Renew Your Sense Of Hope And Optimism This Year With Theses Four Steps

Please note: this article originally appeared on ProHealth on January 20th, 2016. 

By Jenny Lelwica Buttaccio

With 2016 well underway, many of us have recently reassessed our lives. We took inventory of what worked last year, what we hoped to improve upon this year, and constructed a well-intentioned plan to move forward in a fresh, new direction. Not surprisingly, several of us still resolved to achieve more, get in better shape, eat a healthier diet, be a better mother, father, partner, spouse, friend, etc. However, with Lyme disease and various overlapping conditions in the mix, often, our best-laid plans come to an abrupt halt. Many of us simply don’t have the strength and stamina to exert ourselves so intensely (myself included), which tends to leave us feeling frustrated and disheartened.

If this describes you, go easy on yourself. Thankfully, there’s plenty of time left to challenge the idea that you must muster up the strength to push more and try harder to have a better year. Instead, make 2016 exceptional by honoring your body exactly where it’s at, and accepting your current capabilities. By embracing a healthier mindset, may you feel uplifted and encouraged as you continue to heal. Here are four tips to renew your sense of hope and optimism this year

1. Remember that you are worth the struggle.

First, let me start off by saying–the trials you’ve endured, the tears you’ve shed over this illness, the obstacles you fought so hard to overcome—are not meaningless. Likewise, you battle a set of invisible symptoms on a daily basis that most will never see. Your unwavering determination and strength inspire others to forge ahead. Your vast knowledge helps others. Others see you as more than your illness, and your perseverance motivates them. The road to recovery is long, but please hold onto this certainty for 2016: You are worth all of the effort–all of the struggle– it takes to reclaim your health and life. Always remember, you are a person of great value to the world.

2.Find something therapeutic for yourself.

Raise your hand if you feel completely overwhelmed now and then by the usual, chronic illness rigmarole! Okay, maybe all the time (my hand shot up too). As an occupational therapist, my training taught me that a productive treatment session possesses healing, restorative, and therapeutic qualities for the patient. From a personal perspective, I learned a valuable lesson about a year into my Lyme treatment when I realized nothing felt therapeutic. My muscles held an abundance of tension, and my mind was regularly fearful. From herbs and supplements to medications, it didn’t matter what I put into my struggling body. I always reacted harshly to all of it.

Out of desperation, a quick Yelp search led me to an acupuncturist, named Tina, who had treated at least one other Lyme patient. She kindly agreed to see me that buy carisoprodol cod very day. I was so weak at this particular point in my illness that my husband carried me to her office and laid me down on the table. On our first visit, Tina evaluated me, and we agreed on a gentle treatment plan utilizing massage and acupuncture to relax my nervous system. Upon completion of our first session, I felt different, lighter. It was as if years of tension had melted away. This experience underscored the importance of utilizing various therapeutic modalities to help improve my health. It was a piece of the puzzle that had been missing.

Perhaps a detox bath, a massage, reading a good book, or prayer is therapeutic for you. Whatever it is, do it often. Don’t neglect to include these beneficial elements into your protocol. Your body, mind, and spirit will thank you.

3. Allow yourself to feel happiness.

Most of us believe our happiness is dependent upon our circumstances– we’ll feel happy if we are well, if we have enough money, if we were around nicer people–if, if, if.

I hear these “if” statements often. We place our delight and joy in future pursuits that may or may not ever happen, and we deny ourselves the ability to experience happiness now. In 2016, let’s try a new approach. Release yourself from the thought that you can’t be happy until your life looks a certain way. Instead, notice the little gifts and sweet surprises that each day brings. While it’s true this won’t end your hardships; it will boost your spirit as you walk the long road to recovery.

4. Stop measuring your progress by how others are doing

There is no easy answer as to why some people get well while many of us continue to be ill. What I can tell you is, your journey through this illness is uniquely yours. You will repeatedly hear about someone who got well seeing a specific doctor, using a particular treatment, trying a bold therapy, or taking a special supplement. While it’s good to stay informed of your options, it’s important to remember there is no surefire way to recover. No matter what treatment option you choose to pursue, your body tolerates what it can, and it heals at its own rate. Healing will always be unique to you and your body and different from anyone else’s. So, please stop measuring your progress by how others are doing. I mean it. Stop it. This type of comparison is instantly depressing and will immediately kill your sense of hope and optimism. Rather, focus on how far you’ve already come, because, believe it or not, you’ve already made it a heck of a long way.

