Partly Cloudy

My chronic pelvic pain is holding in a partly cloudy weather pattern.   For the past year, my pain has been well managed on a very low dose of sustained release morphine. I also take another medication, Cymbalta to help with the local and centralized nerve pain.  However,  new symptoms have been emerging in the guise of menopausal symptoms, maybe fibromyalgia, or "other".

prairie burn : in a week beautiful grasses and flowers and birds return

I have yet to find a pain management doctor to work with. The ones we have consulted, immediately state that they are procedural pain management specialists. They like to work with the part of the spine that attaches the head to the neck and the lumbar spine, or lower back. When it comes to the part that turns into the tailbone or pelvis, they get insecure, and turf us over to the gynecologists.  Most pain doctors like to do clinical procedures like nerve blocks.  Makes sense to them, right?  Just draw up some medication, inject it, tell the patient it might work, and then bill the insurance company.  No need to have a long, detailed conversation with your patient regarding the nature of the pain and what meds have been helping, not helping, or creating side effects.  And, then they don't have to deal with the cumbersome paperwork imposed by the DEA regulations and weed out potential drug seekers from the actual pain population. 


 We are a labor intensive bunch and low reimbursement units. Hate to break it to you, but we are called "units" when it comes to billing.  


However, it leaves the chronic pain patient without a captain of the ship, and often we get lost in a murky sea of symptoms. Symptoms that often are so familiar to us, but they can still cause us to lose our bearings.  


Over the past several months, I have been having a really tough time during the night especially.  Most of my friends and family have heard me complain of terrible insomnia, hormonal night sweats, fatigue and awakening feeling like I have the flu and totally unrestored sleep.  I talked to several doctors and recently saw a neurologist.  She was very suspicious that I was developing fibromyalgia. She wanted to start me on Lyrica, but I declined and wanted to do a little more investigation. 


Next, I saw a nurse practitioner/naturopath and she felt my symptoms were not classic fibromyalgia symptoms, but she knew they had a varied spectrum. She wanted me to test my hormones and also do a thorough evaluation for many tick borne diseases.  I am still waiting for those results.


In the meantime, I decided to do some of my own personal detective work as I was really getting frustrated and feeling low and defeated.  I started to document my symptoms and record when they were happening and describe them in full detail. 


A typical record would read like this:
04:00 can't sleep. legs ache.  sweating. flu-like feeling. so achey, all over. my whole body is weak. sweaty. muscles twitching. jaw hurts. my bones in my whole body hurt
08:00  feels like I didn't sleep at all.  drag myself out of bed.  take my morning dose of morphine.  Tai chi wakes me up.


3:00 tired, hardly did anything today. bones starting to ache.  want to take a nap.  take a vicodin 7.5 mg.  hour later feel better.


I started to notice this pattern of weakness and pain at certain times of the day.  It also coincided with when the morphine might be wearing off, or reaching it's nadir.


In the meantime, my husband finally found a pain doctor who actually works with pain patients like me.  She told him that she'd be happy to work with me and was concerned about my quality of life.  Ahhhh...  I love it when they use those quality of life sentences.  I'd like to have a quality life. She told him that even though the morphine is dosed twice a day, that it runs out faster and she often has to prescribe it 3x a day in divided doses.  That is what I figured out on my own, and it has already been helping.  I am looking forward to this visit.


I wanted to share this because it is likely a very common problem and it can happen for many reasons.  When we get comfortable with our disease and our doctors get comfortable with us, sometimes we stop taking the fresh look with "new eyes".  It is so important that when we see our doctors that we are very specific with telling them how our pain is now, compared to how it was at the last visit. Get detailed with describing the quality of your pain so you can help your doctor help you. All my doctors, including me and my husband were going down the fibro track until I really stopped and dissected the information and analyzed it by taking a step back and looking at the data.  We have to be our own scientists sometime.  The other thing that happens is that when you have been on a med for a long time, the doctor may get complacent about asking you how it is working.  With any neurologic drug, especially a narcotic, it is paramount that you let your doctor know if you think you are responding differently to a med than you did in the past. Or, if you have new symptoms, help your doc out a bit and actually say, "could this new symptom be related to my meds?  Let's talk about each of them".  Again, these are examples of advocating for your self, and actually helping your doctor help you.


