The Lunder Chronicles: Stories from the Hospital to Recovery
My journey is not typical, not easy, and not fun, but the hospital experience means everything. So today I share my most recent hospitalizations and what my time and experience at Massachusetts General Hospital was like, but to also thank and give recognition to all the doctors, nurses, medical teams, and my specific neuro team who helped care for me.
I’ve spent way too much time in the hospital, most recently my time spent there surpassed my initial two surgery stays combined. Staying in the hospital is never fun or desired but I think it’s all about what you make of it and what the nurses and doctors make of it when interacting with you. Having good doctors and nurses makes all the difference in the world to the patient experience, and I’ve been lucky enough to have a great team of both. If this post ever makes it across the desk of someone in administration at Mass General, I want them to know of my experience but also just how amazing their staff is.
Not Like Every Other Time, Shunt Surgery 1 of 3…
Recently I was admitted to Mass General’s Emergency Department (E.D.) at the end of January when I was feeling not so great after a conference I was at. My symptoms were that of what I suspected to be hydrocephalus, and by golly was I right. My CT Scan showed enlarged ventricles compared to my very healthy and happy MRI earlier in the month and was cause for concern. I was admitted into MGH’s Acute unit in the E.D. and was immediately swarmed by nurses and the E.D. attending, having monitors hooked up to me, bloodwork done, and more. Then my neuro team arrived. AHHH the ever wonderful neurosurgical team. The residents rolled in to give me the game plan - full shunt work-up (X-Rays and CT Scan), plus a shunt tap (OUCH). Let me tell you something, shunt taps are not fun by any means, and this was my first experience having one done, but for EVERY. SINGLE. ONE. (I ended up having 3 over the next few weeks) the residents that did the tap made it as comfortable as possible (you guys ROCK). For those of you wondering what a shunt tap is, it’s similar to a spinal tap where the goal is to pull off cerebral spinal fluid (CSF). The purpose of this for those of us with shunts is to allow the doctors to pull off excess fluid as both a therapy to relieve hydrocephalus symptoms almost immediately, check the flow of the CSF through the shunt and ensure it’s functioning properly, and to see if there is a CSF infection by culturing some of the fluid. Since we’re not going into the spine like in a spinal tap, to do the shunt tap they find the reservoir of the shunt and stick a large needle through the skin of your head (the shunt rests on the skull under your skin, with a catheter inserted inside of the skull which is what’s feeding the fluid to the rest of the shunt system) and into that reservoir to pull off CSF, thereby “tapping” the shunt. So, fast forward to a few hours later after having that full shunt series workup done, the resident working with me came in and advised that exploratory and possible revision surgery was needed per my primary neurosurgeon (this would be 1 of 3 surgeries over the course of the next 3 weeks). I signed the consent forms and before I knew it the O.R. team came and collected me from the E.D. and wheeled me into the operating room.
Surgery was the last thing I wanted. Honestly, when I was sitting in the Neurosurgery Clinic at the Yawkey Outpatient Center earlier that evening after having my initial CT Scan, I was fighting tooth and nail on the need to be admitted with my nurse practitioner and the neurosurgeon. Not because I don’t care about my own well-being, but I had a big interview at work the next day for an internal position that I’d been waiting for to open up for months and I didn’t want to miss it. Now, let me backtrack a bit here…I know most of you are probably reading this and thinking “GIRL, you have a neuro-related medical issue, interviews don’t take precedence over that!” (which is something that just about every other person in my personal life who knew I was fighting being admitted essentially said to me). However, for the last year up until I had strabismus surgery with another amazing surgeon at Mass Eye & Ear, I was at a standstill. I had been working from home since I came back from leave 9 months earlier, had to be chauffeured into meetings by my parents because I couldn’t drive, and was not able to advance my career for the last year and a half. So between finally resuming work at the office in early January and this job interview, I felt like the pieces were finally coming together for me after a hard year. So, giving in to being admitted was not something I was going to do easily, especially since in the past the shunt work-up usually clears and we adjust the shunt setting, do an overnight observation, and discharge me the next morning. However, after much discussion, me seeing the severity of my CT Scan (way worse than I thought), I realized that being admitted was my only option and gave in (and obviously for good reason because in the end, this ended up not being like every other time).
