The Long Middle with Mary Monoky

Living Chronic: Embracing the Long Middle of Chronic IllnessIn this episode of Living Chronic, Brandy Schantz and guest Mary Monoky explore the profound journey of living with chronic illness, focusing on the often-overlooked "long middle" — the lengthy, uncertain phase between onset and resolution. They share personal stories, insights on trauma, and the importance of resilience, connection, and understanding in navigating this complex experience.

• The motivation behind sharing chronic illness stories later in life, including the freedom to be open about personal struggles

• The significance of Maslow's hierarchy of needs in managing chronic illness survival and growth

• The cycle of giving up and picking oneself up again, illustrating resilience in the face of repeated health crises

• How animals and nature serve as anchors for mental well-being and motivation during long-term health struggles

• The concept of the "long middle" — the enduring, often invisible phase of chronic illness lasting decades

• The challenges of navigating complex healthcare systems, diagnosis delays, and unrecognized symptoms

• The impact of chronic illness on loved ones, including trauma, invisibility, and changing family dynamics

• The importance of listening to and trusting your body, using tools like wearable data for self-monitoring

• The critical need for greater understanding and treatment options for dysautonomia and related conditions

• A call to honor the trauma experienced by both patients and loved ones, recognizing the interconnected ripple effects

Note: This episode is a deep dive into the emotional, physical, and social nuances of long-term chronic illness. If you're living through the "long middle," you're not alone and your experience is valid and shared by many.

Transcript

Brandy Schantz (00:01.024)
Welcome to Living Chronic, I'm Brandy Shans. Today I'm here with Mary Monakee. She is an author and a heck of a chronic illness warrior. We have a lot to talk about today. So welcome, Mary.

Mary Monoky (00:14.842)
Welcome, Brandy. Good morning.

Brandy Schantz (00:17.154)
Thank you for being here. you have a sub stack called Chronic Wisdom. And you've also written your memoir, The Quiet Edge. Tell me a little bit about what inspired you to start writing about your experiences.

Mary Monoky (00:31.952)
What inspired me was that I finally feel like at 65 years old, that I can finally take the mask off. Like there's this freedom that my age has enabled me to say, this is what I've been through, but I didn't feel I could share it while I was in it, if that makes sense.

Brandy Schantz (00:39.342)
Mm.

Brandy Schantz (00:48.832)
Yes. No, absolutely. It makes perfect sense. think so many of us are the same. I went through the same thing in many ways. I didn't feel comfortable completely sharing everything that I was going through and feeling. It was so overwhelming and traumatic as I was going through it. It's not until later when you start reflecting that you're really able to not just talk about it, but be insightful about it.

Mary Monoky (01:16.856)
And I agree. I think that you have to have a certain level of stability in your well-being. For the longest time, Maslow's pyramid. I was stuck at level one where I was struggling for survival in and out of the hospital for a period of years where I was so involved in that struggle that I couldn't really even speak about it. It was just head down and indoor.

Brandy Schantz (01:21.388)
Mm-hmm. Yes.

Mm-hmm.

Yes.

Brandy Schantz (01:33.709)
Yes.

Brandy Schantz (01:40.686)
Mm-hmm.

Yeah, absolutely. I talk about Maslow's hierarchy of needs all the time on this show because it's very important. People, you know, to me, because I'm going through this, ask the silliest questions about these higher level things. And I'll say, I'm really just trying to get my meds right now. I'm just trying to figure out how to survive this week because I have XYZ happening or I'm dealing with this kind of infection or whatever it is I'm dealing with at the time.

I can't get off the bottom. It's only been more recently that I've started climbing a little bit and I'm like, oh, hey, it's a little self actualization going here. Let's think about what I've been through and how it affects others.

Mary Monoky (02:17.005)
Exactly.

Mary Monoky (02:27.066)
I'm glad now looking back that I didn't know how long I would be there because if I had known that it wasn't just a simple recovery, I don't know if I would have had the tenacity to hang in there that long. People look at me and say, well, how did you survive all that? I'm like, one minute at a time.

Brandy Schantz (02:31.714)
Yes.

Brandy Schantz (02:38.892)
Right. Yeah. There's a cycle. Yeah, there's a cycle.

Brandy Schantz (02:47.916)
every time, yeah. I often tell people I give up often. I give up often. I'm still here? Yeah, that's because I eventually pick myself back up again, but I give up often, you know, it's just that cycle.

Mary Monoky (02:51.845)
Yes.

Mary Monoky (03:01.732)
Yeah, I think when people have learned that I've been chronically ill for 25 or 30 years now, they're like, well, you must like be special. And I'm like, there's nothing special about me. I don't have this overwhelming desire, you know, to, I don't know, be an example or, you know, I don't want to die because I want to see my kids. That's not the truth. The truth is random things just happen to people. And I think I'm just an ordinary person.

Brandy Schantz (03:11.615)
No.

Brandy Schantz (03:27.788)
Yeah.

Mary Monoky (03:31.844)
who put one foot in front of the other, but now feel like there's something here in my experience that other people could learn from.

Brandy Schantz (03:41.678)
Absolutely, and that's what we talk about. There's no blueprint. There's no manual when you become chronically ill nobody hands you You know how to guys. So here's how you're gonna survive this and you've had 23 brushes with

Mary Monoky (03:57.413)
Yes.

Brandy Schantz (03:59.118)
And that's a lot. It's not just the longevity of your chronic illness. It's how severe it got. And again, that getting back up again over and over and over again. So tell me, how did you first start to figure out, okay, how do I get up from this when you're going through this 23 times?

Mary Monoky (04:22.124)
After the 23rd time and I had been on hospice at that point because they're like, there's we've done everything we can. There's nothing more. So you mentally start, you know, cutting out things so that there's just you and your immediate circle. And when I survived, I found that I was surviving simply because there was less medical intervention in my life. But I survived and then I moved from where I was residing to an easier place to live, one floor.

Brandy Schantz (04:30.19)
Mm-hmm.

Brandy Schantz (04:34.222)
Mm-hmm.

Brandy Schantz (04:44.206)
Mm-hmm.

Mary Monoky (04:52.95)
And I felt so untethered, so unmoored with no navigation, no direction on what do I do next now that I'm still here. So I moved to Florida. I hate Florida, but Florida offered me sunshine and the ability to be outside. And I sat in the yard and connected with a little baby cat that was a feral cat. And it was that first moment of connection with another human being, well, not human, but a soul.

