#then I discharged him to physical therapy rehab the next day and that’s when I got the fist bump

[amarantoestrella]

Trying to hype the pre shift anxiety for work tomorrow away and thinking about all the good experiences like hugs and thank you’s and smiles, etc, and remembered a fist bump I got from this patient that had a bad experience with almost everyone but me. That was my friend :(

[a-christmas-carol-from-hr]

Penelope and Ulysses

AN: marley lives au. marley gets discharged from the hospital and returns home. there's growing pains.

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The apartment had never looked better.

Ellen had been awake until five in the morning cleaning. She’d scrubbed at the floor, and stripped all the beds, and dusted until her eyes had blurred. She’d only slept for two hours and then she’d awoken again, returning to bleach the toilets and shower by seven. By the time nine rolled around, the place seemed to glitter.

Ellen still saw flaws. There was a streak on the window. She should have alphabetized the new DVDs. She’d have to buy a new rug for the foyer. She’d done so much, and it still wasn’t good enough. But she didn’t have time to fix it now. She was expected at the hospital for ten.

She’d even cleaned out the car. It shone with a next to new gleam as she drove towards the hospital, a jaunty little air freshener hanging on the mirror. Ellen didn’t usually drive. The car they’d had was rarely used. The wheel felt unfamiliar under her hands but she got to the hospital without even a splash on the hood.

The nurse on Marley’s ward smiled at her as she approached. “Ms. Scrooge! Today’s the day.”

“Yes.” Ellen said. “It, er, is.”

All things considered Marley had made a remarkable recovery. Considering he’d almost died on Christmas Eve, a release home in mid-January was a wonder. He’d dreaded the idea of going to a rehab, and Ellen had dreaded not getting him home. But he’d been approved, provided he attend physical therapy regularly and kept up with all his treatment. Ellen had been making charts and schedules for the past week. He would be fine. He had to be.

“Mr. Marley had a good night,” The nurse said. “He’s very excited to return home.”

“We’re very excited to get him home,” Ellen had no idea who the ‘we’ was. They had no friends besides each other. But it seemed like the right thing to say. “Do you know what time he’ll be released?”

“Noon, if Dr. Dickens has anything to say about it. Just get him all situated and we’ll get him out as soon as possible.”

At this point, Ellen could navigate the stroke ward with her eyes closed. Marley was in a private room at the very end of the hall, just next to a water fountain. He was asleep when she entered which wasn’t a surprise. Post-stroke fatigue was among the most common symptoms. Lately he’d spent much of his days sleeping.

His face was pale and drawn, as it had been ever since the stroke. His cheekbones, always sharp, jutted against his skin. He still looked so terribly unwell, and it still took Ellen by surprise when she saw it. But the stitches in his head had begun to heal, ripped flesh giving away to scar. He was healing. Slowly, but surely, he was healing. And she would make sure he’d continue to heal.

He’d get better, if it took every cent they had. He’d get better.

He had too.

He slept for the next twenty minutes. Ellen got to cleaning while she waited. He’d only picked at his breakfast, so she set the tray aside. She put the pull out bed right, and stripped the sheets to make things easier. She gathered Marley’s few things, packing clothes into a suitcase she’d brought. He only began to stir when she was putting the bag by the door.

His eyes fluttered open. He looked so pretty, even when waking up. Everything Marley did was pretty. Damn the man. His gray eyes flickered around the room before falling on her. And then he smiled.

It still gave her a thrill.

“‘Lo.” He said.

“Hello.” Ellen said. She moved to his side. She took his bad hand in her own. It was now dotted with scars from IV ports, and he couldn’t feel her touch. But she still held his hand.

“How long did you sleep?” She asked.

“They brought breakfast at nine, and it turned my stomach.” He stammered terribly, but she could still understand it. “I wasn’t about to eat that.”

“It’s good for you.”

“That’s why I won’t eat it,” Marley wrinkled his nose. “I want bacon and sausage and eggs.”

“You’ll get a fruit salad and like it.” Ellen said. “I’ve stocked the fridge with every kind of healthy food imaginable. We’ve never had more food in the house. Fruits, and vegetables, and lean proteins.”

“Maybe I’ll just stay here…” Marley mused.

“Absolutely not,” Ellen said. “You’re coming back whether you like it or not.”

Marley leaned a little closer, but his nose wrinkled. “Do you smell bleach?”

Ah. In getting things ready, Ellen had forgotten to shower. “I was cleaning.” She moved away. “I’m sorry. Does that hurt your head? I’ve bought a whole range of scentless shampoo, conditioner, and body wash, as well as lotion, scrubs, cleanser-.”

Marley held up his other hand. He suddenly looked overwhelmed. “Slow down. Slow down.” He said. “I can’t- follow.”

Ellen immediately stopped. “Sorry.”

“No, it’s- fine.” He said. “Just- not used to it. You’ve talked more these past few weeks than you have in seventeen years.”

Ellen blushed. She’d been doing that more recently too.

Marley tilted his head to the side, as if trying to shake out the fog. Ellen was reminded, not for the first time, that as much as he had stayed the same Marley had changed. He was slower to follow things than he had been. It was harder for him to listen along. Her partner was still in there, she was sure of it, but it would take time. She had to keep things simple.

“I went to the fancy soap store and everything,” Ellen said, lowering her voice and slowing down. She had to make sure not to ramble- her regular ‘flat’ voice was apparently easier to parse. “The one we used to make fun of. Turns out the people are quite nice.”

“Oh yeah?” Marley asked, disorientation fading. He liked her voice, he said. It was ‘grounding’.

“I asked what would be best, and they made me up a basket. I even used the face cleanser.”

“You? You have a skin care routine?” Marley asked. “I have been gone a while.”

“I’ve got everything set up. It’s like a new place. We have new snacks, and some new furniture, and I got all those streaming services that people like. We’ll have fun.”

Marley laughed tiredly. “That would be a first.”

It would be, and it was a depressing thought. But Ellen couldn’t let any of those in. So she just gave his hand a squeeze.

They sat in the quiet after that. Marley valiantly tried not to fall back asleep and Ellen mentally cataloged everything she’d have to do. Once she got him home, she’d have to set up his pills. That was crucial. Then she’d have to settle him in wherever he wanted to be. The trip would likely be exhausting, so it would be best if he rested. But she also had things he could do if he didn’t want to. She’d tested each and every new streaming service the previous night, so he could watch something. She had blankets, and snacks if he was hungry, and books to read and games to play and everything he could ever possibly want. It was just a matter of getting them for him.

Oh. And she should probably shower. That would probably be best.

Dr. Dickens came in right on time. He shook both of their hands and reminded them of all their upcoming appointments. After a brief discussion of everything, he told Marley to behave himself and that they’d see each other in a few days. Marley forced himself to give the doctor a firm handshake.

“Thank you, Doctor.” He said. His voice was shockingly small.

“You’re very welcome, Mr. Marley.” He said. “Take care of yourself.”

They got a wheelchair to push him out. Marley could walk a little with the help of a cane, but he quickly became exhausted. There was no way he could walk out on his own. Ellen pushed him down the hallways, pausing occasionally so Marley could shake the hand of a nurse or doctor who had seen him. He stopped a lot to thank the nurses. It was funny, in a way. Marley would never have stopped to talk to a ‘minor’ member of staff before all this. But he stopped every nurse he recognized and said a kind word. Imagine that. Jacob Marley saying a kind word.

Ellen left him inside the lobby while she walked to get the car. She swore as soon as she stepped outside. It had started to rain. It wasn’t supposed to rain today. Everything was supposed to be perfect.

Luckily she was prepared.

“I’ll just wrap this around your shoulders,” Ellen said, walking into the lobby with a blanket in hand. “I shoved it in the back to be safe.”

But Marley weakly pushed her hands aside. “It’s only a minute trip between the car and here.”

“I don’t want you to get cold-.”

“I don’t want to be treated like an old man, woman!”

“You are an old man.” Ellen said. And she immediately knew that was the wrong thing to say. Marley’s eyes widened before they narrowed, and he turned to look ahead, avoiding her gaze.

“Jacob-.”

“Let’s go.”

Everything was supposed to be perfect.

Everything was all quiet as they entered the apartment. Ellen had made sure the lights would be dimmed when they returned, just to be as soothing as possible. Things were cleaner than they’d ever been, and new furniture was placed here and there, but the apartment was mostly how Marley had left it. As he glanced around, arm in arm with Ellen, he had that same distant look he got when trying to place something in his memory.

“You’ve changed things.” He said finally. “It looks nice.”

‘Nice’ wasn’t exactly what Ellen was aiming for, but she’d take what she could get. Ellen helped him to sit down and then she bent to take off his shoes. Marley stared off, mind working overtime to adapt to change. He’d had that far-off look often, lately.

Finally he looked back down. “…My shoes?” He said, looking at his feet. He looked legitimately confused and that made Ellen’s heart twist.

“I took them off.” She reminded him.

“Oh.” He said. “You didn’t have to do that.”

“I don’t mind.” She said, standing.

“Where did they go?” He asked. They were sitting right beside him.

“Don’t worry about it. I’ll put them back.” She soothed. “What would you like to do now?”

“Now?” Marley asked.

“You’re a free man. You can do what you’d like.”

Marley’s brow knit together. It was the same expression he wore when deep in thought. It shouldn’t be used for something so simple as doing something in his own home. The doctor had warned this would happen. His recovering mind had gotten used to the hospital. There might be a relapse in confusion when he returned home. He’ll adapt. They’d said. But it didn’t make it any easier.

Finally he spoke. “I…think I’d like to lay down now.”

Ellen didn't know why that stung. Marley needed rest. He needed sleep. He needed to heal, and recover. But a part of her, the terribly selfish part who wanted him back, hurt all the same.

"Are you sure?" Ellen asked. "I can set you up in the living room. We can watch a show."

Marley shook his head. "No. I'd like to lay down now."

“Are you sure?” Ellen repeated. She couldn’t tell why, but it felt as if everything was unraveling. It was irrational, and idiotic, she knew. But he was home, wasn’t he? It was stupid to think about anything else. He was home. That was all that mattered. “Alright. Yes, of course.”

She helped him into the bedroom and out of his clothes. There was nothing titillating or shameful about the action - this was helping her partner. She found a pair of silk pajamas Marley had stolen from an AirJapan flight and helped him into them. Ellen tried to ignore how they now hung on his frame. Marley had been slight before he’d entered the hospital, and the lack of appetite and motion had only slimmed him down further. She buttoned the buttons on the shirt while his head lolled back, eyes screwed shut.

“Are you in pain?” She asked.

“No,” He said. “No. Not really. Just tired.” He opened his eyes. “So tired.”

“It’s been a big day,” She said, now fully pro-rest. Yes, yes that would make him well. “You need to rest.”

She pushed aside the blankets and helped him lift his legs onto the bed. She tried to ignore how he sighed with relief the second he was laying down. “I’m just going to shower,” She said as she pulled the blankets around him. “I’ll be a few minutes at most. Scream if you need me.”

Marley just nodded. It seemed difficult for him to speak.

Ellen quickly moved into the shower. She’d filled the space with tons of things Marley would like, but hadn’t gotten anything for herself. She had to shake the shampoo bottle to get some out. By now Ellen was a master of efficient care, and she’d finished her shower in under ten minutes. She changed into a set of sweats she’d specifically bought for when he was back. It was made of a soft material and was a gentle peach color. Soothing on the eyes. Perfect for him. Even her clothes had been chosen for efficiency in making him well.

He was laying so terribly still when Ellen came back into the room. Instinctually she checked for the motion of his lungs moving up and down. Before all this she never thought she could be spellbound by the act of breathing, but it was one of her new favorite things about him. She thought he’d fallen back asleep before his eyes fluttered open again.

His mouth opened but no words came out. A look of frustration crossed over his face.

“What is it?” She said, moving to his side. She sat down on the edge of the bed and leaned forward. “What is it?”

His mouth opened again. He was staring intently at her, focused on something in particular. He lifted a shaking hand up into the air.

“Do you want your glasses?” She asked. He shook his head. “Water?” Again, no. “I can get you something to-.”

“Shh!” He finally managed to say.

Ellen fell quiet.

His hand reached up into her hair. “No, don’t do that,” She said, trying to move away. “It’s still wet. I don’t want you to get cold.”

But he persisted. He pushed aside her hair and tucked it behind her ear. Inexplicably his fingers lingered there.

His mouth worked again and again. Finally, he could speak.

“Forgot.” He said.

“Forgot what?” Ellen asked.

“Ears.” He said simply.

“Ears?” Ellen asked.

“You have…” He paused. “Beautiful ears.”

It was such a strange thing to say. It was such a nothing thought to think. Ellen didn’t have beautiful ears. They were just ears. They looked like every other human’s ears. But he was staring at them like he was seeing them again for the first time. And he was awestruck.

This man was awestruck by the mere sight of her ears.

And it made Ellen cry.

Ellen Scrooge did not cry. She was stern, and she was cold, and she was so emotionally repressed that she’d long since stopped crying. She had become teary when Marley was so ill, and had forced herself to get it together. She had forced herself to focus on making things better. On putting him right.

But here he was. At home. And things weren’t better. She’d done all this stupid shit, and things weren’t better. Because Marley was broken, and none of her careful plans, none of her research, none of her changes or gifts or special outfits would change that. Only time would put him right, if they were given that mercy, and even then he may never recover.

