Pregnancy and Depression

I have never been the kind of person to sugar coat anything. I am open, honest, and transparent most of the time. And yet my pregnancy has been an incredibly difficult thing to share with people. Early on in my baby journey I deleted my Facebook. I haven't done the typical "weekly bump photo" like most bloggers love to do. I thought I would too! I have limited myself to using Twitter and Instagram and even those things I rarely post anything on. I have been so very protective of my pregnancy and I think it's because my pregnancy hasn't been what I'd hoped or what others expected it to be.

Society in general has this image of pregnant women as these glowing, feminine goddesses. *GAG* oh sorry, did I just ruin it for someone? Pregnancy for me has been miserable and not just because of the usual pregnancy symptoms... because while those are horrible and I do mean horrible... they aren't the worst part. The worst parts are the moments when someone tells you that something might be seriously wrong with your baby. Or when you completely loose any attachment you ever had to the child growing inside of you. Or the moments when the antepartum depression sinks in so deeply that you truly see no reason to exist anymore.

I was talking to a friend of mine today who struggles with depression as well and I told him that I think one of the hardest things to deal with these days is that people see me as weak. They think I am overreacting or that I just don't "handle" pregnancy well. That maybe if I fought a little harder, I could beat the depression. If I were stronger then maybe I wouldn't be so miserable. As if I have a choice in it all.

But see, that is not how depression works. Depression is not a choice or a mindset that you can choose to overcome. It is not something you can pray away or give a pat on the back and expect it to disappear. It is not about mental toughness or about your will to fight. Trust me... coming from someone who has overcome so much. It is no lack of will or strength or tenacity that is getting the best of me. This friend of mine told me something today that made me smile and I even felt a little bit proud. He said,

"The thing is that the people I know with depression are some of the toughest fuckers on the planet. I would go through hell with those people. I'll take someone who battles depression and can still be a success over anybody. There's nobody tougher."

Amen friend. And thank you for reminding me of that truth.

I am thankful for people like him. People who get it. People who reach out despite the fact that I am no bowl of cherries. People who aren't afraid to include me in their life because of where I am. People who don't just ignore it or me because it is uncomfortable for them to face. I am struggling with depression and while it may not be fun and I may be different.... I am still me. I am still here. Still fighting. I still get up every single day. I go to work. I take care of myself and my baby. I clean my house. I fight to live even on the days where it feels pointless. If that isn't toughness or resilience I don't know what is.
I'm hoping that on the off chance that someone stumbles across this post and is struggling with depression... especially pregnancy related depression.... I hope you know that you are not alone. But more importantly, you should know that if you are still waking up every day and choosing to live... you should be proud. You my friend are a badass. 

I Wish I Knew: What Nobody Tells You About Prenatal Depression.

These days I am taking life one step at a time. I seem to be more familiar with anxiety and a lot of fear as of late. Sometimes it feels as if the isolation is drowning out so much it is hard to tell what is reality and what is the result of the hormones surging inside of me. I feel inadequate and like a complete failure a lot of the time. Instead of feeling feminine and glowing, I feel the extra weight I carried before pregnancy pushing its way out in places too visible for my own comfort. As a result I look further along than I am and people tell me I am huge. I feel self conscious about that. I am tired and winded with each step up my stairs. I am told often that it will only get harder the bigger I get. A claustrophobic's worst fear. I read people's birth and postpartum stories and I squirm in my seat, dreading what is to come with all of my being. I don't recognize myself, my body, my spirit. I wish someone had told me how hard pregnancy was. How motherhood starts from the minute that the second line appears. Despite the tiny heart beating just inches away from my own I feel incredibly alone. Scared and sad.... and so very guilty for feeling so. very. sad.

Last week, I was out with Chris running errands and the entire time I held back tears. A blank stare on my face and this hollow, soulless feeling lurking inside. When we got home, he climbed the stairs to his office and I stood in our kitchen and cried. No... I sobbed. Partially relieved to let it out but mostly devastated that I feel so alone and empty even around the ones that I love so much.

Right now I am battling a horrible case of Influenza A H1N1 coupled with a nasty rhinovirus. When we were driving into the ER last night I saw my life slowly spiraling away. My lungs tightening up and the wheezing growing so loud it almost drowned out the pounding of my rapidly beating heart. I panicked, gripping the seat belt... trying to will myself to breathe. "Just breathe. You are okay. Just breathe, Andi" I said out loud. I pictured myself collapsing and being intubated in the waiting room of the ER, ending up on a ventilator for weeks. Oddly enough, being in the hospital was incredibly comforting, heading home afterwards was again horrifying. During discharge my heart rate shot up to the 120's and they had to double check that I didn't need more fluid before leaving. The anxiety is slowly taking over and it is debilitating and depressing. 

The saddest part about struggling with prenatal depression is this tension between the life that is forming inside of you and the deep despair you feel about the whole process.  I have never loved anyone or anything so much in my entire life. The moment I knew this life was growing inside of me was a moment I will never forget. It was euphoric and terrifying and life changing. There are moments where I feel those flutters and I can't help but think that I am the luckiest woman in the world to have my son moving inside of me. To be his mother. To love that deeply... seeing those little hands waving across the screen and little feet curled up so small and yet so defined. To hear that quick heartbeat so loud and so strong, growing every day. It brings tears to my eyes... good tears. Tears of deep gratitude and awe, filled with a desire to be better than I have ever been... all for this sweet baby boy who is already redefining my entire existence. Yesterday, in the hospital I was telling Chris how scared I was that our little boy would be harmed by my virus. He told me, "He is in the eye of the storm, babe. He is just fine." What truth. Sure enough, there he was on the ultrasound swimmin' around like a champ. His heart rate truckin' along at his usual 150 beats a minute. He is my peace. My joy in all of this. My eye in the midst of the storm. My sweet Bentley.

I find myself crying out in prayer every day... begging God to make me worthy of this responsibility... of this gift. Praying that I would be enough for my child. That I could give him everything and love him in all the ways he deserves. To be strong enough to overcome my own crap and to believe in myself enough... to trust that in the midst of my mess I could be a good mom... the best mom for my precious boy.

I wish someone had told me that being pregnant isn't always joyous and wonderful and filled with that glittery glow I expected to have. Maybe they did... but I didn't hear it or understand it the way that I do now. People say rude things and your body is unkind to you and yet that same body is miraculously creating another human being all in one breath. Everything is foreign and feels scarily out of control. Pregnancy is hard. Motherhood is hard... even at this stage it is so challenging. I know I will be okay... but I really wish I was better prepared for this... that this is what making a baby turns out to be for some.

