Chronic muscular pain may be linked to a previously unknown principle for how pain signals are transmitted in the human body.
This is shown by Umeå University researchers Tuija Athanassiadis and Karl-Gunnar Westberg, in collaboration with Canadian associates, in the scientific journal PLoSONE.
Muscles have sensory organs called muscle spindles. Their task is to inform the brain of changes in muscle length. Muscle spindles, therefore, contain a special type of large diameter nerve filaments that signal stretch of the muscle.
The Umeå scientists’ studies show that muscle spindles also contain fine nerve filaments with pain receptors. When a muscle is damaged as a result of overloading, these pain receptors are activated by the release of a signal substance from the neighboring stretch-sensitive nerve filaments in the muscle spindle.
It was previously believed that the pain receptors in muscles were exclusively found in the membranes that surround the muscles or in connection with the blood vessels in the muscle. With these new findings, the Umeå researchers are drawing attention to a hitherto unknown and interesting mechanism. Damage to the stretch-sensitive nerve filaments of the muscle spindle may contribute to and sustain chronic pain in jaw muscles as well as in other muscles.
Pregnant women with fibromyalgia (FM) experience significant pain, fatigue, and psychological stress, symptoms that are often misdiagnosed or undertreated as a normal part of pregnancy, according to a pilot study by Karen M. Schaefer, D.N.Sc., R.N., assistant professor of nursing at Temple University’s College of Health Professions. Her research, the first to look at the impact of pregnancy on women with FM, was recently presented at the 2006 Association of Women’s Health, Obstetrics and Neonatal Nurses’ convention in Baltimore.
Fibromyalgia is a chronic condition commonly found in women that causes pain in the muscles and soft tissues of the body. Many sufferers feel weak from fatigue, and the condition, at its worst, can lead to disability.
“Until now, there was only anecdotal evidence suggesting that women with FM had a rougher time during pregnancy,” said Schaefer. “This data is the first step toward gathering hard evidence of FM effects on this group and will hopefully help us identify ways to reduce the impact of fibromyalgia during pregnancy.”
For this study, Schaefer recruited pregnant women with and without FM through an Internet announcement on a fibromyalgia Web site. Study subjects were between the ages of 29 and 31, in their third trimester, with no history of stillbirth and free of chronic illnesses other than FM.
The women were then mailed a questionnaire about fatigue, depression, pain, and ability to function. A demographic form was also used to assess the number of painful areas in the body as well as age, marital status, education, hours slept, and use of medication.
Schaefer’s results revealed that pregnant women with fibromyalgia had a hard time functioning, felt more stiff and tired, and experienced pain in more body areas than women without FM.
“Most women with FM have trouble getting this condition properly diagnosed, let alone knowing where to turn for help once their condition is identified. We need to start looking at how FM affects all areas of these women’s lives and come up with ways to provide as much comfort and support as possible,” she said.
Immediate treatment by a physiotherapist, bypassing a waiting list, can reduce problems with recurring low back pain, reveals a thesis from the University of Gothenburg, Sweden.
Many people suffer from low back pain, and most get better. However, those who suffer from long-term pain can find that their work, everyday, and leisure activities are limited to varying degrees. Given that long-term pain often requires extensive treatment, it is important that the pain be treated at an early stage.
“I wanted to find out whether patients‘ low back pain could be alleviated in the long run if primary care clinics could offer examinations and treatment by a physiotherapist without any delay in the form of a doctor’s referral or waiting list,” says Lena Nordeman, a registered physiotherapist, and researcher at the Sahlgrenska Academy.
As part of her thesis, she, therefore, carried out a study in a same-day appointment model with the option of going straight to a physiotherapist, with or without a referral from a doctor. The effect of receiving an examination and treatment within 48 hours was subsequently evaluated compared to being on a waiting list for four weeks before receiving the same treatment.
60 patients with low back pain for 3-12 weeks took part in the study, which was carried out in primary health care in Södra Älvsborg, south-west Sweden.
“We saw that both groups improved after the treatment ended. The group that had been given early access to an examination and individualized treatment maintained their improvement after six months, while the group that had been held on a waiting list were more likely to suffer from recurring back pain,” says Nordeman, who draws the conclusion that early examination and treatment by a physiotherapist as soon as a patient asks for care could be important for reducing low back pain in the long term.
Her thesis also included an investigation of 130 women who had suffered from low back pain for more than three months and who among others had undertaken a walk test. A follow-up after two years revealed that the walk test was a good predictor of both future ability to work and limitations in everyday activities.