And this broken, shattered man with a mind trying to repair itself had looked at her and been struck by the beauty of her stupid fucking ears.

And it made her cry.

Ellen’s head bent forward and the tears she’d not allowed to fall slid down her face.

“You’re so stupid,” She whispered. “I do not have nice ears.”

He smiled. It was that same crooked smile he always had. The stroke hadn’t taken that from him. It had taken so much, but it hadn’t taken his smile. It hadn’t taken him.

Ellen crawled across his legs onto the other side of the bed. She moved his arm to the side just long enough for her to lay next to him. She placed her head on his chest as his arm moved around her shoulders. He couldn’t feel her underneath his hand. He had no sensation in his hands. But he rubbed her shoulder anyway.

Ellen could hear his heart beating in his chest. It thud-thud-thud’ed away, as regular and even as a clock. Ellen had done all sorts of horrid, scandalous things with Marley that would shock their peers. She knew his body and his soul as well as she knew her own, but she’d never stopped to just lay her head on his chest and listen to his heartbeat. It was such a simple action. Who knew that the sound of a heartbeat could be so-.

“Beautiful.” Ellen murmured.

“What?” Marley asked, already half-asleep.

“You have a beautiful heartbeat.”

There was a pause. And then he began to laugh. Jacob Marley, her partner in everything, began to laugh.

She’d forgotten the last time he’d done that.

“You’re so stupid,” He said. “I do not have a nice heartbeat.”

“You started it,” Ellen said. “You opened the dam with these strange compliments. I expect we’ll never put the genie back in that bottle.”

“If you compliment the beauty of my jawbone, I want to be taken back to the hospital.” He said, but he held her a little tighter. He had no intention of going back there.

And Ellen had no intention of letting him go back there either.

She’d only just gotten him back.

[nightingiall]

little do you know, chapter 22; give me love

Fact: “Lack of sleep leads to sugar cravings.”

previous chapters + drabbles

Niall’s hand was cold.

It was a bit odd, considering he was always so warm. He was her sunshine boy. His entire being was made up of this all-encompassing warmth that always seeped into her skin and made her feel warm too.

But his fingers were cold now, as she held one of his hands in both of hers. He was fast asleep when she walked into his room, lips parted slightly as he snoozed the afternoon away. She knew he was probably feeling drowsy from whatever it was that they were currently pumping into his arm so she let him be, instead settling for holding his hand and trailing her fingers through his hair. His scruff was growing out a bit since he probably hadn’t had the opportunity to shave. She made a mental note to bring him his shaving kit the next time she came.

Zayn and Harry were sitting in the waiting room, allowing Liam and Harlow to head back home to freshen up and take a nap. Mona was grateful that they left her alone with Niall. She didn’t want to seem like a creep for staring at him while he slept. She couldn’t help it, though; she missed him. She couldn’t help but take in the little bruise on his forehead or the cast on his leg and not feel a sharp ache in her chest.

She didn’t realize that she had fallen asleep until she felt someone’s fingers brushing a strand of her hair out of her face and flinched slightly. When she opened her eyes, Niall was watching her, a small smile on his beautiful face. “Hi,” he murmured, voice groggy. He looked like he was struggling to keep his eyes open. “I wondered who was squeezing my hand so tightly.”

It was only then that Mona realized her position. She was still sitting on the chair next to his bed, but she ended up leaning against her forearm which rested on the guardrail of his bed, her other hand still holding one of his. She loosened her grip, sitting up only to realize that the angle with which she fell asleep was not good for her neck, which felt stiff as she straightened up now. “Sorry,” she muttered, rubbing her neck. “Was that what woke you? You should get some more rest.”

She attempted to shift away, but Niall held on to her hand firmly, his other hand coming up to trail lightly over her cheekbones and down her jawline, up her nose bridge and across her eyebrow. “You haven’t been sleeping,” he said softly, bright blue eyes following the movements of his finger. Mona found herself holding her breath, warmth blooming to the tops of her skin, and she hoped she wasn’t blushing as hard as she felt like she was. “And you’ve been crying.”

Mona huffed out what she hoped sounded like a laugh as his eyes met hers. She couldn’t help the way she felt like she was melting in his gaze, completely enamored by her sunshine boy, even when he was watching her so sadly. “Nothing new there,” she tried to joke, but it only caused Niall to frown, and she found herself tapping the corners of his lips so they’d curl back upwards again, the gesture so achingly familiar that she almost started to cry again.

“Am I dreaming?” His voice sounded heavy and muffled, like he was starting to fall asleep again, but she could tell that he was trying very hard to keep his eyes open. “I’m not dreaming this time, right?”

She didn’t know what he meant by that, but she reached out to flick his nose, chuckling softly at his soft grunt. “No,” she murmured into his hand, her lips brushing over his knuckles. Those were bruised too. “You’re not dreaming.”

He sighed in what sounded like relief, his eyes fluttering shut for a few moments. She started to wonder whether he had fallen asleep again when he opened them to look at her, a sort of desperation in the baby blue. He looked a bit like he was in pain, which made her lean closer to him, eager to give him whatever he needed, to protect him. “I’m sorry, Mo,” he whispered, voice cracking a bit, and he held onto her hand as if he were afraid that she would run away. “I’m—” he took a deep breath, “when you said that you were done I was so afraid that you meant it. And then you weren’t here with the others—I thought—”

“Shhh,” she interrupted, smoothing his hair from his forehead. His forehead was warm. Niall blinked a few times, moisture collecting beneath his lashes, and Mona thought that if he cried she would actually lose her mind. “It’s not important, okay?” She tried to keep her voice even and calm and quiet as she continued to stroke his forehead. Their noses were almost touching and she hadn’t even realized when she had leaned so close to him. “Get some rest, alright?”

“’M sorry,” he mumbled. Sleep was beginning to overtake him but he was still trying to fight it.

Mona pressed a kiss to his hand before releasing it, resting it on his tummy as she pulled the blanket up to his chin. Because she couldn’t resist, she trailed the back of her finger over his cheek, his overgrown stubble rough against her skin. “Go to sleep,” she whispered, running her fingers through his hair. There was still product in it from the night before, so she worked her fingers through the strands to loosen them up.

Niall closed his eyes in response, shifting a bit so his pillow was comfortable. He took a deep breath and sighed it out. His lips quirked upwards a bit when she pressed her lips to his forehead.

It wasn’t long until he fell asleep.

~ Mona tried not to visit him too much. She knew that it would be best for them to keep their distance for a while. Well, that it was best for her. She was still trying to wrap her head around her feelings for Niall and what the future could hold for the two of them. She knew they needed to have a conversation about everything, but she didn’t want that conversation to be in a hospital.

Still, she noted items that he would need or want while he was recovering in his hospital room and brought them for him, usually while he was sleeping. She brought his razor, shaving cream, and toothbrush on one day because she knew he was a hygiene freak and would have wanted to brush his teeth and shave. Then, she brought over his laptop and glasses because she knew he must have been bored whenever he couldn’t sleep. He was never much of a TV person, usually choosing to read a book or get some sort of work done.

She also tried not to think too much of how she intuitively recognized these things about him.

One time she ran into a family walking into Niall’s room just as she was walking out of it. The boy, who looked to be about thirteen or so, introduced himself to Mona as the one Niall saved from getting hit by that car. His name was Jorge. “Are you his girlfriend?” he asked Mona. “He mentioned someone named Mona being mad at him when we were in the ambulance over here.”

“Erm…” Mona had no idea what to say to that. “Well, I am Mona.”

Thankfully, before she had to think of something else to say, Jorge’s mother spoke. She was holding a bouquet of flowers with a card. “Niall is such an angel. You’re so lucky to have him.”

Mona couldn’t remember how the rest of that conversation went. She was too focused on how she was going to get out of there before Niall got back from therapy.

It was only about two days until he was almost ready to be discharged. Harry told her that they’d been doing some physical therapy exercises with him and going over how to clean the wound and change the bandages. She figured that maybe she’d get some of his favorite ice cream, knowing that it would lift his spirits a bit.

After finishing up some paperwork with Jingle at Connemara’s, she headed out to get his favorite Ben and Jerry’s ice cream, chocolate chip cookie dough, before making her way to the hospital. Because Harry and Liam spoke extensively about Niall’s therapy schedule to coordinate visitation times, she knew that he most likely wouldn’t be in his room right now, but in the rehab center instead. She figured that she would just leave the ice cream with a note on the top and call it a day.

Apparently, though, either Harry and Liam were wrong, or Niall had a schedule change, because there was none other than her sunshine boy sitting on the bed when she walked in.

He smiled at her when she paused at the door, her presence a distraction from whatever he was doing on his laptop. “Hey, Mo,” he greeted, his voice soft. His demeanor was a bit cautious, but his eyes glittered hopefully.

“Hey,” she breathed out, a bit caught off guard. She had sort of planned out how this visit was supposed to go and it was already being thrown off course. There was a brief pause where she tried not to look so much like a deer caught in headlights when she noticed that his smile was beginning to waver a bit. So she gathered herself together and held up the bag, managing a smile of her own. “Want some ice cream?”

Niall grinned at her, closing his laptop and setting it aside before patting an open space on his bed for her to take a seat. And…okay—this wasn’t exactly where she expected this to go. But she was here and this was happening and she figured she should just go for it.

So she sat down, careful not to jostle his leg, and handed him his pint of ice cream. She got one for herself too, so it was a bit quiet for a while as they dug in and figured out how to deal with this uncomfortable tension between them. The silence, while not unbearable, was a bit awkward, and she couldn’t think of anything to say beyond cringy small talk, so she kept her mouth shut.

“Thank you,” Niall started, and she was thankful that he was the one to break the silence, “for the ice cream and…the laptop and glasses and everything else.”

“Oh,” was what came out of her mouth, mostly because she didn’t expect him to know it was her who brought his things. When she met his eyes, his were slightly guarded and nervous. “Yeah, uh. No problem.” She shifted a bit and ended up accidentally tugging the sheet under his leg, bringing her attention to the cast. It didn’t look as bandaged up and scary as the first time she saw him, but it still caused a lump to grow in her throat. “Are you,” she breathed before clearing her throat slightly, “are you feeling better?”

Niall shrugged, spooning a bit more ice cream into his mouth. She had a sudden flashback to them eating fancy ice cream in Vegas, her heart skipping a beat for a moment. “Yeah, I guess. Can’t wait to get back home though. I miss my bed so much.” Mona chuckled at that, which made him smile. It softened a bit, and she knew that he was about to bring up the elephant in the room. “I’m glad you came.” He looked down at his ice cream for a moment before meeting her eyes again, and this time, he let down his walls and allowed her to see all of the emotions swirling in that bright baby blue. “Or that I caught you this time.”

Mona gulped, averting her eyes in favor of fiddling around with the spoon in her ice cream. She knew it was now or never. She was so tired of beating around the bush with him. After everything that had happened, all she wanted was for things to be normal again. “Sorry,” she mumbled, “I didn’t mean to avoid you or anything. It’s just…”

When she trailed off and looked up at him again, his lips had curled downwards the slightest bit. “Complicated,” he murmured, completing her train of thought.

She nodded, huffing out a laugh and shaking her head. “Yeah.” She looked towards the window saw that the sun was starting to set. “Complicated.” She remembered when she once thought that he was the sun and she was the moon; he cast his light on her and made her better. They made each other better people. But they didn’t know if they could co-exist.

She had been so lost in thought that when Niall reached out for her, she startled a bit. He paused before entangling their fingers together, those ever-expressive eyes reflecting something that looked like sadness. “I’m,” he started, voice wavering a bit like he was unsure of himself, something she didn’t see in him often. “I know that you don’t want to believe me and everything but,” he shifted closer, “I do care about you, Mo. So much, and—for so long, and—” He worried his lip between his teeth for a bit, thinking over what he wanted to say, and Mona was so entranced by him, hanging on to his every word, to his every movement. When he spoke again his voice was hushed and quiet. “I am so terrified of losing you.”

She hadn’t realized she was holding her breath until she exhaled at his words. Because she felt the same. She was so terrified of losing him too. She was absolutely devastated when he left for Ireland without an explanation, that feeling keeping her up on some nights as she tried to imagine her world without him. She couldn’t.

“And,” he took a deep breath, squeezing her hand a bit. “I want to be with you. You’re the only one I want to be with.” He held her hand with both of his now, eyes never leaving hers. “I know I was upset before but I swear, I will wait for you, however long that takes.” He gulped, wetting his lips a bit. “But,” now, his tone changed, sounding more cautious. “If that’s not what you want—if you tell me right now that you feel absolutely nothing for me—” The air around them stilled. She felt like she was holding on to his every word for dear life. “Then I promise you, I will leave you alone.”

This time, she was the one squeezing his hand. There was so much to unpack in his words that she was reeling, unsure of where to start, what to say. Suddenly, Nick’s words were coming back to her: “You need to stop overthinking every goddamn thing you do.”

He was right. It was a tendency that clearly usually ended up being her downfall. And the facts were that she was in love with him, and she wanted to be with him. So what on earth was stopping her all the time?

She knew the answer to that too: Cleo.

Niall seemed to sense her thoughts because his next words were, “You’re the only one for me, Mo. You were always the only one.”

She tried to swallow down the lump in her throat. “I—” She took a deep breath. There was nothing that made her anxious now. There was just one feeling: hesitance. “I think I need…time.” Niall was watching her like she had the power to destroy him, and she racked her brain for something, anything, that she could say to make him feel a bit better. “But,” she started, and Niall leaned forward the slightest bit, “I don’t feel absolutely nothing for you.”