Miraculous. Frightening. Life-changing. Sad. Hard. Undoubtedly worth it... but still so very hard.

The Letter

The other day I was cleaning out the boxes in my office closet that had been with me since I was 15 years old. Years of moving, transferred from house to house and box to box. I had over a decade worth of letters and cards that had chronicled my life through the eyes of those around me. As I sifted through and tossed the generic "Happy Birthday! Love, Aunt Sue" cards into the trash I came across an open envelope. 

It had unfamiliar writing all over it and it wasn't a letter I had remembered even owning let alone reading. It was from my dad and it was addressed from jail, dated in 1991... I was 6 years old.  There was this moment as I opened the letter where everything else went blank. Almost as if I forgot what I had been doing up until that second. The wind had left my lungs and I felt that clenching in my chest. I slowly sat down on the floor and began reading the words on the pages. The apologies and the desperate pleas to not be afraid. The six places he told me I love you and the three where he said not be afraid. I counted each one... soaking it in just as desperately as he had written the words.  The few memories I had were all there... even the swans he had taught me to draw as a little girl. 

 There I was.... just a few days before my 29th birthday as I sat on the floor of my office, sobbing over the words. Tear drops staining the page, blurring the ink into incomprehensible puddles. The questions that had always been in the deepest parts of my being were right there in a box, on a shelf... in my office... all along. Did my dad love me... or more poignantly 

Am I lovable?

Most of my life has been lived with the desperate desire to be captivating, pursued and longed for. A hope that one day the void of not having my father's love would be filled. The wound of being abandoned somehow healed over. It never ceases to amaze me just how much that father wound has managed to impact every part of my identity. Just when I think I have overcome the breath of it... there it is. I know I have come so far and I know I am not alone in this struggle. It doesn't take a broken home to struggle with issues of worth but a broken home and an abusive father only magnifies the hurt. 

“We desire to possess a beauty that is worth pursuing, worth fighting for, a beauty that is core to who we truly are. We want beauty that can be seen; beauty that can be felt; beauty that affects others; a beauty all our own to unveil.” 
― Stasi Eldredge, Captivating: Unveiling the Mystery of a Woman's Soul

So today, I am reflecting on that desire, that hurt, that loss, that wound. I am praying that somehow it will heal enough to not sting so much. I am praying for the strength to believe in my own worth... and I mourn the ways in which I have not loved myself enough. 

And maybe along the way... in sharing the journey... others can be healed too. 

Hannah

It is my first day off so my sleep is broken and I am awake at 4:00am.

I tried to close my eyes ...willing my mind to rest

but all that could cross my mind were the events of this week.

This week I took care of an alcoholic of 40 years. 

He had come down with a horrible bacteria infection that rendered him too ill to drink. 

His estranged wife explained a little of what had led up to this point 

but she had been through this before and could not stick around.

His daughter however arrived at the unit in a fluster of anxiety and fear.

Shuffling from side to side, adjusting her Raiders beanie every few seconds.

Hannah was her name.

I smiled, "I'm a Raiders fan too. My name is Andi and I'll be your dad's nurse until 8:00am".

She smiled and then quickly began asking very specific questions about her dad's health.

She followed up the questions with an immediate proclamation, 

"I am the one who takes care of him so if you have any questions..."

she trailed off, still nervously fidgeting and shuffling her phone from pocket to hand and back again.

She began to tell the full story ...of how it all began.

She was adopted ...like me

He was sober briefly ...until it went sour around her 8th birthday.

She has been taking care of him since she was ten years old.

Her mother gave up and has been living in a different section of the house for years now.

Hannah knows every detail of her father's history because she has been taking care of him since she was ten years old ...ten years old.

He wanted to sober up after being ill so she had been managing his withdrawals at home.

Every time he'd shake she'd give him a shot or two of vodka.

But the withdrawals became unbearable and he began vomiting and soiling himself and passing out. 

So she brought him into the Emergency Room and here we are.

I looked this little girl in the eyes and asked her, "How old are you?"

"I'm 18."

I closed my eyes and put my hand on my chest and had to pause for a moment.

"Hannah, I don't know if anyone has said this to you but I am so sorry. You don't deserve this because he is a grown man and he is your father and I am so sorry." 

I couldn't hold it in anymore and I began to cry.

Partly because I am devastated for Hannah 

but mostly because Hannah has that oh so familiar look.
I know how far she has to go in order to be healthy and whole 

and just how painful that journey will be for her. 

She stopped for a minute and just gave me that smile that comes when you're trying to hold back tears.

That moment when you know that someone gets it and that someone sees you... and that small ache rises to the surface.

She quickly stuffs it all back into her neat little box and the subject is changed.

I talk to her more and I encourage her to finish college ...transfer out of here a.s.a.p.

She nods and agrees, so there is hope for her.

This week Hannah broke my heart and I am awake now at 5:30am praying for her.

Praying that she will someday overcome the co-dependency that has been crafted into her being. 

Praying that someday she might find faith in God and peace in His grace.

Praying that someday she knows the love of a father that she never had

Praying that she gets into college and runs away from this mess

and that she begins to heal ...deeply heal.

This week I am praying for Hannah to know truth

and I weep for her ...even now, I weep.

January 27th

It has been one year since Chris and I got married. I have so many emotions about our anniversary. We have been through so much this year. Everyone told us that the first year of marriage would be the hardest.  I will say that we have been through a handful of things that have made this year challenging. I have no doubt that marriage is the most difficult thing I have tackled thus far.

We are lucky enough to be surrounded by amazing family and friends who have supported us and been there for us through this first year. I am so incredibly blessed with in-laws that I love just as much as my own family. I feel so at home with them and I could not imagine my life without any of them in it. 

If there is one thing I have learned this year about myself and about marriage it would be summed up in one word ...perseverance. Choosing to join my life with another human being has forced me to persevere through so much. When I was single I had the choice to run from and ignore a lot of junk within myself. Now that I am accountable to another person I have to reconcile all of these messy parts within myself. The moments when I don't feel like being considerate or gracious or loving I have to choose to think of the other person first. I have to choose to address the parts of myself that are selfish and defensive and just downright emotionally ugly. 