Now here is where I also need to insert some serious accolades (for privacy I’ve not provided full names of my doctors or names of my nurses). My neurosurgeon Dr. N and his residents are AMAZING, and his nurse practitioner is AMAZING. I don’t say this about a lot of doctors or nurses because I have had my fair share of crappy ones or ones who were dismissive of my issues. However, this team has been nothing but respectful, thorough, kind, compassionate, and empathetic. I was getting prepped in the O.R. when my surgeon walked in, we had a good chat and I raised my concerns about them shaving too much of my hair (I had most of my hair shaved off for the first two surgeries last year and finally had got it grown out to a length I was happy with and wanted to avoid having to start over again, superficial I know, but can you really blame a girl who’s just rehabbed her hair for the last year?). This was something I had already addressed with the resident before I was brought to the O.R., who promised he’d request minimal shaving, bless his soul (and during his Neuro-ICU round with the rest of the team the next morning made sure to tell me before he left that they did keep to their promise of a minimal shave). We joked about shaving my hair and his game plan for how much he was going to take off, and about me being there again (he promised me 2020 was MY YEAR, HA!). I was able to see the big monitors in the O.R. with my CT imaging on it and we talked about everything that he was going to do in the procedure. He also apologized about me having to miss my interview and jokingly offered up his resident to fill in for me as he said he’s an expert interviewer. We all had a good laugh and I was thankful and appreciative for his support. It meant a lot to me that the whole medical team was empathetic to the fact that I had to miss out on something so big in one’s personal life to have emergency surgery. In the O.R. the nurses got me situated on the operating table, prepped the medical equipment around me, and then they prepped me with oxygen prior to putting me under. As they started to give me the IV meds one of the nurses grabbed my hand and held it to comfort me (which meant more than she’ll ever know) since sedation is an uncomfortable thing no matter how many times you go through it. I woke up a few hours later and was wheeled into the Neuro-Intensive Care Unit (Neuro-ICU) where I had nurses caring for me around the clock. The next morning I was met with occupational therapy and physical therapy and by the afternoon, I was sent home to recover. The whole experience was quick but met with exceptional care and kindness from every medical professional that attended to me.
An Unfortunate Discovery…Shunt Surgery 2 of 3…
Fast forward to 5 days later, I was home recovering and doing fairly well minus the abdominal pain from the incisions for the shunt drain, when I woke up on that following Sunday morning feeling absolutely awful. I knew something was severely wrong as my symptoms were worse than they had been when we went down the week prior. So I took a quick shower (desperate for one, and my first I was allowed since I could finally get my incisions wet from the previous surgery) with assistance from my mom since I had poor balance, and packed an overnight bag (see my post on “Hospital Essentials” for what I recommend to pack!) knowing I’d likely be there for more than one night this time. I showed up to the Emergency Department early that afternoon with my stepdad and had called in advance to tell them I was coming. At this point, I could barely walk with ease and my head was hurting (rare for me to have headaches with hydrocephalus) when I moved it. When I got to the E.D. we were quickly swooped into the check-in room and then down to a room in the Acute part of the E.D. again. I was met with some nurses, an attending, and of course the neurosurgical residents. My surgeon wasn’t in this evening and the goal the team had was to try and relieve me symptomatically and get me through the afternoon and evening so we could do surgery the next morning with my primary neurosurgeon. I appreciated this because it’s nice to have your primary doctor for each issue who already knows your history like the back of their hand. Not that I don’t trust any other doctor to care for me, but it does give a patient, I feel, a sense of comfort to know that they will still be cared for when needing surgery by the same primary doctor (unless it was absolutely emergent). Again, the usual workup upon arrival was done, X-Rays, CT Scan, and this time we did two shunt taps. One in the E.D. when I arrived, and once more when I was up in Neuro-ICU to take off more fluid while we waited to do surgery and to relieve me of my symptoms. Of course, should anything have taken a turn for the worse throughout the night we had all agreed, and I consented, that I would have surgery overnight with the on-call attending neurosurgeon to avoid any major issues from occurring.
