One Organ Lighter

So, the partial silence on this blog has been because I've been laid up recovering from that much-needed gallbladder removal.  January 7th came and went very easily, thank God: believe it or not, I was at the hospital by 6 am and home before noon.  Three tiny incisions (one dead center of my abdomen a few inches below my breastbone, another probably 8 inches down and to the right, and a third on my right side a few inches below where my ribs end) and one much larger one (in my belly button up top) later, I'm a slowly-recovering human sans a malfunctioning organ.

(Let me just slip in here that it blows my mind that they can remove an organ through four small incisions.  The ones on my abdomen are just over a half inch long tops, with the highest one being the biggest and, I found out, the incision through which Adolf Gallbladder exited me.  The one in my belly button is an inch to an inch and a half long.  My dad had to have an open procedure, and his incision is positively massive.)

The past few days have been...interesting...

• January 7th: went into hospital, had gallbladder removed, came home.  Was able to eat for the first time in literally days, which I celebrated by eating (over the course of 24 hours) four small bowls of my momma's homemade chicken noodle soup and crackers.  (This, in hindsight, was a great thing and a terrible thing all at the same time.)  Slept a ton, paced a lot, learned that getting up from laying down blows and that I had an incision on my right side I couldn't see past my boob.  (The moment of discovery was, in retrospect, positively hilarious.  Imagine a petite 20-something woman trying to leap off her sore side from laying down, unable to do so, and having her mother help her up, all while she's babbling about discovering the mystery "missing" fourth incision and how they shouldn't have snuck a fourth in on her like that as she went into surgery willingly...I was on painkillers, ok?)  I also learned that hiccuping and sneezing are the absolute worst thing to do right now.  Painkillers from hospital controlled pain well.  Momma went home that night; Hubby called off work for the next day as a precaution.  I also learned that gas pains settling where my gallbladder was removed was, bar none, the worst pain of my entire life, and I had shingles once.  I literally cried and scared my poor husband about to death.


• January 8th: Oh my word, did this day ever blow.  I woke up with one of the worst sinus headaches of my life, dizzy, lightheaded, and incredibly nauseous.  Whatever motion sick patch they put on me at the hospital before surgery abruptly quit working sometime during the night (...and my body decided it was allergic to its glue, creating hives I just cleared up), and my body subsequently decided it hated the painkiller and wanted it deported from my body, either from me not eating enough when I took it or from just deciding to assert its new-found independence.  I don't remember much from this day that wasn't spent throwing up or trying NOT to throw up.  Once we forced crackers into me long enough to keep down Advil, I was okay.  It was a very long day for both of us.  Hubby called off the following day to be safe as I hadn't ate a thing past crackers and chicken broth in 24 hours; he was worried with how dizzy I was that I'd have trouble getting around the apartment alone.  The poor man, bless his soul, only left the apartment to pick up a casserole from my brother at his workplace while I was on the phone with my mom, pacing out gas pains, after both Momma and I encouraged him to go get it so I'd have food options available past soup.  Thank goodness I had eaten so well the day before, as we think that reserve is what kept me going most of Thursday when I couldn't even keep ice chips down.


• January 9th: WORLDS better today.  The soreness from surgery finally hit me full-force without painkillers in my system, making getting up to move around my apartment like I should a bit problematic.  Hubby, again, was an absolute God-send through this, helping me up when I needed it and making it so I only had to get up to walk, not to retrieve things (mostly as I was very unsteady on my feet--lightheadedness has been my chief complaint of recovery).  For some reason, my left eye (which has had a muscle imbalance my entire life) was absolutely refusing to focus on anything near my face, so I was unable to do most anything I enjoy (gaming, crocheting, knitting, reading); I settled for random shows on Netflix and Hulu as I could focus my eyes on our TV across the room.  I also started trying little eye exercises I recalled from my childhood to get my eye to work again with my prismatic glasses.  Slowly started eating real food again.  We also started being a bit concerned that the...end products...of digestion weren't happening.  The surgeon had warned us that my digestive system would probably launch all kinds of varying rebellions for a few days, so we gave my GI tract a deadline of afternoon the next day to get its (...literal...) shit together.