I know we have both struggled with learning to live with another person and adapting to the fact that your time is not solely yours anymore. It is shared with this other person who doesn't necessarily do things the way you would. We have had to figure out the balance of life together instead of life as a single person. 

We have survived job transitions, the loss of family members that were integral parts of our lives, and me starting school all in this first year. It definitely hasn't been easy...

but it has been absolutely the best thing I have ever committed myself to. This man that I married has made my life so much brighter, happier and full of love in ways that I never could have imagined if I had chosen to stay single. 

Marriage is the most sanctifying process I have ever endured. The love I receive from this man is one of the greatest gifts I have been given. The ways he fights for me and chooses to love me even in the midst of my mess ...it has not only been humbling but transforming in so many ways. I am so lucky to have someone so caring, loyal, patient, and strong. 

Chris, I love you more than you'll ever know and I can only hope to be the wife you deserve every day. Thank you for loving me in all the ways that you do. Thank you for always striving to be a better man. Thank you for being you. 

Happy Anniversary husband. Here's to many more. 

Afraid.

I am a worrier. I always have been and to some extent will probably always be one. I think it has a lot to do with how I grew up and the circumstances in which I was raised. Everyone did the best they could but in many ways stability... especially emotional stability, was not something I saw around me often.
As I entered my young adult years and began living on my own I did everything I could to form a very structured, stable environment. Everything from the people I surrounded myself with to the home I lived in and the job I kept... it was all managed very closely. On the outside at least. In many ways my internal world was in utter turmoil but I did everything within my power to keep the things and the people around me constant. I did not and still do not handle change well.
When people left it scared me. When plans were derailed I panicked. When I knew it was time to move on to another job I froze... paralyzed with fear. I even remember a day, years ago when I still lived with my mother, it being an unhealthy living situation a close friend of mine asked me why I was hesitating to leave so much. "I don't know who I am if I am not my mother's daughter." I told her. I was so very afraid. Afraid that I would fail. Afraid that if I loved people they would leave. Afraid to get attached. Afraid to believe in myself. Afraid to trust that God had me in His hands. Afraid of branching out. Afraid. Afraid. Afraid.
I think, in many ways I am a thousand times better when it comes to not letting fear rule my life. Yet, there are still moments where it catches me off guard and I am struck with that familiar pit in my stomach. That gnawing feeling that it will never really be okay. 
This week has been filled with those moments. There have been things this week that have reminded me that no matter how much I plan and no matter how many walls I build up... life just happens. In a strange way getting married has magnified that fact. I don't know that I have trusted a human being as much as I trust my husband. I have let him into places that no other person has been. I have opened my heart to him... and his family. Those walls I have so fervently built to protect myself from hurt have been slowly displaced. I have become vulnerable to this man in a way I haven't ever in my entire life.... and you know what? It terrifies me.
Somewhere in the back of my mind I am convinced that it is too good to be true... and that someday, something will take this man that I love just to remind me that nothing I have is secure. To remind me that attachments are bad and that people will inevitably always leave. I know logically it is ridiculous but it is a real fear of mine and this week that fear has been thrown in my face in a very real and tangible way.
Luckily, I am blessed enough to have people in my life who understand what I am feeling and can even share their own journey with the very same thing I struggle with too. Still... I can't help but lay awake at night and wonder... what if?

What if life happens?

As a Christian I know I need to trust that God does in fact have me in His hands... because He does and He always has. Right now I am just afraid to believe it and that is difficult for me to admit... but I'm trying. So, today, my prayer is short but it is genuine and it is real.

“Lord, I do believe; help me with my unbelief.” ~Mark 9:24

The Color of Humility

“Death opens a door out of a little, dark room (that's all the life we have known before it) into a great, real place where the true sun shines and we shall meet.”
― C.S. Lewis, Till We Have Faces: A Novel of Cupid and Psyche 

 In the ICU we are all about control. Almost every ICU nurse I know would agree with that fact. In death there is no control. I guess that's part of what I love about palliative care. In a world where you can't beat the inevitable... at least I can have some control over how it ends... I can offer some solace at the very least. The chaos stops and there is only the person... no IV lines, no balloon pumps, no chest tubes, no monitors. Just pure nursing care. Today I am taking care of a dying patient and for some reason, today has not felt that way. There has been no solace here. It has felt exhausting and uncomfortable. There is an unease to everything about this night. I couldn't put my finger on it but as the hours have gone by I have felt it.
That gnawing feeling in my stomach. It wasn't until I saw my patient's family react to a simple question that I was able to pinpoint the source. A simple, "Do you want to be called before he passes away?" and the whole countenance changed... I saw that smile turn into a stern, furrowed brow and that pit in my stomach grew.
They think their loved one is going to recover and so until the very last breath they will force every invasive procedure possible in hopes of prolonging life. From that point on I realized why I wasn't settled and I don't know why it didn't hit me sooner. This is not end of life care...
In the ICU we are supposed to save lives and many times we do. We use our medical knowledge and nursing care to fix people up so they can live again as they once did before. But the reality is that most often life will never be the same. We have patients here who have been in our hospital for over a year. They have gotten sick and gotten better more times than I can count and in the end they usually end up succumbing to the inevitable. They die here... sometimes alone and often times after a long and painful hospital course... and I think to myself. What was it all for?
And if we can't save their life... at the very least we can make them comfortable in their last moments on this earth, right? But, what happens to the patients who are obviously dying and yet the family just isn't ready to let go yet?
It is that grey area that I find hard to handle and this patient was the epitome of all of that. We have to poke and prod until the very end. We have to do things we don't agree with and don't like. We have to face the fact that we cannot save every life and that medicine has its limits.... and I have no control here...

and I hate that.

I hate that grey area between death and life... where we have to wait and see...to pretend it will all be okay despite what we know will inevitably come. It is in those moments where my hands are tied and I have to be the one to carry out the invasive procedures while the family is able to get the incredible, devastating courage to let their loved one go. It is in those moments where I have no control and if the only thing I can do to provide comfort to a dying man is to pray for him as I give him a bed bath and some new sheets to pass away in... well then that is what I will give.

This is the grey area of the ICU where my faults stare glaringly back at me and I am reminded of just how insignificant I am.... of just how selfish I can be. That when a family is battling with the fact of losing their father, brother, uncle, husband... all I can think is, "I hate this" It is the grey area that reminds me of how insignificant my needs are when in comparison to those of a dying man.
It is painful and uncomfortable and in the middle of all that grey it is incredibly humbling.