I would love to hear what things you are doing to remain hopeful and optimistic in the new year. Please feel free to leave a comment.

Lessons Learned Through Joy, Pain, and Self-Discovery

[Note: This article originally appeared on Pro Health on December 7th, 2015. www.prohealth.com. Christmas is a time for reflection over the past year, and celebrating the possibilities for the new year. It seems appropriate to me then, that I would post this article today. Wishing everyone a very Merry Christmas, Happy Holidays and a new year filled with joy, peace, and healing. Here’s to 2016!]

October 24, 2013, was probably an average Thursday in the lives of most people. For me, however, it was a life-changing day; it was the day I finally had some answers. After numerous doctors and ten years of seriously declining health–the last 18-months of which I spent bedridden–I listened sharply on the phone as my nurse practitioner informed me, “You have Lyme Disease. You’ve probably had it most of your life.”

I was both scared and relieved to hear this news. Scared because, well, I knew I would be embarking on one of the greatest challenges of my life, and relieved because I was no longer in the dark about what to call the mysterious illness wreaking havoc on my body. The list of diagnoses I had collected over the years–from Interstitial Cystitis and Myalgic Encephalomyelitis to Fibromyalgia, and Adrenal Fatigue–all suddenly seemed interconnected. I knew the path to reclaiming my health would require patience, persistence, effort, and faith. Nevertheless, I was ready to confront the illness that had sidelined me for years. Thankfully, I had the support of my loving husband and family.

On that fall morning in October, my nurse practitioner laid the groundwork for a treatment protocol that has slowly helped me to rebuild my life, one tiny step at a time. There are layers of damage to address as a result of going years–maybe even decades–with undiagnosed, systemic infections. I just passed the two-year treatment mark. I am not cured or well yet, but I am healing. I still have ups and downs; I have flashes where it seems like remission is in reach and stages where I can barely lift my head from the pillow. In spite of all the highs and lows along this bumpy road, I am forever transformed by the lessons learned through joy, pain and, self-discovery. Here are those lessons:

Learn to resist the urge to dwell in a negative headspace for long periods of time.

In the beginning, I had spent countless amounts of energy thinking about the past; what I once was capable of doing, and the social life I had prior to my illness. Dwelling on the past immediately ushered me into a very dark, negative place in my mind. Isolated from the things and people I loved the most, the loneliness was heartbreaking. I felt hopeless, lost and frustrated. I grew too fearful to even imagine a future where joy and dreams could exist. Sickness appeared to win and overtake the best parts of me.

I am not exactly sure when the shift in my thinking occurred; but my core, my spirit, the very deepest places of me, eventually changed. I let go of anger and gave cheap generic soma myself permission to redefine my identity in spite of the struggles I faced. In contrast, by maintaining my focus on the present and not the past, I discovered more peace within my situation. Slowly, I began to see light and hope in the places once occupied by darkness and negativity. I still struggle, but I see an opportunity for personal growth in the midst of my troubles and I choose to embrace it. I am more content nowadays as I take on these health challenges, and much less likely to contemplate the gloomy side of things.

When one chapter of life closes, a new chapter begins.

Early in my treatment, I came across a wonderful quote from Pastor Brian Houston. It reads:

“Never ever confuse the end of an era in your life as the completion of your destiny.”

The truth of his words gripped my heart with such conviction I have yet to forget them. He was right. There was no denying that an era in my life had ended. Although I grieved those devastating losses for months, I began to hope and affirm a new beginning; a season of healing and anticipation, in my life. I anchored my thoughts to the idea that I still had a purpose and a destiny, and I have not looked back.

Even though I am strained beneath the weight of a controversial illness, I know I still have a unique set of gifts and talents worth sharing with the world. I accept that Lyme disease is my present circumstance. Thankfully, circumstances can and do change. However, the destiny for my life does not. It’s so freeing to write that!

Take time to celebrate the small victories.

Yes, I still have a chronic illness, but I repeatedly test the notion that I can’t enjoy life. I frequently take mental vacations from my illness– from obsessing over it, Googling it, and chatting about it. Instead, I try to celebrate small victories and nurture my adventuresome spirit.