• January 10th: I started feeling well enough to be stir crazy, and Hubby really wanted to watch the NFL playoff games (we don't have cable), so we packed up to spend the day at his mom's and do our laundry there.  (We forgot the laundry...because we are just that skilled...)  I finally achieved the so-called end-product we were waiting on that morning, so I was finally starting to feel a lot more like myself.  I could eat pretty much anything I wanted, but my stomach really hurt if I ate more than 5-6 grams of fat in a single meal.  Came home unbelievably exhausted but relieved that I could do something, even if it was collapse on my mother-in-law's couch wearing pajama bottoms and a sports bra under a hoodie.  But gosh darn it all, people, I did my hair that day.  That was progress.  Oh!  I also got my left eye to finally start cooperating, so I spent some of my night playing Pokemon HeartGold on my Nintendo DS.  I still wasn't mentally with it enough to try crafting, and I was too tired a lot of my waking time to focus on a book, so I avoid all of those.


• January 11th: My body decided to raise a mini-Hell over my deciding to eat real food the day before; I spent most of this day near a bathroom or wondering if I should move near one.  I was super light-headed if I got up for too long, and the incision in my bellybutton started itching and stinging a ton.  Spent the day on the couch alternating ice and heat on my bellybutton incision and napping as needed.  I discovered some cool Youtubers in my boredom, played a ton of Pokemon, and overall was just bored, bored, bored.


• January 12th: Lightheadedness finally started evaporating when I realized that it kicks in if I get too hungry; for some reason, my body gets lightheaded about a half-hour before I feel hungry.  Started eating small meals every few hours to keep this at bay.  Felt brave enough to cook dinner, empty our dishwasher, and reload it.  I also learned at dinner that I cannot eat a regular-sized meal unless I want to eat it sitting in my bathroom...it doesn't end well.  Bellybutton incision still raised a minor hell every time I laid down (felt like it was being pulled apart); mirrors and a loving Hubby confirmed it wasn't infected, so we didn't think much about it.  Lightheadedness, though diminishing, still persisted while I was up on feet for too long.


• January 13th: HUGE chunk of the dermabond gluing my bellybutton incision shut popped off early in the morning; clearly that was the issue behind all the pulling-stabbing-stinging pain.  Incision still looks fantastic, so woo!  Still getting super lightheaded, dizzy, or unsteady when walking around the apartment for too long, though I did manage to make dinner, unload the dishwasher, and reload it with a few sitting breaks nestled into that plan.

And that leads us up to more recent history.  I'm clear to return to work next week, which is two work days later than I originally wanted.  The night of the 14th, I talked Hubby into letting me drive us to our local Tops and get groceries.  He agreed.  We got my car scraped out of the snow, defrosted, and out of the driveway.  I drove us to Tops with no problems sans some bellybutton/belly discomfort from the seatbelt, even through my winter coat.  I got us into Tops, got a cart (figuring I could lean on it if I needed to), and into the store we went full of hopes and goals.

Ladies and gents, I didn't make it out of produce before I wanted to pass out, and that's literally the first section you enter in our local Tops.  I never fainted, passed out, or the like, but I was very unsteady on my feet and visibly worn out.  I nearly collapsed into the driver's seat of Tony the Super Impala while Hubby returned our cart, my head hung in exhaustion while I willed up the power to drive us the 10 minute or less drive home.  We got the groceries into the apartment and put away, and I proceeded to collapse onto the couch in a heap of sadness and exhaustion.  From the time we left the apartment to the time we got home, we were gone exactly an hour and a half, and that 90 minute journey kicked my butt.  My stomach throbbed.  My head spun.  Just, nope.

So, unhappily, we agreed with the surgeon at my first follow-up the next morning that I had no business driving an hour round-trip to and from work and working seven hours (most of which probably on my feet) when I could barely walk around a store without it metaphorically spinning around me.  My surgeon had initially wanted me off work two full weeks, so she was happy to "split the difference" with me on this one; I initially wanted to be back exactly a week after surgery, but it'll be closer to a week and a half when I go back.  I called work, had the surgeon's PA fax the appropriate work release notice saying I was cleared no sooner than the week of the 19th, and I went home to collapse on my couch.

For whatever reason, my body either really sucks at clearing anesthesia from my system (as I had a similar issue when I had a diagnostic laparoscopy in 2013--I nearly passed out at a work fundraiser four days after it and was a wobbly mess most of the following week at work) or it goes into shut down mode after surgery.  I'm a bit infamous in my family, in my circle of friends, and at work for driving myself to the near-breaking point out of altruism and sheer stubbornness, so my theory is my body knows the only way it's going to get me to actually rest is if it full-on demands it.  It makes me too weak to do anything but rest until it is truly strong enough to do what I throw at it.