In Honor of a Patriarch.

I have shared on this space many times about the wonderful family I was lucky enough to marry into. It is a very large, very loving group of people who are crazy and fun and welcoming beyond belief. From day one, I felt very comfortable slipping into the mix of people that called this clan their own.... a clan that is now mine too.

The patriarch of our family started a legacy that spreads beyond generations and has branched out all the way to people like me. A girl who came from a very broken and disconnected family... a girl who now has a place to call home... all because of the love of the two people you see in the picture above.

Today, that patriarch is no longer with us. He passed away this morning and our whole family is still in a somewhat state of shock. I have never had a very close family member pass away. I have seen death time and time again... and yet I have never really experienced it. That hole that is created... the new space in your life where something important is now nothing but an empty void.

When we went to the hospital and saw him... even I was unsure of what to expect. I see death all the time and this was no different... except that it was. You go through the motions... the details of the events are familiar to me but the aftermath was not. As I watched the emotions and reactions from everyone around me I could sense that mode of... 'this is life' settled in me. I know this... its familiar.

It wasn't until we started walking out of the hospital that it hit me. This is unchartered territory... where do we go from here? Life will no longer be the same for us... especially for grandma. I remember the first time I had a patient die in the ICU... the patient's wife stood there after saying goodbye to the man she had shared most of her life with.... she stood outside his room and looked at my preceptor and said, "Now what do I do?"

"How do I just go home without him?"

It was this moment of realization. She would not be going home with him... but she wouldn't be coming back here to see him either. She had to move on... but how? How do you just walk away from the love of your life for the last time? How do you leave the hospital with all of his belongings but without him?
This is what settled in my soul as we drove home from the hospital. That gnawing feeling of the numbness wearing off.

Grandpa, I hope you know how much you are loved... I hope you know how special you were to us... and to me. I am so grateful that I had the honor of knowing such an amazing man who created such an incredible family. I will always remember that moment, right after Chris and I said our vows to each other. You reached out to me first and said, "I have to be the first one to congratulate the new Mrs. Heggem!" I think my face said it all... I was officially now a Heggem!

Thank you for that... thank you for being you.

I know that I can take comfort in the fact that you are in peace, in heaven, celebrating with the God you served so faithfully. But for the record.... we miss you dearly, Grandpa and today we grieve the loss of our beloved patriarch.

Rest in Peace.

The Heart of the Matter

I've been tryin' to get down...

 to the heart of the matter...

 but my will gets weak...

and my thoughts seem to scatter

 but I think its about...

Forgiveness

The Heart of the Matter  

Don Henley

 I woke up early on Monday and as my eyes slowly let the light seep in a sadness washed over me. I looked at the clock just as it turned 6:00am. My stomach began twisting all sorts of ways, knots starting to form.
For a brief moment I panicked thinking that I was coming down with something. A stomach flu of some sorts... until it hit me. Today is my sister's birthday.
I haven't spoken to her in years. I wouldn't even know how to reach her at this point. This is not uncommon in my family. We are disconnected, broken and dysfunctional. The few of us that actually have communication with each other are a tiny handful and the times we actually see each other are few and far between.
I have faint memories of childhood where we celebrated holidays and birthdays... all one cohesive bunch. It seemed as if things were okay... happy even. Maybe that was simply due to my innocence or maybe it was just the inability to see the truth of our family dynamics. At that point I guess anything was better than the abuse I had endured in my previous home. Eventually the facade broke down though and reality set in. There hasn't been a holiday in years that wasn't filled with anger and fighting and frustration and plastered on smiles.
This is why we don't speak... this is why my interaction with my family is minimal and surface level if that.  
If I am being truly honest, it is for the best. I read a blog post recently on the difference between forgiveness and reconciliation. Reconciliation is a two way street filled with repentance. There is little if any of that in my family.
So... I forgive but I do not reconcile.
Fast forward to the next day... work is hectic and busy so I hurriedly settle into report. As I sit there listening to the typical rattlings of the ICU... Intubated 2 hours ago... tachy to the 120's, septic and febrile... I hear "Registered Sex Offender."
My fist clenched around my pen and I took a deep breathe in.
Not today... I don't have it in me to do this today. I have taken care of child molesters and sex offenders before but today, I just can't do it. As I look around the unit and see the chaos... our charge nurse scrambling around like a chicken with her head cut off, I realize that I won't be able to switch assignments and my stomach begins to twist and turn... here we go again.
He remained on the ventilator the entire night so luckily I didn't have to force any interaction. I took care of him to the best of my abilities and went home the next morning exhausted.
I come back to work the next night and I have the same assignment... only this time he isn't on the ventilator and now he is surrounded by his entire family. For the first 2 hours of my shift I was on the verge of tears. Face flushed with anger and fear and disgust all rolled into one big, emotional ball. I tried to busy myself in my patient's room next door, hoping to get the composure to be this man's nurse. Praying to God that I would find someway to detach my own experiences with the horror of what this man had done. Eventually, I knew I couldn't avoid it any longer and I went in to do my assessment. He was a little disoriented but pleasant and joking with his family. I went through the motions and when he was unstable I did everything I could to be reassuring for him. After we got him settled and his vitals were stable he looks at me and says, "You know what... you're a good nurse. I'm really starting to see the skill level of people here and you are a good nurse. You have a very bright future, Andrea. Thank you for taking such good care of me."
It might have been the way he said it or the fact that I was so emotionally drained... or maybe it was the sense of relief I felt knowing I had managed to hide the truth of what I felt towards this man. All I know is that in that moment all I felt was sadness. The only thing I wanted to do was run out of that room... away from him and away from it all. Away from thoughts of anger and abuse and my sister. I wanted to be at home in the arms of my husband where it was safe. Where I could cry and cry and cry... all night long if I needed to.
Instead I just smiled at my patient and said a very quiet, "Thank you." I finished what I was doing and I went into the bathroom and cried. I cried and I prayed that God would give me the strength to forgive.

Wedding Post #2

We had our reception at a small restaurant called Nola. The food was delicious, the service was stellar and I couldn't have been happier with how laid back and fun it all was.

It was nice to be able to expand our guest list a bit more to include some of the people who couldn't come to the ceremony. A bunch of my favorite co-workers came and they are always such a blast.

The girls went crazy over the Mardi Gras beads... I still have a basket full of them at home.