Niall’s eyes widened a bit before he took a deep breath and huffed out a laugh. He gave her a relieved smile, shifting even closer to her to hold her face in his hands. “Think about it,” he breathed, brushing a few of her unruly strands behind her ear. “Please.”

She nodded and he pressed his forehead against hers, closing his eyes, and she did the same. And they remained like that for a while, just holding one another, taking each other in, and taking in the possibility that the future held.

And, in that moment, that was enough.

~

Mona felt infinitely lighter than she had in the past few days.

She couldn’t help the easy smile she had on her face as she left Niall’s room.

They were taking things slow, knowing that there was more they needed to talk about. But at least they were on the same page about where they stood with each other. And that was all that she could ask for given the circumstances.

But, her good mood didn’t seem destined to last. Because just as she was walking out of the building, she ran into none other than Cleo.

“Mona, hi,” she greeted as they paused in front of each other in the lobby. She smiled brightly at her, and Mona managed to send her a smile of her own. Cleo seemed to sense Mona’s apprehension towards her because she faltered slightly, her demeanor becoming more nervous as she walked closer. “Listen,” she started, eyes kind and understanding. “I know there’s a lot happening between you and Niall. And some of it is because of me.”

“Cleo, it’s—”

But Cleo didn’t seem to want to let Mona go without explaining, and Mona knew all too well what that felt like. So she let her finish. “Mona, I promise you, there’s nothing going on between Niall and I. We’re just good friends, I swear.” She placed a hand on Mona’s arm. “He’s in love with you.”

Mona held in a breath, chewing nervously on her lips. “And you…you don’t have feelings for him?” She felt stupid for asking, but she just had to know. It was something that plagued her forever, and she just wanted closure.

Cleo smiled, shaking her head. “No. Absolutely nothing.”

Mona gulped. Her mind flitted back to that moment at Connemara’s. The first time, when she was standing behind the bar and she watched Niall kiss her. The memory still made her heart race. “So, that kiss—”

“It was just,” she tossed her hands up, looking a bit exasperated and embarrassed, “a drunken mistake. It was all a mistake. We both agreed that it shouldn’t have happened.” There was an honesty about her that Mona had always felt. Cleo was always honest and kind. It was probably why Mona always felt insecure about her, because she always appeared to be perfect, while Mona was anything but. “I think,” her voice was soft and slightly timid now, and she looked down at her shoes, “we were both just…lonely. And drunk. Really, really drunk.” She shrugged, looking up at Mona again, smiling. But Mona could tell there was something more behind that smile. A story. “I was having some relationship trouble and Niall…well he was pretty hung up on you. And it just…happened.”

Mona nodded. She couldn’t help but believe her. There was no reason not to. All this time, it was all just in Mona’s head. She had just projected all of her insecurities onto Cleo. And, really, it wasn’t fair to her. “Okay,” she breathed out, nodding. “Thank you.”

Cleo nodded in return. They had never really been close, but this felt like the start of a friendship. “Everyone is rooting for you two,” she said kindly, and Mona could tell that she was genuine. “Including me.”

Mona smiled. This was something that she needed to hear.

This felt like closure, and also a beginning.

[takemycptsd-blog]

Typos and no-shows

CW: discussion of drug use, death, assault, physical child abuse, emotional child abuse, abusive parents, religion, family estrangement.

This is what happens when he's using again. It's what I get as the initial signs at least. We're remote, so I don't see all the other things that go with it until he's crashed.

It starts with last minute texts written in an uncharacteristically loose way. Dropped words, swapped letters, subjects without predicates. It's not a thing if that's your style, but that's not my brother's style. He's always been Mr "Straight A". He usually is one of those people who corrects typos in texts, even when the typos are just noise and don't change the meaning. I mean, usually he is when he's not high or crashing.

This is why my heart sunk yesterday when I got the fragmented text from my brother cancelling an hour before he was supposed to come visit. Again.

After his vague excuses, he asked "can I call you later". He didn't call later.

It's the next day. It's cold. I feel sick. Will he call, crashing and sobbing, telling me how it's my fault he uses because I don't have a relationship with our parents? Will he be safe? The last time, that I know about, somebody died. My brother tried to resuscitate him. The person threw up in my brother's mouth, the person’s ribs cracked. He died in the hotel room. The police were involved. My brother was shaken, hard. That call was particularly bad. My brother said he could still taste the coffee flavored vomit, could still feel the ribs crunching under his hands. My brother said it was my fault. 

I take these calls. I cry, and listen to him crying. I tell him I will come with him to therapy when he’s back in therapy, when he’s ready, and we can talk about it more there. I tell him if it’s hard for him to be “split” between our parents and me, that I’m truly sorry and ask what I can do - other than reconnecting with our abusive parents - to make this less terrible for him. He says he understands, but then he tells me that I have to make up with them, cries about how short life is, and how I’ll regret it if they die before we reconnect. I tell him I won’t be, and if I am, that’s my business and something that I and my therapist will work on. That right now, as it has been for the last nearly 20 years, my life is better for having ended my relationship with them. 

The time before the guy died, my brother called from a state away. “I’m in Pawtucket” he told me through sobs. It was around christmas. It was late. My husband and I were going to go get him. My father, who at the time was still in denial of his vision loss, ended up driving in the dark to get him. My parents got him a bed in rehab, then my brother was discharged to a partial day program. My parents called me to tell me that they wanted to talk about my brother and how we can support him. I agreed. 

The day they came over, I was sick. My ovary had torsed, twisted inside me and was dying. It was painful. I didn’t know that was what was happening yet, I just knew I was in pain. They came over, and my mother spoke only of herself. It was the first time I had seen her since her conversion to catholicism a few years prior. She was wearing a large, rough wooden cross on a twine cord around her neck. It looked medieval, and not in a cool way. I imagined she’d ordered it online from some outlet that sold genuine religious doodads made from sanctified materials. 13th century wood from St. WhoeverTheHell’s wagon. Iron from a recently recovered papal horseshoe. 

My father spoke very little, and mainly of my brother’s failures, his “fuck-ups”. This meeting was not, as advertised, a meeting to discuss how to help my brother. It was a chance for my father to complain, and my mother to try to worm her way back into my life, using my brother as an excuse. At one point, she looked at me with tears in her eyes and said “I feel like I should say I’m sorry.” I sighed. We’ve been through this, she and I. “Sorry for what?” I asked, not kindly but not cruelly. “For... everything” she said. 

No. If she’d actually given this real thought and done real work on it, she would have been able to offer an apology for the many concrete things that she did that made our relationship untenable. “Sorry for everything” is a request for absolution for everything for always. It’s a get out of jail free card that allows her to skip the shitty, hard work of acknowledging all the ways she harmed me as an abusive parent. I told her if she was looking for absolution, to talk to a priest. I hear they do that. I tried to refocus on my brother. She left the room and blew her nose. My father wouldn’t look at me. “What can I do to help with (brother)?” I asked them. It became clear they had no idea. They don’t need to, but then you know, don’t come over to my house when I’m in fucking agony with the notion that we would figure this out together, then fail to work on figuring it out. 

And my father. I wanted to ask him if when he was kicking my 4-year old little brother around the floor, punching him, or locking him in a laundry cabinet in the basement for hours while he wailed and screamed... if my father thought when he was doing those things that possibly he might have been signing his kid up for a life that was going to be so much harder than it needed to be. 

I called my parents today after hearing nothing from my brother since yesterday morning’s broken text. My father called back, sounding hassled. “I’m about 99% sure he’s using again” he told me. I know better than to ask them what I can do. What I can do, apparently, is wait for my brother to crash. I can hope he’s safe. Not for the first time, I find myself wondering if I’m supposed to call him out more on when he’s using. I wonder how much trust is good and right and how much is irresponsible and bad going forward. When he starts rescheduling with these broken texts - do I ask? Do I ask “Are you using?” “Are you safe?” Would it tell him I don’t trust him if I ask? How horrible would that feel for him, I mean, if he’s not actually using and is just tired or something. 

I used to swoop in and save him. Buy him a ticket home. Pick him up from a bus station at night and drive him to the ER where we waited, with him increasingly agitated, to be seen. To be admitted somewhere, for the increasingly hard to find rehab bed. But this is 10 years later, and I’m too sick now to reliably rescue him. All I can do is listen when he calls me crashing and crying and hope he’s safe. 

[avengerdragoness]

For The Better Pt. 3 [Jason Todd x Reader]

A/n: Finally the final part. Sorry this took so long. Hope you guys like it!

Warning: talk of pregnancy

Part 1 - Part 2

_____

Jason was pacing the waiting room, hoping the doctor would come out soon. Tell him that you were okay, that you’d make a full recovery and at the end of your rehab things would be normal again. That’s all he wanted. He wanted you and your life together. You shouldn’t have been out after sundown. Why hadn’t you called him? He’d have came to pick you and Eli up in a heartbeat.

Eli watched Jason pacing, an overwhelming feeling of guilt weighing on his heart. He was the reason you were fighting for your life; why you’re on an operating table. He rubbed his face and glanced up at Jason. He’d never seen him so tense. He stared at his large frame and the blood on his jacket. The Red Hood jacket. He was staring at the Red Hood, one of Gotham’s most infamous vigilantes. But also the man who took him in and gave him a home. How could he do this to Jason? To you?

“Mr. Todd?” A doctor in dark blue scrubs came out. Jason immediately went over to him, Eli meeting his side. “How’s [F/n]? Is she okay?” His tone was full of worry and ran at a quick pace.

The doctor nodded. “She is stable, luckily. We had to repair some parts of her bowel and pelvis, but she is stable.”

“Can I see her?” Jason asked, almost pleadingly. He had to see you. See you breathing, hear your heart beating.

The doctor nodded. “I can take you and your son to see her shortly. She’s still in the OR at the moment.”

“I-I’m not his…” Eli tried to correct the doctor but Jason stopped him by putting a hand on his shoulder. Eli looked up at Jason before nodding.

After a few more moments, the doctor took Jason and Eli to your room. You were still under anesthesia with tubes and wires hooked up to you. Jason almost felt sick at the state you were in. How could he let this happen?

He strode over and took your hand, kissing the back of it. He felt tears creep at the corners of his eyes, unsure if they were from relief or stress or fear. However he pushed them back. Eli came up next to him, he had tears streaming down his cheeks. “I’m sorry Jason. This is my fault.”

Jason shook his head and stood to put a hand on his shoulder. “No it’s not, don’t ever say that. She was protecting you. Just like I would, just like any of us would.”

Eli nodded reluctantly.

“Mr. Todd, there’s one more thing I think we should discuss in the hallway.” The doctor said. Jason took a deep breath and patted Eli’s shoulder before following the doctor. He sighed before turning to Jason. “I’m afraid the way the bullet ricocheted caused too much damage to [F/n]’s ovaries and uterus that we couldn’t repair in surgery.”

Jason’s throat tightened. “What are you saying?”

“I’m sorry Mr. Todd but I’m afraid that with the damage it will be close to impossible for [F/n] to ever conceive a child.” The doctor replied solemnly. “I… I thought you may be the one to want to tell her when she wakes up.”

Jason was noticeably shocked by the diagnosis. You could never have a child of your own? Never? He mustered the strength to nod and thank the doctor for everything they had done, for saving you, before heading back in the room.

Eli could tell Jason was upset but didn’t push him to know what the doctor said. Jason simply sat beside you and stroked your hand. Holding back tears.

The next morning you slowly woke up to the sounds of beeping and humming of machines. Smelling the sterile smell of a hospital, your eyes slowly peeled open. Bandages were wrapped around your body and, despite the pain killers, you felt the sharp pain in your abdomen.

A weight could be felt on your hand as you looked over. Finding Jason sitting there. His fingers were laced with yours as his head rested on the sliver of bed you didn’t take up.

Slowly you let go of his hand and threaded your fingers in his hair. “Jace? Baby wake up.” Your voice was quiet and hoarse, but enough to stir him awake. His eyes were bleary but soon focused when he realized you were the one to wake him.

“[F/n], babe, how do you feel?” He took your hand again and gave it a gentle squeeze.

You smiled, “I’m… okay. It hurts a little bit, but whatever meds are in me are helping.” You gently stroked your thumb over her knuckles. “How are you?”

He shook his head. “You’re the one who got shot and you’re worried about me?”

“I’m always worried about you, especially when I can tell you’ve been crying.” Your hand let go of his in order to gently stroke the puffy, red, dark circles under his eyes.

“I… I have something I need to tell you baby” He took a deep breath. Taking his hand again you gave it a reassuring squeeze. “What is it?”

“I… The doctor told me that the bullet ricocheted a lot and it caused a lot of damage to your uterus. Doll, the doctor said that they fixed what they could but you can’t get pregnant anymore.” He tried to keep his voice steady and calm but he could see how that news came crashing like a ton of bricks on you.

“What?” You whispered.

“I’m so sorry baby” He shook his head. “I should’ve gotten there sooner.”

Tears pricked at your eyes and you shook your head. “It-It’s n-not your fau-ult” Jason was quick to wrap his arms around you and hold you. Letting you sob into his shoulder and your tears soaking his shirt.

Eli was outside the door. He heard everything. You couldn’t get pregnant anymore because of a bullet that was meant for him. He’s the reason you can no longer have children.

