Survivor Story from Caregiver, Stephanie Howe
My name is Stephanie. I’m an oncology pharmacy technician, I mix chemotherapy IV’s, at Robert Wood Johnson University Hospital in Hamilton, NJ. This is my story on how I almost lost my partner, Derek, not once but three times over the course of three months in the beginning of 2020 from type A aortic dissection and aortic aneurysm.
On January 21, 2020 at 3:498pm, my phone rang and Derek’s name came up on the screen. When I answered, it was a nurse calling from an ER with an update on Derek. An update? What in the world was she talking about? She continued to explain that Derek was with her, be was brought in about half an hour earlier by ambulance and there’s something wrong with his heart, a dissection. He was being transferred to a trauma center who were more equipped to handle the situation. I asked if it was serious and she said he is going for observation, sometimes medication can fix the problem or he may need surgery. I spoke to Derek briefly; told him I was leaving work and will see him soon. I had absolutely no idea how critical the situation was, at this point! About 45 minutes later, I’m at the check in desk asking for Derek’s location and was told he was being prepped for the OR. WHAT? OR? WHAT IS HAPPENING?!? As I was brought back to him, the surgeon came in and explained that Derek has a type A dissection and needs emergent surgery. It will probably be about 7 hours. He added that this is very very serious and 50% of patients don’t make it out of the OR. Surprisingly, I stayed calm and I knew in my heart he would make it out. About 6 or 7 hours later, the surgeon comes out to talk to us, Derek’s family was there also, and starts by saying he is going to give it to us straight and that he isn’t a hero and didn’t try to be one. He was able to repair the dissection and that part of the surgery went well, however, there’s still a 7.2cm aortic aneurysm that couldn’t be repaired as he felt Derek would not have survived. Around 2am, we went up to the ICU to see Derek and speak with his nurse and then went home.
At 8:45am, January 22, the surgeon called Derek’s mom with concerns that Derek is unresponsive. What I realized later on was that phone call was to tell us that it wasn’t looking good and to get there immediately. From the time of that call, to the time his mom and I arrived, Derek had moved his toe! His lactate level was 19mmol, his AST >7000iu/L (yes, that is how it read on the results page), ALT 5,359iu/L, he was in hypovolemic shock and multiple organ failure. Miraculously, 12 hours later, Derek stabilized and was being weened off of sedation. The next day, I walk into his room and he is wide awake. I couldn’t believe my eyes! The ET tube came out a few hours later and he continued to improve and was discharged February 1, 2020.
At the follow up appointment with the surgeon, Derek still had severe shortness of breath and was told it is to be expected as his body was still in recovery. A month later it was worse and we were referred to Dr. Joseph Bavaria at University of Pennsylvania Hospital in Philadelphia. Now, it’s the end of March and Covid had hit hard. Derek was told to send his records to the office for review. Due to Covid, Dr. Bavaria was only taking critical cases. The consultation appointment was made about a week later for April 14, 2020. We left that appointment with surgery scheduled for April 22, 2020 (3 months and 1 day from the first surgery).
During those first 3 months, we knew how lucky Derek was to be alive. In fact, the cardiologist he saw afterwards sent him to cardiac rehab. Imagine Derek’s surprise when he was kicked out the first day! The cardiologist at the rehab couldn’t believe he was sent there with a 7.2cm aneurysm and severe leaky valve. What we later found out was that Derek was basically a ticking time bomb which explained the quick response from UPenn once they received all the health records. If you think that this story is unbelievable, wait until you read the next part! Ten months later and I still am still working my way through PTSD. I know every part of his health records and can rattle them off to any doctor without needing to look. I am amazed at what the human body can overcome! The shock on medical professionals faces when they hear a brief summary never ceases to amaze me. To see that look on a doctor’s face makes me realize the April surgery was one that is not done often and one with an outcome of the patient walking away with major problems to other areas of the body.
On April 22, 2020 at 5:55am, I dropped Derek off at the front entrance of UPenn for surgery. Due to Covid, I was not allowed in the hospital at all. We were told that he would probably be in for 5 to 7 days, the surgery was for dissecting aneurysm repair, redo valve and root procedure. I said I love you, see you in a week and drove away to go straight to work. What happened next nobody expected! It is noted multiple times in the surgical report how complicated the surgery was. I am still learning what everything means and Derek has a very diseased heart. This story will only tell the parts I truly understand, I’m sure there’s plenty of incredible parts to the trained eye and well some things we are better off not fully understanding!