Finally, as I am now bringing in a 4th doctor into my team, I need to make sure that all of her notes go to my other doctors so they stay up on my care.  She'll need to send copies to the gynecologist, my pmd, and the neurologist.  And I expect them to know the latest about me when I go for a follow-up appointment.  Finally, I will also share some current literature with them so they can learn a little more about pudendal neuralgia and pevlic floor dysfunction.  That team approach means that sometimes I coach them.  Even when you are at your weakest, try to take charge and be your own best advocate.  Try not to get burned in the process.


I'm hoping partly cloudy, becomes clear blue sky here quite soon.


Peace, Healing, Humor,
Cora




☀ my lonely fish are so hungry and they want to dance so please stop a while, feed them and play

Thank-you Woollies

Last post I mentioned I wanted to get back to my journal.  I picked up my favorite leather journal that I have ignored for quite a while.  It has beautiful rich brown grainy leather, with a thin leather tie to close my secrets.  I love looking back to see what I've written over the past months.  I found a little note of gratitude that I'd like to share. It's modeled after a blog called Thx Thx Thx by Leah Dieterich in which she shares a daily thx on her blog.  I love that practice of simple and sometimes banal and even disgusting thank-you notes. 

This one I wrote last January, no doubt on a cold winters night.

Thx Thx Thx-

my beautiful wool bedding.  You gave me sleep, restful sleep when my pain was such that I was the princess on the pea.  I could not tolerate a normal mattress, or any kind of common bedding. Every sheet felt like sandpaper on my skin.  You cradled me in wool. No need to count sheep. I'm sleeping on a cloud again, border collie dreams beside me.

Peace, Healing, Humor,

Cora

❤❤ my fish want some peppermint bark

☀☀ my bedding comes from surround ewe you can find it on my links

Page Break

Hey friends,  over the past two months I've discovered that I am thoroughly enjoying writing again.  Now that blogging has returned me to the practice, I may take a little break from blogging and see where the practice of writing essays takes me.  I'll leave it up and post now and then. Hope to hear from you and if you have any questions, need any help with finding resources, just contact me through the email provided.


Want to share this little poem with you.  Harry, a four year old friend created it and his mom transcribed it.  This is his first poem and it is published with his permission.

The tiger runs behind him.

Accelerate!

☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀☀


please stop by and visit my fish
they'll get lonely ❤

Guest Author: Anna Tells It Straight

Thanks Anna,

Your wisdom 

and resilience, 

inspire all.

Cora

It’s tempting to present myself as a very well put together, calm, collected, successful woman (with vulvodynia). I could fall in love with the image of myself as the person who is so strong that nothing fazes her. I imagine that if I were that person I would just incorporate the pain into my sense of self and move on. My life would still be completely my own, entirely under my own discretion. Pain would just become one more little thing, like groceries or a period that must be incorporated into my daily life. Instead of pain having two parts – the physical and the psychological. My image of the ideal woman or girl living with vaginal pain would avoid the psychological ramifications of a life lived in pain and be free to just cope with the real physical pain. 

That image of the perfect woman probably isn’t helpful to any of us who live with pelvic pain, it definitely is not useful for me. But acknowledging that I wish I was her is probably necessary – at least that way I hope to prevent her from creeping too much into my thoughts without my awareness. I don’t want to come across like I have figured pelvic pain out. I haven’t. Chronic pain is a path I walk that changes every day. 

My life, My work, My self

In the early 2000s, I started graduate school in sociology and I am currently on the brink of finishing my long-awaited dissertation. My research focuses on how educational and social experiences in schools promote positive or negative adolescent development with a specific focus on health behaviors like weight control.  More generally, I am interested in how individuals use their education to gain health advantages. I never knew I would learn to use the research for my own survival through barrages of tests and overwhelming experiences with doctors.

In the US, there is a strong positive connection between education and health – meaning the more highly-educated you are, the more healthy you are on a variety of measures of health, like mortality (how likely you are to die), morbidity (how likely you are to have a serious disease), and self-reported health (how healthy you feel). My research interest is in how experiences early in the life course, while kids are still in schools, form a foundation of knowledge that people are able to draw from to gain better health for the rest of their lives. You may think that income or health care is the reason why the higher educated have better health (because those with more education are more likely to have higher, stable incomes and are more likely to have stable or better access to health care), but the link between education and health is much more complicated than just that. 

