Depression: An Update

Depression is hard. 

Photo by Greg Rosenke on Unsplash

That's true. And, yet, a huge understatement.

I can see ways that I've improved:

• I can more readily spot the signs of depression worsening.
• I have been growing my toolbox with ways to help me in battle.
• I find myself reaching outside of myself more than I used to.

I'm trying to focus on those things, but the truth is that there's so much other stuff chattering in the background... that I'm right back where I've been time and time and time again. Like there's no way to not.

Over the years, I've experienced depression to varying degrees. It's always there, though the depth, intensity, and disruption vary. Each episode is a unique and ever-changing combination of depression, anxiety, and panic attacks... making it a moving target to identify and manage. 

I've been in a depressive cycle for nearly 4 years. There have been moments of sheer beauty and joy, but the lows have been just as impressive as the highs. 

Depression does its best to push those positive moments out of my memory, while latching on to the painful ones. I'm doing my best to allow the space to grieve the losses and experience the joys, both with the intensity that shows up.

I seem to have more recently turned a corner to experiencing the deep lows, but the highs feel dampened. This may be partly due to deep sadness and grief stacking atop the depression. It's too heavy. 

I'm so tired and weary. The daily battles feel like a permanent fixture in my life.

I'm not sure how to get through all of this... but, there is no other way but through. 

Update: I wrote the above some number of months ago. 

There have been ebbs and flows to my experience of depression. Sometimes, depression is in the background and things don't feel quite as heavy and dark. Other times, there's a sense of emptiness and it feels like there's a blanket over everything. It takes a lot of hard work and energy to try to allow and accept even the difficult moments. I'm trying.

"I’ve managed to live with and through Depression before and can do it again. And that is a truth Depression cannot dispel." - Marie Shanley (Mxiety)

Allowing What I Need Right Now

I'm grateful for words that show up at the perfect moment and resonate.

Photo by Andreas Wagner on Unsplash

"Allow yourself the things you need right now. Whether that's space, rest, support, or something else, know that you are not a burden for taking care of yourself." - To Write Love On Her Arms

I'll admit that I don't always do the best at identifying or allowing myself what I need in the moment. It's something I've been intentionally working on... and it feels like life is giving me tons of opportunities to practice.

I have read the above quote at different moments over the past few months. It remains something I need reminded of, even though my responses to it have varied. 

• I have no idea what I need right now or how to make it through this pain, this grief, this moment. None of those things will bring relief or reprieve. 
• I am doing all the things I'm able to do for what I need right now, including, acknowledging that various pains (physical, mental, emotional) often team up with one another and have a propensity for telling lies. 

I'm fighting back with truths:

• This moment is hard, and I will make it through.
• The pain and grief are real, and I'm anchored to the One that will see me through each wave of every storm.
• I am doing what I can to take care of myself, and that is always enough.️

I know that there's likely more I want to write and explore on the topic. I'm choosing to focus on getting through the current storm, jotting thoughts down as I'm able, and being ok with revisiting them when I'm better able to. 

Pain Wraps Us Tightly Into Ourselves

Pain wraps us tightly into ourselves.

Photo by Erik Kroon on Unsplash

I wrote these words a couple years ago. They have proven to be so true. I have seen and felt it in me. I have seen and felt it in others.

Physical pain. Mental pain. Emotional pain. Spiritual pain. Relational pain. All pain. 

When pain is acute and deep, focus tends to draw inward. Toward the hurt, pain, chaos within. 

It sometimes feels like there's no way out of the protective walls that shoot up when the brain thinks we are in danger. The truth is that those walls often close off the very people that are willing to help. 

"I started to build a home with all the walls I was putting up for myself, but when I was finished, I realized I had built a cage and didn’t make a key." - Lidia Longorio

I have worked for years to recognize and intentionally act in ways that counter the closing off that feels natural when pain hits hard. 

One way I do this is to reach out, when I feel myself closing off and turning inward. I do this through prayer and connecting with a friend. It doesn't always make an immediate notable difference for me, but I can usually notice that it positively impacts the person I reach out to... and it ultimately impacts me, too, even if it's delayed. 

My goal in reaching out is to connect. This sometimes involves sharing about my current struggles, but not always. Oftentimes, it's simply to let them know that I'm thinking of them. This is likely related to me feeling alone in that moment and wanting others to know that they're not. I find that true connection helps both individuals feel less alone. 

"Knowing that you're not alone really does make all the difference in the world." - Normani Hamilton

A Year in Review, Kinda (2021)

I like things to be in order. I always have. Sometimes, it gets me locked into place and prevents me from starting or reaching out or sharing at all. It's more than ok to start from where you are... from where I am. That's where we are: now, this moment.

This year has included many health-related challenges, including a hospitalization, multiple infections,
major surgery, new symptoms, testing, imaging, new diagnoses. Oh my!

Photo by v2osk on Unsplash

I've faced a lot, made it through a lot, and learned a lot. 

I'm still going through a lot, processing through a lot, and focusing on healing a lot. 

A lot.

It's been nonstop.

Generally, my primary way of processing is through writing. It's how I move through life's ups and downs... especially the latter.

This year, though, my writing has been more focused on documenting what's going on, defining a bunch of new to me terms, and doing my best to wrap my mind around it all. The processing part has been tricky, as I've often been merely trying to get through one moment to the next. 

I want to write.
I want to process. 
I want to share.

I need to survive.

There are times that the physical side of recovery consumes all of my energy. That's compounded by trying to strike a balance of allowing the emotional aspects to ebb and flow, and not getting completely swept away by the waves of emotion. Physical pain is rarely experienced without an emotional impact, at least for me.

So, I write thoughts down. What that looks like varies: snippets of thoughts or ideas, a list of questions, prayers, words or songs that resonate with me, unedited raw emotion, a moment when dots suddenly connect... even a complete blog post.

Then, weeks and months (and, sometimes, years) pass by before I finish or share / post what I started writing in the midst of it all.

I know that it's ok. And, it can feel overwhelming.

I have to start somewhere. Somewhere is here. Now.

I'm struggling. On multiple fronts. 

There are times that it feels like there's no time, space, or energy to slow down to process something before another thing drops. 

I recognize that I'm in a season of needing to focus on my health and hurts. I know that it's important. Crucial, even. I know that it's what I need to do. And, it's really hard. 

I'm not comfortable with needing to focus on my stuff so intently, for so long. It's exhausting. 