For those of you who do suffer from hydrocephalus and are reading this post, you are probably wondering what my symptoms were or usually are since I mentioned at the beginning of this post that my case is not “typical” nor “easy”. Well, it’s a fabulous question since I don’t follow the textbook symptoms for hydrocephalus (apparently my brain and I like to give my doctors a good challenge). The first trip down my symptoms were mainly extreme dizziness, a change in my balance and gait, and nystagmus (unfocused vision). The second time around I was experiencing head pains/headaches when I would move my head even if I was lying down (usually hydrocephalus head pains/headaches are relieved by lying down), had dizziness that was even worse than the first time, my balance was essentially diminished, and I was suffering from some onset diplopia (double vision), and severe nystagmus. Typically hydrocephalus patients have headaches as the key symptom, but I do not, so having them this time was an extreme red flag for me. For those of you not familiar, hydrocephalus is an abnormal amount of CSF fluid increase within the brain’s cavities.
I have to give a shout-out to the Neuro-ICU nurses on Lunder 6 who were phenomenal. I loved all of the different nurses I had, both day and night. They were all very kind and empathetic to what I was going through. I was in a position where I really couldn’t do as much for myself as I’d like, so they had to help me with a lot. I kept apologizing and they always told me to never say sorry because it’s their job to do what they’re doing and they totally understand why I cannot do the things I would normally be able to do. I also had a lot of nurses that were around my age so they really understood where I was coming from and what I was feeling, but they made sure to put me at ease and made me as comfortable as possible.
Two notes to future patients: 1.) BE KIND PLEASE. Honestly, your hospital experience is all about what you make of it. I knew that being in the hospital was inevitable but I also knew I was in good hands. I also know I am not the worst-case scenario, and there was no need to be a difficult patient just because I was angry about my situation. Joke with them, make conversation, be kind and patient, be understanding when they cannot bring you something that instant, or when they come back and say “I am so sorry I got tied up helping another patient” or “I apologize for the delay I was dealing with a situation with another patient and nurse on the floor”. Recognize when you are OK and let them know it’s OK that something happened. I find that the nurses and doctors appreciated the patience I had. And honestly, if you are suddenly experiencing something that requires urgent attention, that’s what your call light is for and they will get a nurse to you ASAP. 2.) BE YOUR OWN ADVOCATE. Tell them what you’re feeling, don’t hold back to make yourself seem like a hero if you aren’t comfortable or your symptoms are worse, or when you are struggling to do something for yourself. They cannot help you unless you tell them you need help. Be honest about what is going on, what the past scenarios have looked like, and help them put the pieces together. I am no easy case and my nurse practitioner has a literal LIST of my symptoms (because she is amazing and super organized), notates what I do and don’t experience, etc. I’ve also been able to help them by being upfront and honest about what I am experiencing, how many times certain symptoms happen, and when something is a new symptom which is why we are more concerned or monitoring it more closely, etc. These things all help to ensure you get the care you need from the nurses caring for you.
Neuro-ICU
My first night in Neuro-ICU the nurses spent their time just keeping me comfortable and helping get me to my surgery that would take place early the next morning. They were very kind to my stepdad and my dad who were with me through this whole ordeal, answering questions and keeping them informed on what was happening. My mom has usually been the one to be in the hospital with me and has a medical background so she has a firm understanding of most things that are taking place compared to my dad’s, but she needed to be home and would come down later on in the week. The resident who had to tap my shunt at midnight made it as comfortable as possible for me and kept me distracted by chatting with me about different things so I didn’t think about the pain. My experience on Lunder 6 has always been wonderful and I will NEVER take for granted the kindness of those nurses and the residents. We made it through to the next morning and they got me prepped to go down to the O.R.
When I woke up from surgery I was in a good amount of pain. For this surgery, we took out a brand new shunt (which was now infected because we had determined I had a bacterial infection, found from pathology results received just before I arrived on Sunday from my old device, which was the main cause of this whole ordeal) and placed an external drain instead. The nurses greeted me when I woke up and checked my pain levels, talked to me about what I was allowed for medications, and we game planned together what would work best. I’ve had heavy meds before and I personally don’t like taking them, so if I can get by on just Tylenol I will. They were good about checking the drain regularly, once again, answered my family’s questions, and kept me as comfortable as possible. Again, I apologized a lot because they had to do a lot for me, especially since I couldn’t move as much with the drain in (like help me go to the bathroom and clean-up and bathe me) because it’s embarrassing to feel and be so useless when you are 26 and otherwise healthy. They were sweet and made sure to know that I shouldn’t feel bad whatsoever.
