Effective Pain Management and Symptom Control in Palliative Care for Rhabdomyosarcoma Patients

Effective Pain Management and Symptom Control in Palliative Care for Rhabdomyosarcoma Patients

Palliative care is a crucial part of the treatment plan for patients diagnosed with rhabdomyosarcoma. This rare type of cancer primarily affects children and adolescents, presenting unique challenges for pain and symptom management.

Rhabdomyosarcoma patients often face a grueling battle with various symptoms that can significantly impact their quality of life. These symptoms may include chronic pain, fatigue, and emotional distress. Here, we delve into how palliative care can help alleviate these burdens and provide relief.

The role of palliative care in cancer treatment cannot be overstated. It aims to enhance comfort and improve the life quality of patients at any stage of the illness. By focusing on both physical and emotional needs, palliative care teams work closely with other healthcare providers to ensure a holistic approach.

Pain management forms a core part of palliative care, aiming to address the multifaceted nature of pain. From medications to non-drug approaches like physical therapy and relaxation techniques, there are multiple strategies to help manage pain effectively.

Symptom control goes hand-in-hand with pain management and includes addressing fatigue, nausea, and other distressing symptoms. Techniques such as lifestyle modifications, nutritional support, and complementary therapies can make a significant difference.

Lastly, supporting patients and their families through this challenging time is essential. From counseling services to support groups, many resources are available to help everyone involved cope better.

Understanding Rhabdomyosarcoma and Its Challenges

Rhabdomyosarcoma is a rare and aggressive type of cancer that affects the soft tissues, often those connected to the muscles. It is most commonly diagnosed in children and adolescents, with about 350 new cases identified in the United States each year. This type of cancer is known for its rapid growth and tendency to spread to other parts of the body, such as the lungs, bone marrow, and lymph nodes. Because of its aggressive nature, early detection and swift intervention are crucial for improving the prognosis.

One of the biggest challenges with rhabdomyosarcoma is its diverse presentation. The symptoms can vary widely based on the tumor's location. For instance, a tumor in the head or neck might cause issues with vision or swallowing, while tumors in the limbs could result in noticeable lumps and mobility issues. These varied symptoms can sometimes lead to delays in diagnosis, making the condition more difficult to treat effectively.

The treatment of rhabdomyosarcoma often involves a combination of surgery, chemotherapy, and radiation therapy. These treatments can be grueling and have significant side effects, including pain, fatigue, and nausea. It's essential to balance aggressive treatment with quality of life considerations, thereby making palliative care a vital component of the overall approach. Palliative care teams work alongside oncologists to manage symptoms and provide emotional support, helping both the patients and their families navigate this challenging journey.

Another significant challenge is the emotional and psychological impact on the patients and their families. The stress of dealing with a cancer diagnosis, coupled with the intense treatment regimens, can lead to anxiety, depression, and emotional fatigue. Support services, including counseling and support groups, are critical in providing emotional resilience and helping families cope better with the situation.

"Managing rhabdomyosarcoma is not just about treating the cancer; it's about addressing the whole patient – their physical, emotional, and psychological needs," says Dr. Jane Smith, a leading pediatric oncologist.

Research and advancements in medical technology have improved the survival rates for rhabdomyosarcoma over the years. However, the rarity of this cancer means that it is still under-researched compared to more common types of cancer. Continued investment in research is essential for developing new and more effective treatments that can offer hope to those affected by this challenging disease.

Given the complex nature of rhabdomyosarcoma and its treatment, a multidisciplinary approach is often required. This involves pediatric oncologists, surgeons, radiation therapists, nurses, and palliative care specialists working together to create a comprehensive treatment plan. Such collaboration helps in catering to the multifaceted needs of the patient, making sure no aspect of their care is neglected.

In conclusion, understanding rhabdomyosarcoma and its challenges involves recognizing the physical, emotional, and psychological burdens it places on patients and their families. A balanced approach that combines aggressive treatment with supportive palliative care can make a significant difference in managing the disease and improving the overall quality of life for those affected.

The Role of Palliative Care in Cancer Treatment

Palliative care plays a vital role in the treatment of cancer, especially for patients dealing with conditions like rhabdomyosarcoma. These patients often experience severe pain and a range of other distressing symptoms that significantly affect their quality of life. Palliative care aims to alleviate these issues by providing comprehensive support that addresses physical, emotional, and psychological needs.

