Yes I have Crohn’s Disease. Yes it is a physical ailment. That doesn’t mean it doesn’t affect our minds though. When people hear the words mental health, many will think of diseases like schizophrenia. However, just because we have a problem with our gut, doesn’t mean we can’t also have a problem with our mind and need some mental help.
Within my first year of being diagnosed with Crohn’s Disease, I was seeing a shrink. I was only 16 and it was not my choice to see one. My doctor wanted me to see him because he felt that I should be able to go to school and the reason I wasn’t going was mental. (Nice GI dr I had).
Over time I have dealt with a number of issues with my disease one of which is depression. Many people with IBD will experience depression at least once in their life, some will experience it many times. I myself have had numerous bouts with it, the last time being the beginning of 2012. I was so fed up with my disease and didn’t want to go on anymore. I was spending all day in the bathroom, in constant pain, and had to sight of relief.
My problems were real, but I would soon learn that what I was going through was nothing compared to others. What about all the people with IBD that have to have surgery for a resection or worse, have part of their intestines removed. I can’t even start to imagine what goes through someone’s mind when they are told they will have to have an ostomy bag for the rest of their life.
Mental health is overlooked when it comes to IBD but in fact, from experience, it goes hand in hand with our psychical disease. The problem is many GI’s are not educated on how to help. Psychologists and psychiatrists get a bad rap, but we need to put our hands in theirs. We must seek them out and learn to use them as much as we use a GI doctor.
There is no shame it seeing a shrink. Just because you go to one doesn’t make you bad. All it means is that you need some help sorting out your feelings. And really, if it helps us feel better, isn’t it worth it.
This post will have a double meaning to it. It will serve as my post for National Health Blog Post Month and it will server as an update on my treatment. If you follow me, then you know what I am about to write about.
I want to talk a little about an alternative drug treatment for Crohn’s Disease that is growing in popularity. Now, it isn’t a supplement that is over the counter or some herbs. It is a prescriptive medicine but I say it is alternative because currently, it is not an approved treatment for IBD. I am talking about Low Dose Naltrexone or LDN.
Over the years I have tried every type of medicine for my Crohns. It started with the sulphur drug Azulfidine and has ended with the biologic Humira. I have done Prednisone, Dipentum, Azacol, Remicade, Cortiform, Lialda and possible some others that I can’t remember. None of these meds helped me and in fact I usually got sicker on them and developed other issues. With Humira I developed a bad case of psoriasis. After 24 years of traditional therapy, I was open to something new.
Naltrexone has been around for years. It is mainly used to help drug addicts get off drugs. It works by blocking the euphoric feelings from opiates. It was found that it can be used in a small dose, 4.5 mg compared to 50 mg, and still work. During a study on the drug it was found that by blocking these receptors, it was helping in the body fight off inflammation and heal itself. So a person can take Naltrexone in a low dose, not get major side effects and have it heal their IBD.
The downside to Naltrexone is that it is an old drug. It has been around for many years. This has made the drug very inexpensive. Because there is no money to be made on the drug, why would the pharmaceutical companies spend millions to research it? For a month’s supply I pay $15. I don’t even put it through my insurance.
So how well does it work you ask. Well, to start, the beginning is rough. There are some side effects in the beginning so beware. For the first 2-3 weeks, you will have insomnia. The drug works by kicking in your endorphins at night, around 3 in the morning. It will keep you up when this happens. You will also have very vivid dreams that seem extremely real. Don’t worry..this will all pass. Eventually your body gets used to the endorphin rush and you will sleep. In fact, Naltrexone helps with producing serotonin so it helps you to sleep better.
As for my use, I have been on LDN for about 2 months now. Overall I feel great. I can finally say that I am no longer in a flare, which started in early 2011. I was having a real rough time and even though going gluten-free helped, it never fully took me out of the flare. Now, I am feeling normal again. I go to the bathroom around 3-4 times a day…something I haven’t done in many years. My best day would be 8-10 times a day. I have no gut pain, no joint pains, no eye problems. My psoriasis from Humira is healing and going away. I am starting to feel like a normal person again.