And here it goes….
Timeline of the day:
-9:30am-text from UPenn that surgery has started
-11:43am- Karen, nurse liaison, calls with first update. So far so good. It’s looking like the valve will need to be replaced. Estimated finish time 5pm
-2:37pm-second update from Karen. Currently working on valve replacement. All is well so far. Estimated finish time 8pm
-4:32pm-final update from Karen. She was leaving for the day. Dr Bavaria wanted her to tell me that things were still smooth, they were about half way done. I should expect a call around 8pm or 9pm.
-8:26pm-I was finally connected to the floor he should have been on. Was I forgotten about? Covid policy is still new to everyone. They said I definitely would get a call once he’s out.
-9:56pm-I call again. Surely, he must be out by now?!? A little more complicated than expected. Again, promised I would receive the phone call once finished.
-11:58pm- I call again. What is going on? I don’t understand! I haven’t heard from a single person since Karen left at 4:30pm. Please tell me something, anything. They said there’s complications and he is still in the OR. At this point, I am in a complete state of panic!
-12:34am- Dr. Bavaria calls me. He said when he opened Derek up, he was a mess. They are trying their best. At this time, Derek was fighting for his life. I could hear it in Dr. B’s voice. Derek wasn’t going to make it. He told me there was a 50/50 chance but it really wasn’t looking good. This call was a minute and 8 seconds long. He told me to pray and to pray hard. He was going back in to the OR and will call me again. About 2 weeks later, I found out, when this call took place, Derek had arrested.
-3:15am- Dr. Bavaria calls and this time his voice didn’t sound as grim. Derek had pulled thru for now. In Dr. B’s own words, “Frankly, I’m amazed he made it this far!” He said Derek looked a helluva lot better than he did at the -12:30am call. It bought him some time but they didn’t know just how much. The entire aortic area had to be reconstructed and his chest must be left open for now.
-3:31am- Dr. Evans called. Nothing new to add from Dr. Bavaria’s call but he did say to me that what he just witnessed was simple incredible!
The hardest part after the first phone call from Dr. Bavaria was when I had to call Derek’s mom, who was alone at the time, and tell her that her son wasn’t going to make it. It was really bad and we were told to pray and to pray hard. After that call, I called Derek’s brother. I was in a state of hysteria and I was screaming he had to get to his mom’s house, Derek was going to die. At the time, I was living with my sister and her family. I walked into their room and I just crumbled. My sister brought me back to my room and laid down with me and rubbed my back as I screamed at the top of my lungs that God couldn’t take him from me yet and just cried and cried. To this day, she says that she has never heard someone cry like that. It was coming from deep down in my gut. She was so heartbroken to see her little sister about to lose the love of her life. There’s only one time in my life that I heard a cry similar to what was coming from me and that was 18 years ago when my best friend died and I was standing behind her mom at the cemetery. It’s a sound I was never able to describe or forget and now that sound will always be with my sister.
7 hours after the surgery had ended. Dr. Evans was on the other end, telling me that Derek wasn’t looking very good and he had to go back to the OR for what was most likely internal bleeding. I was an absolute wreck. The nurse liaison called at 1:45pm with an update. Derek was still in the OR, there was definite internal bleeding and doctors were trying to stop it. The good news was that Derek was stable, his aorta and valve looked good. Dr. Bavaria passed the message on that the next 48 hours would be the most crucial. For some reason I had it in my head that the surgery wouldn’t be much longer after the nurse’s call but boy was I wrong. At 8:38pm I sent a text to Dr. Bavaria. The following is what was said.
Dr. Bavaria, I’m so sorry to bother you. I haven’t heard from anyone in 7 hours. What’s happening with Derek?
He replied at 8:52pm
Hi! I just broke out of the operating room. Been with him all day again. I was going to call you in a bit but I’m glad you texted. He’s hanging in there. We really made a lot of progress this morning and early afternoon. Bleeding controlled and all was much better. Then out of nowhere he arrested but we were right there. I had to revise the operation a bit, which I did. He’s now off of heart and lung machine. Heart, aorta and valves all good. We’re struggling a bit with his lungs and his ability to oxygenate but he’s improving. So, we are hanging in there but it’s simply a tough road. Right now, I’m pleased with his fundamental repair and heart. The lungs have some issues.