There are several concepts brought up in the academic literature on the link between education and health that have been particularly useful to me in thinking about how I need to deal with the medical establishment in order to optimize my chance of getting the best care possible in the case of my vulvodynia. An article that has struck me every time I have read it, is an article by Annette Lareau.  In it she describes how the way individuals interact with doctors highly impacts the doctor’s ability to give high quality, salient advice.  The idea I take from her article is that people who are willing to be honest and blunt with their doctors (however difficult that may be, which it often is when the subject is vaginas or sexual dysfunction), will get better medical attention. Another concept that has stayed vividly in my mind comes from the work of Catherine Ross and John Mirowsky – the idea of personal control.  When individuals feel like they can control the direction of their lives, they are more likely to have better health outcomes. Personal control is a key concept in health – if I don’t believe I can change my illness, then giving up may be very tempting. Instead, if I do my best to change my life to maximize health and minimize illness as best I can, I am most likely to have the best mental and physical health possible. Personal control also bleeds into the idea of empowerment – that I can take charge of some parts of my medical decision-making and become an active participant in my healing.  

Now let me rant (at least a little) about being a Patient Expert

In the case of vulvodynia, where treatment can take years and patients like me have to endure chronic pain for a long time, there may be times when the patient may know more than her doctor (if she chooses to pay attention to the trends of her body and if she chooses to get out there and inform herself about her disease and her options). A good doctor is key, but active participation on the part of the patient may make significant difference. 

We have a tendency in this culture to revere doctors and “modern” medicine. For me, questioning my doctors became the most important thing I could possibly do. Feeling in control, empowered, and confident enough to question authority became very important. Ironically, or at least to me it sometimes felt ironic, I was often crying while questioning my doctor’s latest ideas or her choice of drugs to treat my latest infection.  But crying, feeling upset, does not oppose control, empowerment and confidence. Becoming comfortable with my vulnerability that arose from being in pain, needing my doctor’s help, and the stress of also knowing I needed to keep my head in the “game”, was important too.  

I am currently almost five years into my journey with vulvodynia. For a long time, I really did not want to identify as someone with vulvodynia, and so I didn’t want to read too much about women’s experiences with it. It sounded too horrible. What if that became me? What I really wanted to know was that there was a finite deadline, an end in sight. Reading about women’s experiences weren’t guaranteed reassurance – until I had accepted myself. And I was really scared. Finally, I began to reach out and make connections. While there are people out there who are overwhelmed by their pain and who may overwhelm you, there are also people out there so full of amazing health information, support, and open ears to listen to your sorrows or triumphs – it can really help (maybe some other day I will rant about the importance of social support to health). There were also success stories out there. Women got better? WOMEN GET BETTER! Sign me up!

It took time, and the help of a wonderful team of physical therapists and my acupuncturist and me taking good care of my health, to start healing, but slowly things began to change. I went from never being able to sit, to being able to sit three hours straight, to eventually being able to sit all day at work (but of course taking regular walking breaks to take care of my pelvis). Certain other things came back to me – like my sexual desire – with time and work with my caring partner. Life also became easier because I adapted – I have a huge wardrobe of skirts, slacks, yoga pants, sweat pants and all things loose and comfy (before vulvodynia I owned one skirt). Though clothes are always challenging (because some days any clothes can hurt), I have options that help me feel better about the fact that I can’t throw on my favorite jeans. 

No one wants to think that they will have to live with chronic pain, but sadly (because I have see too many of my friends get sick with serious diseases like cancer), I realize that health is a privilege that many of us don’t get to have. Pain is awful. But I have been given this one life. I feel my only choice is to make of it what I will. I can choose to compare myself to my seemingly “healthy” friends, envious of their jeans-wearing carefree ways…or I can recognize the reality: I don’t know if that woman is suffering from vulvodynia or pelvic pain even behind her jeans. If she doesn’t have pain, maybe she has something else – some other silent illness she feels sorrow over that I don’t know about. Maybe I shouldn’t judge. Maybe I’d rather just focus on what I do have. Focus my energy on my healing. Of course with a few temper tantrums about the injustice of it all thrown in (I am not perfect), but a girl has to have a mindset to deal with something so frustrating and constant as chronic pain.