I'm well-versed in managing and seeking support for the chronic illnesses I've had for years. Asking for and accepting help have been things I've gotten much better at over the years (Help: A Four-Letter Word). The trouble is, there's been so much new health stuff this year, and I don't yet know what help or support I need to ask for. 

It's frustrating to so frequently have something new, worse, and/or more going on with my health. I feel like I don't have much left to give to others... and, that... that is so hard.

I acknowledge that feeling it doesn't make it true. It's a self-judgment / critique. I truly believe that a poll of my people would show that I'm giving others love, support, care in multiple ways and that I am and have always been enough.

I'm also able to recognize that I've grown in how I handle and face uncertainty, change, loss, complexity. I'm still learning and growing, for sure. 

I don't know how things will look here on my blog moving forward. I plan to continue to use this space as a place to process and share. I think that might look like a combination of words I wrote in the moment and where I'm at in the process now. 

I'm looking forward to writing and sharing more of my journey. 

"No matter how big or small, allow yourself the chance to reflect on all of the things you've championed in the past year. You are allowed to feel proud of yourself." - Olimatta Taal

13 Years Later, Now

I recently posted Reflecting 12 Years Post Accident, which I wrote in 2020. Please feel free to click over and give it a read. While I don't post about it every year, I felt the need to, again, this year (2021).

Mixed emotions. That's how I feel, as the 13th anniversary of my car accident approaches. Each year hits a bit differently. It doesn't always affect me. I took the power of that date back several years ago. I know that the date isn't inherently bad... yet, I feel the weight of it a bit more this year.

Photo by Tengyart on Unsplash

This year, it makes sense why it's on my mind more.

On September 30, I woke with what I labeled a "sleeping injury." I had pain and limited range of motion in my right shoulder and neck. I joked about how ridiculous our bodies are, that I could hurt myself while in an unconscious state.

I figured it was simply a matter of sleeping weirdly and that it would dissipate in a few days.

It didn't.

The tightness, pain, limited range of motion worsened each day. I've tried: heat, ice, muscle relaxers, nsaids, theracane, lidocaine patch, gentle massaging and stretching.

My sleep and daily functioning are both being disrupted and limited. I want to write, but I'm having a difficult time physically doing so.

There's an emotional component to this pain, as well, as it's reminiscent of past trauma / pain.

I know that our minds are prone to distort or misremember things, including pain experiences. This is often compounded by time. Understanding all of that, there's still a familiarity with the pain and limited range of motion I've been experiencing.

I injured my neck and right shoulder in a 2008 car accident. While I don't fully remember a chunk of time after the accident, I remember pieces. One of those pieces is that there was a lot of pain and I was physically very limited in using my right arm and neck.

Two years after the car accident, I had a neurostimulator implanted (2010). I had a very long and difficult recovery, including severely limited range of motion in my neck.

I've been doing a good job recognizing the connection to these past traumas / events that my mind and body are making, and reminding myself that they are separate. The car accident isn't happening right now. I am safe. 

In light of current struggles, I'm being reminded:

• Healing isn't linear - past grief, trauma, loss, challenges keep showing up. Each time they do, I do my best to feel it and process through.
• I'm safe - it can be especially difficult to remember this, when there's such similarity in how I feel (physically and/or emotionally). 
• I'll get through this, as I have previous challenges.

Update: I was seen by primary care on 10/5. I woke on the 13th anniversary day (10/10) with the first notable improvement in symptoms since they started. I'm so grateful for that. I have imaging and doctor appointments on the schedule to help determine the path forward.

In Loving Memory of Jordan Conkle

*Sensitive Topic / Trigger Warning: death, suicide

My cousin, Jordan Conkle, died from depression by suicide on November 3rd. 

Loss and grief are part of the human experience, happening in a multitude of different ways throughout our lives. It's never easy. Processing tragic, devastating losses is really hard. I want to share some things that I’ve written, as I've tried to wrap my mind around this loss. It may be a bit bumpy, but grieving is rarely smooth sailing. 

In the Moment

Today started like any other. When I checked my phone, however, I had a missed call and voicemail, overnight. I listened to it and reached out via message to find out more. It was about Jordan, but that's all I knew. I didn't feel up to a phone call, but my anxiety nagged at me, so I texted my sister in law to see if she knew what was going on and if Jordan was alright. She immediately called me. Ok, so it's something that takes explanation. My mind didn't immediately jump to the worst (which is actually an improvement for me). 

Then, she said the words. The words that made everything spin and stop at the same time. 

Jordan ended his life last night.

What?

She repeated it.

I started to collapse down and lose it. Jeremy caught me and helped me safely down to the ground. 

I think I whispered, "Jordan's gone," in disbelief.

There is no good way to find this type of thing out. That said, I'm grateful for the family member that reached out during the night and for my sister in law. She was direct with telling me what happened, and was a soft and safe place for me to experience the initial shock and wave of emotions. I'll always be thankful for her love and care in such a heartbreaking moment.

Thoughts Day-of

Today, I found out that my cousin ended his life last night. I don't know how to wrap my mind around this.

Losing someone is hard. The circumstances around the loss, I find, can magnify different parts of the grieving process. You still must travel through the stages, in whatever order they present and re-present, but some come up more or are more pronounced.

This year, I've lost two people, both completely unexpectedly. I knew losing people would happen. It's part of being human. I wasn't prepared for the losses to strike so soon to people in their 30s, like I am. It's so hard to process, on multiple levels.

I don't want to sit in it, but I've been in the depths of depression. I know how bad that place is, and I'm so grateful that I've gotten out. I know others that have been in that place, too. We live with deep depression. There's a knowing that only people that have experienced that type of depth can have, even though everyone's experience is unique. I try to support those I can, in the ways that I can. They ultimately have to get out of the pit, but I can sit with them and shine a light for them when they're surrounded by darkness. 

I woke today, wishing it had only been a bad dream. It isn't, and that is crushing.

Memorial Service

The memorial service for Jordan was held in-person in Texas, followed by a graveside service. They streamed the memorial service on the church's social media. My sister and I were able to FaceTime and watch together. 

I attended a virtual memorial service earlier this year, but this one felt different. We weren't in Zoom rooms watching the service together. It felt like everyone was gathered together, and we were watching from afar. There was a disconnect. 

During the service, I learned that Jordan's favorite worship song was Here I Am to Worship. Jordan was someone who lived and loved big, and he's deeply missed by many.