As of today, I'm 10 days post-op and finally starting to feel more like myself.  I have an area over my belly button that's swollen, tender, and finicky still, but the swelling is finally starting to go down.  On doctor's orders, I'm keeping my trusty rice bag on it heated whenever I think of it, and that seems to be doing the trick.  Over 95% of the Dermabond has fallen off by now, and I am slowly looking less like I put up a good battle in a knife fight.  One incision kind of looks like a butt, though...which is weird to me.  My belly button one also stings a ton the longer I'm up and moving, probably because its positioning in my belly button means it gets bonked and rubbed a ton.  Overall, I'm at that point in incision healing where they freaking itch.  The one on my right side is particularly brutal with this, especially as I usually sleep on that side.  I also often forget where exactly that stupid thing is, so I catch myself scratching it...wwhheenn I hit it and send myself into a fit of owing over the pain.  I also have some minor swelling in my lower right ribs and find that my digestion is a bit finickier than I'd like.

Despite all of this, I feel better than I have in literally years.  The pain in my ribs is finally, finally gone.  I can eat most anything I want (within reason) without huge worry or pain.  The heartburn that plagued me for months is gone, and if it does return (say, I eat something fattier than I should have eaten), two Tums soothes it away easily.  I'm still taking ibuprofen daily, but it's mostly a precautionary messure to keep the post-op swelling down and to soothe the stinging in my incisions so I don't scratch them.  If I could get my energy levels to stabilize, I'd be fantastic!

The Last Stand

Last week, physically, blew.  It totally, completely, sucked.  My gallbladder has apparently launched a last, vicious battle against me in the form of what I'm calling mini gallbladder attacks.  Basically, when I eat, I get some (or all) of the following symptoms.

• Moderate to severe abdominal pain (usually upper right)
• Moderate to moderately severe nausea; often spikes the next morning when I wake
• Moderate abdominal bloating
• Pressure under the right side of my ribs
• Feeling of something getting caught under my right ribs when I move
• Stabbing/burning pain under the right side of my ribs
• Diarrhea OR constipation (absolutely no pattern, rhyme, or reason for this one when they happen or which happens)
• Heartburn

I call them mini attacks as they aren't as severe as any gallbladder attack I can recall having; in retrospect, I had two that took me to my knees and absolutely incapacitated me for a day or two.  I literally could not eat a thing without nearly throwing up until it passed.  Though I'm not near that level, I'm having a rough go this week and last.

Basically, I'm eating a ton of plain rice (sometimes with a splash of vinegar on it for flavor), whatever steamed vegetables I have on hand that stay down, chicken or other white meats (all fat hacked off), and various fruit smoothies I can make from things in my freezer.  Hubster and I received a Ninja blender for Christmas that has absolutely been my BFF.  Almond milk is staying in me well, so I make whatever smoothies I can think of with it and fruits to supplement larger meals.  Any big meal I eat, I do so only at home where I am near a bathroom.

To complicate issues, I also got my period just in time for surgery.  It also decided to come with every horrific symptom it could bring with it, just for kicks and giggles.  Since surgery is in two days, I can't take anything but Tylenol for pain.  It's taking the edge off, but not very much.  I didn't sleep at all last night with the pain, though I did sleep a few hours this evening.  I'll be far enough along with Aunt Flo to barely notice it by Wednesday, thankfully, but it made this past weekend doubly hard to handle.

The hardest thing has been stepping back and accepting that I cannot do everything I normally do anymore.  I just don't have the physical ability to do so.

Anniversary! And More Galling News.

Whelp, it's M's and my first wedding anniversary!  How are we spending it?

...well, we both slept in way too late yesterday as we're both night owls and off work until January 5th for the holidays.  So, it's 3:30 am and we're both still up.  He's playing Mass Effect 3 (again), and I'm running a Pokemon Emerald Nuzlocke...as I clearly am a glutton for punishment from my video games.