Though there is nothing romantic about surviving something horrible or difficult, I think its true that through life’s difficulties we learn new things about ourselves, maybe even about our fears, loneliness, and hopefully our ability to give and accept love. I have been most afraid, most alone, and also most in love while having vulvodynia. I have learned how to stand up for myself, how to make medical decisions on my own, how to be hysterical but still make sense when speaking on the phone, how to cry quietly but visibly while I explain my situation to someone new, how to allow myself the space and freedom to get a bit fucking upset about this every once in awhile and how to continue living my life with joy and abandon. I have learned to be brave, to tolerate uncertainty (at least more than I once could). I’ve learned to make the best of a difficult situation and I’ve learned that priorities and living exactly how one intends to live are really important. I also have gotten to the point where I can talk to doctors without getting scared, and I can talk about being in pain (usually) without instantly crying. I have changed, and I like who I am. 

For the record, and to spread a little hope, I consider myself 90% better…I rarely have to think too much about my pelvis, by which I mean I can do almost anything I want and feel no pain. I occasionally have flare ups, and sometimes they depress me, but I have also learned that a flare doesn’t mean I am regressing back to pure pain hell. They too will pass. I just have to be more stubborn than my pain. Stubborn. Now that is a test I can pass! One final thought…I recently, for the first time, asked my physical therapist, how my pain compared to most people’s pain…I add this to give you perspective. While it is true that there are people who have situations that are much worse than my own, my pelvic pain was not insignificant. In fact, I have seen some pretty dark painful times. My message in this moment of pain comparisons is that, I kind of issue a challenge to anyone who feels they cannot heal, to give it a try. My physical therapists helped, my doctors helped, my acupuncturist helped, but I guarantee you that I did it.

* fish are in the snow below,
  stop and rest a while

Rhythm

Fatigue is familiar to me these days.  Often, my sleep is not restful.  When the alarm goes off in the morning, I pace through the snooze alarm cycle and sleep too long.  I wake up even more exhausted, and disappointed about the wasted time. I used to be one of those annoying morning people, up at sunrise with my internal alarm, ready to go on a morning run and do farm chores.

Today, the sun awakens me.   I lie on my comfy wool bedding a few minutes, and slowly slide one weighty foot off the bed, then the other.  Dangling on the edge, I consider my options.  I could take a vicodin and have some coffee to wake me up. That would do the trick.  Or, I could do my morning round of tai chi, and make some green tea. Both would start my engine. 

Still half asleep, I shuffle into the living room, pull up the shades and chains of sunlight glisten on the frosted pasture.  The neighbor's horses graze rhythmically.  The suet bricks are breakfast for the red-bellied and downy woodpeckers. 

I start the water for tea and turn on my favorite Japanese instrumental music.  My legs ache and my fingers are cool and cramped.  The opening stance of the tai chi form is called the horse stance.  It grounds me and connects me to the earth.  I face the window. I see the horses.  I inhale.  I focus on my tan t'ien, the Chinese word for center- the life force. I breathe with my heart.  I am still.  I honor gravity.   Cowboy, my border collie ambles over to me and settles close.  He sighs and collects my quiet energy.  

As I breathe and start the tai chi form, my mind is present, but random thoughts start to enter.  "What do I need to get done today?"  I let the thought float away. Another thought sneaks in.  Just passing through.  I feel the chi in and around my body; my arms float, gently propelled by my tan t'ien.  My muscles are receiving nourishment and they relax.  The blood vessels in my fingers dilate and become warm.  My breath continues to nourish me and I gently awaken.  

☀ the fish need breakfast too.

A Letter

 Recently I composed an open letter that I wanted to send to doctors, PT's and allied professionals that care for people with chronic pelvic pain.  I worked on it for days and it was composed as a virtual symposium and I was the guest speaker.

As a nurse, I did my share of public speaking while working with children and families who faced chronic illnesses.  So, it was fun for me to pretend I had the stage talking to a room full of people who care for us pelvic pain types.  I didn't end up posting that letter or sending it out to the big group, but the exercise helped me identify the concerns I have that affect our care.  I sent a different letter to a few trusted PT's.  I hope to hear back from them.

Over the past four years of living with pelvic pain, I've learned a lot from fellow patients and we share similar frustrations and concerns about appropriate diagnoses and access to experts.  Through these conversations and my own experiences, I'll share some of the questions that I outlined in my letter.  It was primarily focused on PT.

Are there evidenced based studies available to support physical therapy for patients with PFD/PN?

 Has the PT profession considered creating a certification for the treatment of pelvic pain?

 What really defines a PT as a clinical expert in the treatment of pelvic pain, PFD/PN? 

 Is there an algorithm designed to aid in the diagnosis of chronic pelvic pain? 