I'm grateful for conversations with loved ones, both those also grieving the loss and those supporting me in my grief. I'm grateful for my cousins, who reached out and connected. I'm grateful that my sister and I were able to watch the service and be with one another in the ways we were able. I know that there will be waves of processing and grieving, much of which is done alone. I'm so grateful to have people that love and care surrounding me, who will support me however they can.

The Following Months

The holidays were filled with a lot of different emotions, for a lot of different reasons. In light of a loss in the family, my mind fluttered through memories, specifically those of growing up so close with my cousins. 

On Thanksgiving evening, I began to miss more... our big family Thanksgiving get togethers. Kristin and Jordan would get there later in the day and we'd play games. 

As Christmas approached, I felt the missing grow. Missing out being with family and friends, especially in light of a pandemic and unexpected family loss. I had dream(s) that included PaPa and Jordan, two family losses in as many years. I knew in the dreams that they're no longer with us, but they were special all the same. The one that Jordan was in: I think we were gathered as a family trying to watch his funeral service or something. Jordan came to me. He was younger. And we hugged, the way he did. 

I continue to give myself space to process. I wrote, "Jordan, it's Christmas Eve. We used to spend every one of them together (as we grew older, it was the weekend before Christmas). We would be eating, laughing, opening gifts, sneaking off to play with our gifts as the adults talk."

It's interesting the things we remember. I have tons of memories with Jordan, but many of them are simple moments. The silly grin on his face, his facial expressions, the way he hugged and laughed and smiled. 

As I've been processing, it's clear that we don't always remember the details of a memory or moment. That's ok. We can remember and hold onto how we felt in that person's company or presence. Love, laughter, comfort, calm, joy. All of these are so precious. 

Letter to Jordan

Jordan,

How can you not be here anymore? It's so hard to make sense of this world not having you in it. I know that we haven't kept in touch. But, you always have a place in my heart. I cherish the memories of all of us throughout the years. Watching Milan, playing games, playing pool, dressing you up, going to car shows, monthly family birthday get togethers, Thanksgiving at my parents' house, Christmas at your parents' house... I'm grateful that we were able to have that time together. 

We last saw each other in November 2019 at Grandma's 80th birthday party. When you were leaving, you stopped and chatted with me, giving me all of your attention. You told me that you read my posts and you asked me to tell you more about my advocacy work. We talked about Headache on the Hill and me speaking at RetreatMigraine and Miles for Migraine events. You shared that you wished I wasn't in so much pain, but that you're so proud of who I am and the work that I do. Then, you gave me a hug. Your hugs were so healing, a safe and loving embrace. I am beyond grateful for those moments and that memory with you. I felt seen. Beyond the childhood and familial connection, but rather one adult to another. That connection we had, I will always remember and cherish.

Jordan, I'm so sorry that you were in a place of such despair that you didn't see a way out. I won't get wrapped up in how I imagine you feeling or even what mental health challenges you might've been facing, as it's all conjecture, and truthfully doesn't matter... it won't bring you back.

I love you so much, cousin. 

Final Thoughts, For Now

I am working so hard to process the grief. To acknowledge and express the things I wish were different, without carrying the weight of regret. I will continue to process through the hurt places and grieving potential future outcomes. Learning lessons along the way that I can use to help shape how I move forward. Processing through the grief until what remains is love, cherished memories, and lessons to move forward.

Links:

• Obituary: Jordan Lee Conkle Obituary - Visitation & Funeral Information (lucasfuneralhomes.com)
• Memorial Service Video: https://fb.watch/34RAxG6ieW/

About Suicide

• Globally, there is one suicide about every 40 seconds. (WHO, Suicide Prevention Fact Sheet)
• In the U.S., there is a suicide every 13.7 minutes. (Suicidology, Fact Sheet)
• Suicide is the 10th leading cause of death for Americans. (CDC, Fact Sheet" (Suicide – TWLOHA))
• Suicide is the 2nd leading cause of death for Americans ages 10-34. (CDC, Fact Sheet" (Suicide – TWLOHA))
• Males die by suicide four times as often as females, but there are three female attempts for every male attempt. (Suicidology, Fact Sheet)

Resources

• American Foundation for Suicide Prevention (AFSP)
• World Health Organization (mental health and suicide data)
• American Association of Suicidology 
• 22KILL
• To Write Love on Her Arms
• Helplines: 
• National Suicide Prevention Hotline (24/7/365): 1-800-273-TALK (8255) 
• Crisis Text Line (24/7): text TALK to 741741 to connect to a crisis counselor
• NAMI (National Alliance on Mental Illness) Helpline (M-F 10am-6pm ET): 800-950-NAMI (6264) or info@nami.org
• Veterans Crisis Line (24/7): 1-800-273-8255 (press 1), text 838255, chat online
• Additional 24-hour helplines (including child abuse, domestic abuse, sexual abuse)

"No one ever told me that grief felt so like fear" - C.S. Lewis, A Grief Observed

An Update & More Migrainous Musings

I have been struggling with a rough stretch of status migrainosus. I sometimes get flashes of clarity or expression, when I'm in the midst of deep distress... sometimes I'm able to capture the words, scribbling them down wherever I can. Last year, I shared some Migrainous Musings. I'm here, again, yet there's little comfort in the familiarity of this place. The timelessness and dominance of pain described in Pain has an Element of Blank continues to resonate and ring true to my own experience.

I continue to share, and hope you'll excuse the raw, unedited migrainous musings / ramblings of a brain in pain.

There's an emptiness inside me that knows no bounds.
Sometimes it tries to swallow me up.
Is it the pain? The anxiety? The depression?
Or is this emptiness me?

To know me truly,
See the darkness inside me,
Then don't turn and run.

The darkness surrounds.
Is it here to stay this time?
Please don't consume me.

I do not fear the darkness in others. I generally don't fear it in myself. But, there are times that it becomes overwhelming, and I can't see the light.

I feel like I'm disappearing. Shattering into tiny pieces and blowing away in the wind. Like I'm a fragile shell, being crushed by the weight of darkness. Do I still exist? What is left of me, when the pain overflows?

I'm not ok. I know I've been in this place before, and somehow come out the other side. But, that doesn't compute right now. This feels like my forever. Like I'm trapped.

Update 1 (March 3):

I've spent most of the last week in the hospital getting infusions to try to break this status migraine.