It is recommended that patients with long-term widespread pain or fibromyalgia be given education and a physical exercise program to help alleviate their symptoms. Nordeman’s thesis also looked at which patients benefit most from this treatment. 166 patients with widespread pain or fibromyalgia from Gothenburg, Uddevalla, and Alingsås were randomly divided into two groups, the first of which was given a six-session education program and 20-week pool exercise program supervised by a physiotherapist, while the second was given just the education program.
“We saw that the group that received both the education and the physical exercise program showed the greatest improvement in perceived health and that patients with moderate symptoms benefitted most from exercise,” says Nordeman.
Low back pain affects up to 80% of people of working age at some time in their lives, though most will recover. Low back pain can be recurring, and some people will continue to suffer from some degree of pain. In 85-90% of cases, the pain cannot be attributed to a specific illness or injury.
My husband and I have decided the time is finally right to start family planning – or as right as it ever will be! For most (hetero) couples, this might be as simple as throwing out the birth control pill pack and spending more time in the bedroom. Of course, many otherwise healthy couples face fertility challenges that shouldn’t be minimized. But for anyone living with chronic illness, the starting point for trying to conceive may be far behind the average couple.
In my case, I live with fibromyalgia and pelvic pain, including (suspected) endometriosis. My monthly pain from the endometriosis – throbbing cramps – has worsened in the last few months – up to 5-6 out of ten on the pain scale, 15 days a month. My OB-GYN and I decided the time was right to do a laparoscopy to officially diagnose the endometriosis and to remove the painful lesions, with the goal of reducing my overall pain. If my pain is reduced, this is my best chance to endure going off of the birth control pill, which has been my endometriosis treatment for several years. This is why the time will be right for us to try to conceive, or as soon as my laparoscopy is scheduled anyway. It’s strange that my pain has decided the timing instead of life circumstances, but that’s part of being a spoonie, for me at least! If I do have endometriosis, then I may also face fertility challenges, but we will not know this for a while. I’ll cross that bridge when I get there.
The second significant challenge is that the medications I am currently on pose potential risks to a developing fetus. In these cases, the risks are weighed against the benefits for the mother -being exhausted, stressed, depressed, or in-pain Mom is not healthy for the baby either. I have to completely come off of Lyrica, or pregabalin, (FDA approved for Fibro) because a recent study suggests a high risk of birth defects. I have found Lyrica helps with my autonomic nervous system symptoms during flares – goosebumps, chills, temperature intolerance, racing pulse, restless legs, head rushes, increased salivation, etc. Coming off a potent medication is difficult, and often involves worsening pain, sleep, and mood, among other rebound effects. Because my laparoscopy is several months away, I am going to taper off my Lyrica very slowly, over three to four months. Hopefully, this will reduce any rebound symptoms. I’m nervous about what my fibromyalgia will look like off of pregabalin.
I have been taking a long-release tramadol prescription called Tridural. My pain management team believes that the risks of tramadol for the baby – dependence on the opioid activity of tramadol – are outweighed by the benefits to me in terms of pain control. However, I am on the highest Tridural dosage, which has to be taken continuously at the same dose, once a day. So, I am switching to short-acting Tramadol, which you take every 4-6 hours. The goal is to take less Tramadol overall this way because I can modulate the dose according to my daily pain level. On low pain days I take less, on high pain days I take more, with the hope of taking less overall. I recently made the switch and I am having a tough week. I have had difficulty sleeping, stomach upset, and low energy. This is mostly due to trouble getting used to how much or how often I should take the new tramadol. I like having more control however and am hopeful the side effects will subside soon and I will find a good routine.
A further significant issue will be sleep. Having ten hours of sleep is the foundation for my functioning. A bad sleep causes all my fibro symptoms to flare. I take a low dose of doxepin (Silenor)- a tricyclic antidepressant – to help me sleep, with occasional use of zopiclone for nights before important commitments. My doctors are still considering what my sleep prescriptions might be during pregnancy, but zopiclone is generally discouraged. I take a number of supplements like 5htp, melatonin, magnesium, and valerian, which have helped my insomnia a great deal. I will have to come off of all of these too. I am definitely anxious about this part of pregnancy! I am trying a cognitive behavioral therapy for insomnia program by using a book called Sink Into Sleep: A Step by Step Workbook for Reversing Insomnia by Dr. Judith Davidson. Conquering the anxiety I have about the consequences of a bad night’s sleep is definitely helping, by using relaxing sounds and guided relaxation tapes on apps like White Noise and Insight Timer. I take the perspective that all I can do is create the best environment for sleep at the present moment and worrying about what will happen tomorrow is unhelpful. This isn’t a perfect strategy but it is helping me to reduce nighttime wakings now and will hopefully help during pregnancy.