-8:54pm: Thank you so much Dr. Bavaria
-8:58pm from Dr. B: I’m trying. I'm trying incredibly hard.
Derek’s dad passed away a couple years before I met him and Derek’s best friends’ mom, who was like a second mom to him, passed away a few years ago. After this text from Dr. Bavaria, I was so angry. I started screaming and begging his dad, Liz and my best friend who passed not to take him from me. I wasn't ready to have him taken from me. Together in the last 5 years, our relationship had grown so much and I finally was able to knock down the walls Derek always had up. We were stronger than ever before. It was not his time to go. I bartered with them, yes, I made deals with dead people but I know they were around him. Then I’m screaming for Derek to come back to me, don’t follow them!! This sounds so crazy but as a believer in the other side, it’s not so crazy after all.
At 12:30am, the nephrologist called and needed consent to put Derek on dialysis. His kidneys were shutting down. Derek and I aren’t married so I had absolutely no legal say in any of this. So I had all these different doctors calling and explaining what needs to be done then I would stop them and say his mom can only give consent. That process was just as frustrating. Now I’m cursing Derek for not marrying me already lol I was afraid that something would go wrong and no one would be able to reach his mom for consent. It was explained that is the least of my worries and consent or not, everything would be done to save Derek should another emergency take place.
That was the absolute longest two days of my life. When all was said and done, Derek had a total of 4 runs on heart and lung bypass. Over 32 hours of surgery in a 48-hour time frame. Double bypass done. The surgical report reads like a horror story. Dacron graft used to reconstruct the aortic arch in a near “total arch” two-branch graft fashion. The arch reconstruction was performed with sutures literally into the orifices of the left subclavian and into the distal arch aorta. There was no way to do a safe button dissection because the root was extremely thickened and complex. An intra-aortic balloon pump was needed. After placement, they were able to wean him off of bypass but due to significant bleeding behind the aorta, cardiac massage was required and then another run on bypass. Defibrillation and DDD was required before completion of surgery. This is about the only part of the surgical report I can understand and am probably better off not knowing how to read the rest. All I need to know is that Derek was gravely ill during and right after this surgery. Reading through my medical journal I kept, there wasn’t too much optimism in Derek waking up and being the way he once was. In hindsight, I can tell that every conversation I had with Dr. Evans, he was preparing me for the worst. This may sound like this is the end of the story but really the hardest part was just starting.
Friday April 24, 2020 at 12:13pm Dr. Bavaria sent this text:
Good Morning (noon). I’ve been with him almost continually for nearly 48 hours. He’s getting better slowly. Lungs better. Heart OK. Aorta repair excellent. Valves good… Still have some important hurdles to go however. Needs to have a normal neurological exam (not sure about that yet as we haven’t let him wake up completely yet) Also, have to monitor any infection issues which could crop up in the future. Also, kidneys need to be assessed as time goes on. But….he’s better today than yesterday and that’s important.
How amazing is Dr. Bavaria?!? I had a world renowned surgeon personally texting me and staying the night with my partner to make sure he is there should another emergency happen. I was awe struck by this. This is the moment when I knew that Derek would wake up, maybe not the same, but my heart was telling me he wasn’t going to die. The way I saw it, Dr. Bavaria saw Derek had fight left in him, otherwise, why would he have spent all that time trying to save him?
A little after this text, Dr. Evans called to give me a summary. I was still trying to process all of what took place and honestly, 11 months later, I am STILL trying to process the complications. By the time I received this phone call, I was scarred for life by the sound of a phone ringing. I didn’t want to hear it anymore. My heart stopped and still skips a beat every time it rings. In fact, I had to send a group text to my family and friends explaining that I will keep them in the know as I hear more details but please under no circumstance call me. Since I lived with my sister, I let the family know, that I was ok and safe. If for any reason, something goes wrong, Allison (my sister) would reach out to them, however, they were more that welcome to call her to check in on me. So back to Dr. Evans call. He explained that Thursday morning Derek’s blood pressure was all over the place and his hemoglobin tanked, which prompted the 2nd surgery. He did arrest and they think it was a graft from Wednesday’s surgery that clotted and Derek was back up to CICU around midnight. His kidney function ceased which is why the nephrologist called at 12:30am. Dialysis was doing its job and removing the toxins. He ended the call noting that Derek was still gravely ill. They don’t know about brain function and it’s still too far away for any neurological exams/tests.
