surviving a shift with chronic pain

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I deal with chronic pain and fatigue every day of my life. I also work 12-hour shifts as an RN on a busy progressive care unit at least 3 days a week. Over time I have discovered key elements to surviving those long shifts–today I’m sharing them with you!

Don’t work night shift!

If at all possible, avoid working the night shift. When I started my current job, I was required to start working the night shift. I then put my name on a list to move to day shift when a spot became available. I had to work nights for about 5 months and it was awful for my body. I developed terrible eating habits and literally slept all of the time. When I finally moved to day shift, I was amazed at the major increase in energy and decrease in pain. Working the day shift hasn’t fixed everything, but now I can at least function outside of work.

If you have to work nights, try to maintain a consistent sleep schedule. Invest in a good set of blackout curtains and coordinate with your partner/roommate so that you get the uninterrupted sleep that you need.

Pace yourself

I learned early on that I don’t do well working more than 2 shifts in a row. I do my absolute best to avoid working 3 or more shifts in a row. I’m lucky to work at a job where I can pretty much pick the days I want to work in a given week. I’ve discovered that only working 2 days in a row is much easier to for me to recover from. Figure out what works best for your body. This may mean only working one shift at a time, or you may figure out that it works better for you to work your 3-in-a-row and then relax on your other 4 days off.

On this note, plan your recovery period. It seems like even if I only work one shift, I need the whole day after to recover. This means sleeping in and taking at least one nap on my recovery day. I don’t plan on running errands or cleaning anything on my recovery day–I just rest and recover. Don’t be afraid to say “NO” to activities on your recovery day. My husband has quickly learned not to expect anything from me on my recovery days and is even kind enough to hang out with me in bed on occasion!

Take your lunch break (and enjoy it!)

That precious 30-minute lunch break during your shift is essential for your body and your mind. I’ll be honest, I hate talking to co-workers during my break because we usually end up chatting about our jobs. My favorite way to chill during lunch is to stream a short show on my phone and plug in my headphones. I pick a comedy show that makes me laugh and lets my brain just vedge for a while.

I also try to make lunch easy. I love those canned soups that I can just heat up in the microwave. I try to pick something high in protein (lentil, split pea, etc) to last me through the rest of my shift. Plus then I don’t have to worry about meal prep the night before!

Cluster your care

This is probably what helps me most during my shifts. After I get report on my last patient, I take their vital signs before I leave their room to get one set out of the way. Then I go sit down at the nurse’s station for at least 10 minutes, look over my orders, write down all my meds, and plan my day.

I try to knock out everything I can while I’m in the patient’s room. If I have meds due at 0800 and 1000, I try to just bring all those meds to the patient around 0900, knock out my assessment, and ask my patient about any other needs at that time (refill water, bathroom, pain, etc). I also learned from another nurse to put a sticky note on my badge to take notes on while I’m in the room. Then if I notice that I need to change IV tubing or grab a new bag of fluids, I can jot that down on the sticky note. Before I go back into a patient’s room I double check my sticky note and take care of those things while I’m in the room. Not only does this keep me from going in the patient’s room 15 times an hour, it gives me a bigger chunk of time to just sit down and chart.

Basically, anything I can do to conserve energy the better.

 

Do you have any tips and tricks to get through your work day? I’d love to hear about them!

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when you have no direction

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You know those times when you feel lost? Stagnant? Just moving through life with no end goal in sight?

I know you do.

Because I feel that way too.

You may have the best job. The perfect partner. The most loving family. But you may still feel lost and alone in the middle of a world that seems to keep  spinning without you.

It’s ok.

It’s alright to not be “going somewhere” in your life. It’s just fine to be where you’re at. If you’re feeling this way, I have two things to tell you today:

1. Stop putting so much pressure on yourself. I guarantee that you are. I read a quote yesterday that says, “Nothing in nature blooms all year. Be patient with yourself.” Hey, you’re human! Give yourself a break. Treat yourself with the same empathy and compassion that you would show to your best friend. And that leads us to…

2. Take this time to get to know yourself better, to become truly immersed in the beauty that is YOU. What are your hobbies? What foods do you really enjoy? What are your core beliefs? What are the principles that you want to live by?  Write, read, adventure, explore. Be ok with being alone. Become reacquainted with who you really are.