Finally, in order to reduce the pain of pregnancy, I need to focus on strengthening and exercise as much as possible. I already have conditions like sciatica and SI Joint pain, which are common during pregnancy. I don’t have to tell you exercise is difficult during a chronic illness! I have a wonderful physiotherapist (physical therapist) and athletic therapist who designed a gentle strengthening program for me. I found breaking it up into arms, legs, and core exercises that I do on different days helps me to actually do my routine more regularly. However, the unpredictability of each day means it is hard to keep a regular exercise schedule. After three or four flare days in a row, it’s hard to get back into a routine. It’s hard to even call it a routine! However, I know that every day I put in now is going to help during nine months of pregnancy. But to top it off, I am concerned that the reduction in pain medication and associated side effects of tapering off are going to further complicate my exercise goals. It is going to take all of my determination to get stronger!
I hope to continue to share this journey here. It helps me to process and plan for pregnancy. I also hope it raises awareness about the reality of family planning with chronic illness. Ultimately of course I hope it offers shared experiences and support for other hopeful fibro (or chronically ill) Moms-to-be (and Dads too)!
There are times with Fibromyalgia that I exceed my walking limits. It is actually difficult sometimes because the limit changes. It can be a short distance one day and a decent distance the next.
There was a time when I had to run all over campus to get professors to sign my thesis to get it processed. I ran around everywhere looking for everything. Too much. I was in immense pain. I would sit down for a break but it was difficult to get up from that break. I could only walk with a slow shuffling pace because I had gone so far beyond my limit. I got honked at crossing the street, going as fast as I literally could. Made me feel horrible. I get I looked healthy. But I sure wasn’t feeling like it then. I ended up having to get back to my department because I couldn’t handle more. One prof on my team had to help me out, something I had never asked for before-help. Glad he did, though. There was no way I was getting anywhere at all.
This has happened before. Many times actually. Once my spouse and I went to go see the fireworks a few blocks from our house was one time it was a short duration flare. Maybe a 20-minute walk. I made it there. But it was a lot of standing to watch the show. So on the way back, my pain increased exponentially and my pace slowed to a crawl. I think it embarrassed my spouse since we were getting a lot of looks. What is wrong with her? She looks fine? It was an agonizing, and long, walk home for me.
Then there was the time I spontaneously developed a foot problem. It is possible it was plantar fasciitis or something else but caused by FM I have no doubt. It hurt to lift my foot to walk. To press it down with weight. The tendon itself in the bottom of my foot hurt. So I shuffled little shuffling steps for more than a year. I think it lasted 2 years before it went away. Flares up when I wear sandals. Or shoes I shouldn’t. Got a lot of comments on that as well. I couldn’t really walk fast because every step hurt.
Fact is, pain with FM can make us more visible. But when it does it just garners attention. This sort of What is That About? Attention. Because they see no injury. They can’t tell what is wrong. They just look at you funny. Or think you are moving slow on purpose to get in their way or slow traffic.
We, on the other hand, are stuck. Literally stuck wherever we happen to be. With the sole purpose in our minds of a) find a place to stop and rest b) get home as soon as humanly possible. We know we will make it there by inches if we must but it will be painful. And we will ignore the looks. And focus on every single step. Step by step, towards that goal.
Stare all you want. Our mind is on the finish line or at least a bench somewhere where we can rest the pain a bit. I am pretty single-minded when in that much pain. Just get to the car. Just get to the house. Just get to that bench. But I notice the looks. Hard to miss.
This is of concern to me due to my low blood pressure issues and dizziness. And it makes me wonder. Especially since my doc mentioned I may have POTS.
So the study is looking at the Baroreflex response. Without it we would stand up and get dizzy and could faint. It is mechanism in the body that tries to regulate our blood pressure.
The response involves nerves in the blood vessels near, in and around the heart. Receptors called baroreceptors found on these nerves constantly (fractions of a second) monitor your blood pressure. When your blood pressure gets too high, baroreceptors inhibit the heart rate by turning down sympathetic nervous system activity. When it dips too low, they send a message to the brain to increase the heart rate.