One of the cornerstones of palliative care is pain management. It's not just about prescribing medication but also about understanding the nature of the pain, its origins, and how it impacts the patient's day-to-day life. For instance, some patients might benefit from opioid medications, while others might find relief through non-drug approaches like physical therapy or relaxation techniques. The goal is to find a balance that provides the most comfort with the fewest side effects.

Symptom management is another crucial aspect. Patients with rhabdomyosarcoma often deal with nausea, fatigue, and respiratory issues. Palliative care teams focus on these symptoms and tailor treatments to individual needs. This might include dietary changes, exercise programs, or complementary therapies like acupuncture. Every approach is personalized, ensuring that each patient receives care that is as unique as their condition.

Amazing advances have been made in understanding how palliative care can improve the lives of cancer patients. Studies have shown that early integration of palliative care can lead to better symptom control, improved quality of life, and even extended survival rates. By addressing both the physical and emotional aspects of the illness, palliative care provides a more holistic approach to treatment.

When it comes to emotional and psychological support, palliative care is indispensable. The diagnosis of a rare cancer like rhabdomyosarcoma can be a devastating blow, not just for patients but for their families as well. Palliative care teams often include social workers, counselors, and spiritual advisors who provide a broader support network. This holistic support system enables patients and families to cope better with the emotional toll of the illness.

"Palliative care is about much more than just managing physical symptoms; it's about improving the overall well-being of the patient," says Dr. Jane Smith, a leading oncologist.

Communication is another essential component. Palliative care teams act as mediators between patients and their primary healthcare providers. They ensure that all parties are on the same page regarding treatment goals and expectations. This coordinated approach helps in making informed decisions about the treatment options, offering a clearer path for patients and their families.

Another interesting aspect is the focus on family support. Families often bear a significant part of the caregiving responsibilities, which can be overwhelming. Palliative care provides resources and training for family members, teaching them how to care for their loved ones effectively. This support extends to bereavement care, helping families cope with loss and grief even after the patient has passed away.

Ultimately, the goal of palliative care for rhabdomyosarcoma patients is to provide a better quality of life. By addressing the multifaceted needs of both patients and their families, palliative care offers a more compassionate approach to cancer treatment. It's not just about extending life but about making every remaining day as comfortable and fulfilling as possible.

Pain Management Strategies

Pain Management Strategies

Managing pain effectively is a cornerstone of palliative care for patients with rhabdomyosarcoma, given the complex and often severe nature of cancer pain. These strategies encompass a range of approaches, from medication to holistic therapies, each tailored to meet the patient's unique needs. Understanding the multi-dimensional aspect of cancer pain, healthcare providers can adopt a multi-pronged approach to provide relief.

Medications are usually the first line of defense against pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and adjunctive medications, like antidepressants or anticonvulsants, can be used in combination to manage pain. Opioids, while effective, need careful monitoring and management due to the risk of dependency. It's crucial to adjust dosages based on patient feedback and pain levels, ensuring a balance between relief and safety.

In some cases, interventional pain management techniques may be necessary. These can include nerve blocks, spinal cord stimulation, or epidural injections. Such methods are often considered when traditional pain medications are insufficient or cause significant side effects. These interventions can target specific pain sources, providing localized relief.

Holistic and non-pharmacological approaches also hold significant value in pain management. Techniques such as physical therapy, massage, and acupuncture can reduce pain and improve overall well-being. Regular physical activity helps in maintaining mobility and reducing pain severity. Complementary therapies like meditation and relaxation exercises can help manage the emotional aspects of pain, providing a sense of control and tranquility.

Psychological support is another crucial component. Chronic pain is not just a physical experience but also an emotional and psychological one. Counseling and support groups can play a significant role in helping patients cope with pain. Cognitive-behavioral therapy (CBT) has shown promise in empowering patients to manage their pain through positive thinking and behavior modification. These therapies can be a lifeline for patients, offering daily strategies to handle pain.

Nutritional support also impacts pain management. A balanced diet can enhance the effectiveness of pain management strategies and improve the patient's overall health. Proper nutrition supports the body's ability to heal and respond better to treatments, while hydration is essential to manage medication side effects and overall well-being.

Family involvement is equally important. With a solid support system, patients are more likely to report manageable pain levels. Educating family members on pain management techniques and encouraging their involvement in the care process can alleviate patient stress and improve outcomes.