After surgery, while recovering in Neuro-ICU my nurse practitioner from Neurosurgery came to visit me having gotten a notice that I was admitted, and wanted to check-in and follow-up to see how I was doing post-op. Then my neuro-oncologist Dr. W came to visit, just as a courtesy to see how I was doing and connect with me for a bit. To have a medical team that cares so deeply like that makes me feel so supported and not alone no matter what I am going through. I couldn’t have asked for a better group of medical professionals to be assisting me. My neurosurgeon frequently rounds on patients, and he came by once that first day post-op but I was sleeping so he let me be and on his way out I was awake so he swung in to do his routine check, chatted with me and my parents, and gave me recommendations for milkshakes since that is what I mentioned I was craving at the moment. Talk about top-notch service!
The next few days I spent in Neuro-ICU. I had multiple family members and friends visit me. The nursing staff chatted with me during their visits, checking my pain levels and administering meds, and helped me with any needs I had. The Neurosurgery residents rounded each morning, and my surgeon dropped by with the nurse practitioner most afternoons to check-in. I also had a quick evaluation one day from Mass Eye & Ear’s Neuro-Ophthalmology service to ensure no damage was done to the surgical work Dr. C did to correct the double vision a few months ago. Thankfully the results came back normal, a promising sign of no damage. I also met with members of the Infectious Disease team and began the first rounds of antibiotics to help clear up the bacterial infection that I had. Several members from that team came and checked in, asking me a variety of questions about my particular case, medical history, and symptoms. After a few days, I was moved up to general recovery. Now, my first ever experience on Lunder 8 in the Neurosurgical General Recovery suite was not the greatest (almost 2 years prior) so I was very nervous about moving. However, the nurses on Lunder 6 were understanding and supportive and the transition to Lunder 8 this time was great. I was greeted by my new team of nurses on Lunder 8 and was instantly taken care of, they were dialed right into my specific needs and very much on top of monitoring the drain and it’s activity. Any little change in my physical condition was quickly noted and reported to the neurosurgical team who addressed it right away and then suggested any changes that were needed. They also provided a lot of the same help and care that the Neuro-ICU nurses provided, and again, put me at ease that it was their job and I shouldn’t apologize for needing assistance. I couldn’t be happier with all of the nurses I had for the remainder of my time on Lunder 8 (which was almost a full week).
Clearance…Shunt Surgery 3 of 3…
As I mentioned before throughout the entirety of my stay in the hospital, I not only worked with my neurosurgeon and the entire neurosurgical team, but since I had a bacterial infection I had to work with the Infectious Disease team as well at Mass General. I was seen by several different doctors over the course of the 11 days that I was in the hospital. They were in charge of administering which antibiotics I would be receiving to help clear the infection and were giving guidance on when it would be safe to put a new shunt in. I was admitted to the hospital on a Sunday and by Friday it appeared that the following Monday we would be able to safely place a new shunt. Several conversations with the Infectious Disease team and my primary neurosurgeon before that weekend helped to conclude that we would be doing surgery first thing on Monday morning. I also met with General Surgery since they assist with placing the drain in my abdomen. Lucky for me, the surgeon that I had the year prior for my first shunt surgery Dr. M was on my case on Monday. She looked over my latest incisions during her visit with her resident, plus the originals from over a year ago, and we talked about doing a few smaller ones instead for this surgery because of my level of discomfort from the one larger one from last week’s surgery. She’s always super personable and definitely takes the patient’s concerns into consideration and puts them first.
Monday morning came pretty quickly. We would be placing a brand new shunt system, but rather than inserting it on the right side of my head at the previous two shunt sites, we would be going in on the left and creating a brand new site. This would reduce the risk of another possible infection of the shunt. This also meant, shaving the other side of my head, so you can imagine my first thought…minimal shaving. My parents came bright and early Monday morning to my room on Lunder 8. I was then taken by the transport team down to the Peri-Operative floor where they would prep me for surgery and I would meet with my entire medical team (anesthesia, my neurosurgeon, general surgeon, the residents, nurses, etc.). They promised minimal shaving, keeping the type of shave they had to do on the previous side the same for the left side, although the resident joked saying “we can shave your whole head if you’d like!”, I joked back “no offense I don’t trust your shaving skills”. I should point out, I am about 2 months out from surgery (COVID-19 hit and I haven’t seen my hairdresser since or else I would have given my hair some attention by now) and because of the kindness and respect of both my neurosurgeon and his residents, I can easily wear my hair down or up and you really don’t know I have two 3 inch strips shaved from the nape of my neck to the mid-part of my skull. I can’t thank them enough for doing that, because it gives me the confidence to feel comfortable enough wearing my hair up or down in public and at work (when I can return to the office).