Studies have suggested this baroreceptor problem could explain the pain in FM. “A 2010 study asserted that the role baroreceptors play in pain inhibition has been “well-documented.” It concluded that problems with cardiovascular control likely played a role in producing the pain problems FM patients face. Reduced baroreceptor activation in a 2015 study was associated with increased pain intensity in FM as well.”
So are dizziness, rapid heartbeats, increased pain and such known to be common symptoms of FM? They are of M.E/CFS. And they are with me. Even chest pains, and palpitations. People with FM do get palpitations, that I know.
“Baroreflex dysfunction has been observed in women with FMS. However, it is unknown whether the limited involvement of the baroreflex control during an orthostatic stimulus has some impact on the quality of life of the FMS patient. Therefore, the aim of the study is evaluate the relationship between the quality of life of the FMS patient and indexes of the cardiovascular autonomic control as estimated from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP). ”
They enrolled 35 women (age: 48.8±8.9 years; body mass index: 29.3±4.3 Kg/m2). respiratory activity, blood pressure and electrocardiogram were consistently recorded during a 15 period of rest laying down. (REST). And in Orthostatic position during active standing. (STAND).
Traditional cardiovascular autonomic control markers were assessed along with a Granger causality index assessing the strength of the causal relation from SAP to HP (CRSAP→HP) and measuring the degree of involvement of the cardiac baroreflex. The impact of FMS on quality of life was quantified by the fibromyalgia impact questionnaire (FIQ) and visual analog score for pain (VAS pain). No significant linear association was found between FIQ scores and the traditional cardiovascular indexes both at REST and during STAND (p>0.05). However, a negative relationship between CRSAP→HP during STAND and FIQ score was found (r = -0.56, p<0.01). Similar results were found with VAS pain.
They concluded that the lower degree of cardiac baroreflex involvement during STAND in the subjects the higher the impact of the FMquality of life. In other words, we might have problems doing things while standing.
Worthy to note other studies previously:
Evidence of orthostatic problems, however, showed up early in a 1997 study finding that 60% of FM patients (but no healthy controls) exhibited a significant drop in blood pressure during a tilt-table test. Martinez-Lavin followed that up with a 1998 study highlighting the autonomic nervous system problems that popped up when FM patients stood.
A 2005 study found a high rate of fainting (44%) during a step-wise TILT test. I was unable to find any studies evaluating the incidence of postural orthostatic tachycardia syndrome (POTS: >30 heart rate increase upon standing), but Staud, in a 2008 review, claimed that POTS commonly showed up in tilt table tests in FM.
If it means significant restrictions to your daily activities, then, according to medical and government guidelines, yes, you have a disability. This may challenge the ability stereotypes you might have absorbed from the media, where disability is usually linked to the need to use a wheelchair because of a spinal cord injury or limb impairment.
This might get you wondering about what exactly the definition of disability is, how do we usually understand it and what does that means for how we value ability/disability. Mainstream medical models say the problem lies within individual bodies. Disability advocates say the problem lies in our inaccessible and ableist society. I wanted to post an excerpt from my instructor on disability studies to clarify these models and meanings:
The medical model of disability positions disability as an individual physical problem.
The charity model sees disability as an individual personal tragedy that should elicit our sympathy. Dossa (2005) refers to this as the “personal tragedy model” of disability. The “supercrip” model positions disability as an individual challenge over which someone can triumph by dint of hard work and elicits our admiration. In the moral model, the inherently negative stereotype of disabled people, which as Kumari Campbell (2008) points out links to self‐hatred, is something to be borne solely by disabled individuals. What all these models have in common is that they individualize disability, problematize disability, and locate disability in individual bodies that are defined as wrong (Wendell, 1996, p. 360). These all serve “other” disabled people.
Wendell believes that none of these models serve disabled people. She explores and explains the social model of disability as a more useful alternative. This model, which came out of the disability rights movement turns the focus away from disabled people and disability and onto the able‐bodied and ableism. Framing disability as a social justice issue means that the difficulties that face disabled people are located within disabling social structures and attitudes.
The social model arose through the disability movement’s critique of responses to the care needs of disabled individuals. By rejecting the medicalized or therapeutic model of disability in which power lies with professionals and disability is pathologized and individualized, the category ‘disabled’ was transformed into a collective political identity. Disability is understood as being constructed not through physical or mental impairment but through social, cultural, and environmental barriers such as inaccessible education, housing, public spaces, and employment environments; discriminatory health and social service systems; absent or inadequate benefits; and negative cultural representations. The social model requires us to engage with the marginalization and exclusion that disabled people are forced to face in disabling environments and challenge medical and social responses that enforce dependency.