Brandy Schantz (05:02.029)
Mm-hmm.

Brandy Schantz (05:16.462)
Hmm.

Mary Monoky (05:23.024)
that just met me unconditionally and we formed this bond. And that was the first inkling that I could anchor my mental state in Sounds with Nature and connecting that way. And it didn't feel like a tumbleweed floating down the road. And that was the first step to understand what that was.

Brandy Schantz (05:23.158)
Yes.

Brandy Schantz (05:45.09)
Yeah, we've talked a lot about, you know, both of our experiences with getting connected with nature and connection with animals. And we, because that's how we both have journeyed through this. that we're very similar that way. I have been there with my dogs. take nature walks a lot. I try to get outside and get some fresh air, some sunlight, whatever I can as much as possible, because there is a lot of healing and

Mary Monoky (05:55.333)
Yes.

Brandy Schantz (06:14.668)
that action. And of course, we've talked a lot about our dogs too. So everybody knows the role of my dogs in my journey, my healing and my life. Don't be about the role of your dogs too.

Mary Monoky (06:20.326)
You

Mary Monoky (06:29.676)
I would never have imagined myself as a senior citizen getting puppies, but I have two dogs, they're Labradoodles. And after the experience with the feral cat who adopted me, and I lived with this cat in the yard and really became a friend to me and something I look forward to interacting with, I eventually moved back to my home in New Jersey and it was empty, right? There was no other connection. And so I got my first Labradoodle.

And then I realized that doodle needed somebody to help burn off its energy more than I could. So I got a second doodle. And now I have the two and they're the love of my life and the reason I get up out of bed on a bad morning. I mean, it really helps.

Brandy Schantz (07:03.821)
Mm-hmm.

Brandy Schantz (07:15.02)
It's amazing what animals can do for you. There've been so many mornings where I thought, I can't get up. There's no point. And then that dog looks you in the eye with such love and just pleads with you like, hey, please get out of bed and help me. it's like, think, you know what? Yeah, I have purpose. I gotta help this dog. This dog's the best.

Mary Monoky (07:42.372)
Not only that, but on a bad day, when you're laying in bed with a heating pad and waiting for your meds to kick in, my dog will just put his chin on my shoulder or my knee, depending, and just look at me with such empathy, like I'm here with you.

Brandy Schantz (07:47.009)
Mmm.

Brandy Schantz (07:56.17)
Yes. They're so, I mean, they just know when something's wrong. I, they know my oldest, you know, I have Crohn's disease and anybody with Crohn's can tell you often our worst times are in the middle of the night. You're just up and great. I'm gonna spend the whole night awake and in this bathroom and my little Coco come in that bathroom, put her head on my leg and just sit there. Like I got you mom.

Everybody else is asleep. know, Coco's awake comforting me, making sure I'm okay.

Mary Monoky (08:27.332)
Right.

Mary Monoky (08:32.398)
And that's a miraculous thing, disconnection. And especially in the middle of the night, a lot of people with chronic illness pain is harder to manage from midnight to 6 a.m. because our brains are distracted by the activities of life. And so you and your pain. So for other people who are questioning their own, is my pain getting worse at night? No, it's just that your brain is more aware at night.

Brandy Schantz (08:37.826)
Yes.

Brandy Schantz (08:46.934)
Yes, it's just you and your pain.

Brandy Schantz (08:57.1)
Yeah, absolutely. Absolutely. And having that pet, that companion really does make a difference.

Mary Monoky (09:04.586)
It does. I mean, they have studies where your blood pressure comes down if you're just petting a dog. So I now have two dogs.

Brandy Schantz (09:08.257)
Yes.

I, you know, look, if I could afford it, I'd have all the dogs, but you know, the vet bills say otherwise. Three's my limit. But what a great, you know, I feel like that, you know, these fees should be deductible or something you could take, you know. Yes, this is, know, my insurance should cover it, something, because it does more for my health.

Mary Monoky (09:31.987)
As medical therapy, right? Yes.

Brandy Schantz (09:40.962)
that companionship with my dogs, I think, than anything else.

Mary Monoky (09:44.601)
I agree in the years that I've had dogs, I've had a whole lot less doctor visits. I don't know if it's causing correlation, but there's more stability in my life now. And maybe it is the dogs, but I give them credit.

Brandy Schantz (09:48.684)
Yeah.

Brandy Schantz (09:52.728)
You're right.

Brandy Schantz (09:59.254)
Absolutely. It is always the dogs. They're perfect. Let's, you know, I'm always working on some sort of new policy or ideas, talking to people. I'm always walking around DC talking about healthcare and how we can make it better. Give us the dogs. Cover that. But.

Mary Monoky (10:05.36)
They are.

Mary Monoky (10:22.971)
Yes.

Well, they do have emotional support dogs, so many, it's a very gray zone as to whether that animal is allowed on the plane and whether you could check into a hotel. so I think.

Brandy Schantz (10:28.748)
Yes.

It is, yeah.

Brandy Schantz (10:36.758)
Yes, and often for you know for good reason I know that there are very I have a lot of friends with Working dogs and I know that having that trained Animal is is very important. They know how to Act you don't want you know untrained dogs So, you know, I know mine would be like And then you know just be chaos, know when somebody really needs this working dog to help them

Mary Monoky (10:56.122)
You don't want my dog.

Brandy Schantz (11:05.954)
So I understand some of it, but I would love to have my health insurance cover some of the expenses of my dogs. That would be lovely. So you also talk about the long middle. And I love hearing you talk about the long middle. So explain the long middle.

Mary Monoky (11:18.586)
Yeah.

Mary Monoky (11:22.982)
You know, the long middle and I don't I don't even know that there's actual term called that, but I call it the difference between when you have a sudden onset like I did. It was a call bladder attack and the doctors told me, you know, we're going to do a simple procedure. You'll be back to work next week. I'm like, OK, let's do it. And then I didn't get better. In fact, I got worse, but I still believe that this is a resolvable issue and I'll have the next medicine or the next and I'll be back to work. I.

Brandy Schantz (11:34.392)
Mm-hmm.

Mary Monoky (11:53.883)
had no idea that this kind of thing could even happen to people. That you could be healthy and normal and living your life and raising your children and then something goes wrong in your body and all of a sudden you're in some other category. So I went from being highly active to going through the grieving stages. Well, no, initially it was more exploratory. What is this? What's the diagnosis? What's the treatment plan? And that's

Brandy Schantz (12:18.542)
Right.