Six days. Three IVs. Loads of meds. My mind and body are still in turmoil, and I don't know how long it'll take to feel like me again. I've been here before. I know that I get out. But, I don't know how. It feels too hard. I feel too weak.

Update 2 (March 4):

Today is filled with more pain than I feel I can bear. I'm not sure how I can survive it. I've treated hard. I'm trying to give myself rest. Nothing feels enough. I know I'll get through it... somehow... because I always do. Every time. Yet, even that gives me no solace in this moment.

Update 3 (March 5):

I woke today feeling more me than I have in a long time. Pain levels are lower. My mind and body are so weary and I can feel the weight of the battles fought. But right now, in this moment, I'm praising God for His provision and the respite.

"At the end of the day, we can endure much more than we think we can." - Frida Kahlo

Headache on the Hill: Behind the Scenes

As I began writing about my Headache on the Hill 2020 experience, I found a post that was written but never posted from last year's event. The following post is from 2019, though much of it is timeless.

Photo by Ian Schneider on Unsplash

In writing about my experience and the asks of Headache on the Hill (HOH) 2019, I realized that there's another side that needs to be shared.

Every person that went through the process to participate in HOH has their own story of the event. Some people weren't able to make the trip because of health, financial, or other reasons. Some pushed to make the trip, but were then unable to attend training and/or their meetings on the Hill because of health. Some pushed to participate, and then crashed hard afterward.

Headache diseases can be unpredictable. And, everything that participating in a lobbying event like HOH entails adds up and can be difficult to do while living with the uncertainty of chronic health conditions.

Sometimes you can push through, and sometimes you can't. There is no shame in that. Oh! But, I know that those unable to attend their meetings were overwhelmed by enormous emotions.

Traveling alone

I haven't traveled much alone, since I became chronic after my car accident in 2008. My husband and I have traveled, but my only solo travel has been to visit and stay with family. Attending HOH was the first non-family related travel that I ventured out on my own. I was both excited for the independence and anxious about managing on my own. Knowing that I had friends also attending HOH helped put my mind at ease.

The day before the HOH training was a travel day for me. I flew across the country alone. Time in a plane is hard on the body, and I was hurting badly, when I arrived in Washington, D.C. I made it to the hotel, checked in, and collapsed onto my bed. A friend of mine invited me to dinner and encouraged me to come, despite my exhaustion and pain. I appreciated being around people that get it, and I know that my body needed an actual meal after a day of snacking. I made it back to my room after dinner, but I was completely spent. The weather outside was worsening, and my head and body pain mirrored that.

Reaching out for support

I reached out to my sister, in tears. The exchange of messages revealed the spiral that pain often takes me on.

"When I hurt, my brain catastrophizes. I'm trying to not be overcome with thoughts about not being prepared tomorrow, should I take meds today, if I take today I can't take more tomorrow, etc... It's just a spiral I go through. It's hard."

My sister doesn't experience migraine herself. She has a truly beautiful heart, though, and has taken note of things that I've mentioned help me in the past. She recommended heat... all I had were hand warmers, but she encouraged me to use them to try to help manage the pain (specifically my neck pain).

One thing that I appreciated was that she made a couple simple recommendations (heat and ice), which can sometimes slip my mind. She acknowledged what she wasn't equipped to guide me on. Through it all, she offered me what I needed most... herself. Knowledge that I wasn't alone. Prayers being sent up on my behalf. Reminders that my my painful groans are wordless prayers that reach our Father, when we cannot find the words. Sharing a beautiful song to speak truth to my heart in a way that it could hear it. The song she sent on that night: Fear is a Liar by Zach Williams.

The person that was supposed to be my roommate wasn't able to make it because of a status migraine, but she did her best to try to help from afar... even going so far as to try to get some supplies delivered to me to help me through the attack.

I ended up treating the migraine attack, and made it through the night. My mind and body felt the effects of the battle that had raged on the previous day, but I was able to attend the training day. After training, I gave my body rest and quiet.

The day we went to the Hill for our meetings, one of the people in my group was having a bad migraine attack. I offered support in the ways that I was able to, and checked up on him throughout the day. We shared that he was missing the day's meetings due to a migraine attack, which highlighted the impact of this disease.

I've observed, heard others' stories, and experienced first-hand, the love and support that this community has among its members. There is an often unspoken understanding that we all experience pain and other symptoms, allowing for deeper connections and support in ways that can feel like home. There is such great power and hope in knowing that we're not alone.

“Give your weakness to one who helps.” - Rumi

Checking In

I disappeared for a while, and I apologize. When I wrote Migrainous Musings, I was two weeks into an intense status migraine. Unfortunately, it persisted.

Following an unsuccessful round of corticosteroids, I completed a 3-day course of outpatient infusions. They brought it to a bit more manageable level, but it didn't help as much as they did last summer when I did them.

Photo by Kelly Sikkema on Unsplash

Then, I got sick. Deciphering whether head and face pain is from migraine or sinus pressure / mucus is tricky... much less how to treat it. A couple days in, the coughing started and made my asthma flare. Dealing with common sickness on top of chronic illness is unpleasant.

I've been doing my best to allow my mind and body the time and space to rest and heal, but it's hard.

Fatigue, depression, anxiety, insomnia from meds, boredom / difficulty distracting oneself... all on top of the ongoing pain and other symptoms.

I'm trying to complete what I can, when I can, how I can. Then, do my best to practice grace and compassion with myself.

"Give yourself the same compassion and grace that you give to the people in your life that you love the most." - Jennifer Rothschild

Migrainous Musings

I have been struggling with a rough stretch of status migrainosus. When I'm thinking a little more clearly, I know that it will end... but when the pain levels are unbearable and the insomnia from treatment is added to the mix, night can bring out all kinds of demons (anxiety, depression, PTSD). In Pain has an Element of Blank, I wrote about the timelessness and dominance of pain, so this is something I've been facing and working on throughout the last 10 years.

This is part of my journey. Please excuse the raw, unfinished, unedited migrainous night musings / ramblings of a brain in pain; but I thought they might be worth sharing.

All alone, in the dark, is where the true torture happens. The incessant pain is magnified by the lies that it tells. When will it end feels like a question not worth asking. The pain decides without your consent.

Mind racing. Heart thumping, Head pounding, Body screaming.

The light of hope seems so soft and dim, but it's what holds us together when the night seems to never end.

Day in and day out, the pain becomes an unwelcome but constant companion. Sometimes it's there lurking in the shadows, sometimes it walks right along side of us, and sometimes it completely overtakes us.