Take a deep breath. It’s going to be ok.

Because the truth is? You–yes, you–are and incredible work of art. And you are doing just fine.

the sensitive badass nurse

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Since I was a little girl, I have dreamed of being that nurse. You know, the badass trauma nurse who walks with purpose, leading codes and managing complex, dying patients without losing her cool. The typical ER nurse as portrayed on TV.

I know all nurses aren’t like that. Most aren’t, to tell the truth–not even the ones who’ve seen it all. But there are a few nurses who have this demeanor, and they all make my pulse race with admiration. I have always wanted to be like that.

But then there’s me. I am the stereotypical ISFJ personality type, sensitive on the inside, logical on the outside, and so incredibly, stupidly caring. I care about everything, especially when it comes to the well-being of others. It’s probably why I love nursing so much. It gives me such satisfaction to take care of people.

Reading that last sentence makes me a bit nauseous. Yep, I’m that girl…

I recently cared for a patient who was slowly dying of cancer. She was young, not much older than me. I went into her hospital room to inform her of an upcoming procedure she would have done later that day. I explained the procedure carefully, making sure that she understood why and how it would occur. I was about to leave her room when her dam of stress and pain and sickness broke. “I’m just so tired,” she choked out between sobs.

What do you say to that? Everything is going to be fine. But it’s probably not. God has a plan. And apparently, his plan for you is a slow, painful death. Just try to stay positive. Yep, I’m sure she’s not sick of hearing that by now.

They (you know, the all-knowing “they”) say that sometimes the right words don’t exist, that all you can do is sit in the silence and acknowledge the pain.

I think that sounds so stupid.

Guess what, though? I did just that. I squatted down next to her bed and grabbed her hand. She squeezed my hand tightly as she continued to cry. I don’t know how long I sat there, silently blinking back my own tears. When she had finished crying, I mumbled something about how brave she was. Leaving the room afterward was awkward. I didn’t want to leave her alone.

If you are studying for the big NCLEX test, those looming state boards that will grant you your nursing license, you know this already:

physical always takes priority over psychosocial.

Sometimes that’s true. Often, it’s a bunch of crap. People are a big, jumbled mess of complex problems, and if you think all those problems are physical, you are in for a big surprise.

And to be a good nurse, I mean a really good nurse, you have to take care of the whole patient. Sometimes you’re the mean nurse who doesn’t let that patient manipulate you into over-medicating them with narcotics. Sometimes you’re the sensitive nurse who talks to the dementia patient about their cats at home. Sometimes you’re the badass nurse who holds it together after losing a patient. Sometimes you’re the nurse who sits in the supply closet after shift change and cries because oh my GOD that shift was awful.

I’m learning that I don’t want to just be the badass nurse. I want to be all those nurses. I want to take good, quality care of my patients.

My dad used to tell me how important it was to him to be able to tell a patient’s family members that he and his team did everything they could for that patient, no matter the outcome. My goal is to be able to go home after a shift, crawl into bed next to my husband and know that I did everything that I could for my patients. Even if it meant that I wasn’t a  cool, badass nurse that day.

P.S.: Night shift is working havoc on my body and my FM has been flaring something fierce. A post about that is coming soon!

You’re Tough.

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b973df17ad5e15b55b6a84eead9180caHubs and I  are finally settled in Utah. We threw all of our possessions in a u-haul trailer, pointed (south) east, and didn’t look back. We ended up staying in an Air-bnb for about a week while we scrambled to find a place to live. And believe it or not, we did. We’re all moved in to our new, TWO BEDROOM apartment that is mold-free and much bigger than the 400-square foot building we spent our first year of marriage in.

Oh, and yes, we also celebrated our first anniversary! A whole year.

This is a little bit of a side note, but I am so proud of my hubs and our marriage. My symptoms began only a few months after we got married, quickly kicking us out of the honeymoon phase and into the sudden reality of chronic illness. Hubs has been so incredibly loving and supportive. Hashtag blessed.

BACK TO THE POST AT HAND.

This is the odd part about the entire moving process. During the two weeks in which we were actively moving, I was constantly bracing myself for the flare I knew was coming. I was terrified that I would become incapacitated during the process.

But I didn’t.