Derek was stable by Saturday morning which in turn made me a little more stable. By the evening they had stopped the paralytic agent and Derek opened his eyes and wiggled a finger. I was ecstatic and the nurse was too! She made sure to follow with he is still very sick but it’s a win for the day! The only surgery that came after this was the next day which was to finally close Derek’s chest and by Sunday night they had the feeding tube placed in his nose. As the hours passed I relaxed a little more. I went back to work Tuesday April 28.. As always I thanked Dr. Evans for what he’s done so far and he said Don’t thank us until he leaves the hospital, that will be the big victory! I was met with open arms by my amazing coworkers who showed me so much love and gave me so much support that first morning back. I was so grateful for them and I really don’t think I would have gotten thru the next 6 weeks without them. The last time they all saw me was the day of the surgery and all was well, no complications. They were there for me every step of the way. I cried, they cried. A wiggle of a toe, we all celebrated. A setback, we cried together. I could go to any area of my building and someone would be there to hug me or to let me cry on their shoulder. Everyday they told me how strong I was, stronger than I knew myself to be. I will forever be grateful to my coworkers for always being there for me and living the emotions as I went thru them.
From April 22 to May 1st Derek was on life support. Once they closed his chest up on April 26, he continued to make progress with a few set backs here and there. Here’s a summary of the happy and the sad
April 27- Big day for Derek!
· Balloon pump came out and vitals held steady
· The vent was at 70% oxygen the night before and now it was at 50%
· Dialysis still doing its job. At this point, staff were concerned that dialysis would be needed after discharge
· The best news was although Derek was still heavy sedated at this point, he kept opening is eyes and looking at staff when they called his name and followed their finger also
· Good Day! Derek was answering commands (yes/no) and moving arms and legs so no head CT scan was needed.
· His lungs were improving. Oxygen was at 40% and switched to pressure support so he was breathing over the vent.
· Dialysis was still 24/7, they were going to do another 3 days of that and then reevaluate
· At 4pm, I had a long talk with Dr. Evans. I asked him what he thought Derek’s chances are compared to how he was a week ago. He said, the future looks good but we still need to take it day by day. Derek’s risk factors pretty much hold the answers only time will really tell. They were kidney failure, liver failure and the fact that Derek arrested twice and the 4 runs on heart/lung bypass. And the platelet count of 34. That conversation left me feeling defeated and not very optimistic. This was day 7 and I was losing hope. And since I wasn’t able to see him and hold his hand made it that much harder. I wrote Dr. Bavaria and text but it came from my heart and felt I needed to say what I had to. I truly thought Derek wasn’t going to come home ever again.
· Derek gave a thumbs up to his nurse which was significant! When Derek woke up from the emergency surgery in January, he couldn't really speak so he would give a thumbs up to acknowledge he understood what was being said. So when the nurse told me he did this today, I cried my eyes out and explained the significance. I knew in that moment that he would be ok and that he didn't lose any brain function like the doctors had feared.
· Dr. Evans did the bronchoscopy first thing in the morning. Besides some heavy mucus, Derek’s lungs look great. They were aiming for the following day to take the breathing tube out.
· At the end of the procedure, they had to shock Derek’s heart to get it back to normal rhythm (at this point I had decided that Derek did not like to be sedated anymore lol)
· Dialysis was still 24/7 with hopes of re-evaluating in another 3 days
· I was able to facetime with Derek. I think that may have been the happiest day of my life. He did have a bit of ICU psychosis. He was insisting on leaving but I had his car so he said he would call his brother to come get him. I told him he has come so far and has no idea what he just went thru and to just take deep breaths for me and I promised I would be with him every step of the way.
· Also, they were going to try him on 3x a week dialysis so he could go to the step down floor.
· Derek went to the step down unit and the feeding tube finally came out!
· His spirits were great. He was calmer and in a much happier mood. No longer asking me to come help him escape at 5:30 every morning lol
On May 12, Derek and I were facetiming and who walks in? Dr. Bavaria and Dr. Evans! This was the first time Dr. Bavaria had seen Derek alive, awake and talking. I will never ever forget his reaction. Even with a mask on, I could see the happiness in his eyes. Dr. B must of asked every single staff member in the room, how great does Derek look? Can you believe it? Dr. Evans said I know, it’s incredible and Dr. B says, it’s fucking great!! There are no words to describe how truly happy I was in that moment and I was so glad I got to witness it first hand! It gave me instant peace of mind. Ever since this day, when I think back to April and those horrible first weeks, I don’t really hear Dr. Bavaria the way he sounded on that very first call. I can hear and picture him and the happiness written all over his face that Derek was up and talking to him. My heart was so full of love!!