According to the World Health Organization (WHO), comprehensive pain management is essential for maintaining the quality of life in cancer patients. They emphasize a step-wise approach, starting with non-opioid medications and escalating to stronger opioids if necessary. This method, known as the analgesic ladder, ensures a systematic approach to pain management.

StrategyEffectiveness
MedicationsHigh
Interventional TechniquesModerate to High
Holistic TherapiesModerate
Psychological SupportHigh
Nutritional SupportModerate
Family InvolvementHigh

Effective pain management for rhabdomyosarcoma requires a comprehensive approach. By embracing various strategies and tailoring them to the patient's needs, healthcare providers can significantly improve the quality of life for these young warriors fighting a tough battle.

Symptom Control Techniques

Managing symptoms in patients with rhabdomyosarcoma is fundamental for enhancing their quality of life. These symptoms can be incredibly varied, including fatigue, nausea, weight loss, and emotional distress. Proper symptom control techniques ensure patients can better tolerate the discomfort and maintain some level of normalcy in their lives.

One of the most common symptoms encountered is fatigue. This can be overwhelming and severely affect daily activities. Techniques to combat fatigue often include regular, gentle exercise, such as walking or swimming, which helps boost energy levels and improve mood. Adequate sleep is also essential, and creating a sleep-friendly environment can make a big difference. Limiting caffeine intake and maintaining a consistent sleep schedule are simple but effective steps.

Nausea is another prevalent symptom. Dietary adjustments can help manage this issue; patients are advised to eat small, frequent meals throughout the day rather than three large ones. Foods that are bland and easy to digest, like crackers and applesauce, can help minimize nausea. Sometimes, anti-nausea medications prescribed by doctors can provide relief as well. Additionally, ginger tea or ginger supplements have been found soothing for the stomach.

Weight loss can be particularly concerning, especially in younger patients. High-calorie, high-protein diets are beneficial to ensure patients receive the necessary nutrients without having to eat large volumes of food. Supplementary drinks like protein shakes can be extremely helpful. Working with a dietitian to create a personalized eating plan can offer tailored solutions that cater specifically to the patient's needs.

"A well-balanced diet is critical and can profoundly impact how well patients cope with their treatment," states Dr. Sarah Thompson, a renowned oncologist.

Emotional distress is an often overlooked but critical symptom. Counseling and mental health support, such as seeing a psychologist or joining a support group, are essential to manage this aspect. Encouraging open conversations about their feelings can alleviate some of the burdens these patients carry. Stress-reduction techniques like meditation and deep-breathing exercises can also be valuable tools for emotional management.

Skin care is essential for those undergoing treatments like radiation, which can cause skin irritation. Gentle, fragrance-free moisturizers and avoiding extreme temperatures while bathing can help keep the skin in good condition. Additionally, wearing soft, breathable fabrics can reduce skin irritation.

Regular monitoring of symptoms is vital for effective management. Keeping a health diary can help patients and medical professionals track symptom patterns and recognize triggers. This information is crucial for tweaking treatment plans and ensuring proactive management of symptoms.

To summarize, managing symptoms in rhabdomyosarcoma patients involves a multi-faceted approach. By addressing both physical and emotional needs, we can significantly improve the patient's comfort and quality of life. Simple lifestyle changes, dietary adjustments, and mental health support all play critical roles in symptom control.

Supporting Patients and Families

Supporting Patients and Families

Supporting patients and their families through a diagnosis of rhabdomyosarcoma involves a compassionate approach and a range of resources designed to assist with both emotional and practical challenges. A cancer diagnosis, particularly a rare one like rhabdomyosarcoma, can be overwhelming, and family members often find themselves in need of care and support just as much as the patients do.

One of the primary goals of palliative care is to offer psychological and emotional support. Counseling services are available to help patients navigate their feelings about the illness, treatment, and life changes. These services extend to family members, allowing them to express their concerns and anxieties openly. Children and adolescents, in particular, may struggle to articulate their fears, and professional counselors can provide them with the tools to understand and manage these emotions.

Support groups offer another valuable resource. These groups allow patients and their families to connect with others who are going through similar experiences. Sharing stories and hearing from individuals who understand their struggles can significantly alleviate feelings of isolation. It's common for these groups to be facilitated by healthcare professionals who can guide discussions and provide expert insights.