It took time for the shock of the news to wear off, however a dark cloud seemed to lull over you the rest of your time at the hospital.

The day you were discharged was the best thing in the world. The sun and fresh air seemed to do wonders for you physically and mentally. For a while you were stuck in a wheelchair because of the pain it took to walk. But with time and therapy you slowly got back on  your feet.

Slowly the pain that came with having the inability to have children began to fade. It was something you’d have to learn to live with and accept. It was easier said than done, but progress was easily being made. All due to the support Jason, Eli, and Jason’s family provided.

However, as time progressed, Eli got slowly and slowly more distant.

Guilt was consuming him and soon the pain of your inability to conceive was weighing more on him than you. Both you and Jason noticed, and it led to a chat you’d been needing to have for a long time. Since you met the boy.

“Eli?” You knocked on his door. Jason was by your side, a hand around your waist to be sure you were steady. Despite your therapist clearing you, he couldn’t help but always want to support you in some way.

Eli opened his door and was a bit shocked to find you both there. “Can we talk about something please?” You asked gently. Eli nodded and stepped aside. He sat on his bed and you sat beside him as Jason stood.

“We’ve noticed you’ve been distant kid. What’s goin on?” Jason asked as he put a hand on his shoulder. Eli forced a smile, “What are you talking about?”

You shook your head. “Eli we need you to talk to us.”

He sighed, knowing he wouldn’t be able to fool you. “I… Everything is my fault. I was the reason you got shot and that means I’m the reason you can’t have kids.”

“Eli, just because I can’t conceive doesn’t mean I can’t have kids.” You put a hand over his.

“But kids of your own.” He took his hand away. “Your blood, your DNA.”

Jason shook his head and kneeled down, “Kid, family isn’t about blood or DNA. Look at mine. Yes, we have our issues and our quarrels. But with time and patience and trust, anyone can be family.”

He looked up at Jason. “Really?”

Jason smiled and nodded. “Of course, and we’re gonna prove that to you.” He squeezed his shoulder.

“What?” Eli looked between you both.

You smiled and nodded. “Eli, Jason and I signed adoption papers this morning. Officially, you’re our son.”

“I-I’m your..?” He trailed off as you grinned and nodded. Tears sprung to his eyes as his arms were thrown around you. “Thank you! Thank you so much!” He cried into your shoulder. You rubbed his back and swiped away his tears before he turned around and hugged Jason tight. Smiling, Jason patted his back and returned it.

Standing you put a hand on his back and wrapped an arm around Jason. “My boys” you smiled.