Derek continued to improve with each passing day. His blood levels were doing good, they got his Coumadin level steady pretty quickly. On May 14, during our conversation, Derek told me that he had been peeing on his own. He didn’t know what the big deal was. I said, you are peeing, your kidney function is coming back. Just like when he was able to breath over the vent, he was peeing over dialysis. May 20, dialysis was officially finished! His kidneys made a total recovery. During this time, I was working with the social worker about discharge and we were trying to find outpatient by my job to make it easier for me as his caretaker. It was so great that we didn’t have to worry about that anymore! Around this time, the nurses explained to me that Derek’s toes were necrotic. It was on both feet with the left foot being the worst. There were many consult visits from various doctors. No one wanted to jump the gun and go right for amputation. His body went thru a lot and another surgery was definitely not ideal. Worst case, his toes would eventually fall off. Best case, and there’s no way this would happen, Derek would regain circulation to his feet and maybe just lose the tips. We were both told not to get our hope too high because the likelihood was slim to none.
May 26, 2020 (5 weeks later) DISCHARGE DAY!!!! The social worker set it up so I would be able to pick Derek up and bring him to inpatient rehab closer to home. I cried sad tears, happy tears, and laughed the whole way there. What a journey it’s been and I knew there was still a lot more work to come. Derek was at rehab for a week and then was discharged home on June 3, 2020. The following day we had his 6 week post op appointment with Dr. Bavaria. Derek was the most popular patient. Everyone came in to see him and even Dr. Evans facetimed us since his time at Upenn was finished. Derek is always referred to as the miracle man by the office staff. When we got home from that appointment, we wanted to celebrate so we ordered out. Derek enjoyed eating real food, so much so that he bit his tongue and it wouldn’t stop bleeding. So off to the ER we went. Again, because of Covid I wasn’t allowed to stay with him but since it was the hospital I work at, they let me stay with him to get checked in since he couldn’t talk. Some topical tranexamic acid and the bleeding finally stopped after close to 4 hours and back home we went. He told me that the ER doctor was simply amazed by all he had just went thru and was not the first nor the last doctor to ask Derek if he knows how lucky he is to be alive?!?
It was a huge adjustment when he got home. He was so weak and could hardly eat between his tongue and a weird taste he kept complaining about. Then the wound clinic happened. It was what we thought a simple follow up appointment from inpatient rehab but the wound clinic nurse was in for a real treat lol She worked on his toes, which at this point, looked phenomenal. What the doctors said was close to impossible actually happened. Derek’s toes started to heal and regain circulation. At that initial appointment, I asked the nurse if she does leg wounds as well. She was in for a shock of a lifetime when she saw the leg wounds. They were huge and starting to get infected. We had a home nurse coming but I was always at work when they were there. Derek said homecare wrapped the wounds per instructions from UPenn and said they looked great. That’s when I knew the homecare nurses were pretty much useless. I would end up redoing everything when I got home at night. And it was very clear the wounds didn’t look normal. So now we had weekly appointments at wound clinic for toes and legs. They were wonderful and so awesome with us. About 2 months later, the leg wounds were healed and his toes were back to normal!! He lost the very tip of 3 toes but you would never know it by just looking at them.
I wish I could say that everything was smooth sailing from inpatient rehab to wound clinic to being home in his own bed. Unfortunately, 3 weeks after discharge from UPenn, Derek’s breathing was getting really bad. As his caretaker, I was beyond concerned. I would listen to him sleep and his breathing was not right and he was still really winded just walking 10 steps. I tried for days to get him to go to the ER because it was very serious but he never wanted to go. If you asked Derek then or even now, he will tell you he feels great, he’s alive and that’s good enough for him. Of course, it’s wonderful but he was ignoring the whole breathing issue. A nurse finally convinced him to go to the ER at UPenn. Derek was in congestive heart failure. He was admitted and stayed for a week. They took over a liter of fluid out of his lungs and chest. When he left UPenn in May, his ejection fraction was roughly 45%. Sadly, somewhere between discharge and readmission he had a major heart attack. He didn’t feel a thing, even to this day when I tell him that he looks at me like I’m crazy. His most recent echo was Feb 12,2021 and his EF is at 30%. Not the news we wanted to hear but miracles happen and with the help of modern medicine, maybe just maybe we can get that a little higher.