What does it mean for our practice and for us as people, if we understand disability as individual rather than social? How is our practice impacted if we see most disabilities as resulting from individual failure to properly manage one’s life and avoid risks – including the relatively new requirement that parents/ mothers use genetic testing or amniocentesis to avoid having a disabled child? Alternatively, if we work from the social disability model and “value the differences of people with disabilities…what implications does that have” (Wendell, 1996, p.8) for our practice?
Most commonly, doctors are given the right and the authority to decide whether or not someone is disabled and to define the nature of the disability. What a doctor decides can and does determine access to benefits and entitlements. As Wendell points out, defining disability serves a larger political purpose. It reinforces the idea that disability is located in individual bodies (or brains); it makes disability into a problem of the disabled person, and it reinforces the power of doctors to pronounce on disability. But what then happens for people with unrecognized, undiagnosed, or undefined problems? Where does illness, especially chronic illness, fit into disability definitions?
I’m taking a disability studies class this term as part of my social work program. I study part-time, online. I thought I would post some of my reflections on reading articles for the class. People living with FM and CFS/ME don’t always think of themselves as ‘disabled’, but the way the world is organized and the way these conditions affect our bodies certainly mean we do live with a disability.
Reflections on Eli Clare’s (2001) Stolen bodies, reclaimed bodies:
I found that this poetic article illuminated the physicality of the experience of living with a disability in a way that I had never encountered before. Weaving the author’s personal experiences along with disability theory was incredibly effective in making the central point of the article. Clare argues that the disability rights movement identifies the social and material conditions that oppress disabled people as the locus of change, rather than the individual’s impairments of the body. However, in so doing, the body and somatic experience often gets lost in progressive disability discourse. Clare makes the point that our bodies are a key part of our identities, and mediate our engagement with the external world.
I have never thought about the social model of disability in these terms before. It makes sense to me, though, both intellectually and viscerally. I identify as a person living with a disability, and one component of my experience is chronic pain. Chronic pain, from my perspective, never fits neatly with the assertion by the social model of disability that the only location of problem and change in society. My relationship with my body, the pain that I feel every day, is also a site of struggle, and a challenge in my life, alongside the social oppression that I face as a disabled person. Disability, then, for me, is about both a relationship with myself and the external world. This article provided me with new ways to understand the internal and external realities of disability. Clare connects one with the other, as part of the disability rights movement; “without our bodies, without the lived bodily experience of identity and oppression, we will not truly be able to reconfigure the world”
You’re sitting in the doctor’s office, being told you have an incurable illness. Maybe you have to leave your career, or pull back on your workload, with set accommodations. You can’t live up to being the involved wife, parent, sister, or daughter you planned on being. Travel becomes difficult, athletic ability falls off, and favorite hobbies or pastimes become more challenging. But mostly you just don’t feel like you. A period of grief ensues over your previous life, and it crashes over you in waves.
Eventually, you start asking the big questions. Can you live a good life despite pain? How do you find meaning again amidst all the change?
I don’t have THE answer, but I did find some answers. I had to understand what I’d found meaningful in life Before Fibro (B.F.). And then I had to find the meaning behind the meaning- why is something sustaining, nourishing, enjoyable? Finding meaning is epitomized by the quote “A life well lived is a life fully experienced.”
I was a very career-focused B.F., finding satisfaction in the field of global health (HIV/AIDS prevention and treatment). Once all that stopped, I felt stuck and lost. The one thing I had been certain of, my “calling”, was gone. Making a difference through my career had given me a sense of purpose.
Travelling was my favorite activity. I came to realize that experiencing different cultures and ways of life was important to me because it had made my own worldview expand. Broadening my horizons made me feel vital and alive.
How to replicate that feeling from my couch at home? An answer came surprisingly from the podcasts and audiobooks I listened to during my enforced rests. I found I enjoyed learning about history, as a way to travel from my armchair. (I’m a ). Learning feels like time well spent, whether it’s listening to a historical mystery or an episode of a podcast on ancient Egypt. After all, curiosity keeps your brain healthy and young. What do you geek out about? It can be anything, from an academic subject to a hobby, to DIY project techniques. Intentionally find ways to learn about things you find interesting, from online classes, podcasts, audiobooks, or just connecting with interesting people online and asking them questions. The time that feels spent on rewarding things makes meaning.