Eli grinned and he wrapped his arms around the both of you. Exchanging a smile with Jason you rubbed his back. “We love you kid.”

~~~~~

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[lovelyredrose]

Tried writing stories again after a long while don't know if it's good just wanna share it i guess .

_____________________________

The sun is setting from my view

As I was looking at the beach

The waves keep crashing by the shore

Just like the last time

The day you proposed to me

It was the most perfect view with the most perfect moment

The tears I keep pushing away finally come crashing down

And I keep wishing you are here with me

In this perfect view with my perfect person ,

That that memory replayed in my head like it was yesterday

We were on the road

You were driving, and I was sitting beside you

We’re about to go home from our dinner date

We’re laughing and telling each other stories on what happen on our work

And our song played Finally // Beautiful Stranger by Halsey

“I like this song, I remember when I met you and suddenly my world stops, babe until now I can’t believe you are still here with me and we are getting married oh I love you so much babe”

Beautiful stranger // Here you are in my arms and I know // That beautiful strangers // Only come along to do me wrong // And I hope, beautiful stranger // Here you are in my arms

You smiled and kiss my hands

“You know from the first time met you I know you are going to change my entire world, I love you so much baby and I'm glad you are going to be my wife”

But I think it’s finally // Finally, finally, finally, finally safe // For me to fall

As the song ended we look at each other like we are in our own world and you kiss my hand again and continue to drive

Then suddenly at that moment my entire world stops

I saw the truck driving towards us

I screamed your name

You covered me

And I heard the loud crash and everything went black

The next thing I knew, I was in the hospital

My body feel heavy and sore and I can’t move

My throats feels dry like I haven’t drunk water for months

Words won’t come out

But then I open my eyes

I saw my parents

They come rushing by my side as soon as they realize I was awake

My mom holds my face and kept crying

And they hug me as they cried

When they pull away from me

And they ask me if I needed anything

I sign for a water

So they get the bottle and help me drink it

I finish a whole liter water

Then my throat feels a little better, and my voice is suddenly back

But it was croaky

Then I look again in the room as if I was looking for someone

I tried to ask them

But then suddenly the doctors and nurses come in

And ask me if how I was feeling

“My body is sore and my throat still feel a little dry after drinking water”

“That is normal after months of being unconscious'“

Unconscious ?

Months ?

Then suddenly I felt a sense of panic

And then I remember what happen that night

Then my head hurts

“Hey take it easy your not yet completely healed”

“Um, my fiance where is he?, The man I’m in the car with “

Then the doctor look at my parents

“I think It’s better if they are the one to tell you”

Then they suddenly left

“Mom, tell me where is he? Dad please where is he?”

I fell my tears suddenly fall

“Just calm down and we will tell you”

And they come closer to my bed

I tried to calm myself and my mom wipe the tears on my face

“Honey, what is the last thing you remember”

“That a truck is driving towards us he shielding me and I heard a loud crash then everything went dark”

“That was 3 months ago, You were in a coma for 3 months “

“3 months? But what about my fiance what happened to him ma”

“Honey, both of you were unconscious when bought in the hospital, You were both injured but..”

“But what ma”

My lips quivered

Trying my best not to cry

“Honey, when he arrived in the hospital he is already dead they tried their best to revive him but his body already gave up I’m sorry honey your fiance died three months ago”

Dead?

Died?

No!!

Impossible

It can’t be

I wanted to scream

But there is no voice coming out

And the tears I’ve been controlling

Suddenly broke free

“No No Ma, tell me what papa said ain’t true please tell me he is well, that he is just in the other room recovering, please tell me that is not true, I couldn’t live without him”

“I’m sorry honey but everything your pa tells you is true “

I screamed

Babe you told me you will not leave me alone

We still have that dream wedding on the beach like you promise

Then why

Why did you leave me alone

Why

As I cried my heart out

I didn’t notice a nurse came in and injected something on my arm

Then I felt drowsy

Since that day

Everything made no sense

There are days that I Can’t eat

I couldn’t talk to your family so every time they come I pretend I was asleep

Most of the days I felt like I don’t want to live

I don’t want to go to therapy so I have to pretend my body hurt

Some days I didn’t take my meds until the day where my mom finds out

So she always monitors me while taking them

A month has passed by it felt like years

And then one day

His mom unexpectedly came during one of my rehab sessions

“Hi dear I know it still hurts when you see me but I guess this is the right time to give this to you and always remember when you are ready to see us again our home will always be open to you”

She handed me an envelope and leave

When I return in my room, my parents were out

As I lay in bed, I clutched the envelope and thinking if I should open it

If I’m all ready to hear from him again

I took a deep breath then I open the envelope

It contains a letter

but when I open it ,

Below it taped two rings

Our supposed weddings

And a tear escaped from my eyes

I remove it from the letter

and clutched it

Then I look up and read the letter

This is his vow

My dear wife ,

Shit, it still feels so unreal to call you my wife you made me the happiest man by standing beside me in this altar

I can’t still believe you agreed to marry me I don’t know what you see in a man like me but I know what I see in a

Girl like you that makes me so lucky. You are the most beautiful women I have ever dated, Your heart is so pure

And kind. Because of you I become a better man you always bring out the best in me and you are my biggest

Supporter. You never left me when I was at my lowest and when everything is hard. I know our journey was like

A roller coaster. There were trials. But we always overcome it, especially when we are together and I know there

Are many trials ahead of us, but with you by my side I can overcome anything. This is just the start of our loving

Journey together, I can’t wait to grow old with you and spend the last of my days with you. I don’t want to ruin

the mood but when the day comes and we are old and grey and they come the day when I left you alone

Remember that I will always be with you, not physically, but in your heart and in our memories together. Don’t

Cry for way too long okay I hate it when you cry, Just live even though I’m not by your side and even though it’s

Hard and everything is a mess. Remember that I will always love you and maybe remember that on days when

It’s hard so it can give you strength to overcome this. And promise me this when if that day comes keep smiling

Even if it’s fake and even if it’s hard, just keep smiling and just keep on living okay. I love you and I do”

I didn’t notice that tears come streaming down my face as I was reading his vow

And I pick up our wedding ring and cry

I din’t notice my parents already came back, and they hugged as they saw what I was reading

That letter saved me

I started living again and doing my best for recovery

To honor his last wishes and my promise to him

So in case he saw me from up there he will be proud

Days and Months went by

The therapy is a success and I can slowly walk again by my self

Then I got discharged from the hospital

“Dad can you drop me off at his house I think it’s time to talk to them again”

I saw a small smile from my dad and mom

“Sure honey”

When I arrived at his home

Tears threatened to escape but I push it away and smile

“Thanks, I guess I’ll stay here for a while and just call you to pick me up”

“Okay just call us when your done”

I slowly walked near the house

As I arrived at the doorsteps

I rang the doorbell

Then suddenly the door open and his mom standing there

“Hi, auntie long time-”

She cut me off by hugging me

“I’m glad, so glad that you are here come in”

I sat by the couch in front of his mom and dad

“I thought this day won’t come, I thought we will also lose a daughter”

His dad stands and hugged me tight

then he pulls away

and sit again

“I’m sorry, but it’s just been so hard to see you guys without remembering him”

“We understand that is why were glad you came today”

“Mom, thanks for the letter it really helped me fight to live again”

“No need to thank me it was his words that helped you”

“I don’t want to impose but can I see him”

“Sure, let us bring you there”

After a while we were driving, heading to the cemetery

When we reach his grave

I felt numb

His name engrave to a tomb stone

I can’t cry

It felt unreal

It finally sinking slowly

That he’s not here anymore

I felt his parents lean on me to comfort me

I look up in the sky and whisper I love you

Even though I know no one will respond to it

“Thank you mom and dad, for bringing me here”

“Anything for you even though you didn’t get married, you will always be a daughter to us”

“And you will always be my second parents”

“Come, We’ll bring you home”

As we went back to our car

I look at the grave for one last time.

Looking by the sea

As I stop myself from crying

It has been a year since the accident

We supposed to be having our ceremony today

But here I am by the beach alone

I still keep my promise to you, babe

But for just today allow me to be sad for all the things we never did

And for not having you beside me .

[ellie-andthemachine]

This story is amazing, @supernaturalfanfics23.

This past weekend, I drove 4 hours to be with my best friend. This past Thursday, LifeAlert called her, saying that her father had been unresponsive and that they were dispatching an ambulance to his home. He is a closet/functioning alcoholic, as was her mother who is now in a nursing home with alcohol induced dementia.

Her father, Jack, has a small bleed on his brain. He was transferred to another hospital about an hour away. My best friend is adopted and a single mother with no other siblings or family members to really help or care.

Jack was so intoxicated that he was talking out of his head, knew everything one second, nothing the next. Kept asking my best friend for a rocks glass and some gin or a beer, even demanding it. I kept saying that the hospital didnt have any.

The hospital started talking discharge. I was afraid of what might happen to him and my best friend if he was released to his own home. He's a mentally and emotionally abusive person when on the drink.

The nurses and neurosurgeons told my best friend that they cannot do any type of operation without him agreeing to get sober and to stay sober. I knew it was going to be a long shot. They recommended that my best friend talk to her father. Except, he doesnt really listen, but instead puts her down.

I took my best friend to the side and told her that I would talk to him. I didnt know how, but I would. And I did.

I told him of my own family. I have some family members who are alcoholics. I also used the most important thing to Jack. His own family.

Jack is a business man. Loves when people tell him how it is while being looked in the eye. A firm hand shake. I talked to him about family, about being there for them and seeing his daughter happy and his granddaughter graduating high school and going to college and graduating and one day seeing her get married. All while looking him in the eye and firmly holding his hand.

And the man gave it in return.

I told him I was giving him 24 hours to make a decision. Did he want to willingly get clean or not?

The next afternoon, I made my way back home, another 4 hour drive. I received a phone call.

"You did it. You got through to him. You gave me my dad back. He is 100% willingly to check himself into rehab and physical therapy and to get clean. You did it."

If I never do anything right in my life again... that is enough.

That’s our job. Look out for our little sister.

Author: @supernaturalfanfics23

Summary: You met Sam and Dean on a hunt. You go out for a night of fun but they don’t know your an alcoholic going on to 11 months sobriety.

A/N: this was just written really quickly and I know very little about AA meetings or how the program works so I apologize for any wrong details.

Y/N P.O.V

“Y/N?” I jump and look up from yet another book in my hands. Constantly reading was my hobby.

“What?” I asked not hearing what he said.

“I said do you wanna come with?” Dean repeats. “Sam and I are going out for a drink.”

“Well dean is. I’m going for food. And to drive dean home.” Sam adds in.

“Nah, I’m good here” I answer turning down again because of where they’re going. I just don’t know how I’ll handle it.

“C’mon Y/N. you’ve been in the bunker for too long. We haven’t had any cases yet. Come out have some food at least” Sam asked looking hopeful. Probably to hang out while Dean finds another girl.

“Alright fine. Give me 5 mins” I answer while I head to my room to change.

We get to the local bar and restaurant and dean starts off with a drink and burger. His usual.

“I’ll get some chilli fries with cheese and just water for me.” I order. Sam is telling his order to the waitress when Dean interrupts.

“C’mon its a night out. She’ll have a Long Island iced tea”

“No. I’m good with just water.” I smile to the waitress before giving dean a warning look to not try that again. She takes Sam’s order and walks away.

“Are you okay?” Sam asked.

“Yeah I’m just going to go to the restroom.” I say. As I walk away I hear Sam getting irritated with Dean.

“If she wanted a drink she would’ve ordered one.” Sam loudly whispered to Dean.

When I get back to the table the food already arrived and Dean was gone. He was across the room hitting on another girl.

“Hey, he ditched already? That must be a new record.” I laughed trying to lighten up Sam’s worried look.

“Close, if he’d left just 30 seconds sooner.” Sam laughed. I started eating. Dean came back and had his burger. The waitress came back and dean ordered another drink. It was so tempting. Just the smell of the drinks around me it was hard not to order one.

“I’m gonna head back home” I said to Sam.

“I’ll drive you.” I nodded knowing Dean will still be a while.

“Hey where are you going?” Dean asked.

“Sam’s just dropping me off. I’m feeling tired.” I answer with the least convincing excuse ever.

The drive back to the bunker was silent. I didn’t know how to talk to Sam about this or even Dean who loved his drink a little too much. Sam dropped me off in the Impala and drove back to wait for Dean. I opened the door and was welcomed home with silence. It had been only six months since I met the boys but tonight the temptation to have a drink was worse. The half empty bottles of all kinds of drinks laid around the bunker. The nearly empty bottle of whisky on the counter, the half empty bottle of vodka at the desk. It was everywhere. I pulled out my necklace from my shirt to admire the green AA chip with the number 10 on it. If I go to a meeting today I’ll get the red 11 month chip. I’m so close to a year I can’t screw this up.

I needed something to do so I started cleaning. I cleaned for hours there was nothing left to clean. I know if I go in to Sam or Dean’s room they wouldn’t like it. The alcohol had been put away but the urge was still there.

“Screw it.” I said putting the chip down and pouring some vodka into a glass. I brought the glass to my nose and smelt the familiar smell. I put the cup down and struggle. Should I drink it? No it’s been a hard 11 months I shouldn’t. But who cares if I’m a drunk? The thoughts went back and fourth in my head. I screamed as I picked up the glass and threw it to the wall, hearing it shatter and the liquid I so badly desired spill all over the floor. Sam appeared around the corner looking concerned with Dean right behind him. Coming in through the garage was the only way they snuck up on me. Tears streaming down my face

“Y/N, what’s wrong? Are you ok?” Dean asked running to my side and Sam standing across from me at the table. Words wouldn’t come out. Sam looked around and picked up my necklace.

“Is this an A.A. chip?” Sam asked. I just nodded. Still crying.

“You’re an alcoholic?” Dean asked slowly getting up. Again words wouldn’t come out, nodding again. Sam looked back at the mess.

“Did you?” He asked not wanting to ask.

“No, I didn’t have any of it.” Sam sighed with relief. “But I really want to.”

“Okay, we should get you to a meeting” Sam said jumping into action. “Dean you stay here and go to bed” Dean just agrees, I guess in his drunken state didn’t want to interfere.

The drive back into town was long but the meetings ran all night. Especially on a weekend like tonight. I managed to stop crying but Sam never said a word.

“It’s okay to ask questions you know” I said breaking the silence.

“How long?” He asked.

“12 years of drinking, and 11 months sober. The longest I’ve lasted.”

“12 years? Your only 26.” Sam exclaimed, shocked.

“Life was great. Long story short dad wasn’t much of a dad and mom was never around” I stated. We arrived at the community hall where they we’re the only ones with lights on. “Do you want to come with me?” I asked.

“Are you sure?”

“It’s not a cult. It’s an open door. But I’ll be getting a chip tonight if you wanted to see that.”

Sam just nods and parks the car. We walk in and Sam’s uncomfortableness was so high I could feel the tension.

We walked in and I found the meeting runner.

“Hello, what can I help you with?” She asked.

“Today is my 11 months. I just needed my next chip.”

“Congratulations. Are you going to share tonight?”

“Yeah” I said nodding. I needed to share this.

“Alright I’ll call you up next.” She smiled. I guided Sam to go and find us some seats quietly because someone was sharing. The guy finished and the lady I spoke to comes up.

“Okay tonight’s a special occasion for one of our members. She is getting her 11 month chip tonight. Come on up dear.” I took a deep breath and stood up. I wasn’t the only one that looked so young there but it was intimidating.

“Hello, my name is Y/N and I’m an alcoholic”

“Hi Y/N” the room said in unison.