In fact, my flare didn’t begin until a full week after we had moved into our new home. Granted, it left me almost bed-ridden for several days with pain, nausea, and severe anxiety. But the timing was perfect. I never thought that I’d be thankful when it comes to a fibro flare. My only explanation was that the words my mother and grandmother had pounded into my head were taking action: “Em, you’re tough. Just like mom and Meme, you’re tough. You can do this.” One of my earliest memories is of hearing these words after I had badly scrapped my knee.

I’ve been struggling to find the balance between staying active and involved and pushing myself beyond those ever-changing limits. After seeing what my body has “tough-ed” out through this move I’m a little more confident that I’ll be able to improve my quality of life over time.

Which I sure hope happens! I also forgot to mention (yay, fibro-fog) that I GRADUATED from NURSING SCHOOL with my bachelor’s degree!! I take my NCLEX test in about two weeks and am actively looking for a full-time job. Whew. We’ll see how it all turns out. Life is always an adventure, right?

Hoping your week is filled with spoons!

Alternative Therapies for Fibro

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After three months of waiting for my rheumatologist appointment, the day finally came. It was a fairly uneventful appointment. The doctor poked and prodded me and asked me questions about my pain and fatigue. He ended the appointment by saying, “I agree with your other doctors–I think you have fibromyalgia.” Really? Shocking.

He also was adamant about letting me know that I didn’t need to come back to see him. He didn’t want any part in managing my fibro, and he was content to let my PCP handle it. About that…

Turns out my current PCP just retired. The new PCP that she had me go see refused to change any of my medications or provide me with any refills. Instead, he had me go and see a homeopath. Now, I try to have an open mind about homeopathy. But to be honest, I don’t have a lot of faith in homeopathy remedies. I went to see the homeopath anyway and was thrilled at how much time she spent with me in the office. It was wonderful. But her answer to all of my problems was to discontinue all of my medications (which I refused) and to provide me with a remedy that she said would make me feel “calmer.” Not a remedy to help with pain, fatigue, nausea, or brain fog. Needless to say, I don’t feel any calmer. I also don’t feel any different.

So you could say I’m a little frustrated with my healthcare providers right now. But I’m really determined to be in control of my health.

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Because of this, I’m sticking with my current medication regimen and searching high and low for other alternative therapies that I can try on my own. Here’s what I’m doing so far:

  • 5,000 IU/day of Vitamin D
  • Calcium/Magnesium combo
  • DHA supplement
  • Melatonin for sleep (helps me fall asleep, but I’m still not getting quality sleep)
  • Magnesium gel/lotion
  • Aromatherapy
  • Yoga/walking
  • Meditation
  • Vegan diet (Fairly simple: think lots of rice, lentils, fruits, and veggies. Trying to cut down on sugar intake.)

The yoga and walking have definitely helped my overall well-being. When I’m able to move, I feel like I have more energy. I think being able to exercise also gives me a sense of control. Meditation has done wonders for my mental state. I’m trying to focus on keeping my brain as healthy as possible so that I can deal with all of the physical crap.

So, dear readers, any suggestions for alternative therapies? What has worked for you? I’d love to hear your thoughts on alternative therapies as well as homeopathy!

May your day be filled with spoons and the little joys of life.

Tom, Dick, and Harry

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Tom, Dick, and Harry.

That is the name of the mountain I climbed yesterday. It has got to be the dumbest name for a mountain that I have ever heard. It sounds even dumber when I try to brag about my accomplishments. Like, I’m sorry, you climbed what?

But that’s not the point. I climbed a freaking MOUNTAIN yesterday.

It was 6 miles round-trip and 1,700 ft of elevation gain. And it hurt like crazy. But I did it.

I’ve been a novice mountain climber since I was a kid. I grew up in Colorado climbing 14,000 ft mountains. I thought that I would never be able to attempt something like that again. But climbing this measly little 5,000-and-something-foot mountain gave me a little twinge of hope that I might be able to work up to being more active.

And as a side note, yes, I’m paying for it today.

Here’s the last big mountain I climbed: San Luis Peak, one of Colorado’s fine fourteeners. This was the summer of 2014 after I had just started nursing school.