 One that would help the primary care doctor diagnose and refer more promptly.

What efforts are being made regarding a campaign targeted at primary care physicians and OB/GYN's to aid in better diagnosis and referral of patients? 

Is there an effort being made to educate pain specialists in the unique needs of the pelvic pain patient?

 Is there any collaborative effort on the part of PT's to document the outcomes of therapy?    For example a questionnaire at certain intervals post-discharge from PT.  Perhaps at 3, 6, 9, 12 month intervals to determine outcomes, quality of life, functioning after PT.  Other outcome measures such as disability claims, return to work might be evaluated as well.

 I have spent a lot of time looking at the IPPS site.  When I read the bios and mission statements of the doctors there, they are quite impressive. I am wondering how active they are in pursuing these goals, as some are very similar to what I have outlined above.  I do want to say that I think the books that have been written thus far, the educational patient handouts, and few t.v spots (which were sensationalistic) seem to focus on pelvic pain as primarily a sexual pain issue, and they minimize or dismiss the overall lifestyle effects.  In addition, they fail to address the complexity of the heterogenous patient population that develops pelvic pain.

I concluded my letter with comments from the point of view as a patient, a nurse, and what I have observed as a member on some pelvic pain forums.  Generally speaking, many chronic pelvic pain patients are on their own when initial treatments fail.  The care is quite fragmented and primary care doctors are uninformed about the diagnosis and treatment options. The result is often that patients end up with significant  financial, physical and emotional costs.

I hope to get a useful dialogue going to improve communication between the specialties and improve our access to people with expertise. The reality right now, is that like many patients with chronic, misunderstood conditions, there is a dearth of peer reviewed studies,  educational materials and access to expert practitioners.  That leaves many patients running in circles like the proverbial hamster on a wheel, spending our limited resources searching for answers.  This post and that letter, is a small attempt to help us get off that wheel.

Peace, Healing, Humor

Cora

❦ feed the fish

    make a wish

                

Guest Author Pomegranate: Six Word Memoir

Still me

Still smiling

Just smaller

❃  how peaceful it is

       to feed the fish

Invisible Friends

Four years ago when I developed pelvic pain, I remember a PT telling me about a support group called Happy Pelvis on yahoo groups.  I instantly loved the name, given that my pelvis was grumpy at the time and I felt afraid and isolated.  I couldn't really get my mind around the concept of talking about my personal health issues to strangers on a computer screen.   I signed up anyway, and lurked for a while until I felt comfortable enough to join in the conversation. 


Through Happy Pelvis and another group called HOPE I have met some amazing people. They are courageous in sharing their stories, insights and experiences both positive and discouraging. Beyond emotional support, I have found resources that I would not have found anywhere else. I've been able to educate my doctors, family and friends with information from these communities.


A few women are now my dear friends.   Despite our age differences and geography, we became fast friends. To one, I am a surrogate big sister and we can talk about life well beyond what initially connected us. Our family backgrounds are strikingly similar and that made us instantly familiar with each other. When I am having a bad day, she is there for me with a sweet text message and a photo of her beautiful cat. Another sends me photos of her travels to Costa Rica and together, we share a distant sunset. 


 I recently reconnected with a friend after she took a break from the support group.  I thought about her so much over the past year and I was elated when I saw her return.  We caught up by phone the other day exchanging stories about disappointing doctors and other frustrations related to pelvic pain. She told me that she was adding a new puppy to her family, and I quickly went into dog training mode and shared my expertise.  Bon and I  were able to slip right back into the cadence of our friendship. Listening to her southern accent adds texture to a friendship where we likely will never meet one another. There are times when I have to remind myself of that.  


The two groups that I belong to are a sanctuary.  They provide a sacred space to vent and share with others who are on the same trail as me. Like therapy, I can go there and dump my worries and support others. I can preserve my strength and be more available to my husband, my dog and friends around me. 


I'm fascinated too by the sociology of the groups. . Sometimes I sign on and study the screen names and avatars. I laugh every time I see Pelvis Stressley.  Now, how did he come up with that name?  Her Majesty writes each post with commanding confidence and royalty.  I wonder about Tiny Dancer?   I imagine a little tinker bell, petite and waif-like. 


Then there are names like Graceunderfire.  I say it real fast. I want to have "graceunderfire".  A reminder of what we need now and then.