Regardless of how wonderful a support network we have, there are moments that simply have to be faced alone. In the dead of night, when everyone is sleeping, the pain, anxiety, and isolation make their move.

Photo by Travis Bozeman on Unsplash

I've written several Haikus (and Tankas) previously in my journey, here and here. Sometimes it helps to try to focus my mind on thinking or writing in a specific way.

Darkness breeds darkness.
Incessant pain tells us lies.

We must seek the light.

We may feel alone,

But we never truly are.

Reach out and have faith.

Stark desert. Dark night.

Looking for a small reprieve

From the pain and fight.

“Be patient and tough; someday this pain will be useful to you.” - Ovid

Establishing Care With a New Provider: Step by Step

You've made the decision to seek out a new healthcare provider... what's next?

This is the third post for establishing care with a new provider: My Journey and The First Step.

Photo by rawpixel on Unsplash

Below are some guidelines to help you through the process. I've divided them into before, during, and after the appointment.

Before 

• Find a healthcare provider. Follow this link to Find a Headache Specialist. 
• Check insurance coverage and restrictions. Contact or search to ensure your new healthcare provider will be covered by your insurance. If your new provider is a specialist, check with insurance to find out if a referral is required. 
• Schedule your appointment. Either have you current provider submit a referral or contact the new provider to schedule an appointment. Specialists are often difficult to get in to see. Be prepared for a long wait to get on the schedule. 
• Request and complete paperwork ahead of time. Some providers will automatically send you the paperwork ahead of time. If they don't, simply request it. 
• Request to transfer your medical records and test results. Contact your current and/or previous provider(s) to make this request. You'll need to submit a record release form. The transfer of records can take several weeks, so make the request early. 
• Consider bringing someone with you to your visit. Make sure this is someone that you're comfortable having in the room with you. Have him/her take notes of what the doctor says, so that you can focus on the appointment. 
• Make a list of questions and concerns. Prioritize the list, as you may not be able to get to all of them.
• Prepare a list of current medications (including prescription, over the counter, vitamins, and supplements). Providing a list of previous medications can be useful, as well. 

During

• Share your short introduction. This doesn’t have to be done in a formal way, but it can often provide a good start at the appointment. 
• Answer questions honestly. This is not a time to wear a mask. Try not to over- or under- state the intensity or severity of your symptoms, as an accurate assessment is important. Be prepared to be specific in describing symptoms and how they affect you. 
• Address your list of questions and concerns. It may not be possible to address the entire list during the appointment. 
• Clarify if there is anything the healthcare provider would like you to track. Each provider has different preferences about what they want tracked, for how long, and in what format. 
• Discuss goals of treatment. Sometimes the goals and expectations that we have for our treatment plan vary from our doctor's. 
• Discuss expectations for communication between visits and for emergencies. 
• Ensure that you know / understand what your next steps are (testing, treatments, etc), and when you should plan your next appointment. 

After

• Complete any follow-up tasks your provider requested (if applicable). 
• Follow the treatment plan you and your provider have agreed upon. 
• Request office notes for your personal records. Some doctors utilize an online portal for records and communication. 

Rest assured that the initial appointment with your doctor is just the beginning. You don't have to get everything in during that first interaction. This is the start of a partnership and another part of your journey.

"Coming together is the beginning, keeping together is progress, working together is success." - Henry Ford

Establishing Care With a New Provider:

• My Journey
• The First Step
• Step by Step

Establishing Care With a New Provider: The First Step

You might be seeking to establish care with a new healthcare provider under any number of circumstances, but knowing how to proceed can be daunting.

First, congratulations on taking charge of your health. Finding a provider that is a partner in your care is a powerful thing, and is definitely worth the time and effort involved.

Second, take a deep breath.

Photo by sydney Rae on Unsplash

It may feel like you have an insurmountable climb ahead of you, but just take it one step at a time. 

I previously shared My Journey. Here are a few things that helped me move forward in establishing care with a new provider. 

Many of us have a lot of data on our chronic illness, including medical history and pain trackers. Understand that there's simply no way that a doctor has time to go through all of that for each patient... and that's okay. 

A lot of what I was so overwhelmed and anxious about was feeling that I wasn't going to be able to provide all the answers or information the doctor would need to partner in my care. 

Having a brief introduction prepared is a good place to start. Being able to concisely share a description or outline of your journey is a great skill to have. Consider how you would share your health story in just a few sentences. Some questions to guide you:

• When did you start experiencing headache? 
• When were you officially diagnosed? 
• What was your diagnosis? 
• What categories of treatments have you tried (e.g., medications, devices, alternative therapies)? 

You know your body and your experience better than anyone. The combination of your new patient paperwork and your short introduction should result in a conversation between you and the provider. They will ask for more details when they need to, and you'll be able to answer because it's your experience. 

Establishing care with a new healthcare provider can be difficult and stressful, but it can also be hopeful. This is an opportunity for a fresh start. A new partnership. A different set of knowledge, skills, and experiences.

"The journey of a thousand miles begins with a single step." - Lao Tzu

When I was writing about this topic, I found myself addressing it from two different angles: personal experience and as a step by step process. It’s not unusual for me to struggle with which way I want to share, as well as with indecision. I’ve chosen to post both, as I believe them to both be useful in seeking and establishing care with a new provider. Stay tuned for the Step by Step guidelines.

Establishing Care With a New Provider:

• My Journey
• The First Step
• Step by Step

Establishing Care With a New Provider: My Journey

A friend of mine recently moved to a different state and is facing the daunting task of finding and establishing care with a new healthcare provider. When she shared this with me, I remembered all of the feelings and emotions that had flooded me, when I faced the same thing. Sharing my journey to help others is a big reason why I started this blog, so it only seemed right to sit down and write.

This will be a multi-part post. I'll share my story, and then I'll lay out some guidelines to use in your own journey (First Step and Step by Step).

Establishing care with a new healthcare provider?

Photo by rawpixel on Unsplash

I’ve been there. It can be a time of mixed emotions. Anxious. Overwhelmed. Scared. Exciting. Hopeful. 

I’d known for a long time that my doctor was out of treatment options for me to try. He did his best to help me maintain, but he had nothing new in his toolkit to offer. Despite him outright telling me multiple times over several years that this was the case, I wasn’t able to hear and accept what he was telling me. 