On Monday, I saw my GI. As I have mentioned in the past, I am his first patient to use LDN. It is an experiment for both of us. He seemed very happy that I was doing so well. I am happy that I am well, but I am really happy because if I do real good on it, he might decide to use it as a therapy for other patients. This really makes me happy because not only does it open up a lot of doors for people who are in my situation, but the fact that I would be able to change a doctor’s mind on treatment options. I have always liked my GI as I felt he listened well and was open to new ideas. I wish other doctors would follow his lead.
I think everyone thinks about their life and how they live. When you’re a kid you are carefree. You run around playing all the time thinking you are immortal and nothing can hurt you. As you get older, you learn to appreciate life and when you have a family you get insurance.
Growing up with IBD really makes you appreciate life even more. When all your friends are in school or outside playing, a lot of times we are in bed with pain. When kids get together to have a pizza party we are sipping tasteless broth. We look at ourselves in a mirror and ask why. Why can’t I have a normal life..and we start to really appreciate what we do have. After awhile we learn that even though we are sick, we are alive. After you have lived some years with the disease, you see that you can live and start to want to do things. We have all been there. We look at what we haven’t done and think, what can I do to enjoy life. Maybe it is taking up jogging since you can stay local and near bathrooms. For others, maybe it is skydiving for charity. But we learn that just because we have a disease, it doesn’t have to end our lives.
Over time we learn to live with our pains and drug side effects. We know there will be hospital visits and stays in our life. We know there are days we won’t get out of bed…or the bathroom. But we also know we have a life to live and we try to live it to it fullest capacity.
When I was 15, I got sick and was in bed for a week. After I got diagnosed, I went back to school and tried to live a normal life. Within half a year, I got pneumonia and that put me in a horrible flare. I stopped going to school. I never saw my friends. My life was staying in bed watching TV (this is before cable). It was watching certain shows that made me realize I was wasting my life. I found a new hobby while I was sick. I started to love cooking and I was watching a number of cooking and food shows. I then started to realize that if I stayed in bed I would never amount to anything.
So, my parents got me some teachers that would come to my home to teach me. I caught up on my schoolwork and eventually graduated. I wanted to live life again so I decided to chance it and go away to college. I wanted the full experience and yes, I did get it. I decided that I wasn’t going to let my Crohn’s run my life. I got my education and degrees. I met some great people and eventually also me my wife.
Over the years I would have some Crohn’s related issues, but I would always think back to my bed ridden days and vow to continue living life. I would not ever let my disease get to me.
And then my life changed. My father in law lived with Ulcerative Colitis for years. He had it so bad that he had to have his intestines removed and lived with an ostomy for a number of years. I saw life in him. He had numerous problems because of the bag but he always chose to fight on and live. And then his and my world crashed. He was in and out of the hospital with an unknown problem. Eventually it affected his heart too much and he passed away from a heart attack. His ostomy caused him to have electrolyte problems which eventually caused a lot of problems for him.
I say my world crashed because he was an inspiration to me. He always tried to stay positive with his situation and I could only wish to be half a man if I was ever in his situation. During his funeral, his friends would talk about how he was always full of life and had such a drive.
Part of me never grieved for him. I never had the chance. My wife and mother in law were devastated and I had to stay strong for them. I was hurting on the inside but could never show it. As the days went on, it was harder to show my feeling. Here it is a year and half later and I still have the pain. It still is deep in me and I don’t know how to release it. Not only do I hurt because I lost a great father in law, but I hurt to know that one day I can be in that same situation.
Medicine has not helped me over the past 24 years. I am on the last medicine available and even this is experimental for Crohn’s. I know I have a mild case but if I fail on meds and have to eventually go off all meds, my Crohn’s will get worse. Where will that lead me. Will I need surgery? Will I have to have my colon removed? Will I be like my father in law and end up with tons of problems?
No one likes facing their mortality. As I kid I did a lot of dumb things. Now, with my 40th birthday creeping up to me, I look to what I have left in my life. I know that I won’t live forever. My question is how will I live it though. Will I spend each day thinking will this be the day my medicine stops working? Or will I live it like it is my last and have a blast. Right now I take it one day at a time. I try to enjoy the time I have here. I do what I can and try to help who I can in the moment. If I am here tomorrow, then I will continue on. But unlike when I was 6, I know I have an expiration date. Hopefully, it won’t be for another 50 years as I still have a lot to do with my life.
This letter is to inform you that you are now caring for a patient with Crohn’s Disease. There are a bunch of things you should know about the disease and how it will affect your life.