Lately, I've gotten to know a lovely woman called Pomegranate.  I stumbled upon her blog which inspired me to start writing again.  As we delicately start sharing little seeds of our lives with each other, I sense a friendship developing.  


I know that these friendships remain in the virtual realm, and are likely to be transient.  Yet, the support and guidance we give one another is a gift.  The definition of friendship is evolving for me. I have a collection of invisible friends. But they are real.


Peace, Healing, Humor
Cora


☟fish below, glowing, hopeful for some food 
and a visit. sweet karma when you feed the fish 
and wish upon a fish.

Guest Author Bonnie: Six Word Memoir

Pushing, pulling.

It hurts.

Be still.

 ❦teeny tiny fishes have many wishes

please feed us and you'll relax too

My Island

I wrote this essay a little over two years ago.  I re-read it when I need to find my center.

Today I went for a beautiful hike with Elsa, my nine year old Border collie. We live near the state forest in the mid-west and the hiking in May is perfect. After a long, still winter the prairie comes alive in the spring with songbirds, beautiful grasses and fun little critters for Elsa to chase.  It’s a time for us to breathe in our surroundings and walk in silence together.


The Ice Age trail system intersects where we hike and it is a popular spot for long distance runners to train.  Nearing the end of our hike today, a thirty-something woman with well-defined biceps, wearing Oakley glasses and an I-pod ran past us.  I could hear her rhythmic athletic breath at work, and her bouncy long runner’s ponytail bobbed back and forth under a baseball cap. 


In an instant, that old competitive spark welled up in me. I couldn’t help but feel like she was lapping me in a training run. After all, that is what I often did to others in the past. I wondered if she thought “Oh, look at that nice middle-aged woman on a leisurely stroll with her dog.”


Before pelvic pain hit me, leisurely and stroll were not words that I used in the same sentence. I was the one that went for long training runs and skied early morning powder runs. I was the one that rode my bicycle through Europe for three months.  I was the one that wrangled four hundred pound miniature mules and worked dogs twice my size. 


After the runner babe whizzed past me it took a few moments to let the memories of the former me go. I looked at Elsa trotting next to me, breathing with the extra effort that she uses now since she developed a heart problem. She was totally in the moment- soaking the warm sunshine into her black fur, while anticipating the chase of an unsuspecting gopher. 


Elsa reminds me of what is true. We don’t get to choose what happens to us, but we can choose how we respond. When pelvic pain moved into my life, I had to regroup and make choices. Choices about how I wanted to live each day and what was possible each day. In the beginning, I was in total survival mode. 


The first few months were a daily battle.  I felt like I was climbing Mount Everest, and never got past base camp.  Sleep became my summit.  If I could get a few hours of sleep, maybe I could make it through the next day. 


I learned quickly that pain demands efficiency.  My days were broken down into hours and consisted of small goals that were signs to me that I still functioned.  A good day consisted of getting a few hours sleep, feeding the dogs and horses and my husband, Keith.  If my pain was tolerable, then sleep was possible. 


I also noticed that I needed to put the superficial relationships in my life on hold. I stopped accepting phone calls from certain friends.  I stopped responding to unnecessary emails. Recently, I put out emails alerting friends that I was turning my phone off and checking out for a month.  I used to joke with my old soul friends, that my life was now like the show “Survivor” and I was kicking people off my island.

My island is my home and I’ve created a nurturing place.  My island is my family, a few close friends and my animal companions. I am no longer that runner babe.  I am no longer riding my horses.  I meditate.  I take long leisurely walks. I am learning how to breathe. Really breathe.  I am learning to live with pain each day.  I am learning to live with uncertainty. I am learning to relinquish. 


I am learning to go deep into that divine place that John O’Donohue; a Celtic philosopher calls the “inner landscape”.  He says that our bodies are temporary residences for our soul.  Perhaps my soul has been asking me for a gentler home and I intend to honor that request. Maybe I should have listened sooner.

Do they have an app for that ?

Girls, text yourself a message to breathe today. An Intentional breath. A mindful all about ME breath.

Inhale big into all four chambers of your heart, gently exhale all the way through

your belly. Keeeeeeep going. Feel the wonder of l e t t i n g  g o. There is always more of more to let go. Release.

Breathe it out. Open the door and escort a little pain out, perhaps "pain" would like to take a hike.  Give birth to an amazing haiku. 

          ❤❤❤❤❤❤❤❤❤❤❤❤❤❤