Derek is my world. I almost lost him twice in the span of 3 months. Here we are a month shy of his year anniversary of his April operation, which I consider the real surgery. It’s been tough, for me as well as for him. I cannot possibly imagine what he went thru, what he thinks when he opens his eyes each morning and realizes he here another day. How could anyone fathom that feeling without going thru it personally? I never downplay what happened to him. In fact, I often say that Derek wasn’t just knocking on Heaven’s door, he entered and said Nope, not yet God and came back to us. He doesn’t have any outer body experience stories, although he is convinced there’s a sportsbook at UPenn and he was there with Dr. Evans at the bar. Those must have been some good drugs he was on!
Derek is not one to show emotions, he holds everything in. We have struggled together in the past 6 months. To him, he was the patient, he was the one who went thru all the surgeries and the recovery. He doesn’t understand why I get so upset at times. I tell him, those 10 days you were on life support, I lived it. I went to work everyday, taking calls from all different doctors, then taking that information and sending it in a daily group text to keep everyone updated. His one friend asked me if one of the texts I sent was from the doctor himself. I said no, I wrote that based off the notes from my call with the doctor. She couldn’t believe how well it was written. And due to my profession, I understood every single thing the doctor explained daily. When Dr. Evans told me that his platelets were a bit low, I asked what were they at and when the answer was 34, I freaked out. I knew that was bad! Derek didn’t have a clue what was happening at that time. That’s another struggle I am currently going thru and have been since this all began. I work at an outpatient oncology center. I have nurses, doctors, pharmacists, social workers and more right there, everyday. Anything I don’t understand, I will simply ask. One of the doctors I work with, Dr. David Richards, had been my angel here on earth. I thank him all the time. And he always says, what have I done? My answer, Dr. Richards you’ve done more for me than you will ever know! Ever since he found out about the April surgery, he checks in with me on the days he’s in the building. Always looks at Derek’s labs when I’m worried about something. Asks about Derek by name, not hey how’s your boyfriend doing. It’s little things like that, that I appreciate. And my coworkers have been amazing with answering my questions to the best of their knowledge. This has been the hardest year of my life and without every single one of my coworkers, there’s no way I would have gotten thru the darkest days.
The problem lies with Derek and listening to me. I may not have RPh, RN, or MD after my name but I am very smart. I explain everything to Derek in a way for him to understand. I let him know why his counts may be off, or what he’s feeling is a side effect from the medicine. I have been right about 97% of the time but yet he doesn’t listen to a word I say. So instead, I have to go to the doctor appointments with him and ask the doctor, in front of Derek, questions that he and I have already discussed just so there’s an MD answering him. I’m sure a lot of it has to do with he’s probably scared to death and can’t take in the enormity of it all. But it’s beyond frustrating. I lost the girlfriend role along the way and now have caretaker as my title. Obviously, things will never be the way they were before January 21, 2020. There’s things he can’t do and won’t ever be able to do, like work again, but I’m ok with that. As long as I still have him here with me, it doesn’t matter what obstacles we have to hurdle together. I think a part of him doesn’t want me to see him this way and doesn’t want me to have to take care of him. I tell him I love him and all of that stuff doesn’t matter to me. If we were married, it’s a vow we would take. In sickness and in health. I’m not trying to be a nag or a know it all, I just want to help him so he can enjoy whatever time he has left on Earth and hopefully with us, together with a future. This is life, there’s no guarantees. I could just as easily die tomorrow, we don’t know what the future holds. I want him to let me back into his heart, to get back to the love we had, that I STILL HAVE, for each other. Maybe him reading this story will help him understand my side of the story. I always ask him to talk about what’s on his mind about the surgeries, current health issues or anything else he may be worried or scared about. I tell him, I am there for him and have been every step of the way, holding his hand when we couldn’t be together during those 6 weeks. He let go somewhere along the way and I get it and I try to understand how scary it his from his perspective. My world shattered January 21, 2020, again on April 22, 2020 and then in August 2020 when I was no longer the girlfriend/partner or any title of the sorts. But I hope one day, he will find my hand again and hold on to it. We are in this together and I love him with all my heart.