First, remember that the person you are taking care of has the disease, not you. Right now they are probably scared because they have a uncurable chronic illness. What they need most is love, affection and some sympathy. They are in constant pain and will probably never feel “normal” again. It is your job to help them get back to normal as best as THEY can.
Second, listen to them. Don’t ever assume you know what they are going through or what they feel. If they say they have pain, believe them. Sometimes they may seem alright, but most times there is a pain within their gut. Think about how you feel when you have a sunburn. Well, Crohn’s is like a sunburn on the inside of the intestines and it is constantly being touched. Ah, I see the lightbulb go on above your head…you have an idea now on what they are feeling like.
Next, don’t try to force feed them. An appetite is a tricky thing for someone with Crohn’s. One day they can be nauseous and not want to eat. Other days, they will want to pig out. Also, they are going to find that there are a bunch of foods that don’t agree with them. If they want to try a specific diet, let them. If they say they can’t eat a certain food…believe them. Don’t try to make them eat something because it is healthy. Not everything healthy is good for someone with Crohn’s.
Your patient is not going to like the medicines that they are on. If they are taking Prednisone, they are going to get depressed. You should know right now, they will gain weight. Their face will swell up and this is called a “Moon Face”. Just let them know that it is normal, they are still beautiful or handsome, and that it is temporary. One day they will come off the steroid and their weight will come down. Now, sometimes if they are in a constant flare, they may lose weight. Try to give them some supplemental foods like Ensure to help maintain their weight. Don’t ever mention how skinny they look. They know they are losing weight and don’t want to be reminded of it.
My last advice I can give is never ever ever say they are sick. They have a chronic disease that will be with them all their life. They know how they feel and they want to try to look and act normal. To them, it is something that is now part of their life. To them, being sick is like catching a cold or a flu. Having Crohn’s doesn’t mean your life ends..so why should they think they are sick. Treat them as you would treat anyone else. Play with them. Talk with them. Give them hugs and kisses. Let them know that their life will move along and that they have nothing to be ashamed off.
Thank you for taking the time to read this letter. I hope it will help you in caring for your new patient. If you have any questions, feel free to ask me. There is also a huge community of people with their condition online. Turn on your computer and look for them. They will accept you and your patient into their family with no questions asked. You are now about to embark on a great journey.
Today we had a choice for our post to list our strengths and weaknesses or make a playlist. Well, if you read my blog, you will see that I have done the playlist before, so I figured I will do something new..and list my strengths and weaknesses.
Strengths:
My first strength is compassion. It used to be a weakness but lately, I have had so much of it. It wasn’t until I had my worst flare that I started to understand my disease. I never truly understood it before so my compassion towards others wasn’t as strong. Now that I have had a healthy dose of reality, I feel for everyone. It has been my driving force behind this blog.
Determination. When I put my mind to something, I go for it. This blog is proof of it. I wanted to really start to help people. I first started with video but didn’t like it. Instead of just stopping I decided to try writing. I tried 2 other sites previously but didn’t like how the blog was coming out. I could have given up again. Instead, I kept looking for a good website to use and here I am.
Willing to Learn. I am like a sponge. I try to absorb as much information as I can about a subject. In this past year alone I have learned more about my disease and treatments then I knew about it all my life.
Weaknesses:
Stubborn. My wife will agree with this one. I am a very stubborn person and sometimes this will stop me from learning things. If I think I am right or know something, sometime it takes a while to convince me otherwise. I am trying real hard lately not to be as stubborn. I think it is working as it has caused me to be more empathetic towards others.
Ignorance. I say this because for many years I kind of chose to be ignorant about my disease. I didn’t choose to learn more over time and never chose to learn about new treatments. Of course, this is changing also and I have decided to open my eyes more.
Lack of concentration. This I blame on the CD because…….wait…what I was I just thinking… 🙂 Just kidding. I say this one because sometimes I have a really good idea and try to come through on making it happen. But then I lose sight of it and just stop focusing on it.
Well, I am sure there are more of both strengths and weaknesses. I am curious if anyone notices something in me they would say is a strength of weakness. Let me know. I want to improve myself and would love any feedback.