Honestly, I was afraid. I’d been with this doctor for 7.5 years. He was the first headache specialist I was referred to in the year following my car accident (The Battle Begins). He had helped me through so much, and I was comfortable with him.

• I was afraid of starting with someone new. 
• I was afraid that I’d have to retry failed treatment options. 
• I was afraid I’d have to prove and defend my pain and disability levels. 
• I was afraid of the monumental task that starting with a new doctor while having such a complex medical history felt like.

I had spoken with a couple doctors at patient conferences about what was important for establishing a new relationship with a healthcare provider. This helped ease my mind a little bit about what I needed to do to prepare, but it still took me a year or two to get to a place where I was prepared to take that step. 

My doctor was very supportive and kind about me moving on to a different headache specialist. He sent the referral and continued my care until I could get in with the new doctor. 

I prepared a lot at home for that new doctor, but much of it was to make sure my mind was in order... for me, having order can help ease my anxiety, even if only a little bit. 

My first appointment with my new headache specialist was incredibly smooth. I had submitted all of the new patient paperwork prior to the appointment. I never felt like I had to defend myself in any way. He didn’t question how much the pain has disrupted my life... he trusted my word. That was hugely uplifting and powerful. Since each doctor has different preferences about what they want tracked, I clarified that with him on our first visit. We also discussed expectations for communication between visits and for emergencies. 

I left that visit “grateful for renewed hope with a new specialist. Looking forward to this chapter, as it already promises opportunities to make positive changes in my life. The road won’t always be pleasant… sometimes it’ll be downright miserable… but, I have a good support team that knows I can do it, even when I’m uncertain.” 

I only saw this doctor a few times before I moved a couple states away. I struggled with separating from a doctor that was a true treatment partner. We had barely scratched the surface, and the fear that I may not find another doctor that I trusted and would be a partner in my care lay heavy on me. 

Time to start over... but on a much larger scale, as I would need a new dentist, eye doctor, and primary care doctor, in addition to a headache specialist. It felt like a heavy task, but it was no longer monumental. There was a sense of hope that getting new perspectives of my health might reveal new possibilities in treatment and quality of life. 

I chose to find a headache specialist first. My previous doctor referred me to my current doctor and continued care until I could be seen. 

My first appointment with my current headache specialist was a lot like the previous one. I submitted all of the new patient paperwork prior to the appointment. The appointment was smooth, which I attribute partially to me continuing to hone in on my experience. We, too, discussed expectations and ensured we were on the same page as one another. 

That appointment initiated a series of consults and testing to address other health concerns and comorbid diseases. I saw around 8 new doctors (in addition to testing) in the following 5 months. Each doctor needed my story, but from a different vantage point... from the vantage point of his/her specialty area. It was exhausting, but I learned so much. 

I realize that not everyone has access to a headache specialist and that not everyone will have a smooth, positive experience. There are not even close to enough headache specialists available (there are less than 500 in the United States), and most doctors don't receive much education about headache medicine. All we can do is be prepared to do our best to find a healthcare provider (even if it's not a headache specialist) that is willing to partner with us in our care. 

"The fears we don't face become our limits." - Robin Sharma

Establishing Care With a New Provider:

• My Journey
• The First Step
• Step by Step

Heavy Baggage

I've always loved reading and learning. That hasn't changed. But, the time has come to unpack and face the heavy baggage of that love. Let me explain...

I have boxes upon boxes filled with books, binders, and notepads. They no longer seem to have a place in my life. Yet, I struggle immensely with even the thought of getting rid of them... as if, by doing so, it would somehow negate the knowledge and lessons I acquired through them.

One of the professors at my Alma Mater, University of Dallas (UD), said that the purpose of the school's intense Core Curriculum is to learn from many of the great thinkers, and then to formulate our own worldview. The UD website states that:

The Core is an opportunity to inquire into the fundamental aspects of being and our relationship with God, nature and our fellow human beings. The Core curriculum embodies the University of Dallas’ dedication to the pursuit of wisdom, truth and virtue as the proper and primary ends of education.

I feel like I've learned from every book, article, and class I've encountered. I may not have enjoyed or taken something from each one to add to my worldview, but each one taught me something. And, in that, it's difficult to dispose of them.

There's an added piece of the puzzle, though.

I envisioned a life where I would be a professor. I would conduct research, write papers and books, and teach students. I would be referring back to these books, and possibly to some of my notes (if only just to see how my perspective might have shifted over time). They would serve an important role in my life.

But, since my car accident (7 years ago!), a lot has changed. Many of these books have remained in boxes that entire time, while others have only been moved from boxes to bookshelves and back to boxes.

For the time that they were on the bookshelves, I would sometimes feel like they were a visual (and painful) reminder of how much in my life had changed. I haven't been able to read and write like prior to the accident. I felt like I had lost the ability to be a scholar, and that broke my heart.

I was cleaning one of our bedrooms yesterday... the one with half of the closet full of those many boxes of books, binders, and notepads. I felt my heart start to pound quickly in my chest, but I didn't have a panic attack. I'm taking that as a sign that it's time to try to deal with the boxes and the related emotions that will surface.

I'm not sure how to best face all of this, but I think it's time. I'm not going to just dump everything out. I'm going to go through the boxes (when hubby is here to help me safely move them from their resting place): carefully considering what to keep and what not to, thanking each of them for their service and place in my life, and then either donate, sell, or recycle.

I know that this is going to take some time, but it's time.

Status Migrainosus: A Difficult Week

I'll warn you (and apologize) up-front, this post may be kind choppy...

This has been one of the worst pain weeks I've had in a long time. I've taken migraine and pain meds (maxed out) and rested a lot. My doctor prescribed a round of corticosteroids, which hasn't seemed to offer much relief.

Status migrainosus is basically a severe intensity migraine that is unremitting for more than 72 hours. Now, I have some degree of head pain every, single day. I have chronic migraine, which means that I have migraines 15+ days per month. And, yet, I get these status migraines that I seem to have no way to prepare for. I know, intellectually, that at some point the pain will break. But, it doesn't seem like it, in the midst of the pain, especially when nothing (meds, coping skills, etc) is offering any relief.

Sleep Disturbance
My sleep pattern is completely insane. Since this horrible stretch of migraine pain began, my hours slept per day (can't say per night because some nights were no sleep, but a nap during the day) have been:

• 8.25 hours
• 3.50 hours
• 9.00 hours
• 3.25 hours
• 17.00 hours
• 0.00 hours
• 15.75 hours

Talk about out of whack! Hypersomnia intermixed with insomnia... quite a toxic combination.