Mary Monoky (12:21.478)
complicated in today's healthcare, the over specialization of medicine, where you used to have a primary, but now the primary sends you to a gastroenterologist, to a neurologist, to, you know, around and around and around you go and you're sick, so you don't feel well. And so that stretches on. And then finally you get this point where you're six months out from the initial onset and you're like, this could be my forever?

Brandy Schantz (12:49.358)
Mm-hmm.

Mary Monoky (12:50.618)
Well, then what? I mean, for me, it was continuation of the same thing. I had a GI disorder which required IV feeding and I have ileostomy. So that combination became very lethal with IV intravenous lines getting infected. And I would develop central line sepsis, which is what caused me to nearly die 23 different times. So you survive that, but then there's no language.

Brandy Schantz (13:08.558)
Mm-hmm.

Mary Monoky (13:20.944)
for what happens between the sudden onset and the long finish. Like I'm not gonna die from this illness. It's not gonna kill me. So, but I'm not actively ill, but I'm not actively well either. It's this middle phase that if it was shorter, it would be so much easier to deal with. But in my case, that middle phase is 20 plus years of not being who I was and not quite as well as I'd hoped to be.

Brandy Schantz (13:27.5)
Yes.

Mm-hmm.

Brandy Schantz (13:44.141)
Yes.

Brandy Schantz (13:49.87)
I I use your phrase now, honestly, I like it, long middle. It explains a lot. And I think most of my listeners who are dealing with chronic illness can immediately relate to this because there was, you know, thinking about my own situation, the beginning, the reaction to my medication. And then just this time period of me trying to get doctor's appointments, going between different specialists, figuring out.

What next? What's my treatment supposed to be? Is the treatment going to work? Am I going to get any kind of increase in my, know, improvement in my quality of life? And that is a very long time. And it feels so rudderless and empty because there's nothing grounding you in so many ways. There's just nothing grounding you. You're just going to doctor's appointments and trying to figure out what next? How do I start living my life? Where does this

Mary Monoky (14:40.346)
Yes.

Brandy Schantz (14:48.747)
end

Mary Monoky (14:49.574)
for a long time, thought, this now my job to be a professional patient? I rejected it. I just rejected it. It made the hair on the back of my neck stand up. I'm like, I am not accepting that role. If that's the one that's been given me, no, I'm not doing it.

Brandy Schantz (14:52.982)
Yes! And it is a full-time job.

Brandy Schantz (15:00.63)
Yes.

Brandy Schantz (15:06.198)
Mary, let me tell you, you never know when I'm gonna have some sort of a crazy like meltdown. I mean, they just come, I try to warn people, I'm like, look, I'm fine, I'm fine, I'm strong, I'm focused. And then there's a meltdown. I can't tell you when it's gonna happen. And I have a new doctor for my dysautonomia. He's one of the handful of specialists in the United States. He is Navy, so he was moving, he was PCSing to a different hospital.

and didn't have everything set up at the new hospital and he wanted me to go through some more autonomic testing, redo a lot of the tests I had to see how far my disease or my disorder has progressed. And because he wasn't set up in the new location yet, he said, well, let me give you a referral out. Mary, I was calling people, you know what they were doing, they were doing the, well,

We need this language in the referrals. And I went back to his nurse. She put in some language. No, not that language. We need this. And after about three or four times going back and forth, I kind of threw everything I had up in the air and had a meltdown. I I can't do it. I can't do it. I can't do it. I'm not doing this. I'm not. I'm not. I'll just get whatever testing when your lab is up and running. Slam. And then my next appointment with my doctor, he says.

Mary Monoky (16:25.574)
Perfect.

Brandy Schantz (16:28.526)
We don't have to do anything. We'll take your time. No referrals, you don't have to call for a referral. But you know what, that was the trauma. Because I can't keep doing this as a full-time job. I've got to move on. As a matter of fact, there's a part of me that I've had a lot of discussions recently where I said, you know what, I can't even do anything related to this full-time. I need a full-time job that has nothing to do with sickness. Nothing.

because it is so traumatic when you've had to do it every day for years, years.

Mary Monoky (17:01.446)
I am. After hospice, when I kind of stabilized, I thought I have so much knowledge, I can empathize. I have earned a master's degree in social work and I thought I am the perfect person. Guess what? No, no, no, I'm too close. And then I would carry that energy, their story home in my heart and could not discharge it. And now I.

Brandy Schantz (17:15.586)
Yes. No. Too close.

Mary Monoky (17:29.656)
I was dealing with my own trauma, my own illness, my own future. And then somebody else is on top of it. All that education, like I cannot do this. I'll find another way. Can't do that. But yeah, I couldn't do it. Yeah.

Brandy Schantz (17:39.48)
Mm-mm.

Brandy Schantz (17:44.047)
It's amazing. It's amazing. But you know, hey, if you've been through it, we know the trauma is real. And I don't fault anybody for their meltdown whenever they want to have it because nobody wants to do this for a full-time job. And somehow we're stuck in it.

Mary Monoky (17:59.941)
No. And you know, I think a message to patients is you can say no. Like, especially those disorder, Namiya tests, they aggravate your condition so they can see where you're at. So, you know, you're going to feel terrible after the after the test.

Brandy Schantz (18:06.06)
Yes, you can.

Yeah.

Brandy Schantz (18:16.248)
Can you believe these tests, honestly? This is torture. I want to call up some human rights groups and complain.

Mary Monoky (18:19.384)
I just say no.

Mary Monoky (18:26.086)
We're gonna strap you to a table and then we're gonna tilt you upside down. No, no.

Brandy Schantz (18:29.55)
We're going to induce all of your symptoms. I'll never forget that nurse the first time when I had that tilt table, I call it the tilt torture test for good reason. And she's just sitting there, this nursing nurse, nurse, just, you know, how do you feel now? I'm throwing up, hit the waste basket, you know, I'm like, you know, I'm having tremors, I'm shaking, I'm throwing up, I'm sweating. I'm like lady.

Mary Monoky (18:34.64)
Mm-hmm. Yes.

Mary Monoky (18:45.51)
you

Mary Monoky (18:52.346)
Yes, it's literally provoking all of your symptoms.

Brandy Schantz (18:58.718)
longer of this do I have? Just hit the waste basket try to breathe so you don't pass out we have another 45 minutes like

This is torture. It's torture. Somebody call the Hague.