“Tonight, I was very close to not getting this.” I said as my voice cracked. “I was alone at home after being to a restaurant with a bar. I thought I could handle it.” I held my breath a second while I tried to hold back years. “I poured some Vodka in a glass and was ready to drink it. It felt as if those few minutes of debate we’re hours passing by. But I didn’t drink it. Not even a drop.” I sobbed. “My two best friends, who are more like big brothers I never had walked in. I hadn’t told them I was an alcoholic. They saw my 10 month chip” I said holding up my necklace. “And I told them why I had it. So, my brother drove me here before I couldn’t ruin my 10 month sobriety.” But now it’s 11 months and I know it’s a long hard road. But I made it this long I can make it another 30 days to my 1 year anniversary.” Said smiling though my tears. There was some clapping as I went back to my seat. Sam and I stayed until I was ready to leave.

We got back home and I heard the sink running. Sam and I walked into the kitchen. Dean was standing at the sink spilling every bottle of alcohol down the drain. His hair was wet, he must have showered.

“Dean?” I asked. He looked at me and turned off the tap.

“Y/N, are you okay?” He asked.

“Yeah, I’m okay.” I answered. “I got my 11 months.” I say holding up my red chip. “What are you doing?”

“I don’t want to make you feel like that again. No more of these in this bunker” he said pointing at the empty bottles. “Not until your good and ready to be around it.” He stated. I embraced him in a hug.

“Thank you Dean” I looked back to Sam.

“Thank you both” Sam came over sandwiching me between them.

“That’s our job isn’t it?” Sam asked. “Look out for our little sister?”

[junker-town]

What’s the latest on Ryan Shazier?

Shazier is making incredible progress after a terrifying spinal injury he suffered in December against the Bengals.

Steelers linebacker Ryan Shazier suffered a spinal injury in December and has been making slow progress in a quest that stretches far beyond the gridiron.

Shazier has made numerous public appearances since his injury; arguably his most powerful came during the 2018 NFL Draft, when he walked onto the stage with some help from his fiancee, Michelle. Shazier will not play in 2018, and though he has said that his goal is to return to the football field, it’s possible he may never be able to play again.

A timeline of Ryan Shazier’s injury and recovery

Here’s everything that happened since Shazier was injured on Dec. 4, 2017.

Aug. 3

At the Steelers’ annual Friday Night Lights practice, Shazier showed fans that he is now walking on his own, unassisted and without a cane:

Today was a great day. The team had a wonderful practice. But I also got to enjoy the fans‼️ If you were able to make it to the stadium, here if a little bit of what happened‼️ I promise you the lord is not done working yet‼️ Keep Shalieving 5️⃣0️⃣ #shalieve pic.twitter.com/LHiRXHa5gN

— Ryan Shazier (@RyanShazier) August 4, 2018

June 6

Shazier spoke at a press conference — his first time speaking to media after his December injury.

“My dream is to come back and play football again,” Shazier said. “I’ve been working my tail off every day and I have that in the back of my mind every day I go to rehab.”

Shazier said he’s been surprising doctors with his progress throughout the rehab process. His goal for now is to be able to walk by himself without the support of a cane.

He also said that he’s not afraid of suffering another injury if he eventually returns to the field, but added that “he’ll have to play safer and keep his head up.”

May 3

The Steelers are giving Shazier his entire 2018 salary upfront:

The Steelers have converted $8.26M of LB Ryan Shazier’s 2018 base salary into a signing bonus, per source. Shazier, placed on PUP Wednesday, earns that money now. While there are no cap implications, it’s a great gesture by a first rate organization.

— Field Yates (@FieldYates) May 3, 2018

May 2

The Steelers placed Shazier on the physically unable to perform (PUP) list, which means he won’t count against the team’s 90-man limit for the offseason roster.

April 26

He made a surprise appearance at the NFL Draft, when he walked for the first time in public since his injury. His fiancee, Michelle, walked with Shazier to help him to the podium. There, Shazier announced the Steelers’ first-round pick, safety Terrell Edmunds out of Virginia Tech:

We all #SHALIEVE. pic.twitter.com/cByTumbaHa

— Pittsburgh Steelers (@steelers) April 27, 2018

After, he thanked fans for their support:

I’m truly blessed and humbled from all the prayers, love, and support that I have received . This is what keeps me going. Just continue to #Shalieve pic.twitter.com/p1kAZfG8xT

— Ryan Shazier (@RyanShazier) April 27, 2018

A dramatic week got even more so the next day, when a tornado hit his parents’ home, but everyone is OK.

A tornado hit our home today. It damaged the roof, destroyed the backyard and took our patio furniture somewhere. But there is some good news. Were all alive!#Shalieve#Grace&Mercy

— Vernon J. Shazier (@VernonShazier) April 28, 2018

April 14

Shazier was an honorary captain at Ohio State’s spring game. He used a wheelchair to get to the Buckeyes locker room, where he stood up to address the team before the scrimmage. Shazier also stood up to wave to the crowd at Ohio Stadium:

#Shalieve || The presence of @RyanShazier was felt during this year’s spring game. His return was a testimony of love of #TheBrotherhood. #GoBucks #LongLiveTheBrotherhood pic.twitter.com/jNlIyAaBG7

— Ohio State Football (@OhioStateFB) April 17, 2018

April 11

Shazier attended a Pittsburgh Penguins playoff game and while standing, he led the fans in a “Let’s go Pens” cheer.

Playoffs... HERE WE GO.#BurghProud pic.twitter.com/Ro4JhsGVlw

— Pittsburgh Penguins (@penguins) April 11, 2018

Shazier attended an NCAA tournament game in Pittsburgh.

March 4

During the NFL Combine, Shazier hopped on the phone with NFL Network’s Mike Mayock and Rich Eisen.

“My end goal is to allow the Lord to let me come back and play at the high level that I was before,” Shazier said. “Every day I try to get better. I strive for the Hall of Fame and I was doing that through this year, the whole time I was playing. And I still do that while I’m doing rehab. I know it’s still a possibility. I have the Lord and he has my back and I constantly feel I’m going to come back and play football.”

Feb. 28

At the NFL Combine, Steelers GM Kevin Colbert announced that Shazier wouldn’t be playing in the 2018 season:

Steelers GM says Ryan Shazier won’t play in 2018. “We know that, he knows that”

— Adam Stites (@AdamStites_) February 28, 2018

Feb. 20

On Feb. 20, Ryan Shazier spoke for the first time about his injury when he was a guest on his teammate Roosevelt Nix’s podcast. Shazier said that he’s making progress every day and that he plans to play football again one day.

Feb. 7

Team owner Art Rooney II confirmed that Shazier will still be heavily involved with the Steelers next season:

Art Rooney on Ryan Shazier's future: "I expect Ryan is going to be here one way or the other and have a roll on the team one way or other in 2018"

— Ed Bouchette (@EdBouchette) February 7, 2018

Feb. 6

Shazier attended a Penguins game and stood up, with some help, while fans gave him a standing ovation:

A well-deserved STANDING ovation for this guy. Welcome to the game, @RyanShazier! pic.twitter.com/IhBscrsXTT

— Pittsburgh Penguins (@penguins) February 7, 2018

Feb. 4

ESPN’s Adam Schefter shared on Super Bowl Sunday that Shazier hasn’t just regained feeling in his legs, but he’s also regained movement and is “engaging in a regular walking routine.” But Michele Tafoya reported that Shazier wasn’t walking on his own, which Shazier then confirmed himself.

Feb. 1

Shazier posted the most encouraging sign of his recovery to that date with a picture that appeared to show him standing — albeit with support from teammate Ben Roethlisberger.

I’ve had a lot of 1st downs at UPMC, but you know being the defensive guy I am, my mind is on 3 and out. With that being said, I want everyone to know that I’m moving on to the next step of the process. Today’s a big day for me as I’m officially being released from the hospital. I want to take a moment to thank the people who have helped me the past two months. First and foremost, I want to thank God because at the end of the day I don’t think I’d be making progress without His vision and hands protecting me and my family. I will continue to trust in Him and thank Him, because it all starts with Him. To my family: you’ve been my rock. Words can’t express how thankful I am for you Michelle, RJ, Mom, Dad, and VJ for always being there for me. You’re my everything. To Jerome: my trainer and best friend. Thank you for being there from day 1 and every day after continuing to push me to be better every day. I’d like to thank Dr. Okonkwo, Dr. Harrington, Dr. Maroon, and Dr. Schroeder for their amazing work on my procedure and continuous care. I can’t appropriately express how grateful I am for how quickly you’ve helped me bounce back. I want to thank the medical staff at UPMC for their amazing care, support and therapy they have given me- especially Joe, Nikki, Karolina and Dani. I know the staff will continue to help me find a way to keep on pushing as we continue therapy. The support from my teammates has been truly amazing. From former players to current players and their families- they have helped me and my family day to day with visits and gifts. We can’t thank you enough. I want to thank Mr. Rooney, Coach T, Mr. Colbert, and the entire Steelers organization for the unwavering support they’ve given me. I knew they were an amazing organization, but more than ever they’re family to me. Lastly, I want to thank Jimmy, Candice, and the CAA Sports staff for being here when I need them most. I don’t know if I’d be where I’m at or making the progress I’m making without you guys. I want everyone to know that all of the support and prayers are absolutely being answered. I will continue to work hard and push and find a way back. #Shalieve #Steelers #prayfor50

A post shared by Ryan Shazier (@shazier) on Feb 1, 2018 at 10:57am PST

That same day, the University of Pittsburgh Medical Center released a statement saying that Shazier was discharged from inpatient rehab and will transition into an outpatient program to continue his recovery.

Jan. 14

Shazier was on hand to cheer on the Steelers during their Divisional Round game against the Jaguars.

#SHALIEVE pic.twitter.com/Q48FqcCfwh

— Pittsburgh Steelers (@steelers) January 14, 2018

He spoke to his teammates in the locker room to encourage them, according to CBS’ broadcast.

Jan. 10

This was the first photo that confirmed Shazier was in a wheelchair. His family and the team have kept details about Shazier’s condition close to the vest to protect his privacy as he recovers.

I want to thank the Lord for the first downs that he has been allowing me to achieve. The touchdown is going to come in his timing, but today was a first down. I was finally able to make it to practice with my teammates. It’s great to be back for practices and meetings. Just to be able to feel a part of it means the world. So I’m working harder than I ever have to get back. Ive been making strides over the past month and continue to make progress. Taking it day-by-day, but I’m far from done. The Lord has not finished his work yet. I want to say thank you to the fans and Steelers Nation for the prayers. If it wasn’t for my family, friends and your prayers I wouldn’t be were I am now. They have lifted me and my family through this journey and I ask for you to continue praying for me, as I continue to work daily on improving my health. #Shalieve#Steelers#prayfor50

A post shared by Ryan Shazier (@shazier) on Jan 10, 2018 at 11:13am PST

He visited his teammates at practice for the first time before the Steelers’ divisional matchup against the Jaguars, bringing an emotional lift as the team prepared for the postseason. Cameron Heyward told NFL Network’s Aditi Kinkhabwala that Shazier said he has good days and bad days. But the days he’s able to spend around his teammates are always good days.

Jan. 4, 2018

Shazier’s father, Vernon, said that Ryan regained feeling in his legs.

“He’s much better,” the elder Shazier told Pittsburgh’s WPXI-TV, “but we’ve agreed to keep his progress private until he’s ready to share where he’s at.”

Dec. 17, 2017

Shazier made his first public appearance since the injury at the Steelers’ Week 15 game against the Patriots,. He waved a Terrible Towel to pump up the crowd:

Dec. 12

The Steelers put Shazier on injured reserve, officially ending his season.

“Unfortunately Ryan will not be able to contribute on the field during the remainder of this season,” Steelers President Art Rooney II said in a statement. “However, even off the field Ryan will continue to be one of our team leaders. We know his spirit and positive outlook will help him to continue in his recovery, as well as serve as an inspiration to our team.”

Dec. 10

Shazier celebrated the Steelers’ Week 14 win over the Ravens with his teammates from his hospital bed via FaceTime.

#SHALIEVE : @RyanShazier pic.twitter.com/T3bN1DB8M5

— Pittsburgh Steelers (@steelers) December 11, 2017

It was their first game after Shazier’s injury.

“We didn’t play without him. He was out here with us, and we know it,” quarterback Ben Roethsliberger said after their 39-38 dramatic win. “Buddy, we love you so much. This one was for you, bud.”

Before the game, Antonio Brown and several other teammates wore customized cleats in honor of Shazier.

Dec. 7

Shazier underwent spinal stabilization surgery, according to an announcement from the team:

Statement from UPMC Neurosurgeons & #Steelers Team Physicians on Ryan Shazier pic.twitter.com/nE7xgsx7Tx

— Burt Lauten (@SteelersPRBurt) December 7, 2017

“I’m not worried about him playing for us again, I’m more worried about him,” Steelers defensive coordinator Keith Butler said via the Post-Gazette. “Y’all have been updated as much as we have. The thing that we’re hopeful for and prayerful for is that he comes back and he’ll be OK. The football stuff is secondary. His life is a lot more important to me than football.”

Dec. 6

Shazier was transported back to Pittsburgh to stay at the University of Pittsburgh Medical Center:

Statement on #Steelers LB Ryan Shazier (Wednesday, Dec. 6): pic.twitter.com/7AVSzXMksr

— Burt Lauten (@SteelersPRBurt) December 6, 2017

Dec. 5

The Steelers updated Shazier’s status throughout the day:

Statement by #Steelers GM/VP Kevin Colbert on LB Ryan Shazier pic.twitter.com/WEp6wktNCu

— Burt Lauten (@SteelersPRBurt) December 5, 2017

Joint statement from Dr. David Okonkwo (UPMC) & Dr. Joseph Cheng (UCMC) on #Steelers LB Ryan Shazier. pic.twitter.com/ou4UkTRvVR

— Burt Lauten (@SteelersPRBurt) December 5, 2017

“I really have no update in terms of his medical status other than what was released earlier,” Steelers head coach Mike Tomlin told reporters. “I would imagine at the appropriate time that those who are responsible for his care will give you a reasonable assessment of where he is. I imagine that would occur as soon as later on today.”

“From my perspective, obviously it was a tough evening,” he said. “Ryan’s a trooper. I had an opportunity to spend some time with him, and he’s in good spirits.”

Dec. 4

Shazier was injured during a Monday Night Football game against the Bengals in Week 13. On Cincinnati’s first possession of the game, Shazier went to the ground clutching his back after tackling Bengals wide receiver Josh Malone. It looked like a normal, everyday kind of tackle until Shazier didn’t get up.

Shazier was immobilized on a backboard, carted off the field, and taken to a Cincinnati hospital.

Steelers coach Mike Tomlin did not have an update on Shazier’s status after the game.

“This is a tough game, tough business,” Tomlin said. “5-0 (Shazier) is our brother.”

What does Ryan Shazier mean to the Steelers?

Shazier has been the Steelers’ biggest defensive playmaker since they took him in the first round of the 2014 draft.

The 25-year-old Shazier means so much more to the Steelers than that, as was seen in the way his teammates reacted immediately after his injury. They had a hard time holding back tears in the immediate aftermath and for the rest of the game.

“I don’t think Vince (Williams) stopped crying until after halftime, and that’s one of the most gangster dudes on the team,” safety Mike Mitchell said, via The MMQB’s Greg Bishop. “People had to grab him by the face mask and be like, ‘Yo, you’re the middle linebacker now. You can’t be sniffling.’”

The Steelers went on to win that game, beating the Bengals 23-20. They won four of their last five, locking up the second seed in the AFC before falling to the Jaguars in the Divisional Round.

He wasn’t on the field, but they didn’t do it without Shazier.

“When you see him, you know how much he loves football and wants to be out there for us,” linebacker Anthony Chickillo said, through the team’s website. “You just want to go hard for him. You just want to win for him.”

What’s Shazier’s prognosis?

Shazier started rehab days after undergoing surgery. He’s still very much a part of the Steelers, even if he never takes the field again.

Shazier and his family believe that he will play again.

“Yes, I do,” Vernon Shazier said. “I Shalieve.” Shazier and his family consistently use that play on Shazier’s last name and the word “believe“ when talking about his injury.

The injury was terrifying, and it’s difficult to even think about whether Shazier can or will play football in the future. What matters now is just Shazier’s continued recovery.

[alivurun]

Ed Mitchell s Story of Esophageal Cancer