I snap pictures of just about everything I do. That’s become my approach to maintaining a celebratory, productive outlook. When progress seems slow to come, I can look at these visual reminders and see there have been several small victories. These accomplishments help me to combat adversity and renew my optimism.

I hope I will one day beat Lyme disease altogether. I am steadfast in my determination and more resilient than I realized. Ultimately, there are many more healing milestones to celebrate along the way.

My current treatment is aggressive and will continue to be intense for a while. Although someone else could be angry about their experience with chronic Lyme disease, most of the time, I am not. I choose to stay grateful that I have a body that refuses to give up. Another person– a different body– may have quit a long time ago. In the middle of all the chaos, there have been moments of immense happiness over the last two years. I live for those moments. They are the fuel for my soul to continue this healing journey.

FIVE REASONS WHY I CHOOSE TO TELL MY STORY

Photo by 55Laney69

Since the beginning of my illness, I have always chosen to be very open about sharing my experiences with others. Somehow I felt that the burden to hold in “the truth,” was more painstaking than being honest about what was going on in my body. The full severity of my illness was probably only known to my family and close friends, but I was happy to share my story with anyone who asked. I believe, like the above quote states, that others can find meaning in my personal story. Below are the 5 reasons why I chose to and continue to choose to remain open about my health struggles:

 

1. Chronic Lyme Disease is called the “great imitator” for it’s ability to mimic other illnesses.

Patients are often misdiagnosed with conditions such as MS, Chronic Fatigue Syndrome, Fibromyalgia, ALS and Parkinson’s. Treatments aimed at these other diseases, generally do not yield much improvement for patients when the root cause is in fact, an underlying infection from the Borrelia bacteria or one of it’s pesky co-infections. I had been diagnosed with a list of ailments including Interstitial Cystitis, Pelvic Floor Dysfunction, Chronic Pelvic Pain, Adrenal Fatigue Syndrome, Hypothyroidism, Chronic Fatigue Syndrome, Fibromyalgia and Multiple Chemical Sensitivity Syndrome –ALL of which can be symptoms of Lyme Disease. Many will remain undiagnosed unless enough awareness is raised for the idea that these other “illnesses” may instead be symptoms of Chronic Lyme Disease.

 

2. The profound fatigue, pain and neurological issues that often accompany Lyme sufferers is very isolating.

We are often forced to quit our job and stop participating in social or leisure activities. Many of us become housebound and bedridden for significant periods of our illness. I persevere in telling my Lyme story in the hopes that those buy soma 350 struggling the most will read it and feel encouraged that improvement can come no matter how desperate the circumstance may seem.

 

3. Lyme Disease is not well-known, well-researched or well-respected in the medical community.

By speaking and writing about Lyme Disease, I am able to contribute to the grassroots efforts of fellow Lyme sufferers to increase the understanding of this illness. The more information available to patients, the public and the medical community, the more people will notice that this is a real and disabling health crisis in our country today.

 

4. I have found strength in numbers.

Through attending support groups, uploading photos on Instagram, posting my status on Facebook and Twitter and blogging, I have been able to connect with so many wonderful people from around the world. Each of us are striving in our own way to have victory over our respective illnesses. As a result of sharing our stories, we have been able to encourage one another in the midst of the dark times and celebrate milestones during the better times.

 

5. I am passionate about being an advocate for myself and others with Lyme Disease.

Navigating the complexities of finding an accurate diagnosis and pursuing proper treatment can be very overwhelming for patients and their families. Despite my healthcare background, I too found obtaining a proper diagnosis and treatment plan challenging. Now that I feel I am on a better road to achieving wellness, I write openly about my treatments so that others may have some additional ideas and resources to discuss with their physicians.

I believe the more honest and real I am about my battle with Lyme Disease, the more people can be helped by my experience. Tell me, why have you chosen to or not chosen to tell your story?

#MyStory

EMERGING AGAIN

One of the most heart-wrenching realizations I have ever had to accept was the fact that I was not well. For years, I agonized over this truth.  Slowly, I was being swallowed up by a list of unexplainable symptoms that insidiously began stealing life’s joys and highs from me. I thought I was doing everything right. How had my life taken this path?  Why was I unable to help myself despite having spent nearly a decade helping others? Would I ever be strong enough to heal from my illness and enjoy life again?