Mary Monoky (19:11.622)
Right, and I think.

I don't understand why that is needed. mean, they have simpler ways to diagnose dysautonomia.

Brandy Schantz (19:18.68)
Nice.

Brandy Schantz (19:22.51)
Well, you know what I have, I wear a Garmin everywhere I go before all this nonsense happened. I was an athlete. I can give you data for 15 to 20 years, accurate data. My heart rate, I can give you my blood pressure because I take that, you know, I can tell you everything that has happened on my body for years. I brought in that data to show every doctor. I had charts, I had graphs.

Still they wanted that tilt table test. Excuse me.

Mary Monoky (19:54.469)
Yeah, I think we need to expand what the criteria for diagnosis is. Like it's like if you don't pass their test, then you don't have it. But we live in the body that knows at my age now, I could tell you what my heart rate is at any moment of the day, simply by how I feel. You know, I had a reaction to the COVID vaccine the day before I had was wallpaper in my bedroom. So upright and got some energy.

Brandy Schantz (20:01.527)
Yes.

Brandy Schantz (20:11.948)
Yes.

Brandy Schantz (20:18.38)
Yeah, me too.

Mary Monoky (20:24.294)
The next day, I couldn't stand up to use my electric toothbrush, which is two minutes. I mean, you just kind of know where you're at. And for the people who are beginning this, if they could learn to monitor how their body's functioning versus relying on outside, like your garment, that's telling you. link that to how you feel, and then you'll know in the future. Like I know my heart rate now is 102. It's good.

Brandy Schantz (20:26.594)
No. Yeah, yeah.

Brandy Schantz (20:32.961)
Yeah.

Brandy Schantz (20:40.364)
Yeah.

Yeah.

Brandy Schantz (20:47.458)
Yeah.

Mary Monoky (20:52.862)
I mean, it's a little high, but that's good. I just need to drink some more and put my feet up this afternoon. I'll be good.

Brandy Schantz (20:58.092)
Yeah, that is the key, understanding your own body. And I think it's not just understanding your own body, but learning how to communicate that to medical professionals. Because sometimes that's the hard part. I kept trying to say, look guys, healthy women in their 40s who've been running their entire lives just don't stop being able to run. It just doesn't happen.

Mary Monoky (21:22.512)
Wait.

Brandy Schantz (21:24.814)
This is not age, you know, I'd have a lot of doctors, well at your age, I'm like, Hey doc, I'm not 94. Let's back it up here. People in their forties are out there running marathons and three hours. It's, it's, it's okay. Um,

Mary Monoky (21:42.468)
Right, and you as an athlete had better muscle tone and a lower heart resting heart rate. So you're coming into it and more advantaged or disadvantaged. can take it. It depends on which way you're looking at it, right?

Brandy Schantz (21:46.112)
Mm-hmm. Yeah.

I looked very different. Yeah, no, absolutely. Yeah, it was a very interesting journey. I looked very different than most of their patients. So they couldn't quite pinpoint what was wrong. also, being who I am, I kept trying. I never gave up. I realize now, at the time I didn't, you know, there were...

What was I supposed to know? Nobody could give me a diagnosis. I kept getting these tests done. What's happening? Who knows? But in hindsight, had I just given up and stopped trying, I probably would have been diagnosed much earlier. Because not moving and not exercising, if you have POTS and dysautonomia, that's what will get you bedridden real fast. You're deconditioned and next thing you know, boom, you're in the bed. But I kept trying to run.

Mary Monoky (22:34.49)
Right.

Brandy Schantz (22:44.616)
I kept trying to exercise. I was convinced and turns out I was actually pretty accurate. I was convinced if I, because my limbs were experiencing all this weakness, but my core was fine. So I kept doing a ton of core work and I thought, you know what, if I can just have a strong core that'll somehow send me through this, which I wasn't wrong entirely. I mean, a strong core helps your blood flow. So here I was, I kept doing all the strength training and you know, I realized that my balance was really off. So I'm doing

Mary Monoky (23:03.632)
Right.

Mary Monoky (23:13.509)
Yes.

Brandy Schantz (23:14.444)
all this yoga, trying to fix it myself and all things that are actually what you're supposed to do. So when I'm going into the doctor complaining, they're like, well, look, you're standing. did you say you're running? Yeah, you're fine. You don't have it. Yeah, you're okay. It took so long to get them to hear me.

Mary Monoky (23:33.767)
But I had the same experience, but the other side of that coin. went to my primary, after all of my illnesses, I wound up with this autonomia and all those things that complicate your recovery. So it's not only just your GI disorder, there's these layers. So I talked to my primary, I'm like, I can't walk from here to the parking lot without having to sit down. She's like, well, what do you mean you can't walk? Your legs don't move. I'm like.

Brandy Schantz (23:38.926)
Mm.

Brandy Schantz (23:43.916)
Yeah.

Brandy Schantz (23:47.426)
Yep. Yeah.

Mary Monoky (24:03.588)
Like walk with me. So she walked with me and you know, we're walking down a corridor that's maybe 300 yards and you could see where I'm starting to get breathy and we get to the exit. I'm like, take my pulse. One hundred and seventy two. I'm like, that's that's the problem. She's like, she just looked at me like I. Flower guess it. Well, she said to me, well, what are you doing about that? As if I supposedly had to have an answer.

Brandy Schantz (24:15.438)
Mm-hmm.

Brandy Schantz (24:22.275)
Yeah.

Brandy Schantz (24:29.235)
I'm...

Mary Monoky (24:30.502)
I'm like, I'm talking to you about it. She said, well, stop eating salt, which apparently is the opposite answer. But I think in general, there's a lot of unknowns because you present looking normal. I don't know what you're supposed to look like when you have a chronic illness. But I hope I never get to that point that, you know, I don't look like myself.

Brandy Schantz (24:36.152)
That's the opposite. Yes.

Brandy Schantz (24:55.178)
Yeah, I mean, and that's, you know, that's the truth for so many of these chronic illnesses. You do look like yourself. Those, they're invisible illnesses and you're trying to explain what you're experiencing to a doctor who might not see what you're seeing. And people look different. That's the one thing I've learned about dysautonomia. Of course,

All of us with autoimmune diseases, chronic illnesses, all these different things were more susceptible to dysautonomia, women especially. But it looks so different in each one of us. I did Advocacy Day with Dysautonomia International, and there was a woman in a wheelchair, there was me, there were people there representing their loved ones because their loved ones could not get out of bed. So when you think about that wide range of people, and then just talking

Mary Monoky (25:41.648)
Mmm.