Financial insights help ease the burden of care, which often includes extended treatment and hospital stays that can strain a family's resources. Many organizations offer assistance programs for medical expenses and other costs associated with long-term care. Social workers are also a key part of the palliative care team, helping families navigate financial options and access appropriate services.

“Too often, healthcare is thought of exclusively as medical services. But when we're talking about palliative care, it needs to be comprehensive and include emotional and financial support as well,” says Dr. Martin Connor, a leading palliative care specialist in Australia.

Regular family meetings with the healthcare team can enhance communication and ensure everyone is on the same page regarding treatment goals and care plans. These meetings provide an opportunity for family members to ask questions, discuss concerns, and receive guidance on the patient's day-to-day needs.

Educational workshops and seminars for families are another excellent support mechanism. These events can offer valuable information about the disease, treatment options, and coping strategies. They also serve as a platform to learn from medical professionals and connect with other families facing similar challenges.

Creating a supportive home environment is equally essential. Healthcare professionals can advise on making necessary home adjustments to accommodate the patient's needs, such as setting up a comfortable recovery area and ensuring accessibility. Additionally, teaching family members about symptom management techniques can empower them to provide effective care at home.

Spiritual care and support are available for those who find comfort in their faith. Chaplaincy services are often integrated into palliative care programs, offering spiritual counseling and support tailored to individual beliefs and practices.

In summary, supporting patients and families dealing with rhabdomyosarcoma involves more than addressing medical needs. It encompasses emotional, financial, and spiritual aspects, ensuring that both patients and their families receive comprehensive care. The goal is to enhance the quality of life and provide a network of support that fosters resilience and hope.

Comments (18)

  1. Matt Gonzales
    Matt Gonzales September 12, 2024

    Wow, this is such a needed conversation 🙏
    My cousin went through rhabdomyosarcoma at 11, and the palliative care team was literally their lifeline.
    Not just meds, but the music therapy, the silly cartoon marathons, the quiet hugs after chemo… that’s what stuck with us.
    They didn’t just manage pain-they made space for joy, even in the hardest moments.
    People think palliative = giving up, but it’s really about fighting for quality, not just quantity.
    So proud of the teams doing this work. You’re heroes in scrubs.
    Also, if you’re reading this and know someone going through it-send a meme. Seriously. It helps more than you know 😄

  2. Richard Poineau
    Richard Poineau September 12, 2024

    This is just another example of how medicine has become a feel-good industry instead of a science.
    Why are we wasting resources on "emotional support" and "acupuncture" when we could be investing in real cures?
    These kids are dying. You think a meditation app is going to save them?
    And who approved this nonsense? The government? Insurance companies?
    Stop coddling. Start curing.
    Or are we too soft now to tell kids the truth-that sometimes, there’s no magic fix?
    Just sayin’.

  3. Angie Romera
    Angie Romera September 13, 2024

    OMG I CANNOT BELIEVE THIS IS STILL A THING 😭
    Like seriously-why is it so hard for hospitals to just BE HUMAN?
    I watched my little brother scream through 17 rounds of chemo and no one even held his hand until the last week when the palliative team showed up.
    Why did it take that long??
    They didn’t even bring him a stuffed animal until he asked for one.
    And now we’re writing essays about it??
    Just DO THE WORK.
    People are dying here.
    Stop making it a TED Talk.
    And stop calling it "holistic"-it’s just basic decency.
    And yes I’m crying right now writing this.
    So what.
    It’s real.

  4. Jay Williams
    Jay Williams September 15, 2024

    It is imperative to underscore the profound significance of integrating palliative care into the therapeutic paradigm for pediatric oncology patients afflicted with rhabdomyosarcoma, a condition which, due to its rarity and aggressive biological behavior, necessitates a multidisciplinary and highly individualized approach to symptom management.
    While pharmacological interventions remain foundational, the adjunctive application of non-pharmacological modalities-including physical rehabilitation, cognitive behavioral strategies, nutritional optimization, and psychosocial counseling-constitutes a paradigm shift in oncologic care, one that prioritizes the integrity of the patient’s lived experience over mere survival metrics.
    Furthermore, the involvement of family units as active participants in care planning is not merely beneficial-it is ethically indispensable.
    It is incumbent upon healthcare institutions to institutionalize these practices as standard of care, not as optional extras.
    Moreover, longitudinal studies have demonstrated that early palliative intervention correlates not only with enhanced quality of life but also with reduced hospitalization rates and improved adherence to treatment regimens.
    Therefore, we must advocate for policy reform, increased funding for palliative training programs, and the dismantling of the false dichotomy between curative and comfort-oriented care.
    Let us remember: healing is not synonymous with cure.
    And sometimes, the most courageous act is to hold space for someone who is dying-without rushing them, without sanitizing their pain, without pretending they are not afraid.
    That is not weakness.
    That is medicine at its most human.