Our favors were plantable paper hearts... seeds that are embedded in recycled paper that you can literally put in soil and watch grow into a beautiful mix of flowers. I hand stamped the envelopes and decorated each little flower pot with ribbon or adhesive borders from the Martha Stewart craft line. I still have yet to plant ours at home but I am excited to see how well it works.

 

 Our cake was a mix of layered Red Velvet with cream cheese frosting and chocolate cake with dark chocolate, hazelnut ganache. It was SO good.

This was my failed attempt at warning Chris not to shove cake in my face....

it obviously didn't work. Silly boy. He's lucky I love him so much.

The toasts were given by Ami and Chris' dad. We were given a beautiful wedding prayer by him that brought tears to my eyes. It was so touching and so thoughtful. I am thankful to be surrounded by so many people of faith and wisdom. I know our marriage will be better because of it.

So that's it. I am now a married woman. Who would have thought? Just a short time ago I was convinced that I would be single for the rest of my life. And while I think that life can be very well lived single or married... I am very glad that I met Chris and I am so thankful to be sharing my life with my best friend. 

<3

Grateful

Working in a veteran's hospital you see a lot of things. A lot of substance abuse, mental health issues and alcoholism... PTSD is rampant in our patient population. It can be a rough place to work sometimes. It wears you down. People are bitter and angry and broken... lost and many times forgotten. 

It is not uncommon to have patients in our unit that have no visitors during their entire hospital stay. It is also very common to have families with very complicated backgrounds and delicate family dynamics. Often times we are not only caring for our patients but we are caring for their families too.  I think one of the reasons I fell in love with the VA is because of the people. One of my deepest passions in life is to show people their value and their worth. I think that is one of the things I have always valued about my faith also. Jesus was a man who loved people... the worst people too. The rejects and marginalized people that no one else wanted to fight for... he fought for them. 

If anything I hope that would be the one thing I can show people. That they are worth it. That they are valued... but most of all, that they are loved. 95% of the time it is not easy working with the patients in my hospital. There are moments though where it clicks and the 5% makes up for the rest. The moments where I am able to step outside of my own crap and realize that these guys are just hurting, broken people who need good care... those are the moments that matter.

I had a patient last week who was unlike the others. This patient had a large, close family. This patient did not have substance abuse in his background. He was a physician and a professor at a very prestigious medical school in the area. Still he chose to come to the VA for his care. His wife was saying how much he appreciated the care he received at the VA and she expressed how grateful she was too. Through foggy, tearful eyes she stroked her dying husband's hair and told him to keep fighting... and that she loved him more than anything in this world. She said that he was her best friend and that she was so grateful for everything he had given her in their life together. The love she had for that man was pouring through every tear she cried and the pain she was feeling was tangible.

It broke my heart and I had a hard time holding it together as I managed the care of this extremely sick man. She asked me how long I had been working in the unit and asked if I liked my job.

I stopped what I was doing because I wanted her to know how much I meant what I was about to say. 

"I love my job. It is an honor to serve these guys. They truly have given so much and the fact that we are able to cater to our veteran's in such a specific way really is so special. I love knowing that we can give back in that way... and especially that we can give such good care to people who often times are not appreciated or understood. I really love what I do and even on the hard days I am still grateful that I have a job where I can show someone that they are valued by the care that I give."

She looked at me and smiled ever so slightly as tears began to fall down her cheeks. 

In the midst of an incredibly exhausting week it was a 5% moment and even now... days later it brings a bittersweet joy to my heart and it reminds me of just how lucky I am.

 

Image Credit

a moment

today every part of my soul feels weary. i have been walking in a sort of daze. a mix of exhaustion and sorrow and gratitude. there are moments in your life that change you. moments that give you such a clear view of your existence that you can never be the same. i made the choice to become a nurse because i knew that if i did my life would never be the same. 

it has been a long month. a busy one in our unit and it has taken a visible toll on everyone. lots of sick calls. lots of complaining. lots of very sick people who need a lot of care and not enough people to give it. emotionally we have all been drained. i am drained too. 

in the past month i have taken care of multiple patients with debilitating, chronic, fatal diseases. they teach you in nursing school how to have boundaries. how to let go and care at the same time. how to set limits with chronic patients without seeming harsh. i have never been good with that. i oscillate between the lines.

yesterday was my last night of a long stretch at work. i was tired and in pain. i had a very stable assignment. not a busy one by any ICU standard. just difficult. one patient on his 7th round of chemotherapy, suffering from a vicious cancer and a mild infection. i was thankful he slept for almost the entire 12 hour shift. thankful for the chance he got to rest and restore but thankful for myself too. thankful for the minimal interaction needed. 

my other patient, a man in his prime, suffering from the end stages of ALS (lou gehrig's disease). the only muscles left with any sort of function in his body were above his neck. he could not move, could not eat, could not speak. he couldn't even breathe without the help of a ventilator and tracheostomy that was placed. he could barely mouth enough words to ask for what he needed. his wife was there at the beginning of my shift. she wanted to make sure the night shift nurse was a "good one." that is always a bit of an anxious thing for me. the ICU is stressful and often times families of ICU patients are burdened with fear and sadness and an acute awareness of their loss of control. then here comes this 26 year old girl who will be taking care of your husband, father, brother... your son, who is on a ventilator and a plethora of medications that need titrating and managing. for them it is terrifying. which i understand. i do. but it is still hard.

it is hard to tell what they expect. what they want. do they want you to be happy and positive and cheerful? do they want you to be serious and somber and just down to business? or do they want you to be friendly with them and treat them like you have known them for years? i see some of my co-workers who are warm and friendly and smiley. hugging their patient's family members and chatting like they are bff's. i have never been good with that. i am not good at being smiley. i am genuine and hard-working and compassionate but i am not smiley. when i am at work i am serious and professional. i think some people see it as being cold and that is difficult for me. i want them to know that i am giving 100% of my attention to their loved one but it is hard when you don't know how that person receives that message. everyone is different. 

often times i am the one who relates to the few that everyone else has a hard time with. the quirky, walled up, introverted ones. the ones that take a little more time to get to know. i get that because i am that way too. maybe it is a trust thing. or maybe its just time. i find though that the ones with the hardest shells have the softest hearts. a lesson my mother taught me years ago and one that i never forgot. 

i knew this could be a difficult night. i was right. it was difficult. it was long. it took every ounce of energy left in my being to give the care i gave. it took a lot of venting sessions in the break room and hugs from my co-workers too. i am so incredibly thankful for them. they keep what little sanity i have left intact. 

i spent 90% of my evening trying to understand my patient's pleas for help. imagine what it would be like to have your mind fully functioning and completely aware of your existence but to have no way to connect that to your physical body. imagine having no way to move into a comfortable position. no way to wipe the tears from your eyes when you are sad. no way to scratch your head when it itches. or move the covers off of your body when you get hot. no way to eat or no way to communicate clearly that you've gone to the bathroom in your bed and need to be cleaned up. no way to tell someone you love them. or to say that you are in pain.

every time we had to do anything to my patient it required a 30 minute session after of discussing ways to reposition him. he would nod and attempt to mouth words but it ended up looking like the mouth of a puppet on strings. everything jumbled together and nothing was comprehensible. i resorted to head nods and one word phrases. 