After meeting with all the doctors and nurses in the Peri-Op room, the O.R. team came to take me to surgery. I had already been given pre-surgical pain meds and en-route to the O.R. was given some anti-anxiety meds through my IV by the anesthesia resident. Every O.R. always looks so different but the feeling is always the same, hustle and bustle by the team as soon as you come in, but met with immediate attention, comfort, and support. I don’t think I’ve ever had a bad experience going under anesthesia in the O.R. Your internal feelings are almost always the same too. I act cool as a cucumber for my parents because I know they are scared, but when I leave their presence and enter the O.R. a small tidal wave of nerves always comes over me. But that support and comfort from the team definitely makes the experience a little easier to go through.
Coming out the other side of this surgery I felt like I was run over by a Mack truck. Immediately as I was waking up from anesthesia I found myself in what I call the “dolphin sling”, basically a large net they place under your body, hook several links up to it, and attach them to a pulley system which then picks you up off the gurney or bed and places you on the table of the CT Scan machine safely. I openly called it that to them as I was alert enough to tell them I knew what was going on, and they found it comical that I called it the “dolphin sling”. After the scan, the neurosurgical resident then was able to take my external drain out but had to place two stitches, uncomfortable, but not the worst thing I’ve had done to me. Then I was moved into a post-operative room to be tended too until they could transport me back to my room to recover on Lunder 8. In the post-operative room they monitor your vitals, provide meds, and address any serious concerns you might bring up immediately following surgery. For me, I was complaining of the pain on my chest, but that’s because I knew it was due to the shunt line. Another nurse came in to follow-up on that and noted I was already bruising and reviewed with me more about the specific pains I was feeling just to confirm it was onset pain from the shunt line and irritated tissue/muscle. The primary nurse was an older woman, sweet, and the nicest thing she did was comb my hair (it needed some serious attention if I am being honest). No one has ever done that and it was nasty from all the stuff they use to sterilize my head. I was so thankful and told her that, it seriously meant the world to me that someone took the time to brush my hair, and as she said: “make you feel a little more human”.
Once I got back up to Lunder 8 I was met by my new day nurse and they got me settled into my room, my parents were already there waiting for me. I spent until mid-day Wednesday after this surgery in the hospital. The Infectious Disease team changed the antibiotics over. I’d originally been receiving Vancomycin and was now getting Penicillin-G every 4 hours via IV. That Tuesday I had a PICC Line placed, which is a much sturdier, larger IV that has two lines for both administering meds and drawing blood over a longer period of time. The regular IV’s you receive in the hospital don’t last nearly as long and are much smaller. The IV Nurse Team was great, it was not a painful experience, but I am not going to call it “comfortable”. It was interesting to watch how they place the PICC Line though, and it was painless to take it out (an at home nurse did it that was assigned to me). I had to have the PICC Line because I would need the Penicillin for 10 more days on the same cycle of every 4 hours and I would have it administered via a pump I would wear 24/7. My last couple of days in the hospital went quite well and having a new shunt that was operating well made a pretty clear difference in how I felt overall. I had one older nurse for half a day on that final Tuesday who gave me all kinds of tips and tricks for overcoming a variety of different deficiencies and issues, helped to get my body’s systems starting to function properly again, and got me moving. She also shared some amazing stories about her history and past and took the time to get to know more about me, which I appreciated. By far, one of my favorite nurses in my entire time at Mass General. By the next day, which was my discharge day I was definitely ready to go home, but I was also nervous about another infection and having to drive 3 hours back to Boston from Maine, or something else going wrong requiring me to go back. I’d say I have PTSD because my body has tried to take me out a couple of times now, and I seem to be some oddball case where everything goes awry for no reason, but we seem to conquer the issue every time and have success on our side. However, that doesn’t mean it makes me any less nervous about something else happening, especially when I am leaving the hospital post-treatment. But my team was confident that things were going to go well and that they’d be there for me if I needed them.