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And for another side note, I used to think that jeggings were the best invention ever. I mean, jeans that feel like wearing leggings. Does it get any better? Now I’m cursing the inventor because half of my pants are jeggings and it hurts to wear them. I’m all about those loose, linen pants now. Do you have a favorite outfit for being comfy when you have to look nice (as in, can’t wear sweats)?

4 am

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It’s 4 am again.

I slept for about 2 hours last night, somewhere between ten and midnight. But I woke up in a panic, heart pounding, body aching. It felt like the sweat was pouring off of me. I laid there for another 2 hours, praying to just fall asleep so that I wouldn’t feel the crushing anxiety or the burning pain. It didn’t go away.

So here I am. It’s 4 am and I’m on the couch writing. I’ve spent the last hour digitizing my calendar system in hopes of making myself more organized. I’m loving the Google calendar app. I’ve eaten my spoonful of chocolate frosting, scoured Facebook, and played all of my turns on Words With Friends. I’d watch TV now but I’ve finished every episode of every season of every show I’ve ever liked. Any suggestions?

Ok, so here’s the real illness talk now. About a week ago I realized that I have been moving out of the denial stage of grief into the angry/sad/depressed stage. It hasn’t been fun. I’ve had to come to terms with the idea that my dream job (flight nursing) may never be a reality. I’ve had to view my future from a spoonie-colored glass.

And honestly, it truly is just depressing.

My mom has had FM since she was in her early twenties–about my age. I tried to explain to her about how hopeless I’d been feeling, about how it was just really hard. I just needed someone to listen and say, “Yeah, I’ve been there. It sucks.” But my mom is a do-er. She quickly replied with her usual, “You can’t focus on that. You just have to keep pushing through. You can’t let this stop you.”

I’m not planning on letting this stop me. I am pushing through. I’m pushing through each and every day that I choose to get up and go to class and clinical and I’m pushing through each night I spend furiously typing away at homework assignments. I’m pushing through when I’m leaning heavily on my cart grocery shopping. I’m pushing through when I don’t think I can push any more.

But just because I’m pushing through doesn’t mean that I’m not still hurting.

I must say that the most comfort I’ve found in the past few days has been reading the blogs of other spoonies, searching for those to whom I can relate. At this point, I’ve stopped trying to overanalyze every aspect of my treatment. I’m just searching for evidence that there are others out there like me. Thank you to those of you that have shared in this way. You are a greater blessing than you know.

Well, good-morning to you! I hope you have a spoon-filled day.

What’s Helped

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There have only been a few things that have helped me cope with the pain recently. But as time goes on, I’m learning more about what works and what doesn’t. Here are some things that I have found helpful so far.

1. Heat

Mainly in the form of a hot shower or heating pad. At home, you can almost always find me curled up with my heating pad. I sleep with it every night and wake up to turn it back on when the auto-off function kicks in. Warm showers have also been a major help. The heat from the water seems to help soothe and loosen up my tight, aching muscles. Showers are somewhat of a frustration, though, as the heat and water dry out my skin and make my eczema worse. Because of this, I only shower 2-3 times a week. I’ve found that showering at night helps my muscles relax a bit and I’m able to sleep better. Tiger Balm has also been super helpful to use at school and in clinical, although the smell is very noticeable. But having the heat and tingling sensation on my trigger points provides a bit of relief until I can get back home and back to my heating pad!

2. Medication

While my medication regimen isn’t perfect yet, there have been a few medications that have helped me tremendously. OTC pain relievers don’t come close to providing relief. I’ve been prescribed Norco 5/325 as a last-ditch-effort when the pain is unbearable. I end up taking one dose two to three times a week on average. It’s not ideal, but sometimes it’s the only thing that works.

I’m also taking duloxetine (Cymbalta) at 40 mg. I haven’t noticed it helping my pain very much, but it has done wonders for my anxiety and depression. I went from being severely depressed and anxious (I was having several panic attacks a week) to feeling very minimal anxiety and few depression symptoms. I’m not at 100% yet, but it’s so wonderful to feel like me again. I honestly  don’t think I could handle my current situation without this drug. My psychiatrist is helping me to slowly increase the dose up to 60 mg, as that is the usual dosage for chronic pain. I’m hoping that a higher dose will provide some pain relief as well. But I’m very thankful for how much Cymbalta has improved my mental state!