Is it your head? no

Is it your arm? no

Is it your shoulder? no

Is it your hand? yes

Okay!

Is it too low? no

Is it too high? no

Is it your fingers? yes

Do you want me to spread your fingers apart? he smiles.

I fix his hands and he begins to nod his head towards his left and looks down at his hand.

Do you want me to fix your other hand too? no

Huh... try to mouth it to me.

Up? no

are you saying head? no

Im sorry but I can't understand. Try again.

I turn on the lights and walk around to the other side of the bed and begin again.

Is it your arm? no

Is it your leg? no...

I take a deep breathe in and proceed to look around for anything that looks uncomfortable.

30 minutes and 10 pillows later we have him propped up in a position that is comfortable.

an hour later the process repeats itself again.

by the end of the 12 hour shift i was translating to people what he was trying to say and dictating exactly where he wanted every limb of his body to be. down to every toe and finger... everything had its place. by the end of the 12 hour shift i had nothing left. i thought about his wife at that moment... and how she looked on the verge of tears when she left the night before. and how i thought that it was because she was sad that her husband was dying. and now i was wondering if it was also because a part of her was dying too. the life she once knew and the love she once had would never be the same. the dreams she had. the children they had. nothing would be the same. ever. and how she must feel so incredibly exhausted and drained after a year and a half long of this.

i wanted to weep for her. i wanted to tell her how sorry i was and how unfair it was and how i wished it were different. for both of them. i wished i could do more. make it easier some how.

i prayed at that moment that God would give her rest then. peace. that she would sleep well and heal too while her husband was being taken care of here. 

when i went into the room to say goodbye that morning he looked over at me and mouthed the words, "thank you. you're the best" and smiled so wide i could see the deep wrinkles form around his eyes.

i could feel the tears reach my eyelashes.
"no my friend, thank you" i squeezed his hand and smiled back.

there are moments in your life when you know that you will never be the same. and in that moment i knew that as i walked down the stairs to my car that morning, i would feel every step and inhale deeply every breath. that i would go home and tell the people in my life that i love them because i can. i also knew that this was one of those precious moments... a moment where i would surely never be the same.

Happy Easter!

This week I have been sick and recovering from a severe sunburn I got during my 23 mile run last week. I only made it to work one day this week because a cold caught me on my first 12 hour shift. The rest of the time I have been miserable at home, attempting to find some position where I am not in pain. It has not gone well. I am totally worn out and I feel drained on every level.

All of that to say that I have been completely detached from Easter week this year... and my heart is a little broken because of it. At a time when the world is stopping to reflect on the life of a man who means so much to me, I realize that I have been focused so much on the wrong thing... myself. 

And the truth of the matter is...

I miss God

and I want more of Jesus' truth to be in my daily life.

So here's to having a blessed Easter weekend, full of redemption, truth and hope!

Green hills and nostalgia

Road trips always seem to bring out the nostalgic side in me. It's something about the endless miles of road, the music, the people.... or lack thereof, that sends me into a lull of memories. A few weekends ago I was able to take a road trip with my BFF's to see a play that my friend had been the assistant director/stage manager of. It was a quick trip and it was jam packed with visits of friends we rarely get to see. It was great to see them and catch up... even if it was only for a meal or a few minutes at best. It was also really wonderful to be able to see into what my friend had been pouring her heart into these past few months and so glad to know that she is incredibly happy with the work she has done there.

The drive was incredibly beautiful and it lit a small fire to the travel bug that has been quietly put to rest since I came home from Lebanon. I love seeing new places... or old ones in a new light. Truly, California is a place that is so diverse it is hard not to see its beauty in new ways each time you drive through the countryside. The entire trip down I just kept saying, "This is basically what Ireland was like! I can't get over how green this is!!".... lush and stunning from every corner. I'm pretty sure by the end of the trip everyone got the point. haha



This is my BFF TK and one of his multiple attempts (and only successfulone at that) to jump into my pictures. haha definitely a keeper. I heart my friends. :)

It's funny how the randomest things can spark a memory. A good portion of the trip we were listening to Jason Mraz's first album... "Live at Java Joe's" and I was instantly thrown back to my first year of college. I had a CD player (yes a CD player... the days before iPods ) that I would carry in my back pack, headphones threaded through the top with that album playing non-stop for basically an entire year.... I rode my bike everywhere and would listen to it the entire ride to school and then to work and then home later that night. Listening to those songs I can picture the exact rode and the exact bike I was riding. The feeling of hope and fear of entering into an adult world where nothing was set out for you like it was in highschool. The naive spirit I had coupled with the feeling that I had to do anything I could to make it through... even if it meant working insane hours to support myself through college. The excitement in knowing that I had so much ahead of me and the feeling that I could do anything if I just worked hard enough....
and it got me thinking... about the dreams and hopes of that 18 year old girl I once knew. I wonder what I would think if I took a snapshot of my life now and showed it to myself 8 years ago and said, "So... this is your life.... is it all you'd hoped it would be?"

I think in many ways I would be incredibly proud and relieved to be out from under a lot of the turmoil I used to live under. In so many ways I am still shocked at how seriously blessed I am... and how far I have come. Just today at work I had to stop for a minute and think to myself, "Yes, Andi.... you really are a nurse...working in the ICU for almost 2 years now! You actually did it!" I can't believe it sometimes. God has had his hand in my life... no doubt about it. Still... there is a part of me that thinks I would look at my life and be really surprised at where I've ended up. Not in a bad way... just a surprised way. At that point in my life I don't think I had any clue where I was supposed to be... I was planning on being an art therapist but really.... I just knew I wanted to help people... and I knew I wanted to travel. There is still a part of me that feels that pull towards other cultures and people and I just wonder.... 8 years from now... who knows where I'll end up?
Kind of an exciting thought, huh?