Memory / Processing Problems

Early this week (day 2 of severe pain), my memory was so bad... it was scary! My mind wasn't working at all - I would forget what I was saying, mid-sentence. My difficulties with memory and processing hasn't been that bad in a long time, and it reminded me of some of the struggles I had following my car accident. Strangely, though, I was inspired (and somehow able) to write a blog post, start to finish - When Your Pain is Invisible: You Look So Good. Honestly, I sometimes have more inspiration to write, when I'm at my low (not lowest) points... in the darkness... it's weird.

Irritability

I know that I've been extremely irritable, and not doing a very good job of filtering it. I've found myself snapping easily. It seems uncontrollable, out of my hands. I'm easily frustrated and/or annoyed by the dog, my husband, anything, everything, nothing...

Visual Disturbances

The visual issues I've faced with this migraine attack have been expansive. Aura, blurry vision, trouble focusing, see flashing lights (in all different lighting, from a dark room to bright outside).

And More...

If all of that wasn't enough, there have been so many other symptoms (many more than I'd like to write here)... aphasia, allodynia, hypersensitivity, vertigo, anxiety, depression, fatigue, and the list goes on...

Oh Yeah, Head Pain

If you noticed, I didn't even really mention the incessant head pain, and the neck and back stiffness and pain. The horrendous and unceasing nature of the pain has been paramount in my week... I can't seem to find relief.

Grateful

I will say, though, that I'm grateful to have been able to spend a little time out at a friend's (wedding) couples shower Saturday evening, and with my Mom to visit my grandmother in the hospital Sunday evening. I can't say that it didn't take a lot out of me, or even that it really even distracted me from the pain, but I'm glad that I could be there for those that I care about.

Disability Case Manager Updates (Nov 2013)

So, I wrote this back in November 2013, but apparently didn't get it posted... and, have been away from the blogging world since then. I'm hoping to be moved to update soon, but I thought I'd at least get this one out there.

One thing that I really dislike is talking to disability case managers. Thankfully, I've been blessed with some really good ones, over the years. But, they're still asking questions that can really upset my anxiety and depression levels. And, knowing that they're just doing their jobs doesn't necessarily make it easier for me.

I talked to my disability case manager today. She was following up on how things have been going and any treatment changes. I had my second round of Botox a week ago, and have an appointment set up with my doctor mid-January. I told her that it's too soon to know whether or not the Botox will provide relief.

All of that is normal and expected... but, she also asks me every time we talk if my doctor and I have discussed what's next:

• what treatment to try next, if this one doesn't work

     or, in the case of today,

• what the plan is for returning to work, if the treatment provides any relief. 

I hate both of these!

The first one makes the assumption that the treatment isn't going to provide any relief. What a quick way to deflate your entire being. Even if you don't really expect a treatment to help, there's normally at least a small amount of hope deep down. Then, you have this external voice asking you to think ahead, as though you have everything already figured out, to when it doesn't work.

The second one makes the assumption that the treatment is going to provide relief. While that's not negative in and of itself, it assumes that the treatment will provide enough relief to allow you to actually return to work. Of course I'm hoping for relief! But, even if Botox is successful, that doesn't mean that I'm suddenly going to be able to return to work.

I responded to her in the best, most honest way I could. I told her that it depends what degree of relief Botox were to provide. And, if it does provide relief, my doctor probably wouldn't immediately have me return to work, since I have a history of treatments providing some relief for a few months and then stop working / helping.

Evolution: How Being a Patient Has Changed Me

Today's topic is "Evolution. Write about how being a patient or caregiver has changed you. How have your goals changed? Have your values changed?"

There are so many things that come to mind for this topic. I have changed a lot, since I started living with chronic debilitating pain 5-years ago. I've written quite a lot on the topic of change... here's one that jumps out in my mind:  Change: Life Since the Accident (Jan 6).

Slowing down
I've learned (and am still learning) to slow down. It hasn't been easy, as I was always on the go, before my accident. I planned nearly every hour of my day... man, was I a planner! But, that doesn't work for me now. I have to be mindful of my body's limitations in a way that I never did before. Otherwise, my body may just shut down and/or I later pay a very high price. So, I find my life is a much slower pace than most others, but that's what I need.

Living in the present
I'm learning more and more to simply live in the present moment. It's harder for me to do at some times than others, but I'm much better at doing it than I used to... I still have a way to go, though. When I'm having good moments, I do my best to cherish and enjoy them, regardless of how long they last. When I'm having very painful moments, I do my best to tend to my body and turn my focus on God - thanking Him for what I have, asking for His peace through the storm, praying for others who are experiencing any pain, etc.

Depending on others
I grew up to be an independent woman, and I've always taken pride in that. So, being thrust into a position of truly needing to depend on others was a huge (undesired) lesson in humility, among other things. I still have difficulty with asking for help, but I'm slowly becoming more comfortable with asking for and accepting assistance from others. I think it's an important lesson for everyone - not to depend on others for everything, but to be able to ask for and accept help when needed.
* There's a blog post that I started almost 2.5 years ago regarding independence / dependence... I think I'll work on finishing and posting that in the next few days. 

Gratitude
I find myself filled with gratitude in a different way than I was before. My list of things I'm grateful for includes even the simplest of things that I used to just take for granted. And, as humbling as that can sometimes be, it keeps me focused on the things, big and small, that God has blessed me with.

I have changed
I've become more focused on my priorities, stronger in my faith, more outspoken in health matters (especially concerning justice for those with disabilities), more understanding of others, and more forgiving of myself and others.

Goals have changed
My goals have changed. Sometimes I feel like a failure because I don't have my 5- or 10- (and so on) year plan on the tip of my tongue. My goals aren't SMART (specific, measurable, attainable, relevant, time-bound), like I was trained to believe is necessary. Perhaps it is necessary, but I don't feel a specific drive or calling of something to do in my life right now. And, while that sometimes makes me extremely anxious and like something must be wrong with me, I'm doing my best to trust that God has a plan for me.

Overall, even though I don't have SMART goals, I do feel more focused on a clear life purpose: to faithfully follow God, allowing Him to work in and through me wherever I am and however He desires. Now, that's not to say that I don't struggle along the way. I don't have any clue what I'm supposed to be doing with my life, but I'm doing my best to root myself in the One who does know.