Brandy Schantz (25:47.488)
amongst each other and Facebook groups, you learn that every person looks very different. For me, my, so I later learned, thank you to the doctor who really put me through the test so that we could get here, I learned that my blood pressure was just crashing when I started exercising. My blood pressure drops. And my, but my heart rate doesn't start going way up until after a duration of exercise.

Mary Monoky (26:08.346)
Wow.

Brandy Schantz (26:16.014)
Now why, don't know why, maybe it's because I was an endurance athlete. My body was so used to being able to run 10 plus miles at a really decent clip, still sitting in zone two, maybe zone three. I don't know why most POTS patients, stand up, heart rate goes up at least 30 beats per minute and bam, pass out. For me, I had to run for a while and then it was like, oh wait, why is your heart rate 180? Stop and walk.

Mary Monoky (26:38.619)
Mm-hmm.

Mary Monoky (26:44.358)
You

Brandy Schantz (26:45.59)
you know, because I'd be at the same pace and then bam, there goes my heart rate and I'd stop and walk and my heart rate would come down. But the second time I started to run again, my heart rate would immediately go up to 180. It didn't matter. I could be sprinting. I could be doing the slowest shuffle you could imagine. Didn't matter. 180 plus. And so it looked very different for me than many other people. And that's I think that's the story of so many people out there living with dysautonomia, whatever it might be, hypotension, know, POTS.

Mary Monoky (26:55.845)
Yeah.

Brandy Schantz (27:15.234)
whatever you're dealing with, it just looks different in all of us. And all these doctors who are just now learning about dysautonomia and POTS haven't quite heard the whole story yet. If you talk to just Autonomia International, of course, they're just brilliant and do so much work in this and they can explain that. But doctors have a lot of work to do and way too many patients. There's not enough doctors out there. So here we are. You go into the doctor and...

Mary Monoky (27:38.416)
That's it.

Brandy Schantz (27:42.956)
I can't tell you how many times I'm explaining to the doctor what is going on and they're learning from me and my appointment.

Mary Monoky (27:50.085)
Yes, I've met with various cardiologists and I said, you know, now that we have a diagnosis, I'm so excited because I thought diagnosis led to treatment plan. Like, and then there'd be a path, you know, out of that forest that I'm lost in. said, no, no, no. Unfortunately, it's our patients that generally advise us. And that was the day the bottom fell out. I was crushed after coming through all of that GI and all of the

Brandy Schantz (28:09.838)
Mm-hmm.

Mary Monoky (28:17.914)
blood issues and the infections and I finally became stable and then his pots kicks in to find out that they don't know what to do about it. And then you get the standard wear compression garments, eat salt. I'm like, yeah, I don't know.

Brandy Schantz (28:22.734)
Mm-hmm.

Brandy Schantz (28:27.682)
Yeah.

Brandy Schantz (28:32.086)
I know.

Well, they don't even tell you how much, you know? I love that we're talking about dysautonomia now. It's on the rise. So many people are dealing with this. And the doctors, yes, compression garments and salt. Well, me being, I mean, I feel like maybe, I guess everybody probably thinks this way, but I definitely think that there was an 80s, 90s, you know, point in time where salt was like the enemy, right? Like nobody, you know? So, you know,

Mary Monoky (29:01.595)
Right.

Brandy Schantz (29:04.27)
I heard it so many times that it was bad throughout my life that I could not comprehend that I needed, how much salt did I need to eat? I'm putting in this, I was told to get element tea. And as a former athlete, know, like element tea is great after a 26 mile run, but I was like, man, I'm supposed to be drinking this and I'm sedentary? That seems like a lot of salt for somebody who's just sitting around. And I still wasn't feeling any better and.

It wasn't until I really became involved with the groups, know, get onto Facebook, look up Exercising with POTS, check out Diss Autonomia International, talk to people and it's the patients that helped me and helped me to understand now you really do need two to three of those elementis a day, 3000 milligrams plus, you know, add in salt into your food and make those snacks salty, get a pickle, you know, find some pretzels.

And it seemed so wild to me, but it wasn't until I just shoveled, know, basically wheelbarrows full of salt into my mouth that I actually started feeling better.

Mary Monoky (30:08.538)
You know, you're right, salt was the enemy. now when you think about it, really think about it, our bodies are salt water. The earth we live on is salt water. Right, but the answer is right in right inside of us and around us.

Brandy Schantz (30:11.37)
N-

Brandy Schantz (30:22.254)
So it's right there. You know what's so funny? I had to laugh to myself when I had this thought. My dysautonomia doctor put me on flujacortisone, which helps your, it's a steroid that helps your kidneys hold salt. So I started this, it's still new. I think this is, might be starting week two, three, I think two and a half maybe.

And I was like, wow, I feel really good, you know? And I noticed my first run was really good. And the very next day, I just, you know, I had so much energy. did a full state, full day of work. And then I had more stuff I was doing. I'm like, wow, I'm so productive. And this is amazing. And I go out for my next run and you know, everything keeps getting better. And this weekend I'm on my run and I'm kind of like going through my head. Wow, this is amazing. I feel.

So like buoyant. And then I kind of snickered. I'm like, buoyant, salt, buoyant. know? Yeah, that makes sense. That's the only way I can really describe it to people. Not only do I have energy, I feel buoyant. Because everything else, was always kind of feeling like I was going to pass out. I was going to have to sit down, put my legs up. Everything feels so down.

Mary Monoky (31:26.0)
You

Ha

Brandy Schantz (31:52.204)
you know, get something that helps me keep salt and I'm buoyant. Amazing.

Mary Monoky (31:55.931)
fantastic. You know, when you really think about it, like it makes such sense.

Brandy Schantz (32:02.391)
It does.

Mary Monoky (32:03.778)
And I think each of us based on our body composition and in your case, being an athlete, you'll find your point where you're gonna function at the best. But when you were saying you were running it and I was like, you're like, I'm feeling, in my mind, I would have been like waiting for the other shoe to fall.

Brandy Schantz (32:13.559)
Mm-hmm.

Brandy Schantz (32:22.25)
well that too. also, know, runners, everybody listening who's a runner knows we have thoughts. I get my best ideas while I'm running. can, I do all the math when I'm running and I solve at least three or four world problems just running. I don't know, you're always thinking. And that's one of the thoughts that's because there's been other times where I optimistic. I'm like, I think I'm getting better. And then bam, everything hits and I'm.