  5. Sarah CaniCore
    Sarah CaniCore September 16, 2024

    Ugh. Another article about how we need to "be nicer" to dying kids.
    Where’s the data on actual survival rates?
    Did any of this "emotional support" make one single child live longer?
    Probably not.
    So why are we spending millions on massage therapists and support groups instead of funding real research?
    It’s all theater.
    And don’t get me started on acupuncture for a 7-year-old.
    That’s not medicine. That’s wishful thinking with a price tag.

  6. RaeLynn Sawyer
    RaeLynn Sawyer September 17, 2024

    This is why medicine is broken.
    They treat feelings like they’re symptoms.
    And now we’re giving kids coloring books instead of cures.
    Pathetic.

  7. Janet Carnell Lorenz
    Janet Carnell Lorenz September 17, 2024

    My niece had rhabdomyosarcoma. She was 8.
    They gave her a teddy bear with a heartbeat simulator.
    She named it Bob.
    Bob went to every chemo session.
    She didn’t live to see 10.
    But she smiled more in those last months than she had in years.
    And that? That wasn’t fluff.
    That was love in action.
    Don’t ever tell me comfort isn’t medicine.
    It’s the only kind that doesn’t burn.

  8. Michael Kerford
    Michael Kerford September 18, 2024

    Y’all are so obsessed with being woke about this stuff.
    Real talk: nobody cares about your "holistic approach" when your kid’s organs are shutting down.
    They care about who’s got the next trial drug.
    And if you’re spending time on yoga for pain, you’re not fighting hard enough.
    Just saying.

  9. Geoff Colbourne
    Geoff Colbourne September 19, 2024

    Look, I get it, emotional support is cute.
    But let’s be real-how many of these "palliative care teams" are just glorified social workers with better titles?
    And who’s paying for all this?
    Insurance companies? Taxpayers?
    Meanwhile, the real breakthroughs are happening in immunotherapy labs.
    Why aren’t we funding THAT?
    Why are we turning hospitals into therapy centers?
    It’s not compassion-it’s distraction.
    And it’s expensive.
    And it’s not saving lives.
    Just making people feel better about not saving them.

  10. Daniel Taibleson
    Daniel Taibleson September 19, 2024

    The integration of palliative care into the standard oncologic protocol for rhabdomyosarcoma represents a paradigmatic evolution in patient-centered care, aligning with the principles of bioethics, particularly beneficence and non-maleficence.
    While the efficacy of pharmacological interventions is well-documented, the complementary role of psychosocial, spiritual, and environmental interventions warrants rigorous empirical validation.
    It is therefore incumbent upon researchers and institutional review boards to prioritize longitudinal, randomized controlled trials evaluating the impact of early palliative intervention on both symptom burden and overall survival.
    Until such evidence is robustly established, the deployment of non-evidence-based modalities-however well-intentioned-risks perpetuating therapeutic misconception among vulnerable populations.
    Let us not mistake comfort for cure, nor compassion for clinical efficacy.
    Progress requires data-not anecdotes.

  11. Molly Britt
    Molly Britt September 20, 2024

    Did you know the government funds this stuff to distract us from the real truth?
    They’re hiding the fact that rhabdomyosarcoma is caused by 5G radiation from school Wi-Fi.
    And the "palliative care"? It’s a cover-up.
    They don’t want you to know the real cure is magnesium and lemon water.
    But they’ll sell you $200 massages instead.
    Wake up.
    They’re lying to you.
    And your kid is paying the price.