In 1994 I was diagnosed with cancer of the esophagus. This is the story of my diagnosis and treatment. I was born in Fall River, Massachusetts in 1932. From my twenties on, I experienced acid reflux on a regular basis and over the years consumed a lot of Gelusil. When I was in my early forties, an esophageal ring was detected at Mt. Auburn Hospital in Cambridge, Massachusetts, but no treatment was prescribed. When I turned 60, I began to experience soreness at the sternum radiating up to the neck, with headache. For 20 months, I called this to the attention of my primary care doctor, a respected cardiologist whom I had been seeing for 15 years -- we had served together in the American Heart Association. He x-rayed me, stress-tested me on his treadmill, sent me to a neurologist, but did not refer me to the one doctor who could have detected my esophageal cancer early on, a gastroenterologist. I saw Dr. T, at least six times during those 20 months, complaining each time of the symptoms. Then, on June 7, 1994, on a business trip to New York City, I collapsed at a restaurant, coughing up blood. An endoscopy at New York University Hospital revealed a "polyp", and three days later I was sent back to Boston for treatment. The "polyp" turned out to be a cancerous growth of "impressive" size. When Dr. T. (my primary care doctor) gave me the bad news, he reached across his desk to a binder and produced the name of Dr. G., a general surgeon. "Do you know him?" I asked. "No, but he's in your insurance plan." So after Dr. T's having seen me for 15 years, the best he could do for me in this great center of American medicine was refer me to a general surgeon he didn't even know. I later fired Dr. T. and told him that if someone hangs up a shingle as primary care doctor and doesn't know the symptoms of esophageal cancer, then he shouldn't be in the business. Most wounding of all was that he didn't take the time to make a few phone calls to see who was doing the best work in this field in Boston. Dr. T. practiced medicine at its coldest and least caring. He combined incompetence and indifference -- a damning combination. My first visit with Dr. G., the general surgeon, was unsettling. He appeared to be a few years older than me, and he drew sketches on the paper of the examining table of how he might open me up. He didn't seem to be too sure about the best way to do this surgery. He sent me to Beth Israel for x-rays and CT- scans. At Beth Israel Hospital two days later, after my CT-scan, I bumped into Dr. G. in the hallway and asked if he had seen my x-rays and if we could put a team of people together: an oncologist, a gastroentrologist, and himself to discuss my treatment. "You can do that if you want," he said, as we stood in the hallway, surrounded by people. "But it won't make any difference. Your chance of survival is not very good -- only 10%. This is a very bad type of cancer." In my mind, in that instant, I fired Dr. G. Luckily, from the moment I came back to Boston, I had been on the phone calling everyone I knew for references to doctors in Boston who were treating my type of cancer. One name kept coming up over and over again: Dr. John Wain, a thoracic surgeon at the Massachusetts General Hospital. As fate would have it, my younger sister, Mary -- a nurse in Fall River -- was taking a course with a personal friend of Dr. Wain. He insisted on making an appointment for me with Dr. Wain. So after my corridor encounter with the general surgeon, I went directly to Mass General and saw Dr. Wain. He looked at my x-rays and CT-scans and confirmed the diagnosis. He said that the protocol they were using (two months chemotherapy followed by surgery) was producing good results. "Is your 5-year survival better than 10%?" I asked. "We're getting about 50% survival for five years," Dr. Wain said. "I'll take it," I said. So he sent me down to talk to Dr. Robert Carey, an oncologist. The next day I started my chemotherapy. It was easier than I anticipated, despite the hair loss and other side effects. During this time I drove out to Lancaster, Massachusetts, to consult with the medical director of the Ayurvedic Health Center. I began a regimen of daily self-administered full-body massages, the taking of certain herbs, drinking a lot of warm water, and eating rather strictly. I had been meditating for 20 years, so daily meditation was nothing new. My sister Dorothy sent me audio tapes of Dr. Richard Moss that were very helpful. I also began to listen to classical music in a new way -- letting the music wash over me uncritically. I also went for a weekly massage, believing that this was a way of stimulating my immune system and getting rid of some of the toxins of chemotherapy. I took money out of my pension fund to pay for this, figuring that if I didn't survive, I wouldn't need the pension anyway. The chemotherapy itself was uneventful except for an allergic reaction to one of the drugs, which drug was promptly suspended. I was hoping that the chemotherapy would shrink the tumor, but a pre-surgery scope didn't show any serious shrinkage. I prepared for surgery. I met with Dr. Wain a week before surgery and asked him not to have others in the operating suite who were not required and not to have interns do any of the surgery, except perhaps the opening and closing. He agreed. I had some medical tests the day before surgery and met with the anesthesiologist, who described my pending surgery as "formidable." He explained that I would be opened up in two places and that the surgery would last about 7 hours. That night, I finalized my will and wrote a letter to my daughters "to be opened in the event of my death." My sister Dorothy (an angel) and her husband Dor drove me to Mass General at 5:00 a.m. the next morning and waited there with Jennifer, my older daughter) until I came out of surgery in the late afternoon. The surgery took 9 hours, and I was later told by the nurses that Dr. Wain never left the room. God bless him! My recovery was very slow. The first tests of liquids never got through the pyloric valve. So they brought me back to surgery to dilate the pyloric. Eventually, I was able to tolerate liquids, apple sauce, sherbet. On one of those dreaded forced marches up and down the hospital corridor, I met my oncologist. "Well, you're a lucky man," he said. "We examined 19 lymph nodes and none of them had cancer. So at this moment you are cancer free." To tell you the truth, I was feeling so miserable, I didn't really care. I found out later that my tumor staging was T3, NO, MO. It was adenocarcinoma arising in Barrett's esophagus. The surgeon had removed 1/2 of my esophagus and 1/3 of my stomach, and my new stomach was now sitting right in the middle of my chest, over to the right. After two weeks in the hospital, I was discharged and went to live with my sister Dorothy for two weeks. (After 20 years of marriage, I separated in 1990 and divorced in 1994.) My energy was low and I was able to eat very little. I was getting most of my nourishment from a j-tube. I slept in a hospital bed (provided by PruCare Insurance), but usually got up at 3:00 a.m. and sat in a chair for the rest of the night. At the end of two weeks with Dorothy, I decided to go back to my apartment. Not a good idea! It was difficult taking care of myself, especially the feeding part. I was barely able to move out of my chair most of the time. Finally, after two weeks, I came down with pneumonia and was taken back to Mass General by ambulance, where I stayed for another two weeks. During this time, I became depressed, a condition I had never before experienced. When I asked for medication for this, two bearded psychiatrists examined me and prescribed a mild heart stimulant, which seemed to do the trick. I stayed on it for about a week. It was now the middle of October. My surgery had been on August 28th. My voice was weak, probably from the intubation. (In time, it returned to its regular strength.) From Mass General I went by ambulance to Youville Rehab Hospital since my doctors weren't going to risk my trying to make it on my own again. I spent two and 1/2 weeks there -- and it was great. A lot of physical therapy, spiritual counseling, excellent nursing, good food, and a wonderful environment. I was released on November 4, 1994, just in time to vote. I didn't go back to work for the rest of November, trying to eat difference foods each day, and remembering which ones were best for me. The j-tube stayed in. I was growing to hate Ensure, which I was taking by tube and in three glasses a day. I felt no hunger or appetite but ate by the clock. Many times after eating, I would get a feeling of seasickness, which usually passed in about 45 minutes. My energy level was poor, but I forced myself to do daily physical exercises. I didn't get back to meditating for a long time and I fell away from my Ayurvedic practices. Three months after surgery, I started to drive my car again and went back to work in late November. I left work at 3:00 each afternoon, since I ran out of energy by that time of the day. Three months later I traveled to New York City on company business and did very well. If there is any advice I can give you it is HANG IN THERE. My life was pretty miserable from the time of my surgery for about three months. But now it is not very different from what it was before. True, I have a little less energy, eat smaller meals, and take medication to combat the reflux. Occasionally, I also suffer from the "dumping syndrome," which happens to those who have had stomach surgery. But life is sweet. And I can honestly say that I have never enjoyed it more! Steve Dunn's CancerGuide, which I discovered when I bought a computer during my chemotherapy, has been a godsend to me. Oncolink and Medline and the National Medical Library are great -- but Steve's personal touch and extremely useful information have meant more to me than any other source. Somewhere in the Bible it is written that, "those who instruct many will shine as the stars for all eternity." In my book, Steve Dunn is already one of those stars. Bravo, Stephen!

Update: September 2012

It is now over 18 years since my diagnosis of esophageal cancer. For the longest while after surgery, I experienced nausea after eating, a feeling of seasickness that lasted about 45 minutes. I now avoid this feeling by not drinking liquids with my meal. I have also learned to eat smaller meals. I take one 20 mg Prilosec daily to prevent reflux. I was able to work full time until I retired in the summer of 1999, can eat any type of food, drink alcohol, sleep through the night (in a recliner), and have very few side effects from my former cancer. I lost 40 pounds after the surgery but gained back some. I no longer see my oncologist, only an annual visit to my primary care doctor. I consider myself blessed by the gift of these extra years. I have renewed old friendships, enjoy the company of my two daughters and three grandchildren, and treasure the joy of life. I have been on two trips to Italy, in 1997 and 2000. Retired from work with UNICEF, now at the age of 80 I am busy writing, consulting, designing web pages, visiting family and friends, and enjoying life more than ever. I hope that my story has been helpful. Since first posting my story in CancerGuide, I have heard from hundreds of people around the world and have answered them all. I wish you health and happiness.

Update: May 2015

Ed Mitchell passed away, surrounded by his family, on May 5, 2015, after succumbing to an advanced MAC infection. He was always grateful for his "extra" 21 years of life after surviving esophageal cancer. Ed was 83. Read the full article

[iainthinesward]

Surgery and Day 1, Post-Operation

I was scheduled to arrive at the hospital at 6:30am on Monday.  The Friday before, someone was supposed to call me but I never heard anything because they were dialing the wrong area code (I need to get rid of my old 415 area code cell phone some day).  I had enough sense to call the hospital and I got my check-in time.  The weekend consisted of picking up our family (who are here to help after the surgery, and celebrate the holidays with us), dinners/brunches in which I abstained from alcohol, Holiday Pops with the PGH Symphony Orchestra, and final preparations for surgery/Christmas.

I took with me a bag full of books, magazines, my wallet, and cellphone.  I brought my brace and crutches from the original ACL-tear rehab.  The pre-operative staff were friendly and after taking my insurance I went to a waiting room where a very tired looking, elderly volunteer shepherded my wife and I to the pre-operative area, which was already bustling at this early hour.  There was no door to my “room”, but there was a curtain, a moving hospital bed and a TV.  I shut the curtain and disrobed completely, putting my clothes into bags and placing the rest of my belongings under the moving stretcher bed.  I tried to read a book but there were several interruptions.

First a PA came to take vitals and ask a few medical history questions.  I had been concerned about some high-ish blood pressure at my last PCP visit, but my vitals were pristine throughout the entire process (at least that is what my wife the NP told me).  I suspect lowering my caffeine intake allowed me to bring down my blood pressure. Next, a nurse anesthetist came to give me an IV.  All of the staff were friendly and kind, which is nice when you’re practically naked and getting poked and prodded.

My surgeon popped in and introduced himself to my wife and shook my IV’d hand.  He was very positive and upbeat and cut to the chase, “let’s get you out of here and start rehabbing”.

Soon, the anesthesiologist came into my room and remarked about my book choice (Harlan Ellison) and I corrected him when he misread autograph as allograph from the surgeon’s notes. He gave me options between a single-administration 12 hour nerve block and a pump that i could take home with me and administer over several days.  Given that the pain hasn’t been very bad since the surgery, I’m glad I chose the 12 hour block. 

The nurse came in eventually and gave me a cocktail of oral drugs including morphine, some calming meds, Celebrex, and I believe a stool softener.  Next a smidge of some anesthetic was pumped into my IV.  At this point I had articulated my name, DOB, and type of surgery at least 6-7 times and my perception of reality was starting to change.  My wife gave me a kiss and headed out to the outer waiting rooms.

Two folks introduced themselves and they lurked around for a while and then finally said “It’s show time” and I was wheeled down the hall.  I remember asking “What are those things?” and the staff explained that the red containers on wheels were suction receptacles. “Everyone asks that”, they said.  I relaxed knowing that I was just like everyone else.

The Operating Room was very bright and there were many people in lab coats milling around.  Some folks introduced themselves and I shifted myself from the moving bed to the operating table.  Then I remember a mask going over my face and everything went dark.

My next memory was gasping for air.  I could hear people rooting me on and eventually I had stabilized my breathing.  I think I was in and out of consciousness until I made it back to the non-operating room.  There, a nurse gave me ginger ale on ice and my wife came to greet me.  The surgeon had called her and reported that I had no evidence of arthritis or any other damage and it was a straight-forward ACL reconstruction.  Someone had attached my brace to my leg which is to remain on until my first physical therapy appointment at least.

I rolled out to the car with my crutches and I was informed by the transporter that a train crash in Washington had killed several people - so I felt even more lucky given my fears related to going under the knife.  In the back of the car, I propped my legs on two pillows and we drove to the pharmacy to pick up some a stool softener and Percocet.  I had already loaded up on over-the-counter Advil for pain and Bayer aspirin for blood thinning.

Since being home, I’ve been using the electro-therapeutic TENS unit (the pads were placed under my bandages before I left the OR) as well as an icepack compression pump.  I’ve been propping my leg up in bed and rotating between Advil and Tylenol.  I can get around on crutches and I can put weight on my operated leg, but I’m trying not to overdo it.  I still have my brace on and have been flexing my quad and doing leg lifts, but all the other physical therapy exercises from my discharge instructions look a bit ambitious at this point.

I was expecting the pain today to be unbearable, but it really hasn’t been bad.  I took the Percocet last night to sleep but i’m not sure that I really needed it.  The 12 hour nerve block may have extended into today or perhaps the pain will have a ceiling.  I did a lot of preoperative leg lifts and rode my bike for months. Since I had a year to heal my original injury, I felt physically prepared.  The original injury hurt way more than the surgery has, but maybe I’ll feel differently once we remove the bandages and I can see what my leg looks like.

[gordonwilliamsweb]

Back to Life: COVID Lung Transplant Survivor Tells Her Story

Mayra Ramirez remembers the nightmares.

During six weeks on life support at Northwestern Memorial Hospital in Chicago, Ramirez said, she had terrifying nightmares that she couldn’t distinguish from reality.

“Most of them involve me drowning,” she said. “I attribute that to me not being able to breathe, and struggling to breathe.”

On June 5, Ramirez, 28, became the first known COVID-19 patient in the U.S. to undergo a double lung transplant. She is strong enough now to begin sharing the story of her ordeal.

Mysterious Exposure

When the COVID-19 pandemic hit, Mayra Ramirez began working from home. She’s unsure how she contracted COVID-19.(Northwestern Medicine)

Before the pandemic, Ramirez worked as a paralegal for an immigration law firm in Chicago. She enjoyed walking her dogs and running 5K races.

Ramirez had been working from home since mid-March, hardly leaving the house, so she has no idea how she contracted the coronavirus. In late April, she started experiencing chronic spasms, diarrhea, loss of taste and smell, and a slight fever.

“I felt very fatigued,” Ramirez said. “I wasn’t able to walk long distances without falling over. And that’s when I decided to go into the emergency room.”

From the ER to a Ventilator

The staff at Northwestern checked her vitals and found her oxygen levels were extremely low. She was given 10 minutes to explain her situation over the phone to her mother in North Carolina and appoint her to make medical decisions on her behalf.

Ramirez knew she was about to be placed on a ventilator, but she didn’t understand exactly what that meant.

“In Spanish, the word ‘ventilator’ — ventilador — is ‘fan,’ so I thought, ‘Oh, they’re just gonna blow some air into me and I’ll be OK. Maybe have a three-day stay, and then I’ll be right out.’ So I wasn’t very worried,” Ramirez said.

In fact, she would spend the next six weeks heavily sedated on that ventilator and another machine — known as ECMO, or extracorporeal membrane oxygenation — pumping and oxygenating her blood outside of her body.

In this photo taken before the transplant, Mayra Ramirez is being monitored by the ECMO team at Northwestern Memorial Hospital in Chicago.(Northwestern Medicine)

One theory about why Ramirez became so sick is that she has a neurological condition that is treated with steroids, drugs that can suppress the immune system.

By early June, Ramirez was at risk of further decline. She began showing signs that her kidneys and liver were starting to fail, with no improvement in her lung function. Her family was told she might not make it through the night, so her mother and sisters caught the first flight from North Carolina to Chicago to say goodbye.

When they arrived, the doctors told Ramirez’s mother, Nohemi Romero, that there was one last thing they could try.