Mary Monoky (32:47.472)
Yes.

Brandy Schantz (32:51.448)
down and I can't walk, I can't run, you know, all of these things. So yeah, there's that thought also enters my mind. gosh, no Brandy, don't be optimistic. Don't do it. Don't do it. Don't do it.

Mary Monoky (33:00.634)
That I think.

Mary Monoky (33:04.454)
That's probably the biggest challenge of this long middle. You know, you almost kind of can predict being where you're at at stable. And then randomly you get a good day or maybe even a good week. And you're like, oh, you know, you got your list of stuff you want to get done. And then in the back of your mind, like, what's going to happen to me when this wears off? And you don't want to jinx it. You don't want to call in the whammy. You don't want to end this good cycle.

Brandy Schantz (33:08.843)
Mm-hmm.

Brandy Schantz (33:13.538)
Yeah.

Brandy Schantz (33:16.982)
Yes. get good.

Brandy Schantz (33:25.27)
Yep.

Brandy Schantz (33:30.638)
No, I know. Well, and then there's the weighing too, right? You're like, I need to get everything done before it gets bad again. Wait, wait, I don't want to overdo it because that will cause me to go backwards. So maybe I should be a bit more measured in what I'm doing. But then again, I want to get everything done. So yeah.

Mary Monoky (33:45.187)
Yes, pacing, pacing, you pace yourself. But it's almost a damned if you do and damned if you don't situation. And I think it's important that all the other people who live with this can can validate this. You're going to have good days. You will. So when somebody is going through a bad day, I try to tell them this is temporary. Nothing lasts forever. You will have good days again. You might have good weeks. You might even have a great month.

Brandy Schantz (33:52.791)
I know.

Brandy Schantz (34:01.783)
Yeah.

Brandy Schantz (34:08.375)
Yeah.

Mary Monoky (34:14.244)
You know, so you just kind of have to breathe through the tough times because nothing is forever. It says there's degrees of wellness and there's degrees of flare ups. you know, having had this really long middle decades, of riding this tide of the ocean waves, I can now say for sure nothing lasts forever. Bad days don't last forever. And to really, really embrace those good days.

Brandy Schantz (34:25.538)
Mm-hmm.

Brandy Schantz (34:38.796)
That's the truth.

Mary Monoky (34:44.016)
Good weeks. Get your list done. Have it ready. Because the good time isn't going to last, but it's not your fault. It's not your fault. You didn't overdo it. It's not your fault.

Brandy Schantz (34:47.406)
Mm-hmm.

No. Yeah.

Well, you and that's one of the things that's hard to remember. Now, sometimes it is my fault because I get a little overly ambitious and start just rushing out like nothing's wrong with me and I do overdo it. But more often than not, it's not our fault. And I think that's what is so difficult for so many chronically ill patients because we want to blame ourselves. Society wants to blame us. Yeah. How many times?

Mary Monoky (35:20.654)
Yes, they do. Yeah.

Brandy Schantz (35:24.686)
I was at an event last night and some, know, my chronic illness came up and this person says, well, don't you think it's just what we're eating? It's the food. And I said, well, I was a triathlete and at the peak of fitness. So no, I don't think it was food that caused this. You know, I mean, my diet was phenomenal. No, I don't think it was food. Yeah. And especially as women too, being that we're the majority.

of autoimmune disease patients, for the majority of dysautonomia patients. Man, we can be hard on ourselves, can't we?

Mary Monoky (36:01.318)
For sure. my underlying issue is a GI disorder. So yes, often I'm like, I don't feel well after I eat. So was lot of slow, deep breathing and telling myself, this is the same food I ate three days ago. And I didn't have a reaction then. It's randomness. I didn't do it to myself. I'm not eating a forbidden food. Like, it's not like I'm gobbling up McDonald's, but you know, it's.

Brandy Schantz (36:08.524)
Mm. Yeah.

Brandy Schantz (36:16.876)
Yeah.

Yeah.

Brandy Schantz (36:26.689)
Yeah.

Mary Monoky (36:31.366)
I, you know, when I'm in it though, when I'm in those stomach cramps and slow deep breathing, I'm like, why did I eat that? Well, the answer was because it, because it was safe three days ago when I had the same thing. So it's not that. Yeah.

Brandy Schantz (36:37.868)
Yep. I'm glad you said that.

Yes, I'm glad you said that because I do I have the same thoughts and I bet everybody else does too We all go through it

Mary Monoky (36:47.142)
That's what I'm saying. think we all share this guilt of did I cause this? No, you didn't. Well, yes, maybe occasionally. Like if you said, yeah, I had a good day and I decided it was you. That's one thing. And for me, with the gut issue, did I cause this more often than not? No. Sometimes, yeah, I'll eat cheesecake, heavy fat, and I'll pay for that. But I I but I do it ahead of time knowing that I want.

Brandy Schantz (36:54.09)
Mm-hmm. No. Yeah, sometimes I do stupid stuff.

Brandy Schantz (37:09.772)
Yeah. Yeah, you know that's gonna hurt.

Yep.

Mary Monoky (37:16.326)
to enjoy the cheesecake. But in re...

Brandy Schantz (37:18.412)
I'll usually say it out loud as if I'm acknowledging and I want everybody as my witness. Okay, I am going to eat this slice of pizza. I will regret it, but I am going to enjoy it right now.

Mary Monoky (37:21.296)
Yes.

Mary Monoky (37:25.604)
Yes. Right.

Yes, yes, think we all a lot of us have our items, whether it's your pizza or my slice of cheesecake or or for somebody else who could be going out to an event that requires a lot of movement where they're not used to it. I'm going to do it and there may be a price to pay later, but it's worth it.

Brandy Schantz (37:35.212)
Yeah. Yeah.

Brandy Schantz (37:50.018)
Yeah, yeah. I'm doing that this weekend with the Marine Corps Marathon. It's going to be, I'm going to regret it on Monday, but boy, is it going to be worth it.

Mary Monoky (37:58.641)
Well, make sure you set yourself up for Monday that you have the right comfort tools, you know, whatever it is that gives you some physical relief, have that ready and, enjoy the process of, this, this run for you and have safeguards. You know, if you have to stop and sit, be available. And then when you get home, soothe yourself and then be proud. I actually say that, you know, I, I did something over the weekend and my muscles are sore. My son said, yeah, but you earned it.