What about you friends? What kinds of things make you nostalgic?

It never gets easier.

For some reason this year I have had quite a few patients pass away. Working in the ICU you expect to see death but surprisingly enough it isn't extremely common. A lot of our nurses will make it through an entire year without having a patient die on them.... AND yet for some reason this year I have had my fair share of comfort care experiences.

Growing up I was always terrified of death... it would keep me up sometimes at night... my mind reeling from all of the awful things that could happen to me or a loved one.... all of the things I would miss in this life if I was to die young. I think if I worked with pediatrics my perspective on death would be much different... but I don't. I work with predominantly older adults and so death is a natural part of the life process. 

This week I have seen another side of death though.... a member in Chris' family passed away a few days ago and it was incredibly sad to be on the other side of things this time. Even though I didn't know him... it was so different seeing the effect of it all. The vigil at his bedside. The smile he gave when he saw the little ones wave to him. The tears and stories and heart felt questions.... "Why now?" 
It reminded me of my first death in the ICU. I cried the entire way home listening to the Death Cab for Cutie song "What Sarah Said" ..... The lyrics "love is watching someone die" ringing in my ears... and I just couldn't get over it.... this person had a life.... a family... memories... a legacy left behind and now... well now they're gone... just like that. 

Gone.

I know that he is undoubtetdly in a better place... a place where cancer does not exist and pain has no hold. I have been praying for the H. family this week and today as they say their final goodbyes as well. I hope they feel the love that I see and feel in their family. It is a gift to have so many people surround you as you leave this world and it is so very clear that even if Uncle M. is not here anymore... his love and legacy still remain in the people he has left behind.

Joy

Waiting for a particular turn of events is a good way to head yourself into disappointment. Depending on anyone to make you happy, make you feel good or lift your spirit is a sure way to place yourself in isolation. When your joy is dependent on people and conditions, it is restricted. Joy must spring forth from you before it can surround you. Joy must be the way you walk and the way you speak to those who come into your realm. Joy is knowing you are doing what you can, the best you can, and you are feeling good about it. Joy is knowing time is on your side and wherever you are, you are the joy. Joy is taking a moment to say thank you, a day to do for self and an energy of sharing what you have. Joy is not what happens to you; it is what comes through you when you are conscious of the blessing you are.

 -Iyanla Vanzant-

 I read this quote on Yolanda Holder's blog this week. She is the "walking diva" and currently is the Guinness world record holder for "most marathons run by a woman in a calendar year." I believe she actually even tied with the male record and did 104 last year. One of which I did a 5 mile run during!

She is incredible and inspiring and I just love that she posted this Iyanla Vanzant quote on her blog. Iyanla Vanzant is one of my favorite authors as well... gotta love such women of strength, wisdom and grace!

This week I have been feeling strange. Oddly detached from everything and just kind of feeling a little emotionally lost or lack luster in a sort of way. Not particularly sad or upset or worn out.... just kind of floating through the motions. You know what I mean? 

This quote came at such a perfect time. I want to have joy. I want to be joy. In my line of work joy is a commodity. I have some co-workers who are those types of people... they exude joy in everything they do... even when they are completely livid or frustrated or exhausted.. they always have a smile to share or a hug to give. I want to be like that more often. 

Joyful.

Earlier this week I read an update on caringbridge.com from one of my old nursing instructors who is battling cancer. She wrote a simple story that stuck with me...

A blind boy sat on the steps of a building with a hat by his feet. He held up a sign that said: "I am blind, please help." There were only a few coins in the hat.
A man was walking by. He took a few coins from his pocket and dropped them into the hat. He then took the sign, turned it around, and wrote some words. He put the sign back so that everyone who walked by would see the new words. 

Soon the hat began to fill up. A lot more people were giving money to the blind boy. That afternoon the man who had changed the sign came to see how things were. 

The boy recognized his footsteps and asked, "Were you the one who changed my sign this morning? What did you write?"
The man said, "I only wrote the truth. I said what you said but in a different way. I wrote: 'Today is a beautiful day; but I cannot see it.'"

 My assignment this week was a tough one... a patient with severe necrotizing fasciitis (trust me you don't want to know more... it's a bacterial infection that eats away at your skin, muscles and bones and causes painful, awful looking wounds.)

Another patient with a severe poly-substance and alcohol abuse history and 3-4 different mental health disorders to boot. Came from our blind rehab unit as a code blue from a narcotic overdose. Now I get him a week after he assaulted about five of our nurses, (including an attempt to kick me in the face while I held him down so that our charge nurse could give him ativan) sending one of our nurses down to the ER after he kicked her square in the chest.

Yeah... not fun. 

So, two days in a row I am buried in dressing changes and drip titrations, hoping to eventually wean this guy off sedation for possible extubation in the morning. The man is on enough sedation to knock an elephant out (7mg versed, 250mcg fentanyl and 0.4 of dexmedetomidine) and is still awake, restrained and agitated... attempting to talk around his ET tube and thrashing all over the place.

Magically, by the end of the first night he mellows out and we end up spending the morning rocking out to Journey and Pink Flloyd on the classic rock station. I am pretty shameless about singing while I work. I grew up in choir and I miss singing so I love it when I have a chance to sing with/for my patients and luckily it didn't bother him at all. The day was busy but it ended well.

The next night it was the same thing all over again.... dressing change.... drip titrations... argue with the interns about getting something other than fluid for my patient's bottoming blood pressure and begging for  basically every. single. thing. I needed to make my patient stable and comfortable.

He was still agitated and nervous... suffering from paranoia and anxiety most of the night.

But then again.... morning rolls around and he is starting to mellow out. I sat at his bedside, holding his hand in an attempt to offer some comfort and he motioned for me to sing for him.... pointing at me and then pointing at his ear... waving his hand in the air like a conductor. I had the song "Landslide" by Stevie Nicks stuck in my head that whole night and knowing he was a classic rock type of guy I figured I'd just sing that. So, I pulled up a chair and began to quietly sing...

"Well I've been afraid of changin' cause I've built my life around you... 

And if you see my reflection in the snow covered hills
Well maybe.... well maybe...

The landslide will bring you down"

It's almost 6:00am now and I can see the sun start to peer over the hills... I finish the song and he motions for me to sing it again. I look at the clock and despite being behind on charting I figure I can spend an extra few minutes here... hoping he'll fall asleep for a little while.