Ramirez was a candidate for a double lung transplant, they said, although the procedure had never been done on a COVID patient in the U.S. Her mother agreed, and within 48 hours of being listed for transplant, a donor was found and the successful procedure was performed on June 5.

At a recent news conference held by Northwestern Memorial, Romero shared in Spanish that there were no words to describe the pain of not being by her daughter’s side as she struggled for her life.

She thanked God all went well, and for giving her the strength to make it through.

‘I Just Felt Like a Vegetable’

Dr. Ankit Bharat, Northwestern Medicine’s chief of thoracic surgery, performed the 10-hour procedure.

“Most patients are quite sick going into [a] lung transplant,” Bharat said in an interview in June. “But she was so sick. In fact, I can say without hesitation, the sickest patient I ever transplanted.”

Bharat said most COVID-19 patients will not be candidates for transplants because of their age and other health conditions that decrease the likelihood of success. And early research shows that up to half of COVID patients on ventilators survive the illness and are likely to recover on their own.

But for some, like Ramirez, Bharat said, a transplant can be a lifesaving option of last resort.

When Ramirez woke up after the operation, she was disoriented, could barely move her body and couldn’t speak.

“I just felt like a vegetable. It was frustrating, but at the time I didn’t have the cognitive ability to process what was going on,” Ramirez said.

She recalled being sad that her mother wasn’t with her in the hospital, not understanding that visitors weren’t allowed because of the pandemic.

Her family had sent photos to post by her hospital bed, and Ramirez said she couldn’t recognize anyone in the pictures.

“I was actually sort of upset about it, [thinking,] ‘Who are these strangers and why are their pictures in my room?’” Ramirez said. “It was weeks later, actually, that I took a second look and realized, ‘Hey, that’s my grandmother. That’s my mom and my siblings. And that’s me.”

After a few weeks, Ramirez said, she finally understood what happened to her. When COVID-19 restrictions loosened at the hospital in mid-June, her mother was finally able to visit.

“The first thing I did was just tear up,” Ramirez said. “I was overjoyed to see her.”

The Long Road to Recovery

After weeks of inpatient rehabilitation, Ramirez was discharged home. She’s now receiving in-home nursing assistance as well as physical and occupational therapy, and she’s working on finding a psychologist.

Ramirez eagerly looks forward to being able to spend more time with her family, her boyfriend and her dogs and serving the immigrant community through her legal work.

But for now, her days are consumed by rehab. Her doctors say it will be at least a year before she can function independently and be as active as before.

Ramirez is slowly regaining strength and learning how to breathe with her new lungs.

She takes more than 17 pills, four times a day, including medicines to prevent her body from rejecting the new lungs. She also takes anxiety meds and antidepressants to help her cope with daily nightmares and panic attacks.

The long-term physical and mental health tolls on Ramirez and other COVID-19 survivors remain largely unknown, since the virus is so new.

While most people who contract the virus are left seemingly unscathed, for some patients, like Ramirez, the road to recovery is full of uncertainty, said Dr. Mady Hornig, a physician-scientist at the Columbia University Mailman School of Public Health.

Some patients can experience post-intensive care syndrome, or PICS, which can consist of depression, memory issues and other cognitive and mental health problems, Hornig said. Under normal circumstances, ICU visits from loved ones are encouraged, she said, because the human interaction can be protective.

“That type of contact would normally keep people oriented … so that it doesn’t become as traumatic,” Hornig said.

Hopes for the Future

COVID-19 has disproportionately harmed Latino communities, as Latinos are overrepresented in jobs that expose them to the virus and have lower rates of health insurance and other social protections.

Ramirez has health insurance, although that hasn’t spared her from tens and thousands of dollars’ worth of medical bills.

And even though she still ended up getting COVID-19, she counts herself lucky for having a job that allowed her to work from home when the pandemic struck. Many Latino workers don’t have that luxury, she said, so they’re forced to risk their lives doing low-wage jobs deemed essential at this time.

Ramirez’s mother is a breast cancer survivor, making her particularly vulnerable to COVID-19. She had been working at a meatpacking plant in North Carolina, for a company that Ramirez said has had hundreds of COVID-19 cases among employees.

So Ramirez is relieved to have her mom in Chicago, helping take care of her.

“I’m glad this is taking her away from her position,” Ramirez said.

Friends and family in North Carolina have been fundraising to help pay her medical bills, selling raffle tickets and setting up a GoFundMe page on her behalf. Ramirez is also applying for financial assistance from the hospital.

Her experience with COVID-19 has not changed who she is as a person, she said, and she looks forward to living her life to the fullest.

If she ever gets the chance to speak with the family of the person whose lungs she now has, she said, she will thank them “for raising such a healthy child and a caring person [who] was kind enough to become an organ donor.”

Her life may never be the same, but that doesn’t mean she won’t try. She laughs as she explains how she asked her surgeon to take her skydiving someday.

“Dr. Bharat actually used to work at a skydiving company when he was younger,” Ramirez said. “And so he promised me that, hopefully within a year, he could get me there.”

And she has every intention of holding him to that promise.

This story is part of a reporting partnership that includes Illinois Public Media, Side Effects Public Media, NPR and KHN.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

USE OUR CONTENT

This story can be republished for free (details).

Back to Life: COVID Lung Transplant Survivor Tells Her Story published first on https://nootropicspowdersupplier.tumblr.com/

[zahrahpatelot]

progress = goodbyes

Time is ticking. Days are passing. Clients are ready to move on. BUT, are they moving on in a better or worse space? The all important ‘reflection’ dawns once again upon us. Assessing my clients progress and my role in it - is scary. It defines your skills, abilities and ultimately decides whether one day ( which is rapidly approaching, if not already) will we be worthy of our degree certificates and titles.

My sweet patient, Mr P was being discharged in a few days and my days were numbered with him. I had built such a great relationship with both the client and his family that it made me genuinely sad to say goodbye. The moment that I hugged his wife and asked the rhetorical question of ‘I hope I made a difference and if Mr P enjoyed our sessions?’ , I wondered, did I? Did I actually make a difference? Did the client progress and the answer is YES! ( hallelujah)

Mr P needed extensive therapy both physically and psychologically when he came in and displayed en emotionally labile state upon our initial meeting. The client was emotional and often lacked the motivation to perform therapy. However the client improved drastically in his ADL’s as he went from maximum assistance to minimal assistance - supervision with set up. The client also had the most important factor which is a promoting factor - it being his extremely supportive family that assisted him in getting through the time he spent at the hospital. 

I’ll allow myself to be slightly conceited here and just put it out there- that I genuinely believe I had something to do with his the upturn in his mood which subsequently changed his outlook on therapy which ultimately resulted in therapy becoming therapeutic (woah, that sentence sounds pretty smart).The client enjoyed spending time with me and hence enjoyed our sessions together and it warms my heart to know that I did make a difference in his life and helped him in his journey to return home - which he did, on my watch too! (Acknowledging the great work of the rehab unit at Hospital X)

Our final treatment session together. Impromptu sessions :) Toilet transfers it was. It was done to perfect the clients ability in toilet transferring as previously done in a session. The client was able to successfully transfer to the toilet using minimal assistance which was great progress. I needed to position myself for safety purposes in front of the client to prevent falls and facilitate movement at the hips (minimal assistance). The client performed that so well and once it was consolidated - we did self-propelling using the unaffected left upper and lower limb The client needed moderate assistance with this due to the clients unilateral neglect which had improved but still existed and hence required verbal cues to direct the client to prevent him from bumping into anything. This also improved the clients physical endurance from 20 minutes to about 25 minutes. 

Progress and goodbyes are closely linked concepts. Goodbyes are usually associated with progress which is inspiring to the next person. Progress of the client can be measured by the therapist’s satisfaction of her progress during their sessions because ultimately it is a learning curve.

[stephenmccull]

Back to Life: COVID Lung Transplant Survivor Tells Her Story

Mayra Ramirez remembers the nightmares.

During six weeks on life support at Northwestern Memorial Hospital in Chicago, Ramirez said, she had terrifying nightmares that she couldn’t distinguish from reality.

“Most of them involve me drowning,” she said. “I attribute that to me not being able to breathe, and struggling to breathe.”

On June 5, Ramirez, 28, became the first known COVID-19 patient in the U.S. to undergo a double lung transplant. She is strong enough now to begin sharing the story of her ordeal.

Mysterious Exposure

When the COVID-19 pandemic hit, Mayra Ramirez began working from home. She’s unsure how she contracted COVID-19.(Northwestern Medicine)

Before the pandemic, Ramirez worked as a paralegal for an immigration law firm in Chicago. She enjoyed walking her dogs and running 5K races.

Ramirez had been working from home since mid-March, hardly leaving the house, so she has no idea how she contracted the coronavirus. In late April, she started experiencing chronic spasms, diarrhea, loss of taste and smell, and a slight fever.

“I felt very fatigued,” Ramirez said. “I wasn’t able to walk long distances without falling over. And that’s when I decided to go into the emergency room.”

From the ER to a Ventilator

The staff at Northwestern checked her vitals and found her oxygen levels were extremely low. She was given 10 minutes to explain her situation over the phone to her mother in North Carolina and appoint her to make medical decisions on her behalf.

Ramirez knew she was about to be placed on a ventilator, but she didn’t understand exactly what that meant.

“In Spanish, the word ‘ventilator’ — ventilador — is ‘fan,’ so I thought, ‘Oh, they’re just gonna blow some air into me and I’ll be OK. Maybe have a three-day stay, and then I’ll be right out.’ So I wasn’t very worried,” Ramirez said.

In fact, she would spend the next six weeks heavily sedated on that ventilator and another machine — known as ECMO, or extracorporeal membrane oxygenation — pumping and oxygenating her blood outside of her body.

In this photo taken before the transplant, Mayra Ramirez is being monitored by the ECMO team at Northwestern Memorial Hospital in Chicago.(Northwestern Medicine)

One theory about why Ramirez became so sick is that she has a neurological condition that is treated with steroids, drugs that can suppress the immune system.

By early June, Ramirez was at risk of further decline. She began showing signs that her kidneys and liver were starting to fail, with no improvement in her lung function. Her family was told she might not make it through the night, so her mother and sisters caught the first flight from North Carolina to Chicago to say goodbye.

When they arrived, the doctors told Ramirez’s mother, Nohemi Romero, that there was one last thing they could try.

Ramirez was a candidate for a double lung transplant, they said, although the procedure had never been done on a COVID patient in the U.S. Her mother agreed, and within 48 hours of being listed for transplant, a donor was found and the successful procedure was performed on June 5.

At a recent news conference held by Northwestern Memorial, Romero shared in Spanish that there were no words to describe the pain of not being by her daughter’s side as she struggled for her life.

She thanked God all went well, and for giving her the strength to make it through.

‘I Just Felt Like a Vegetable’

Dr. Ankit Bharat, Northwestern Medicine’s chief of thoracic surgery, performed the 10-hour procedure.

“Most patients are quite sick going into [a] lung transplant,” Bharat said in an interview in June. “But she was so sick. In fact, I can say without hesitation, the sickest patient I ever transplanted.”

Bharat said most COVID-19 patients will not be candidates for transplants because of their age and other health conditions that decrease the likelihood of success. And early research shows that up to half of COVID patients on ventilators survive the illness and are likely to recover on their own.

But for some, like Ramirez, Bharat said, a transplant can be a lifesaving option of last resort.

When Ramirez woke up after the operation, she was disoriented, could barely move her body and couldn’t speak.

“I just felt like a vegetable. It was frustrating, but at the time I didn’t have the cognitive ability to process what was going on,” Ramirez said.

She recalled being sad that her mother wasn’t with her in the hospital, not understanding that visitors weren’t allowed because of the pandemic.

Her family had sent photos to post by her hospital bed, and Ramirez said she couldn’t recognize anyone in the pictures.

“I was actually sort of upset about it, [thinking,] ‘Who are these strangers and why are their pictures in my room?’” Ramirez said. “It was weeks later, actually, that I took a second look and realized, ‘Hey, that’s my grandmother. That’s my mom and my siblings. And that’s me.”

After a few weeks, Ramirez said, she finally understood what happened to her. When COVID-19 restrictions loosened at the hospital in mid-June, her mother was finally able to visit.

“The first thing I did was just tear up,” Ramirez said. “I was overjoyed to see her.”

The Long Road to Recovery

After weeks of inpatient rehabilitation, Ramirez was discharged home. She’s now receiving in-home nursing assistance as well as physical and occupational therapy, and she’s working on finding a psychologist.

Ramirez eagerly looks forward to being able to spend more time with her family, her boyfriend and her dogs and serving the immigrant community through her legal work.

But for now, her days are consumed by rehab. Her doctors say it will be at least a year before she can function independently and be as active as before.

Ramirez is slowly regaining strength and learning how to breathe with her new lungs.

She takes more than 17 pills, four times a day, including medicines to prevent her body from rejecting the new lungs. She also takes anxiety meds and antidepressants to help her cope with daily nightmares and panic attacks.

The long-term physical and mental health tolls on Ramirez and other COVID-19 survivors remain largely unknown, since the virus is so new.

While most people who contract the virus are left seemingly unscathed, for some patients, like Ramirez, the road to recovery is full of uncertainty, said Dr. Mady Hornig, a physician-scientist at the Columbia University Mailman School of Public Health.

Some patients can experience post-intensive care syndrome, or PICS, which can consist of depression, memory issues and other cognitive and mental health problems, Hornig said. Under normal circumstances, ICU visits from loved ones are encouraged, she said, because the human interaction can be protective.

“That type of contact would normally keep people oriented … so that it doesn’t become as traumatic,” Hornig said.

Hopes for the Future

COVID-19 has disproportionately harmed Latino communities, as Latinos are overrepresented in jobs that expose them to the virus and have lower rates of health insurance and other social protections.

Ramirez has health insurance, although that hasn’t spared her from tens and thousands of dollars’ worth of medical bills.

And even though she still ended up getting COVID-19, she counts herself lucky for having a job that allowed her to work from home when the pandemic struck. Many Latino workers don’t have that luxury, she said, so they’re forced to risk their lives doing low-wage jobs deemed essential at this time.

Ramirez’s mother is a breast cancer survivor, making her particularly vulnerable to COVID-19. She had been working at a meatpacking plant in North Carolina, for a company that Ramirez said has had hundreds of COVID-19 cases among employees.

So Ramirez is relieved to have her mom in Chicago, helping take care of her.

“I’m glad this is taking her away from her position,” Ramirez said.

Friends and family in North Carolina have been fundraising to help pay her medical bills, selling raffle tickets and setting up a GoFundMe page on her behalf. Ramirez is also applying for financial assistance from the hospital.

Her experience with COVID-19 has not changed who she is as a person, she said, and she looks forward to living her life to the fullest.

If she ever gets the chance to speak with the family of the person whose lungs she now has, she said, she will thank them “for raising such a healthy child and a caring person [who] was kind enough to become an organ donor.”

Her life may never be the same, but that doesn’t mean she won’t try. She laughs as she explains how she asked her surgeon to take her skydiving someday.

“Dr. Bharat actually used to work at a skydiving company when he was younger,” Ramirez said. “And so he promised me that, hopefully within a year, he could get me there.”

And she has every intention of holding him to that promise.

This story is part of a reporting partnership that includes Illinois Public Media, Side Effects Public Media, NPR and KHN.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

USE OUR CONTENT

This story can be republished for free (details).

Back to Life: COVID Lung Transplant Survivor Tells Her Story published first on https://smartdrinkingweb.weebly.com/