I am sure a lot of people ask that question these days. We live in a busy fast pace world. No one seems to stop and smell the roses. We work 8-10 hours a day, spend about 2-3 hours commuting and 6-8 hours sleeping. That is about 16-21 hours out of our lives, leaving anywhere from 3-8 hours to eat, shower, do chores, etc. So time for myself…again, what is that?
Sad thing is that for us IBDers, stress is a big factor. It is know that the more stress you have, the more likely you will have a flare or it makes it harder to come out of one. We need to listen to our bodies when it tells us STOP! Let Me REST!!
For me, I make sure to factor in some time to just chill and relax. I try to spend some hours at night just vegging out. This may be watching television or playing on the computer. But it is time for my body to relax and unwind. About every 4-5 weeks, I get messages. This helps in releasing the body of stress and it is a time for me to relax and not think about anything.
There are so many ways for a person to make some time for themselves. One way is to take a class. It can be anything from educational to fitness to recreational. The reason I say a class is that they are usually scheduled ahead of time. This forces you to put it on a calendar and make the time for it.
Another way to make time (and this is more for the ladies) is instead of taking a shower, draw yourself a bath and take a 1/2 hour or an hour to soak it up and relax. If you have kids, tell your spouse to watch over them for that time. Have some wine, play some relaxing music or read a book in there.
Lastly, on the days off from work, instead of doing chores, take your loved one out and have some fun. Go to a movie or museum. Go for a hike if you like. Whatever it is, just do it. Don’t hesitate. If you don’t make the attempt, you will never do it and you will just keep yourself stressed.
Now I know some of you are going to say that they just don’t have the time to do these things. I say, you do, you just don’t know it. If you have a kid, get a babysitter. If you work real long hours, then see about taking a personal day one day. If you just make excuses of why you can’t do it, then you need to look at yourself and ask why you’re not making the time.
Crohn’s and Colitis is a tricky disease. We can go for years with no problems and then suddenly, BAM, we are sick for months on end. If we don’t take the time now for ourselves, we might regret it. No matter the situation you are in, there is always a couple of hours in the day to take as a “Me” time.
So go do it now. Step away from the computer and go enjoy yourself with a loved one and do something fun. Go bowling. Go see a movie. Go to a museum. Doesn’t matter what you do….just go and do it.
This is an interesting topic because you can look at it from a number of different ways. Do you want to be friends with your doctor on Facebook, or do you just want him/her to see what the community thinks? To what extent should they be using social media for?
I currently go to Mount Sinai in NYC to see my GI doctor. In the past couple of years they have started using a system called MyChart. It is a system where you can have access to your charts and labs but also, and this is the part I love, you can send a message to your doctor and have him/her respond back. I have used this a number of times and it is definitely faster than email. Yes, it isn’t social media, but it is a first step.
So what is social media. Those words get thrown around a lot, but do you know what it is? Wikipedia describes it as the following:
“Social media employ web- and mobile-based technologies to support interactive dialogue and “introduce substantial and pervasive changes to communication between organizations, communities, and individuals.” Social media are social software which mediate human communication. When the technologies are in place, social media is ubiquitously accessible, and enabled by scalable communication techniques. In the year 2012, social media became one of the most powerful sources for news updates through platforms such as Twitter and Facebook.”
Now, should your doctor be accessable on sites like Twitter and Facebook? Remember your doctor is spending a lot of time treating patients in their practice and then probably spend time in the hospital seeing patients or doing procedures. Do you want them to spend less time with patients so they can tweet “Going to stick a scope up a bum..Wow..What a view”? Personally, I don’t mind that I can’t chat with my doctors in chat rooms. It means that they are working and I like that. We shouldn’t be pals or friends with them. The relationship should be kept professional.
Now, what about the practice themselves like a hospital or lab or even your doc’s private practice. Now a days, businesses have Twitter and Facebook accounts to help drive business. I am not against this. It would be nice to be able to get information from these sites instead of trying to call. I remember a couple of years back when I was getting Remicade infusions. There was a big storm the night before and I didn’t know if anyone would be there to administer the medicine. It turns out there wasn’t. I had to rely on the phone though to get this info and getting through was not easy. It would have been nice to just log on to Twitter and see a tweet..”Big storm, nurses snowed in, no infusions today..please reschedule” Not only would this save time in contacting everyone but I would know not to bother trying to get in.
I would love to hear everyone’s thoughts on this topic. I am sure there will be a big debate on this. Please leave a comment and let’s get the discussion rolling.