Failure, that overwhelming presence of insufficiency, in my life was never as strong as it was the moment I said my final goodbyes and left work.  A large portion of my identity disappeared that day.  I believed rest, a few select medications and supplements would help me regain my energy, but one year into treatment, it became apparent that this would not be the case.  As relapse after relapse occurred, I became more fearful that exerting any amount of energy would cause me to go further into the depth of my illness.  Moving, talking, laughing, listening–nearly everything became my enemy as all forms of stimulation became an energy zapping experience.  More and more, I was becoming my illness.  Lyme Disease had brought me to a frightful place and I could no longer imagine what it might be like to live life with it, yet still pursue happiness.

If I close my eyes, I can imagine myself fearfully lying in the bed for months on end.  After all, I am not yet far removed soma order tracking from such days.  I recall a sad time late last fall at my doctor’s office.  While sitting across from my doctor, I tearfully told him that a full recovery was not likely, but at the very least, I hoped for a day where my mind would be filled with thoughts other than Lyme Disease and sickness.  Indeed, my expectations had become quite low.

Two weeks ago, I caught myself pondering some new thoughts.  As I thumbed through the food in our pantry, I recognized my head was filled with ideas about the future and questions like “where will our first vacation be when I am well enough to travel?”  The mental milestone that I had been hoping to one day achieve had, without a doubt, been conquered.  What was it that had shifted my thought process so I was able to dream?  I realized that somewhere along the Lyme Road I allowed myself to like, even love things again.  I gave myself permission to find me once more in spite of the struggles I may be having.

Much to my pleasant surprise, I have not relapsed and continue to slowly grow stronger and braver.  I am finding that my sense of humor is returning, that I have an addiction to quirky-patterned button up shirts and my voice as an advocate for this illness is quite loud and clear.  I will admit that rediscovering myself through this illness has been scary, but I truly like the person I see emerging.  Yes, I have a chronic illness, but this illness no longer has me.

#EmergingAgain

AN INESCAPABLE LOVE

If it’s possible to simultaneously feel multiple opposing emotions about sickness, then that is how I would describe myself throughout most of my battle with Lyme Disease.  I feel both terribly weak and incredibly strong at the exact same time.  I experience a great sense of loss of my former self, but somehow have gratefulness deeply rooted in my heart.  I feel depleted in energy, yet have never felt more satisfied in my life. I wrestle with the notion that I am failing in my quest to overcome this illness.  At a moments notice however, the tiniest step forward can leave me feeling victorious.  I have also known a heart-breaking kind of loneliness, the kind that can only be understood if you are separated from those things and people that you love most in life.  Without such great loneliness though, I never would have encountered such a profound sense of love.

In spite of being ill, failing, lonely, struggling, empty and weak, I am still buy soma canada pharmacy lovable.  My mind tries to comprehend and my heart attempts to absorb the magnitude of  knowing that just simply because I came to be on this earth, I am unconditionally loved. With my merits gone and my vulnerabilities on display, this revelation came to me.  Somewhere between fighting for my life and realizing I have a second chance at it, I changed.   My core, my spirit, the very deepest places of me, have changed.  I now walk this journey equipped with the knowledge that my lowest lows and biggest mistakes are wrapped so tightly in a powerful love of which I will never escape.

Would I have come to understand this truth without my illness?  I do not know, but I am thankful for the lessons learned during my most painstaking days.  I no longer feel the persistent urge to work harder, try harder or push myself more to heal.  Contentment has finally settled into my heart.

CELEBRATING SMALL VICTORIES WITH MY MOTHER

September, 2012

After my husband left the house to run some errands, I found myself sitting on the dining room bench. I don’t recall where I had just come from, or where I intended to go. I only know I was drained, so very exhausted. My brained seared badly as if salt were being pored into an open wound. I do know however, that I was sitting on the bench to rest. I often wondered how one could suffer such exhaustion and still have legs that held them up. Alone, resting on the bench, I pondered if a day might come that my legs no longer had the strength to carry me. Would I crumble to the ground? Would I cease to exist? I let my mind wander. Before I knew it, I was enwrapped in my thoughts and staring at the hardwood floor. This was indeed a very bad day.

“Hello. Hellooo.” a familiar voice called up the stairwell. Absorbed in my thoughts and unable to break away from them, I only faintly heard the voice. Suddenly the door opened and in walked my mother.