Over time I came to see that there is a lot of life to live here, in ordinary life, without globetrotting or being career-driven. I never appreciated that B.F., assuming everyday life was boring and humdrum. But in learning to be mindful and still, I’ve found how much I missed before, and how much being present enriches my life. Being on autopilot, or always looking ahead, meant I whizzed past sunsets, birdsong, long hugs, savored meals, belly laughs and so many other moments. Connecting to the beauty and wonder all around us via our senses is possible, even while in pain, even at home. Finding ways to feel that makes life more worthwhile. Mindfulness as a practice, or just realizing the need to be present, means showing up for moments big, and small. Choose to stay with an experience instead of reaching for a distraction.
And the difficult experiences of chronic pain, surviving the limitations, still mean that you are living fully. I’ve grown in strength, resilience, compassion, self-confidence, and patience in ways I never would have before my illness. After all, what else really is the point of life other than to become a better, wiser version of ourselves on this journey? This is another way to have a purpose in life. I’ve come to value growing as a person as one of my most important accomplishments, instead of getting promotions, keeping up with the Joneses, or any of the other markers we are taught to measure our success by. Without fibro, I would have let external factors determine my self-worth. It’s not that I’m grateful for fibromyalgia, or that I’m glad I have it, but I have found a way to make meaning out of it, and find a silver lining. I’m developing as I go; it’s a work in progress, but a worthwhile one.
I’ve written before about the critical importance to our happiness of self-expression and contributing to something greater than ourselves. We are often taught that the only way to do this is to work and be a “productive citizen.” However, there are so many other ways to find connections, such as sharing your story and finding online relationships, to learn from and support others. Writing on my blog and now writing as a freelancer, has transformed my life. Volunteering, supporting others online, teaching, mentoring, and sharing your experience are all ways to contribute, big and small.
Fiction writing has engaged me again in a new way through imagination. (I’m writing a historical mystery set in Niagara Falls during the American civil war when the area was a hotbed of spies and intrigue). Creativity can be a form of salvation, as a craft, art, music, interior decoration, in the kitchen, the garden, on the page, or anywhere else. We shift into an active mode, not passenger mode when creating. Yet we also refrain from intellectualizing, analyzing, number crunching, or any other left-brain thinking. Creativity is about engaging intuitively, emotionally, and symbolically with the world, through self-expression, using the right brain. It’s good for your heart; it’s good for your soul. Don’t disparage it as “unproductive” or unimportant, because it is a meaningful source of intrinsic pleasure. It’s meaningful because it’s a way of being open and engaging with the world around you (sensing a theme yet?), via your senses and interpretations, from your own unique perspective.
We find meaning in our relationships, in our faith, and in our philosophies. But we have to be present, open, and engaged to really benefit from these resources. That doesn’t happen overnight! But tuning in to our senses, our inner strengths, our creativity, our intrinsic interests and sources of pleasure allows us to connect to the world in ways that create and cultivate meaning in our lives. This is a form of strengths-based healing – leveraging your inner resources to create a life fully experienced, and well lived – in spite of adversity.
The world lost a woman yesterday. A boy lost his grandmother, three people lost their mother and a man lost his wife. This woman was a pistol, tough and strong and a force to be reckoned with. I grew up with her tales of adventure, living overseas while young and newly married, her husband in the military. I learned of a day in 1929 when this girl took a shoebox of money she was saving to the bank, to be turned away empty-handed, for her money was worth nothing.
I recall dramatic and gory stories when she worked as a nurse, the night shift in the E.R. I ate many holiday dinners at her dining room table and swam many summers in her swimming pool. I never shared blood with this woman, yet she is the person who gave me one of my mothers. And she too suffered from a silent illness, Lupus. An illness of shared compassion to us Fibromyalgia patients. But she braced herself up and raised her family, one of her daughters developmentally disabled and by her side every single day. She was a woman of courage and strength and integrity, a beauty from a bygone time. Blessed with long life, part of her will go on. In the friends, she loved, each child she created. Birthed and raised and taught right from wrong. Each life she touched, I.V. she poked or Special Olympics she attended to watch her daughter win gold and silver medals. That is what goes on. The memories her loved ones share when brought together as they laugh through their tears, recalling something they did that made her really really mad. The animation and times of a person with a life well-lived. Respected and remembered. Rest in peace, you will be missed.