Recovery
When I got home I was definitely tired and sore. Overall, recovery definitely felt a little longer and more grueling this time. For one, I didn’t have a pump and antibiotics to worry about last year, so this was new, and my body was drained from those antibiotics and now having had 3 surgeries within 3 weeks. Also, my abdominal incision from the first replacement surgery was finally healing, but now I had the smaller ones from this last surgery to worry about and they were quite sore. I was nauseous, dizzy, my balance was not great, and I had to balance carrying this bag with a pump in it all day on top of it all. Showering was a chore because we had to find ways to effectively cover the PICC Line to keep it from getting wet, so everything felt more cumbersome to say the least. Once the antibiotics were over with though, I was feeling ecstatic and a little more energized. It was one big hurdle that was finally completed.
Within two weeks from discharge, we made the trek back down to Boston for a post-op visit with our nurse practitioner. I had to have 10 sutures removed but thankfully my head was numb from nerves being cut, so it didn’t hurt nearly as bad as I was thinking it would since I’ve had sutures removed before and they were painful. I had everything checked over and we talked about my symptoms and my CT Scan which looked good but still showing ventricles slightly bigger than my MRI in January, which we are using as a baseline for me. We also talked about my impending return to work. Based on the events of today we agreed to give it another few weeks, scan again, and do another appointment. This quickly came and went, I was still feeling pretty fatigued, and only one of the ventricles had shown some decrease in size at the next scan. We had moved my return to work date out another month to give me more time since I was still so fatigued and dizzy. I had been doing physical therapy twice a week and trying to rest as much as possible, while also attempting to do some of my regular activities to remain active and keep me moving. Thankfully by the end of March, now a month a half out from surgery, I had turned a corner and started to see a slight return in my activity tolerance both mentally and physically. By mid-April I had turned another major corner and saw a larger decrease in my fatigue and and an increase in activity tolerance, and we agreed I could go back to work ahead of schedule.
I think the hardest thing for many to understand is the level of physical and mental fatigue you experience when you have any sort of brain injury or brain surgery, even several months into the recovery process. For someone who’s 27 (I’ve celebrated a birthday since all of this), standing at the stove for 30-45 minutes cooking a meal should be met with no issues, but after about 20 minutes it becomes extremely exhausting and requires me to sit for quite some time. Computer work or focusing on a task can sometimes be difficult and requires me to take multiple breaks to rest both my eyes and my brain. Many think that because I look good and seem to keep up that the struggle isn’t there. I actually just don’t tend to show it and I put on a good face and power through it. This has caused me some trouble in the past because there have been times where I’ve overdone it and not paced myself, and then it set me back a bit in my healing and recovery process. I’ve learned over the last year and a half that a lot of care is needed to properly heal from a brain injury, but to help continue to thrive once you’ve done so. Sleep for one is important, so I’ve worked with my primary care since I have had sleep issues for years that were only exasperated by the multiple injuries and surgery. I use podcasts to help unwind or music, I’ve even started trying guided meditation when I need a mental mind break, or if it’s been a long week and I need to unwind I go for a walk or take a long drive. It’s important to care for your brain in the healing process just as you would any other part of your body.
To date, I’m doing pretty well considering everything I’ve been through. This post has taken me a while to write. I’ve had to come back to it multiple times, and I’m thankful I have a solid enough memory despite all the trauma and meds to remember most of what happened to tell the story. The biggest takeaway I want from me sharing this, is I wanted to share my story for someone who maybe is going through it themselves, and know what I went through and that they aren’t alone. But more importantly, as noted multiple times throughout sharing this experience, I wanted to make sure the recognition is received for the nurse teams in the Neuro-ICU on Lunder 6 and the Neuro Recovery Unit on Lunder 8, the Operating Room team (Anesthesiology, Neurosurgery, General Surgery, the nurses in the O.R. in Peri-Op, and Post-Op), as well as the Radiology teams who had to scan me with a drain in my head over the course of my time in the hospital, and of course my neurosurgeon Dr. N and his team, my nurse practitioner, and my neuro-oncologist Dr. W. I don’t know where I would be without them, always there to answer every question, assist with my never-ending issues, and always with so much kindness, diligence, and empathy, and that’s been from Day 1. So the only other thing left to say is “Thank You”.
Have a story of your own about your experience in the hospital or working with a direct group of medical professionals to help you through a chronic illness or critical illness? Share it below!