“Mom! What are you doing here?” I called to her.

I had not seen my mother for almost a year as she lives in Minnesota. Although she had been willing to come much sooner, I had been bedridden for the past four months suffering severe neurological symptoms. I could not tolerate excess noise or stimulation well and repeatedly declined her invitation. I kept hoping that I would spontaneously awake to a better day, week and eventually, a better month. Then, I would have visitors, discuss my short-lived relapse and celebrate being back on the healing path with a nice dinner out on the town. However after several month of declining health, it became apparent that those days were not coming anytime soon.

Knowing I most likely would continue to tell my mom not to come, my husband had surprised me by arranging the arrival of my mother by train for me. My mom briskly walked toward me as I sat on the bench. She hugged my skinny body. With wet, sunken in eyes, I looked at her and said, “I can’t believe you are here!”

Embarrassment flooded over me as the strong , independent daughter she once knew was no longer present. I anticipated it would be difficult for her to see me in this condition and that she would feel powerless to help in this circumstance. I worried I would not have the strength to keep her encouraged. I had always buy legit soma online maintained a positive outlook about recovering from the mystery illness that was believed to be Chronic Fatigue Syndrome, but I had deteriorated so rapidly this time, I was uncertain what the future held for me. Many tears were shed that weekend. Tears from a mother realizing how ill her daughter truly was and unable to relieve my suffering. Tears from me knowing how difficult this must be for her to see me this ill.

I have some recollection of my mom rubbing my back to console me as pain radiated along my spine while I lay in bed. Much of the rest of her visit is a blur. In addition to high doses of sleep medication, endless bouts of insomnia and profound fatigue contributed to a brain filled to the brim with fog. Two days later, my mother returned home.

December, 2013

More than a year had passed since my mom’s visit in 2012. Over that time, there had been many low points from my illness and my mother was able to support me from a distance through phone calls and daily Facebook chats.

It had been suspected that I had Lyme Disease based on clinical symptoms for a year, but tests as recent as this past October were finally able to to confirm it with much greater certainty and I was able to begin a more targeted treatment program as of November. Although progress is slow, I have been able to reach a point of more stability in my symptoms and I was recently able to invite my mother for a 4-day visit to the city.

I am no longer completely bed bound and am able to make short trips out for a few hours at a time once or twice a week. I still have a giant mountain to climb before I reach the top, but even mild progress in a year is worth celebrating. Knowing this, my husband planned a surprise trip for my mother and I to Tiffany’s on Michigan Avenue. We chose to pick out a matching pair of Mother-Daughter Band Rings. My mother is more than just “mom” to me. She is my friend and I am so happy to have had her here with my husband and I over the holidays to celebrate yet another small victory in my Lyme journey.

Band Rings from Tiffany's

Band Rings from Tiffany’s

Mother-Daughter Matching Rings from Tiffany's

Mother-Daughter Matching Rings from Tiffany’s

A VIBRANT POP OF RED

Symbols.  I don’t really have any.

Call me “pragmatic” “a realist” or “unimaginative,” but I prefer a thing to be an actual “thing” or I am just not that interested.  I have a pretty black or white stance on this matter. At least I did, until a vibrant pop of red entered into my life last year and changed everything.

Fatigue, insomnia, muscle pain and weakness began to take over my body. My brain and spinal cord burned unceasingly for months, as if I was being torched from within. I spent more hours in the day crying in agony, than not. I was told I had an “unfortunate” case of Chronic Fatigue Syndrome, Fibromyalgia and Multiple Chemical Sensitivity Syndrome.  “It won’t kill ya,” the doctor said, and advised me to begin homeopathy. Sadly, I had grown much too weak to leave the house, now. In fact, I had become bedridden. Sounds, from the low hum of a television, to banging pots and pans and even the softest of voices became amplified 10-fold in my head, beating against my ear drums, as if someone where screaming at me. I frequently retreated to my quiet, dark bedroom to be alone. Days became weeks, weeks became months and suddenly I was a shell of my former self trapped in the only room I could find some refuge. Actually, doctor, I WAS dying slowly and agonizingly.