Another drug that has worked wonders for me is Trazodone. My psychiatrist recently prescribed me the Trazodone to help me fall asleep. My normal sleep pattern for the past two years has started with me lying in bed for at least  an hour before falling asleep. With the recent onset of pain, there have been many nights where I’ve only slept an hour or two. Not a great thing to happen when I’m trying to finish nursing school! I’d been relying on Ativan to help knock me out so that I could sleep, but I hated the hangover feeling it gave me. I also didn’t want to be taking a benzodiazepine that frequently. The Trazodone has helped me fall asleep much faster, and I don’t have that hangover feeling in the morning. I also feel like I’m getting a better quality of sleep, which I’m so thankful for!

I’m taking Gabapentin as well (only 100mg), but I haven’t noticed any difference in my symptoms. My PCP put me on an extremely small dose because she was concerned about the side effects. I’m hoping that she will be increasing that dosage soon. I’ve been taking Magnesium, Calcium, and Vitamin D supplements, but I honestly haven’t noticed them helping much.

**A note on medications and doctors: I’ve learned that I absolutely have to advocate for myself. In nursing school, we are taught constantly the importance of advocating for our patients. But it’s been so hard to advocate for myself. Sometimes I think that my doctor’s office has dubbed me the crazy 20-year-old hypochondriac that thinks she knows more than her doctor. My PCP has been extremely supportive and open to trying different treatments, but it has still been difficult to advocate for what I need, even if it’s just something for pain relief.**

3. Staying Busy

This was something I learned from my mom, who also has fibromyalgia. I ask her often, “How the heck do you deal with this every day?” And her answer is always the same: “I just try to stay busy so I don’t think about it.” I hated hearing that when I was exhausted and hurting. All I wanted to do was lie in bed and sleep (or try to sleep anyway!). But I’ve found this to be extremely useful. When I can barely stand to fold my laundry, I turn on a TV show–right now it’s Gilmore Girls! Focusing on the show helps distract me from the pain and I’m able to get my laundry done. If I’m waiting at a doctor’s office, I bring something to study or read that will distract me from the pain. If I’m sitting through a long, boring lecture for school, I bring a coloring book. I’ve come to realize that I’m always going to be in pain–it’s always going to hurt. But I don’t want the pain to stop me from living my life. When I stop doing things, I start focusing on the pain and start getting emotionally frustrated. It just makes everything worse.

 

Have you discovered anything that has helped you deal with chronic pain?

How did this even happen?

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I’ve been asking myself this question for the past several months… how did I end up here? How did this even happen?

I’d been depressed and severely anxious for over a year. I had an average of at least one panic attack per week. It was frustrating and debilitating, but I was surviving. And then it seemed to hit out of nowhere.

I’ve researched fibromyalgia (FM) for any clue as to how it could have started. There’s a genetic component, so that’s a possibility. My mom was diagnosed with FM in her late 20’s, and most of her blood work was negative–just like mine. The internet says that FM can also be triggered by trauma (physical or psychological), stress, or an infection.

Hmm… Stress.

I’m not going to lie, I’m pretty much always stressed out. My goal is to find some sort of inner-peace through scripture, prayer, yoga, meditation, essential oils, whatever. I hope to be less stressed someday. But being moderately stressed is my baseline. And why shouldn’t it be? I’m in nursing school. But as I have thought about my life the past few months, my mind settled on the day I first felt the pain beginning to seep through my body, and I realized that a majorly stressful event happened that same day.

My husband and I had gone to visit his family for the weekend. His parents are very conservative Christians and live a simple, off-the-grid lifestyle. They have 6 children, 3 biological (including my husband, who is the oldest at 22) and 3 who they are in the process of adopting. They’re wonderful people. But to be blunt, they’re also very stressful.

In particular, my mother-in-law is stressful. I don’t think she means to be, but she has a very sensitive heart. We had a mix-up regarding how long my husband and I would stay with them. My husband had initially told his mom that we would be arriving on a Tuesday and leaving on a Saturday, forgetting that I was scheduled to work and that I had several important doctor’s appointments. As soon as we realized (the Sunday before), we quickly called his mom to tell her of the mistake. We would be arriving Thursday and leaving Saturday. I knew from the tone of her voice on the phone that she was incredibly hurt and offended, and that we would be having a discussion about it that weekend.