We end the 2nd week of National Health Blog Post Month with a topic that I am lucky not to have too much experience about. I am to give advice with negative feedback.
To start, I have only been doing this blog for a short time. So far I haven’t seemed to piss of many people and haven’t really heard any real negative feedback. No one has come after me for the things I have said and I have to say, I am lucky. However, I know we live in a cruel world and one day I will get the negativity. It is just a fact of life.
So how will I and how should you deal with it. Well, for starters, read it. When you finish the comment, read it again. I say this because not all negative feedback is bad. We look at something different from our views as negative. So, read the comment and try to be in that persons shoes. Try to see where they are coming from. Sometimes a negative comment just comes from pent-up anger and the person needed to vent, but took it out on you.
Stay calm. Don’t get all worked up over it. If you get feedback on your blog, remember you control the blog. If you truly don’t like it, delete it. I have had some difference of views in my comments and I leave them. I want my readers to see the whole picture, not just my views. I don’t know everything and if someone has better advice, then let them share it. I may not agree with it, but I can understand it.
Now you might say, what if it is something really bad, something hurtful? Well, that is a whole other story. I know some bloggers that have gotten hate sent their way. They were personally verbally attacked for no reason and the commenter was clearly wrong in what they are saying. For this I say, take the high road. Don’t give in to them. Delete their comment and if they persist, report them. And if it gets to the point where you think you might be in real danger, call the authorities.
Hopefully, no one gets real physical threats. After all, we are just trying to share a part of our lives here. Honestly, if you don’t like what I am writing, then don’t read it. You have that choice. Always remember that the blogger is here to share a story and try to help others. Negative comments take away time and energy from that purpose. So let’s keep it clean out there and remember that we are one big happy family and we need each other for support.
Poop, bum brownie, dookie, turd, water log, and the all time favorite, doodie. Have you guessed what I am going to talk about today?
When it comes to IBD, there is no shortage of taboo subjects. Pretty much everything surrounding the diseases are not pleasant to talk about, especially the acts surrounding the disease. No one talks about going to the bathroom, especially if you’re a woman. It is seen as an unattractive thing and most women will never touch the subject.
But what do you do when you life all of a sudden revolves around the bathroom. I think about the Humira commercial where you see this person walking in a circle always being near a bathroom. That is what Crohn’s and Colitis does to a person. Whether we like it or not, our bowls take over our lives.
No one really ever wants to talk about their poop. I agree it is disgusting and not something pleasant to talk about. But after you have had some bowel accidents you learn to live with it. It’s amazing that we are so obsessed with the food that goes into our mouths but once we swallow it, we forget all about it. The food gets digested and turns into that taboo subject.
So why are we so skittish to talk about dropping the kids off at the pool (one of my favorite sayings). I think it is because it is deemed a filthy and unclean act and we as humans want to be clean. We live in a society where we take daily showers and use hand sanitizers. When we eat things like lobster, we wear plastic bibs to keep us clean and use wet naps afterwards to clean our hands. Now I used this example because lobsters are considered unclean. They live at the bottom of the ocean and eat the poo of other animals. Have you ever wore a bib when you ate a salad or wiped your hands using a wet nap after eating a hamburger?
The thing with poo is that our IBD lives revolve around it whether we like it or not. For a lot of us, it is in the form a diarrhea. With diarrhea come urgency. People with IBD have little control over their sphincter muscle. When we have to go, we have at most one minute to get to a toilet. Many people don’t understand that. I have read so many stories that start off, “We were riding in the car and I said I have to go. My spouse said, I will pull over at the next exit” What that person doesn’t understand is that the next exit could be miles away. We don’t have that time. Now truly means now with us.
Lately I have been hearing more stories about people having accidents or going on the side of the road. More and more people with IBD are starting to open up on the subject. I love it because we are all in the same boat. I think we have all been there at one point. Talking about it gives us comfort to know we are still normal. It also helps take away the stress associated with it.
Another thing about poo, is that it can tell a lot about our health. Doctors can use it to find out if we have certain ailments or diseases. They can see what our body is digesting and what they aren’t. Now I am reminded of the song from Scrubs…and I will end it with the video and lyrics.
Everything Comes Down To Poo Lyrics – Scrubs
J.D.: Hey, Ms. Miller — we just need a stool sample
Patti: Why do you need a stool sample if you think I’m just a nut?