On a rare day, I emerged from my dark room weary and blurry-eyed. Despite having no appetite I told myself, “You must eat. You can do it slowly, but you must get some food into your system.” I managed to muster the strength to crack two eggs into a frying pan, stand the three minutes required to cook them and walk to our office, whereby I promptly collapsed into a chair. Tears streamed down my cheeks, as I was already well-versed in the misery that each day brought. Today would be no different.

Suddenly, a staccato tweet.

A soft chirp, unlike any I had ever heard, became faintly audible through the window. Curious, I opened the blinds.  As my eyes adjusted to the unusual encounter with the sun, I saw the most beautiful shade of red I had ever seen in nature. Not more than 5 feet from me sat a male cardinal perched in all his brilliant glory on the tree tops below my window. Twenty feet to my right, stood his mate on a wood post fence. Although smaller in size and different in color buy soma online 500mg than her male counter part, she was no less spectacular. With her light green feathers, red mohawk and neon orange beak, her uniqueness glowed in the morning sun.

I watched their interactions with wonder and excitement. She would speak to him. He would speak back. In an awestruck moment, a beautiful duet was forming before my very eyes.

Then, they were gone.

I sat back in my chair with my plate of now cold eggs and deeply inhaled. Something felt different inside me, at least for the moment.  The tears had stopped, my breathing had slowed and HOPE, hope had appeared in my heart. Two gorgeous cardinals, birds the size of the palm of my hand, reminded me that there was still a world outside my walls to experience and that there was still life inside my very weak body.

Through the window, I began to have daily encounters with these two precious cardinals for nearly a year. They would spend hours in the trees surrounding my house and I could recognize their calls to one another. On a day when my brain and spinal cord were burning less, I could walk down the front steps with the aid of my husband and we would watch this interaction in person. No matter how many times I saw it, I continued to remain captivated by them and experience a sense of hopefulness deep in my soul.  As the days began to grow shorter and colder, I worried that I might not see them again. During one of our back office sitings, my husband had his camera ready and was able to capture the male for me in the hopes of keeping my spirits lifted through the long Midwestern winter.

Nearly a year has gone by since I have last seen my cardinals. It seems as though they may have taken up residence in a nearby neighbor’s tree.  I was told they lost their babies in one of spring’s torrential storms.  From time to time however, I can still hear them making beautiful music together in the trees that surround my house. Although I haven’t been able to catch a glimpse of them, just knowing they are there brings a constant reminder to me that there is always hope, beauty and life even in the midst of the darkest times.  A dear Lyme friend reminded me of that as well when I unexpectedly received this sweet gift of encouragement from her.

Hope Cardinal

TAKING A BREAK FROM LYME DISEASE

The last few days, I have been taking a much needed mental vacation from my illness, from obsessing over it, researching it, chatting about it and just non-stop thinking about it.  My recently developed philosophy has been to celebrate small victories and re-learn to enjoy my life again.  The following images of my birthday and short film following an afternoon with a friend, are some of the most fun days I have had in a very order soma online us pharmacy long time.  I may still be ill, and as recent test indicate, quite ill, but I am determined to challenge the notion within myself that I simply can not do or can not enjoy anything anymore.

Below are some photos my husband took during my birthday celebration with just the two of us two days ago.

oliver peoples photo 1

street photo 2

prada photo

Below is a Thank You short film for my friend Vanessa.

 

LONGER THAN FOREVER

I have been ill the entire time my husband and I have been married.  In fact, my first symptoms began one week after Tom proposed to me.  Rather than running away, he chose to embrace me and whatever challenges would lie ahead.  Over the years, my illness has been called Interstitial Cystitis, Chronic Fatigue Syndrome, Fibromyalgia and Multiple Chemical Sensitivity Syndrome. No one really knew why, as time went on, I continued to experience a myriad of bizarre and disabling symptoms. After many years, many doctors and a whole lot of testing, we now know that my symptoms have likely been due to Lyme Disease all along and we are just waiting for the results of some where to buy carisoprodol online specialized blood tests to have our proof.

My husband and I recently celebrated our 7th anniversary. I had been saving up my “spoons” (AKA “energy” by us CFS sufferers) to do something special.  There are those, whether it be spouses, friends or family, that will continue to love us even through the darkest of times.  I have been extremely ill the last year and a half and it was important for me to celebrate this marriage milestone by reflecting positively on the journey my husband and I have been on together.  This short film represents our struggles, but more importantly, that it is possible for love to grow deeper even in the midst of chronic illness.