And suddenly something changes... his grip on my hand relaxes and he closes his eyes. Tears are falling down his cheeks and I can see he is in a bittersweet moment. Pain and peace and fear, all wrapped into the same space. 

6:20am now and I look out the window again... this time being greeted with one of the most stunning sunrises I have ever seen. I immediately stood up and snapped a picture with my iPhone... hoping I could show it to my patient since his bed was facing away from the window.

"You have to see this! The sunrise is absolutely gorgeous!" I hold my phone up to his face and instantly realized what I had done....

how could I forget? 

He cannot see it.

This man is blind.

He tries to smile around the ET tube and motions for me to hold the phone closer.... he has a tiny amount of residual sight in his right eye. My heart sank as he squinted and pulled the picture about an inch away from his face. 

"Can you see any of it? Can you at least make out the colors?"

He turns towards me and shrugs with a slight nod and a small smile.

In that moment... that story became so incredibly real to me.

'Today is a beautiful day; but I cannot see it.'

I wanted to cry... I wanted to crawl into a hole and hide from the world, I felt so awful for being so insensitive to my patient... but instead I decided to have joy... I decided to be joy. I described the sky in detail to him and then proceeded to sing to him once more. I sat next to my patient... his hand in mind and I soaked up that sunrise for every minute it had left. I silently prayed... thanking God for the ability to see such a beautiful day.

It is one I definitely will never forget.

"Please Lord... don't let me cry"

"What Sarah Said" by Death Cab for Cutie

And it came to me then that every plan is a tiny prayer to father time
As I stared at my shoes in the ICU that reeked of piss and 409
And I rationed my breaths as I said to myself that I'd already taken too much today
As each descending peak on the LCD took you a little farther away from me
Away from me

'Cause there's no comfort in the waiting room
Just nervous pacers bracing for bad news
And then the nurse comes round and everyone will lift their heads
But I'm thinking of what Sarah said that "Love is watching someone die"

__________________________________________________________________________________________

I know that death comes with the territory of being an ICU nurse. It's simply a part of the job and in many ways it can be a wonderful part of the job. My view on death since I have become a nurse has changed drastically. It is not something I fear anymore... nor is it a negative thing by any means. 

Death in many ways is beautiful and peaceful and incredibly full of grace. 

To be present and actively involved in such a deeply personal moment with someone is truly a gift. 

This week I had a patient die (seems like its been happening to me a lot lately) and it was the most painful death I have ever witnessed. It was expected because the patient had lung cancer with mets to the brain, and bone but still... I don't think there is ever a way to be fully prepared for the death of a loved one. Just a week prior to his death the patient was playing golf with his friend when he suddenly couldn't breathe and was admitted to our ER with a pulmonary embolism. He ended up intubated, sedated, chemically paralyzed and on every medication in the book to maintain his blood pressure, prevent heart arrhythmias, prevent blood clots.... the list goes on.

When I received report from the PM shift nurse... he began desaturating to the low 70's (normal is ideally above 95%). His blood pH was 7.11.... extremely acidotic... not a survivable level by any means. He was on 100% oxygen on the ventilator with peep and pressure support settings maxed out as high as we felt comfortably going. The ICU fellow, intern and resident all crowded into my room and we began thinking of everything we could do to try and fix this.

"I can increase his tromethamine to 20gm? Maybe that will help with the acidosis?"

"ok let's do it..." next blood gas was even more acidotic at 7.10.

 hmm...

"Or what if we increase the peep to 20 and then add vasopressin to increase his pressure and counteract the decrease in cardiac output?"

"We are already on vasopressin... it's maxed out at 0.04... we could try dopamine?"

"No, he has a history of Atrial fib.... it's why he is on amiodarone."

"yikes, ok scratch that idea."

My alarms started beeping... he was now dropping his systolic blood pressure to the 70'sand his oxygen saturation was dipping into the low 60's.

I turned to the resident and reluctantly said "I think we need to bring the family in..."

"I've already sent the intern to call them"

You could hear everyone take a deep breath in and the feeling of defeat in the room instantly filled the air. This was not a battle we were going to win. By the time the family arrived we knew we had only a matter of minutes to have a plan of care discussion. The resident began explaining the situation and the decision was made to withdraw life sustaining measures and to provide comfort care only.

I encouraged the family to take a moment to say goodbye... warning them that it only would be a matter of minutes to possibly hours after I remove all of the medications.

They said they were ready and so I began...

One by one I removed 4 IV poles worth of medication.

I started by increasing the sedation and pain medication and I began with removing the paralytic.

As I wrapped up each IV bag and threw it in the waste bin all I could do was pray... the lump in my throat was growing larger by the moment and all I could think was, "Oh Lord, please be with this family."

"Lord, please give this family grace.... and Lord please.... please don't let me cry."

After all the medication was off I sat in the room with the family and just talked them through what was going to happen. We sat in silence.... the son, daughter-in-law and the patient's wife... all four of us sat in the room and watched my patient's heart rate drop down from 60... to 50... 40.... then at 36 it maintained for a little while.... he was holding on. His daughter and his grandson finally arrived and within seconds the last few beats of his heart mapped out along the monitor and faded away.... he was gone. I stood up and listened to his heart, checked his pupils and looked up at the son and nodded.

Instantly the room was filled with tears. 

"I'm so sorry for your loss. I will give you a few minutes and I'll go get the physician to confirm the time of death." The son nodded back at me and I left the room.

Luckily, my friend Dirk was my neighbor that night and I went straight over to him.... he must have seen the look on my face because he instantly gave me a hug....

"You ok?"

I nodded with a big sigh, "Yeah I'll be fine... this just sucks."

"I know." he replied.

The next few hours were filled with the logistics of dealing with a deceased patient. Setting up the family with the resources they will need. Calling the police to have them escort us to the morgue. Preparing the body, and wrapping him in that dreaded body bag. I held it together for the rest of my shift and when I made it out to my car I tried not to think about the night I had just endured.

Then... I turn on my car and the song by Death Cab for Cutie comes on....

I was instantly frozen... and sooner than I could say "Please, Lord... don't let me cry..." I hear the words

"Love is watching someone die"

Like a ton of bricks on my chest, the reality of what I had just witnessed hit me... and I felt those walls I put up crashing around me... 

and I cried ... I cried that horrible, ugly cry, the entire way home.