But yeah!  We were both determined our anniversary would be spent mostly resting (as we've both ran laps around ourselves for weeks prior to this one and because how I feel physically right now changes almost as fast as blinking) and on a nice dinner out.  On our honeymoon, we ate at a great little restaurant named Japan One, where we got the best sushi either of us has ever had.  This year, we're reliving that at our local Japanese restaurant (which is only about 6 months old) with a sushi dinner, followed by dessert at our local frozen yogurt shop (and one of my favorite places--and they have bubble tea, people!  I have it on good authority that that makes my town a real town.  Next stop? Wegmans!)

After that, the week we have off will be spent putting our apartment into order and getting ready for my surgery on January 7th.  Yes, 7 am on the 7th, my gallbladder will be gone.  I'm hoping it helps with a lot of my pain issues.  My dad mentioned that his gallbladder never technically burst--it just died.  He did, however, mention that a ton of my pain issues and symptoms are all ones he had before his died and rotted inside of him and that all of them were gone after his surgery.  That is a huge comfort to me.

Obviously, I'm nervous about surgery, but I'm to the point where I just want it over with and done.  I want my life back.  I want my normal energy levels back.  I want my right side to stop hurting all.  The.  Time.

The Pain Saga: The Lap and Beyond.

This is part two of my pain diary.  Everything is behind a cut as it's massively long; feel free to skip it if so you desire.

This particular section is also written as a list instead of a diary, mostly as things happened much faster.

The Pain Saga: Pre Lap Era

So, now that I have some answers, I figure I can write up what life has been like the past few years leading to this biliary dyskinesia diagnosis.  Perhaps writing this up will help some random Google traveler to figure out what's up with them before they suffer as long as I did!

I also want this listed here so I don't forget in the future what I went through during this time period.  This literally has been a saga in my life--2011 to now--of non-stop pain issues, all starting around 2008.  So it's not so painfully dull, I'll add in some pictures from each period of time.  Perhaps seeing how well I hid my pain will explain why this took so long to solve.

I'll also put this all behind a jump cut so I'm not clogging up anyone's browser against their will!

A (Happily) Failed Test

My doctor called with the results of my HIDA scan with CCK.  My gallbladder doesn't work.  Though it looks totally normal on scans (past being a wee bit larger than expected) and though it is totally stone-free from what they can see, it doesn't eject bile anywhere near the rate it should.  The office didn't give many details past that and a, "It doesn't work much at all--so little that it has to come out."

I nearly cried...I was shaking on the phone as I heard words that, though scary, were such a relief.  I'm not crazy.  There's something wrong with me, and they finally found it.  Three years of suffering, and I finally have answers!  I shouldn't be so elated to need surgery, but I finally--FINALLY--know why I've been in pain so long.

I know why my digestive system randomly rebels.

I know why I get stabbing pain in my ribs that takes my breath away if I move wrong.

I know why my entire abdomen feels inflated if I eat (seemingly) random foods.

I know why I never can fully know how a meal will affect me.

I know why I suddenly have had heartburn problems for the first time in my life.

I know why I am nauseous every single day of my life with no rhyme or reason.

I know why I'm so unbelievably exhausted all the time.

I know why so many of my aches and pains make absolutely no sense when compared with my known medical problems (supposed estrogen sensitivity and a chronically inflamed right ovary that has a near-ridiculous affinity towards making functional cysts that are smaller than my pain levels indicate.).

I'll still have cyst problems with my ovaries, and there's no way to know exactly what all of my symptoms come from my failing gallbladder before surgery is done, but the bizarre pain parts of my symptoms finally have some plausible, tangible answers with a solution at hand.  Within a few days, I'll have an appointment scheduled with a surgeon to determine when my gallbladder will be removed.  Due to a family history of gallbladder's bursting, mine is to be removed to avoid that possible complication.

On another interesting side to this, we know now over two decades later why my dad's gallbladder seemingly went from totally normal to gangrenous overnight.  (Back story from what I can recall--when I was really little, my dad went into an ER with horrible pains and was sent away.  He soon went back in with the same symptoms and a very high fever.  They decided to remove his gallbladder "electively," mostly to shut him up.  Lo and behold, when they got inside of him they found his gallbladder was not only leaking, but it was gangrenous from leaking for such a long time.  At some point, it burst.  No one knew why or how it happened, but it baffled all doctors as he had no symptoms of gallstones prior to the event.  His mother had her own gallbladder removed under similar circumstances, but hers never burst or developed gangrene.)  My PCP thinks my dad's own gallbladder stopped working like mine and, over a period of years, damaged itself to the point of bursting.  We're glad I didn't go that route, and my PCP and his office are operating assuming that they caught mine in time.