Brandy Schantz (38:01.133)
Yeah.

Brandy Schantz (38:14.09)
Yeah. yeah.

Brandy Schantz (38:21.004)
Yeah.

Mary Monoky (38:27.75)
And I'm like, that's right. That's right. Sometimes pain just happens. But this one I earned. So it's OK.

Brandy Schantz (38:28.039)
I like that.

Brandy Schantz (38:34.358)
Yeah, absolutely. So before we wrap up, I do want to ask about your son. We talk a lot about the trauma that we go through as chronically ill people. And I know your kids have had their own level of trauma themselves. My husband has gone through his own level of trauma dealing with my illness, them dealing with your illness. But we also talked about

how deep that trauma can be and how much we don't talk about it because as a mother you also live through the trauma of your son's cancer diagnosis.

Mary Monoky (39:06.182)
Yeah. All right, so just this year, I have twins. the middle boys are twins. 42 years old, was diagnosed with testicular cancer. At the time of my illness, he was 12. So from his age of 12 to 22, I was in the hospital a lot. His stability was taken away by my illness. So there was nothing secure like mom could be.

Brandy Schantz (39:20.75)
Mm.

Mary Monoky (39:32.967)
home, making breakfast in the morning in an ICU that evening. So my illness was traumatic, but we never spoke about it as adults, like how I'm stable now and how that impacted him. But this year, when he had to go through his own medical interventions, it was terrifying for him and traumatizing for me because I knew what the routine blood draws were gonna happen. I knew.

how sick he was gonna be with his chemotherapy. Not that I had chemo, I know that what it feels like to have medically induced nausea and that you have to endure. So I knew what he was gonna go through. And he never actually verbalized it, but you could see this awareness in his mind opening up and like almost his heart, like his Grinch heart was growing three times as big. He stayed with me during his weak moments.

Brandy Schantz (40:07.406)
Mm-hmm.

Brandy Schantz (40:23.852)
Yeah.

Mary Monoky (40:27.128)
And he allowed me to mother him, which is significant. He's the kind of boy that's like, I can do it all on my own. And I respect that. to allow your mother to take care of you when you're so weak. And I think there was a point where around three of his chemo, he kept saying, can walk. And I'm like, no, you can't. Let me get a wheelchair. And he's like, I can do it. And then he collapsed. And then I'm like, mom knows best. I really do.

Brandy Schantz (40:30.55)
Yeah.

Mm-hmm.

Brandy Schantz (40:54.006)
Yes.

Mary Monoky (40:55.306)
And I think it really has brought us closer. I don't know yet how to have that discussion about he did just get a good MRI yesterday. So we're thrilled with that. I think he's going to move into surveillance. So that's great news. But how how he sees his life moving forward, having survived what could be a terminal illness at 42. Yeah.

Brandy Schantz (41:07.044)
yay.

Brandy Schantz (41:21.472)
Mm-hmm. Yeah. It's interesting when you take a look at the trauma associated from all sides. I said to you earlier before we started the show, I've really been exploring that more as I'm writing my own book because my husband went through just as much as I did, but from a different perspective. And we talk about

medical trauma and what we go through as patients on this show all the time.

We talked about it a lot today, the trauma we experience as patients, but nobody really talks much about the trauma our loved ones go through or how difficult it is as a caregiver. It's almost an invisible place. We both, we've said, we felt so invisible because

Mary Monoky (42:00.135)
Mm-hmm.

Mary Monoky (42:15.365)
Yes.

Brandy Schantz (42:24.768)
our world became so small and you know, friends, colleagues, all these people you used to see in having your life suddenly sort of disappear when you're chronically ill. And people forget about you and always, you know, trying to protect you in some ways. They don't include you in life thinking that that's too much for you. You need to focus on your health. you know, when in reality, it's just hurtful that you're suddenly being forgotten about and

not included in life any longer. And then there's also your loved ones going through it as well. And it's something I don't think we explore.

Mary Monoky (42:57.189)
I think he's a.

Mary Monoky (43:04.186)
Right. I look back on myself and I'm sure I was not full of grace and joy and positive sayings. I'm sure there was some curtness, abruptness, maybe some yelling and screaming, you know, when my pain was exacerbated and I was lost and frustrated and that may have been directed inappropriately at my nearest and dearest. So not only do our loved ones have to deal with the

Brandy Schantz (43:11.468)
No, no, yeah.

Brandy Schantz (43:25.23)
Yeah.

Mary Monoky (43:34.246)
trauma of having their loved one being very ill, but the feeling that they can help and that they have, they're the recipient of our wrath unintentionally, unintentionally.

Brandy Schantz (43:40.152)
Mm-hmm.

Brandy Schantz (43:44.566)
Yes. And I think, and sometimes rightfully so, right? Like you're just going through so much. Like I said, I find myself having meltdowns randomly and I feel justified, but also we're so busy considering the trauma we've gone through. I don't think we consider enough the trauma our loved ones have gone through and what it is like to be on that other end where you are.

Mary Monoky (43:50.136)
sure, sure, sure, sure.

Brandy Schantz (44:13.666)
helpless in so many ways and you're thinking about how you can try to help, but you know, what can you do? And you're grieving your own losses, right? Like so many times for many chronically ill, you know, parents, for example, suddenly now you're a caregiver for your children again, even though they're in their forties. But now here you are back being a caregiver and there's a loss of your own independence and retirement maybe or...

things that you love doing because now you're expected to be there for your kid again. People my age, I'm Gen X, we keep talking about that sandwich generation. You're taking care of mom and you're responsible for mom or dad or uncle sometimes, whoever it is, taking care of that person plus your children. And we just don't talk about the trauma associated with that and how invisible you can be. Because everybody...

expects us to be traumatized as patients, right? When I say I'm traumatized, nobody's like, I never would have thought. Of course they did, you know?

Mary Monoky (45:12.976)
Right.

Mary Monoky (45:18.608)
But you see them in different ways. Like this year, as I was the caretaker, I could recognize myself through my son. He may not have admitted that he was tired or emotionally vulnerable, but he came out in ways like I brought him food. He's like, I don't like it. Very curt. Or he never said thank you. And I'm thinking, what did I do wrong?

Brandy Schantz (45:27.341)
Yeah.

Brandy Schantz (45:31.662)
Hmm.

Brandy Schantz (45:43.308)
Mm-hmm.