  12. Nick Cd
    Nick Cd September 21, 2024

    my cousin died of rhabdomyosarcoma and no one told us about this until it was too late
    why is this info so hidden
    why do hospitals hide the truth
    they want you to suffer so they can make money
    they dont care about your child
    they care about the insurance payout
    and the research grants
    and the fancy new machines
    they dont care if your kid smiles
    they care if the chart is filled out
    and the billing code is right
    and the grant report is submitted
    they dont care
    they never did
    and now im crying again
    and im not even the parent
    im just the cousin
    and i still feel it
    so hard
    so hard
    so hard

  13. Patricia Roberts
    Patricia Roberts September 22, 2024

    Oh wow, so now we’re treating cancer like a spa day?
    Let’s give the kid a lavender-scented blanket and call it medicine.
    Meanwhile, in Japan, they’re using CRISPR to delete tumors.
    Here? We’re doing group hugs.
    Progress.

  14. Barnabas Lautenschlage
    Barnabas Lautenschlage September 24, 2024

    There is a compelling body of evidence supporting the early integration of palliative care in pediatric oncology, particularly for aggressive malignancies like rhabdomyosarcoma. The data from landmark studies-such as those published in the New England Journal of Medicine in 2010 and 2015-demonstrate not only improved symptom control and psychological well-being, but also a measurable increase in survival time when palliative teams are engaged concurrently with curative treatment.
    This is not a luxury. It is not a trend. It is a clinically validated approach that reduces unnecessary suffering and enhances decision-making capacity for families under extreme duress.
    The resistance to this model often stems from a cultural aversion to discussing death, not from any deficiency in the model itself.
    It is also worth noting that the multidisciplinary nature of palliative care-encompassing nursing, social work, chaplaincy, and pain specialists-creates a safety net that prevents the fragmentation of care, which is common in high-acuity pediatric oncology settings.
    To dismiss this as "feel-good fluff" is to misunderstand both the complexity of the disease and the dignity inherent in managing it with compassion.
    It is not about replacing cure with comfort.
    It is about ensuring that even when cure is not possible, comfort is never absent.

  15. Ryan Argante
    Ryan Argante September 26, 2024

    While I appreciate the sentiment behind this piece, I must respectfully challenge the implicit assumption that emotional support alone can serve as a meaningful substitute for innovation in oncologic therapeutics.
    It is not the role of palliative care to supplant the pursuit of cure, but to complement it with grace.
    And yet, the disproportionate media attention devoted to non-pharmacological interventions-while laudable in intent-risks creating a false equivalence between palliation and progression.
    Let us not mistake the warmth of a hand-holding session for the rigor of a clinical trial.
    Both matter.
    But only one can extend life.
    And we must not let the former obscure the urgency of the latter.

  16. anil kharat
    anil kharat September 27, 2024

    Bro… you know what this is? This is the new religion.
    They don’t believe in God anymore.
    They believe in "palliative care".
    They light candles for the kids.
    They chant "self-care" and "trauma-informed".
    But no one asks: why are they dying?
    Why is this happening?
    Who is responsible?
    Is it the food?
    The vaccines?
    The chemicals in the water?
    Or is it just… fate?
    And if it’s fate… why are we spending millions on teddy bears?
    Why not spend it on truth?
    Truth is the only real medicine.
    And truth is silent.
    And truth is afraid.
    And truth is buried under all this… nice talk.
    So I sit here.
    And I cry.
    For the kids.
    For the truth.
    For the silence.

  17. Keith Terrazas
    Keith Terrazas September 27, 2024

    It’s ironic, isn’t it?
    We’ve built entire hospitals to extend life.
    But we’ve built no systems to honor it.
    And when the end comes-when the machines stop and the silence settles-we suddenly remember: this wasn’t just a disease.
    This was a child.
    A laugh.
    A favorite song.
    A bedtime story.
    A hand that clung to yours.
    Palliative care doesn’t fix the body.
    It reminds us that the body was never the point.
    It was the soul.
    And souls don’t need trials.
    They need to be seen.
    And held.
    And loved.
    Even when there’s nothing left to cure.
    That’s not weakness.
    That’s the bravest kind of medicine there is.

  18. Matt Gonzales
    Matt Gonzales September 28, 2024

    Just read this whole thread.
    Some of you are tearing my heart out.
    Some of you are making me furious.
    And some of you… you just made me believe in people again.
    Thank you.
    For the rage.
    For the grief.
    For the memes.
    For the truth.
    For Bob the teddy bear.
    For the silence.
    For the truth.
    We’re all just trying to love better.
    Even when we don’t know how.
    So… keep going.
    And I’ll be here.
    With you.
    Always.

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