So, praise God!  There's a light at the end of this tunnel!

Gallbladder, Round Two

My PCP ordered a HIDA scan to rule out gallbladder once and for all as the cause of many of my issues.  I have to be at the hospital for it between 7:30 and 7:45 tomorrow morning.  Time right now?  4:15 am...this is NOT the time to have insomnia, brain!  And since I have to fast for this, I can't even down chamomile tea to knock me out.

*insert the loud sound of one Cherish's head hitting a desk in frustration*

This would be a significantly smaller problem if the HIDA scan was the ONLY thing I have to do tomorrow.  I'm returning to work at noon, partaking in a long, oft-tiresome meeting, then going straight from work to help set up a company outreach event we do annually until late evening.  That event will kick off on Saturday at 7:30 am.  To say sleep deprivation isn't allowed for tomorrow would be an understatement, but I fear that's just the reality I'm facing.

...Maybe I have a copy of "Walden; or, Life in the Woods" from college...that always knocked me out back in my English major days.

(...no offense to you Walden lovers...I just am NOT one of them.  I understand the greatness of Thoreau's work from a literary perspective and a cultural one, but I have no love of it personally.)

Nevermind

Gallbladder was 100% normal.  Pain isn't "typical" of endometriosis.

So, once again, I'm sent off with no answers or any hope of answers.  I should know better than to expect anything more than that.

Hoping for Spoons

As mentioned in my previous post, I have unexplained pain issues that flare from time-to-time.  I've been doing way better in recent months, but my pains still flare up more than my husband and I would like.  My gynecologist recommended I bring up my findings from a diagnostic laparoscopy done in August 2013 to any doctors I see, partially as she can't figure out if I have endometriosis or something else.  As my moving last year meant I (finally) changed my primary care physician (PCP), I mentioned them to the new PCP, Dr. T., on Monday.

I don't want to go into details just yet, but I'm being sent for a very routine test this Saturday to determine a course of treatment.  Dr. T. thinks my previous surgery's results have a glaring clue my previous PCP should have spotted.  If  Dr. T, is right, 90% of my symptoms can be explained by one medical condition--one that a single laparoscopic surgery would cure.  My husband and I are kind of hoping I do, indeed, have this condition.  Endometriosis is a lifetime struggle; this other condition is a surgery-and-mostly-cured kind of thing.  We like the latter's prognosis a lot more.

If I do end up needing surgery, I plan to schedule it as close to the Christmas break at my job as possible.  That'd put the least amount of strain on my coworkers and also give me 3 solid weeks to recover.  I'd be good as new by the time work started up, though I'd be pretty floppy over Christmas itself.  Considering I had full blown shingles two Christmases ago, I'm sure I can handle that.  My husband is 100% supportive of whatever the results show, as is my family and his.  If I end up needing the surgery, I'm in good company--many family members in his family and mine have had it done.

So, as strange as this sounds, pray the test on Saturday shows I need surgery.  I'll explain more when I have the results.

Spoons...I Have a Distinct Lack of Them...

A few weeks ago, I had one of those days, seemingly from the moment I got up.  When I got up, I was doing pretty okay.  That's pretty good for me, to be honest: there are some days when I'm lucky to be up and moving.  Y'see, doctors think (but "cannot diagnose at this time") that I have endometriosis.  In my case, I get wicked pelvic and abdominal pain that nothing--not even maximum doses of ibuprofen or twice-a-day doses of Aleve--touches.  I could literally feel the pain before I fully woke up, and I would still feel it as I descended into sleep at night.  This went on for well over a year before even one doctor took me seriously.

As of about a year ago, I'm on a newish-to-me medication called norethindrone that, for the most part, is controlling most of my symptoms; I also found that limiting my caffeine helps keep some of the flare-ups at bay.  However, I still get random, horrible flare-ups of my symptoms from time to time, and often I can't find a trigger that led to said issue.

A few weeks ago, it was one of those days.

