strength. The physical pain and suffering I’ve been through are extreme.

The simple reality of my physical limitations is certainly difficult to deal with. I LOVE sports, but I can’t play them. I can’t go to certain places, such as friends’ houses, without wheelchair access, and even if I can, I probably can’t participate in whatever is going on. Even parties or events — which I usually can attend if I want — I choose to avoid because my voice doesn’t carry in loud environments. What’s the point of going somewhere if you can’t communicate? I can’t drive a car. I can’t scratch my own head. Have you ever had an itch you can’t scratch? The list of the more obvious physical impediments is endless and absolutely horrible. But that’s my life. My reality. It’s all I know, yet it’s far from the worst part of my disability. Not walking is the easy part.

So, what’s the worst part? Having to rely on others for everything. I can do only what others are willing to do for me. Because of this, I feel trapped, helpless, and powerless. Even things I actually can do physically, I still can’t do whenever I want. For example, if my caregiver needs to go to bed, I’m going to bed — even if I’m not tired. Although I’m 21, I don’t make most of my own decisions. My caregivers decide for me based on their willingness and availability. I know they love me unselfishly, but I hate being a burden and dependent on anyone.

The second most difficult part is missing out on things like family trips. Simple tasks that most people take for granted, such as taking a shower or going to the bathroom, are extremely challenging if not impossible for me when on trips. Not to mention that when I do travel, I essentially take a hospital room with me. Even hotel beds present a challenge. I need to bring a foam egg crate topper because I need a really soft bed or I’ll be in constant pain. I often say, halfway jokingly, that I’m confined to one square mile of frozen wasteland. As you can imagine, there is so much more I wish I could do.

Given all this, it would be far too easy to sink into despair and self-pity. And to be honest, the temptation is camping on my doorstep. But I have consciously chosen instead to heed the sage advice of Abraham Lincoln, who famously opined, “A man is about as happy as he makes up his mind to be.” So, while I don’t have a choice about my physical condition, I do about my mental and spiritual one. I can’t fix my body, but I can rise above its limitations.

In choosing a title for this column, I first considered “Always Looking Up,” with its too-clever-by-half double meaning —physical and mental. But I’m going to be truthful, it’s less prideful and far more accurate to admit that I’m still, and always, being “Refined by Fire.”

All of my hardships are the fire. Can I extinguish the flames? No. In fact, they only blaze hotter as time goes on. However, what defines me is how I respond. A fire can either warm a house or burn it down. Trials can either refine me or destroy me.

Even though life with SMA is hard, there is a silver lining. Our hardships afford us the opportunity to grow into people of great character, and therefore, to be an inspiration. That’s where I find my purpose. If I handle my adversity courageously, it can motivate others to face their own.

To state the obvious, everyone has their own trials and tribulations. My hope in writing these columns is to encourage people to welcome their suffering as an opportunity to grow — to be refined by fire.


Note: SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of SMA News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to spinal muscular atrophy.

Ryan is a simple man from Bend, Oregon. While he aspires to one day become a sit-down comedian, he has turned most of his attention to writing. He loves sharing his life experiences with people and bringing awareness to his disease. His two favorite things are sports and coffee.
Ryan is a simple man from Bend, Oregon. While he aspires to one day become a sit-down comedian, he has turned most of his attention to writing. He loves sharing his life experiences with people and bringing awareness to his disease. His two favorite things are sports and coffee.
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  1. Sara says:

    High Ryan. My daughter is 6 and she was diagnosed with SMA 2 at 11 months old. I hope to show her your column sometime in the future. We are getting to the stage where she is trying to understand her place within her community and yet she is still pushing to be involved in everything, including karate classes… But I fear there will come a time when she may feel overwhelmed by the enormity of her trials ( I know I do sometimes!). I think your experience could help her. Looking forward to your next post.

    • Ryan Berhar says:

      Thank you! I hope my stories will help encourage kids like your daughter. I know when I was younger I didn’t quite know where to fit in either. Heck it’s still tough even as an adult, because there is just so much we miss out on. My advice to you is to direct her towards activities she can excel at. Physically demanding things like karate probably won’t work, but she can excel at anything mental. Remember, SMA are the first three letters of smart! Tell her that if you haven’t already. Academics can be a good one, but for me chess was a big deal. I couldn’t physically beat anyone at anything, but I could pretty much outsmart everyone.

  2. Martina says:

    Excellent article! I am mother of two SMA Kids (16 months and 8 weeks). Your article is covering nearly all my thoughts about the future challenges with SMA. Go on, write more about. Wish you all the best from Austria

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