Mary Monoky (45:48.954)
Because of my experience, I knew it didn't do anything wrong. I knew that he was feeling something and it came out that way.

Brandy Schantz (45:57.358)
Yeah.

Mary Monoky (45:58.897)
But I think that we really should look at from the mother's perspective, the siblings, the husband, like my son that had the cancer this year is an identical twin. I did have a conversation with his twin and he's like, I don't even know how to mentally process this. Why him and not me?

Brandy Schantz (46:18.287)
wow. Yeah. Now that's, that's heavy. Yeah. That's heavy.

Mary Monoky (46:21.183)
right? Identical twins.

I said, I don't have an answer for that, but it's nothing you did and it's nothing he did. I don't know, but yeah, siblings. And then when the reverse happens, when your children are taking care of an adult, like a parent, my youngest child is a daughter and she feels like most of her young adulthood was being my caretaker, running, running to get a prescription, driving me to a same day procedure.

Brandy Schantz (46:29.163)
No.

Brandy Schantz (46:33.486)
Yeah.

Brandy Schantz (46:47.746)
Mm-hmm. Yeah.

Mary Monoky (46:54.854)
I wasn't aware of that until somebody else shared it with me. Oh, your daughter represents as your caretaker. It was kind of hurtful and prideful at the same moment. Right. Like it hurt that she thinks of that. But I'm glad that she feels a sense of honor in doing that. So it's very mixed up how I feel about it. I don't know how to sort it out.

Brandy Schantz (47:01.996)
Mm. Yeah.

Yes.

Brandy Schantz (47:13.995)
Yeah.

Absolutely.

You know, it's just something that's so complex. You know, I'm trying to write this one chapter on this in my book. And it's made me realize that I just need to take a step back and really think and reflect and dig deep into this reality of the trauma that our loved ones go through, the trauma we experience and understanding. It took me a while to understand. You know, you're so focused on getting well. It's like me, me, me, me, me. The doctor's appointment, the test.

Mary Monoky (47:45.851)
Bye.

Brandy Schantz (47:50.408)
It's, you completely miss how complex all of this is and those relationships and how they evolve and change and how you feel about that. So many don't.

Mary Monoky (48:01.178)
Well, and many marriages don't even survive it because of if you don't take 100 percent responsibility for your own self, your doctor's appointments, getting the test, getting the medication, nobody's going to do it for you. You know, so that is your role at that point to improve your conditions. Right. Whatever's wrong with you, if you have a swollen ankle, put ice on it. If it doesn't get better, get an x-ray. Nobody's going to tell you to do it. You have to do it for yourself. So imagine that now more.

Brandy Schantz (48:11.308)
Mm-hmm.

Brandy Schantz (48:21.133)
Yeah.

Brandy Schantz (48:27.757)
Yeah.

Mary Monoky (48:30.438)
complex where it's you know, a GI condition or or or this autonomia You're living in that body. It's your job To fix it, but then that becomes the single focus not like am I being polite to strangers today? It's just not on your mind

Brandy Schantz (48:50.08)
No, you don't think about that. You don't think about even your loved ones, my being kind, you know, when they're stressed over something that's very normal, like work. And you're like, well, yeah, well, I had to today, you know, it's not the trauma Olympics. And that includes our loved ones who aren't sick at all. You know, they're allowed to, they're allowed to be frustrated that their, you know, coworker did something stupid or their boss is a jerk.

Mary Monoky (49:11.074)
Right, right, right, but they have their own drama.

Brandy Schantz (49:20.218)
And that's totally allowable. And I think we forget that sometimes. And we also don't think about their own loss. We talk a lot about our loss and the grieving of our former selves. But I don't think I've ever really, truly explored what loss my husband went through losing the woman he married. That independent woman who, you know, was able to take on the world by herself was completely healthy. The woman who had

free time to come home and just ask about his day and be concerned that he had a bad day at work and listen and just say, hey, let's just take off and let's just walk up the road and go grab dinner and do all of these things that you just can't, he lost too.

Mary Monoky (50:06.82)
Yes, yeah maybe that one chapter needs to be its own book.

Brandy Schantz (50:08.878)
And I think so, yeah, it's just there's so much there that once I started really thinking about it, I thought, gosh, this is complicated.

Mary Monoky (50:18.426)
Yes, it's the interconnectedness of, you know, an individual person is not an island, right? No man is an island. And this example of how chronic illness can hit somebody and have the ripples, it just goes on and on and on. And even when you think it's settled, like for me, you know, 25 years, I kind of should know what's happening, then something else happens and it starts all over again. You know, the grieving with my son having now had

Brandy Schantz (50:21.602)
Mm-hmm.

Brandy Schantz (50:26.07)
No.

Brandy Schantz (50:32.566)
Mm-hmm. Yeah.

Brandy Schantz (50:42.39)
Yeah. Yes. Yes.

Mary Monoky (50:47.824)
faced a possible terminal illness. And that restarted my own grieving all over again. So I think it's a, I have to kind of realize that there's no beginning and no end. in the long middle, which means you're not gonna have the recurrence of the onset, but you're not gonna die either. There's this long middle. And it's up to us to kind of figure out what we need to.

Brandy Schantz (50:54.36)
Mm-hmm. Yeah.

Brandy Schantz (51:03.81)
the very long middle.

Brandy Schantz (51:11.726)
Mm-hmm.

Mary Monoky (51:16.89)
to stay grounded in our own reality. And what we need to find purpose and passion. For some people it's their dog. For some people it's gonna be a podcast. And for some people it might just be, growing a house plant. It's okay. Yeah.

Brandy Schantz (51:23.534)
Mm-hmm.

Brandy Schantz (51:30.742)
Yeah, absolutely. Now, you know, again, I love the long middle. I keep referring to it as long middle now. So I appreciate you introducing me to that. Mary, you know what? Before we leave, me, tell everybody how can they find you?

Mary Monoky (51:39.59)
You

Mary Monoky (51:47.662)
MaryMonikeeSpeaks.com

Brandy Schantz (51:51.096)
MaryMonikeSpeaks.com. I'll put that in the show notes as well. Thank you so much for coming on the show. We could do 15 episodes talking about diving into all of this, I think.

Mary Monoky (52:01.712)
Well, I appreciate the spotlight that you're shining on with chronic illness and everything that you do. Thank you.

Brandy Schantz (52:07.427)
Thank you. Thank you. Thank you. And thank you for listening to Living Chronic.