I woke up with my entire pelvic cavity spasming.  Think of muscle (or, if you're a woman like me, period) cramps, but make them take over your entire lower pelvis and make them borderline unbearable.  I also feel like I've got golf balls inside of my pelvis, one on each side but away from my actual hip joints.  Once I was fully awake, I quickly realized I had dull aches under my ribs on the right side and my entire abdomen was cramping.  My lower back is also cramped up...okay, no, my entire back.  These pains kicked in early the day before, and they'd been coming and going.  Advil and Aleve are my usual stand-bys for this mess: I take Advil if they're on the milder side and Aleve for longer lasting and/or tougher flare-ups.  That day was one where I counted down the minutes until I could take another 12-hour dose of Aleve, which was just barely taking the edge off my pain.

On days like those, I refer back to what a past student taught me once.  It's called The Spoon Theory, and it is mean to explain life with chronic pain and/or illness to those who don't have such challenges.  Basically, everyone wakes up every day with a set amount of spoons.  Those spoons have to last you the entire day as you cannot obtain anymore for the day, though you can bank spare ones from the previous day.  This is normally a very easy thing to do as many of our daily tasks take no effort (and, therefore, no spoons).  Those with chronic pain or illness, however, have to use their spoons for even the most basic of tasks (like getting dressed, using the bathroom, or [in my case on exceptionally bad days] even the mere attempt of getting into their car to prepare to drive to work).  As a result, their spoons run out faster, and their choices for how their day will go are limited; these people also have to bank spoons at the end of each day as running out may prove to make the next few days impossible for them as they never know how many spoons will be consumed by their conditions.

In my case, I find myself in a strange game of "Can I make it through work or not?" when I have particularly bad flare-ups.  Sitting up in bed--not even getting out of my bed--will take a spoon on those days as that involves bending from the waist.  The drive to work could take three alone (sitting in car and putting the seatbelt across my lap, the drive itself, and getting out of the car), nevertheless the drive home that afternoon.  I also cannot even begin to estimate how many spoons my teaching job could take as I never know how many times I have to move from sitting to standing and back in a day or if I'll have the energy to avoid sitting by standing all day long.  It is a very, very rare day when I can't make it through work, but often I come home too exhausted to do anything but face-plant into the couch.  I normally overuse spoons on my first day of a flare-up making some massive meal my husband and I can reheat for a few days--just to be sure we're both still eating okay.

Despite the pain and the effort ignoring it can take, I'm stubborn enough to go on without people knowing what's happening inside of me.  Often, the only clues people will be able to spot may be a shorter-than-normal temper or a determination to not have to get up out of my chair more than usual.  I carry around a rice bag--essentially, a cloth bag full of rice I heat to work like a heating pad--everywhere I go on terrible days; often, it's my best source of pain relief.  I never bring up why it's with me (even on 90+ degree Fahrenheit days), simply electing to use it when I need it so I can make it through my day.  My students, however, have learned that rice bag, if it doesn't leave my lap, means I'm having a bad day.

Days like those remind me of what I do and why I'm passionate about adult education.  Some of my students are what society considers the worst of the worst: it views them as drains on our resources and useless, selfish people.  However, if I show up at work with my rice bag or if they catch me quickly taking medication between classes, a few of my students step up to the plate.  They go out of their way to not make me get out of my seat in class, bringing questions to me or doubling their efforts to help each other.  They never come right out and tell each other that I'm in pain: instead, they find little, meaningful ways to help me out without making me feel like a sick, weak problem.  When I came back from a diagnostic surgery last summer, students literally wouldn't even let me carry a binder for weeks.  One of them always went and got the binder I needed off the shelf and had it on my table, ready for class.  Another would meet me at my office door to carry the books I needed to our classroom.   A third would walk the sign-in sheet around or bring any papers students finished right to me.

All of these are little things they don't have to do, that no one asked them to do, yet they still took the initiative.  Yes, some of these students have done some pretty horrible things in their pasts.  Others may simply be in the trenches of generational poverty and, sadly, cannot see a life for themselves past the one that they already know and that society routinely (and openly) despises.  Irregardless, they are deserving of respect as fellow people, just as we would want to be treated with respect.

So remember that you can't tell at a glance just what a person is going through.  Teachers (and people) like me may seem like we have it all together but may be literally screaming inside.  People who look rough may suffer in ways they can never describe.  Lend respect and love to all you can, and own up when you have a rough day.

And give yourself some forgiveness for when you screw up.  We all do.