And that we did.

In fact, it came up in a family counseling session that my husband and I had agreed to attend. The family counseling was started to help incorporate the new siblings into the family and resolve tension and issues associated with that. Now, I have absolutely nothing against counseling. In fact, I am ALL FOR IT. I’ve seen several different counselors in my life, and I think counseling is a wonderful thing. But I prefer one-t0-one counseling. Group therapy? Not my thing. Especially when it comes to my in-laws.

I was completely tense through that entire hour and a half. It started out as just a nervous tension until we started digging deeper into our thoughts and feelings about family issues. My anxiety increased. And then…it HAPPENED.

My mother-in-law stated that she felt like we didn’t want to spend time with them. That we didn’t want to be a part of the family. That we didn’t like coming to visit with them. That we were trying to separate ourselves from them as much as we possibly could.

My anxiety turned to panic. And rage. But mostly panic.

We had gotten married barely 6 months before. Nevermind that we had visited his family at least 5 times since the wedding. Nevermind that we had only seen my family ONCE since the wedding. Nevermind that we had saved up for weeks for gas money and took time off of work to come and see them. Nevermind that it was the weekend of MY BIRTHDAY and we lovingly decided to spend it with them, even though that meant that my husband and I didn’t get to do anything to celebrate.

I sat on the couch, hands clenched over my chest and stomach in a desperate attempt to focus on my breathing. I listened as my husband stumbled over his words in a desperate endeavor to explain that his mother’s assumptions were so far from the truth.

I took a deep breath and tried as well, my voice shaking, to help her understand that we couldn’t come visit them every few weeks, that my husband worked full time, that I worked part time and was in nursing school full time. That we lived over 4 hours away and had no gas money. That yes, we were newly married and trying to build a family of our own.

There was no resolution. The topic eventually moved on as my panic clenched every muscle in my body. I sat so tense and rigid on that couch that I was shocked that no one said anything about my state of being. No one seemed to care.

Finally, the session was over. The counselor spoke to my mother and father-in-law for a few moments, as I grabbed my husband by the shirt and drug him out to the garage. We must have looked like we were running away. As soon as we were out of sight, my panic attack really began. My husband pulled me behind a land cruiser and sat me down on a tool box as I desperately gasped for breath. He held me as he’d done many times before, encouraging deep breathing, comforting me with his words. At some point his mother came into the garage, wanting to talk to us. My husband (bless him) shooed her away, saying we’d be out in a little while.

When the panic attack finally subsided and the Ativan had kicked in, I began to feel the ache. It felt flu-like, as if I had been hit by a semi-truck. I assumed it was from my muscles being tense for so long.

But the pain never went away. In fact, it only got worse.

I feel terrible tracing the start back to this event. I feel like I’m saying that my mother-in-law caused my illness, which I don’t believe to be true. But it seem so silly that a stressful event could have started this cascade of sickness. This whole fibromyalgia thing makes me feel silly.

If you have fibromyalgia or any other chronic illness, how did it start for you? Did it come on gradually, or can you pinpoint the day that you first noticed it?

 

Welcome

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I’m not sure if I should welcome you here and thank you for coming, or apologize that you have now wasted at least 10 seconds of your life reading this blog. Regardless.

About me: I am a 22 year old female, working my way through nursing school, newly married to a wonderful man. I’m a Christian, and most other Christians would label me extremely liberal if they ever discovered my true opinions and beliefs. I have eczema, millions of allergies, depression, anxiety, heartburn (thanks tomatoes) and some mild PTSD.

I’ve also recently been semi-diagnosed with fibromyalgia. Apparently a rheumatologist has to lay eyes on me before I can have the disease, at least according to the nurse practitioner I’ve been seeing. This site is a desperate attempt to find a healthy coping mechanism to deal with all of this. I’m not sharing this blog with any family or friends.

I am a fairly level-headed person. I’m not one to show my true emotions with others, and I rarely if ever have outbursts. But I need a place to have outbursts. To let go of some things. My desire is that my openness and honesty is something that you can resonate with. If you are struggling with some of the things I’m going through, I hope you find comfort in knowing that you are not alone.