Turk & JD: ‘Cause the answer’s not in your head, my dear — it’s in your
butt!
J.D.: You see….
Everything comes down to poo!
From the top of your head, to the sole of your shoe
We can figure out what’s wrong with you by lookin’ at your poo!
Turk?
Turk: Do you have a hemorrhoid or is it rectal cancer?
When you flush your dookie down, you flush away the answer!
J.D.: It doesn’t really matter if it’s hard or if it’s loose
We’ll figure out what’s ailing you, as long as it’s a deuce!
Yes!
Everything comes down to poo!
Nurses: Everything comes down to poo!
J.D.: Cardiovascular and lymphatic, yes, the nervous system, too!
All across the nation, we trust in defecation!
Everything comes down to poo!
Turk: If you want to know what’s wrong, don’t sit and act so cool
Just be a man and eat some bran, and drop the kids off at the pool!
Robed Woman: My stomach hurts
J.D: Check the poo
Limping Woman: I sprained my ankle
Turk: Check the poo!
Bloody Shoulder Guy: I was shot!
J.D: Check the poo!
Delivery Guy: A homeless guy threw poo in my eye!
Turk: Check the poo!
Delivery Guy: Mine or his?
J.D: First him, then you!
It may sound gross, you may say “shush!”
J.D. & Turk: But we need to see what comes out of your tush!
Because!
All: Everything comes down to poo!
Whether it’s a tumor or a touch of the flu!
J.D. & Turk: Please, won’t you pinch us off a big, fat clue!
Turk: Our number one test is your Number Two!
All: If there’s no breeze, light a match please!
Everything comes down to —
J.D.: Doo-doo!
Turk: Doo-doo!
J.D.: Doo-doo!
Turk: Doo-doo!
All: Everything comes down to … poo!
Today I am using one of the bonus topics. When I saw this topic I knew I had to write about it. It is one of the reasons I started this blog.
To anyone reading this and are newly diagnosed with either Colitis or Crohn’s Disease, the first advice I can give is….Take A Deep Breath. Your life is about to change forever. You are entering a whole new world. You will have a lot going against you and years of fights to have. So take a deep breath. Relax. Stay calm because you have a very big and caring community behind you to help.
When I was first diagnosed in the 1980’s, I was given some pamphlets to read and sent home from the hospital. I didn’t know what the disease was all about or what was installed for me over the years. Now, there is the internet. In a matter of minutes you can find out all the information you want, see tons of videos, and meet hundreds of people living with the disease.
So, now after you have taken that breath, take another and another. Now sit down and create a journal. Write down your symptoms, your medicine, your diet. This will help you later on in life when you have problems. Try to keep track of every medicine you take and how it helps or doesn’t help you. Keep track of the side effects.
Now that you have done some work, let’s go have some fun. Search the internet. There are so many people out there to help you out. There are a lot of video’s on YouTube to watch. Some are funny, some informational. Some are just video blogs. After you have watched some of the video’s, come on over to Facebook. There are tons of groups with people who have IBD. You will soon find that you are not alone. You will also find that most of these people will be very open to accept you in.
Now that you have had the time to see what the disease has to offer you, you have to take a mental step. You have to toughen up. This disease is a disgusting and descriptive disease. Many people with it are very open and there is a lot of disgusting things. If you are squeamish and don’t like dirty things…well, you will have to change how you are. You yourself will go through some tough disgusting times and it will be easier if you are ready for it mentally.
After all of this your head is probably spinning. There is so much information to take in. You are probably wondering if you will ever have a normal life again. I am happy to tell you that yes, you can. I myself hold down a job, I have gotten married, and I live life to its fullest. Some people do have severe complications and find it hard to live a normal life. But nothing says that this is going to happen to you. Stay strong and stay positive.
The next big thing you have to do is find yourself a really good gastroenterologist. If you are under 18, you will need a pediatric gastro and in a couple of years find a regular GI. It can take years until you find a good doctor. Don’t despair. They are out there. I myself have had at least 6 GI’s before I found a really great one.
So now, do you feel better? You may have a disease but know the disease does not have you. If you ever have a question or problem, there is always someone out there to help you out. And if you want, just ask me. I will do whatever I can to help you because my motto for this disease is “You are never alone”.