This post was written as part of the National Health Blog Posting Month (NHBPM). Other bloggers will share their posts on this FB page.

A Life-Affirming Visit

You know those amazing, life-affirming visits with someone (be it a friend or a stranger), where you leave feeling that your soul has been refreshed / renewed?

I had one of those Sunday night. I had a chance to visit with a long-time friend of the family, who I only get to see every four or five years. She happened to be in town for a few days, and I (thankfully) was feeling well enough to visit a bit with her and some of my family.

She and I chatted with one another for a little while, and I feel that we connected in a special way. She shared with me how she saw me before the chronic migraines (very active and busy, an intellectual, etc), and then recognized and allowed me to talk about the difficulties that have come with learning to live life with so much pain and so many limitations. She said she knows I've always been determined and strong, and that she knows I'll do my best to be and live as well as possible.

She shared bits of wisdom that she's learned over a lifetime of experiences... bits of wisdom that seem so simple and basic, but are truly life-changing:

• Listen carefully to your body.
• Do what feels right to and for you (call it your gut, instinct, or just a feeling).
• Be okay / comfortable with the decisions you make.
• What others say to / about you is about them, not you.
• Don't spend precious time and energy on wasteful things. 

• such as, thinking or worrying about... what others say to/about you, expectations of self and others (what you should be doing), what may or may not happen, and other things that are out of our control.

• There is meaning and purpose in life, even when it doesn't feel like there is.
• The faith that we gain during times of struggle are priceless.

I'm sure there are other things that'll keep coming to mind, as the words shared between us play in my mind further. There were aspects of this journey that I haven't talked about in quite a long time (like identifying myself with my intellect, and the loss of that when I struggled with and then decided not to continue graduate school). It was interesting for me to see what I've dealt and come to terms with, and what is still a little raw to talk about. I know that this is all a journey, and it was nice to share parts of my journey with this friend.

I feel validated and better understood. I also feel a renewed sense of hope and direction that feels great!

I count myself so blessed to have this person in my life, and that she was willing to spend some time sharing with and really listening to me. My heart is filled with gratitude!

ER Visit - Abdominal Pain

Me, drinking the contrast for the CT scan.

On Tuesday, May 28, 2013, I ended up in the Emergency Room (ER).

I had severe abdominal pain that reached emergency level. I'd been hurting all day, but had a horrible pain episode in the early evening (luckily, it was after Jeremy got home, so I wasn't alone). Thankfully, Jeremy made the decision that he was taking me to the ER because I wasn't thinking clearly because of the pain.

It hurt to move at all - in fact, it took a while to get to the car and then into the ER simply because it hurt too much to move or even to breathe.

The ride there was incredibly painful, but we finally made it. As soon as we got inside to the ER lobby, I threw up, was violently shaking, and had numbness / tingling in my hands / arms (and I'd had bad diarrhea Sunday night and part of Monday).

They think it might've been my appendix, and they almost admitted me to the hospital overnight. My white blood cell count was really high. I had a CT scan with contrast - they couldn't see the appendix, but the area nearby wasn't inflamed like they'd expect to see with a severe appendicitis. After speaking with the surgeon, the doctor had me have an abdominal / pelvic ultrasound to check my ovaries (specifically, my right one, since that's the side the worst pain was on) - right ovary looked good, I do have a cyst on my left ovary, but he didn't seem concerned about it.

We got to the ER about 6:30 or 7pm, and were there until almost 2:30am. By 1 or 2am, most of the pain had dissipated. So, the doctor decided that with the tests plus his exams and my pain reports, that I'd be okay to go home. I was released, with the understanding that I was to return if the pain came back. So, no definitive answers - very well could be my appendix, but not sure.

It's Been A While & Neck / Shoulder Pain

I've been away... for quite a long time. I apologize for my absence. There are many things that have been happening, some of which are still being worked out. There's a lot that I'd like to share with you guys. I definitely want to get back to blogging more soon, but it may still be a little bit before I can do that. We'll see how things go... so, please stay tuned. 

At the beginning of April, I started having increasingly severe neck pain; and by the end of the month, my right shoulder started to ache deeply (in addition to the severe neck pain).

The intense neck and shoulder pain really broke me down, making me feel like I was just falling apart. I couldn't find any relief or peace. Everything came to a head, so I went to the doctor to try to help with the severe neck pain (stiffness to the point that I couldn't turn my head to the left), right shoulder pain, tingling and numbness in several fingers... it was bad.

Here's what I wrote on May 3, 2013:

The pain type and intensity are eerily similar to right after the car accident in '08 (at least as much as I can recall). I feel overwhelmed with A LOT of thoughts and emotions that race through me. The pain has made it hard to write or type... even texting. It's re-closing my world, and I don't know what to do. I keep reminding myself that I've grown so much since right after the accident, but I don't know if I can do all this again. 

I went to the doctor today. (5/3). Long story short(er), the severe neck / shoulder pain (and subsequent tingling and numbness in my right hand) could be caused by a few different things - could be muscle spasms squeezing the nerve, bursitis, lasting effects from my car accident, a muscle tear, a bulging disc, etc. It's complicated by the fact that the medical test to best narrow it down is an MRI, which I can't have because of my neurostimulator. My doctor said that there's pain in the rotator cuff, so we might be able to get rid of most of the pain and then just have to deal with the cuff. Or, meds + rest + ice could take care of it. There's so many different possible causes, treatments, and outcomes.

So, I was on muscle relaxants for a couple weeks, and took NSAIDs for a month. I also rested and iced the area. Thankfully, all of this helped, and I've gotten back to my normal levels of neck and shoulder stiffness and pain... which is still pretty bad, but no where near as horrible as it was then (and no tingling / numbness).

During this very difficult and painful time, I reached out to a dear friend, who offered me hope and encouragement. She reminded me of God's promises:

"'For I know the plans I have for you,' declares the Lord, 'plans to prosper you and not to harm you, plans to give you hope and a future'" (Jeremiah 29:11).

She also reminded me that even when we wonder what God's purpose is for us, when we're unable to write, talk, or even pray most days... that what matters most to God is His relationship with each of us... and, even though we may want more (to be able to do more)... He only longs for us to be in and with Him.

So, when I'm hurting so badly that I can't really do much of anything and I feel worthless / helpless / etc... as long as I focus on being in the moment with Him, I'm exactly where He wants me to be... and that's what I cling to.

[Please stay tuned for more updates.]