Walking Towards Motility

Happy New Year

I hope that the beginning of the new year has been as positive as it can be at the moment. Hopefully you had some calming and energising days, a Merry Little Christmas* and ‘guten Rutsch’. May 2021 hopefully bring better days for us!

Updates and Breathing

—— you can skip that ——

Unfortunately, I haven’t been doing well. The bowel atony has worsened (if a complete dysmotility can even get worse). I have been admitted to the clinic a few more times for another decompression and endoscopic emptying. Other than that, some fluids and nutrition iv, and failed stimulation of the bowel didn’t really improve anything. My wonderfully caring angiologist checked again my vessels and I also asked for a second opinion from a specialised vascular surgeon. The blood flow isn’t the cause for the dysmotility, it is the nerves (as I already explained in the last post). The rule of thumb is that only if all of your abdominal main arteries (truncus, SMA and IMA) are stenosed, lack of blood flow can lead to bowel atony. My vessels to the abdomen have been operated on, are transposed…, but ok. Due to further weight loss we have decided to start parenteral nutrition now. I am back in Freiburg as the doctors in the other clinic were clearly overwhelmed and, to be honest, I didn’t even feel safe there anymore. Due to lack of vascular access they decided to insert a hickman catheter rather than a port and started feeding in a low dose. Hopefully we will be able to increase the feed. I desperately need to gain weight as it has dropped dangerously low.

Both are central venous catheters used for administration of medication, chemotheraphy or TPN (total parenteral nutrition) and can also be used for withdrawal of blood (which is wonderful for patients where normal vascular access isn’t possible anymore). Both are inserted if one needs a long-term iv access. They are inserted by a (vascular) surgeon under local anesthetics and with or without sedation in the upper chest such that the catheter ends in a main vein to the heart (upper or lower vena cava). A port is installed beneath the skin, a Hickman above. Afterwards one should take an x-ray to make sure that it is installed properly. They both have a risk of infection up to sepsis and thrombosis. Compared to a central venous catheter which can only be used for max two weeks it reduces the irritation of the vein. During the insertion itself bleeding, vessel damage, lung puncturing, pneumothorax etc can occur. The doctor will know when you need an iv access and those complications are secondary. There is also a Picc line (generally put into the arm), but your doctor will know the best option for you. A port needs to be punctured often and the risk of vascular complications increases and you will have a scar (mine from three years ago is still quite visible). A Hickman is a safer option here, but might be less comfortable for the patient as it hangs down your chest (which also increases the risk of accidents that might pull it out, Bo, when I come home – be careful!). There are some studies that say that a port (as totally implanted device) causes less infections, but the experts here at the clinic has different experience and I trust them (plus with the number of vascular complications I feel much safer with a Hickman). In my opinion, for iv access in episodes (e.g. for a chemotherapy) a port might be better, for daily iv fluids and/or TPN a Hickman should be inserted. I felt that the port was quite comfortable after insertion, I literally didn’t have any pain, for the Hickman line I experienced pain in the chest, shoulder and back and I needed a few days until I was able to breathe properly again.

As my weight is so low, they have a plan to prevent refeeding syndrome and how to efficiently and safe make some kind of weight gain possible or prevent at least further weight loss. When everything seems safe they can discharge me and nutrition will be given at home. At the moment I cannot even undergo further tests regarding the motility due to the low weight. I am waiting for further manometries, another Hinton test, breathing tests and a full thickness resection (which is all explained on the page on dysmotility problems which I will continue writing in the next weeks). If those tests are done we can plan ahead regarding possible treatment options. I also had a nice call with the gastroenterologist from London who understands the problem, gave good advice and suggested a virtual, interdisciplinary meeting with his team and the doctors from Germany. I am very grateful for that, neurogastroenterology is not a common department in Germany and in general there aren’t many doctors that understand the topic. Further, ideally, I need a team of cooperating doctors from (neuro)gastro, vascular/transplant surgery, radiology and angiology that discuss the findings and possible treatment options. Dreams are my reality.

In between the clinics and Ops I live the day as it comes. I am very grateful that the university clinic in Freiburg (yet again) provides competent and safe support.

————-

Diaphragm breathing

During my check up appointment regarding my vessels the vascular surgeon, who also practices as an osteopath, gave some valuable advice. When he examined my abdomen he could feel the stiffness of the diaphragm and mediastinum area, the scar tissue around the celiac plexus and their effect on the whole abdomen and breathing. During the first surgery they had to resect the diaphragm to reach the truncus compression. Every surgery causes scar tissue and nerve irritation and this area is quite sensible. Surgeons use special clamps to keep the areas open, the patients lay in their position for several hours and the anatomy can change or nerves can be damaged (which you always have to sign before a surgery, damages due to false positioning). If you have a laparotomy like me they will need to spread apart the rips. Since then my left thorax has been not in place which I and examiners can feel during breathing. During my appointment the Prof tried to loosen it with some visceral osteopathic and it helped me to breathe more freely afterwards. Since the primary surgery it has been quite struggling to breathe into the deep abdomen and it improved for a short term after this treatment. In fact, it didn’t help with my motility issues, but apparently it can help with stimulating the mobility and motility of the intestines. Thus, some interesting diaphragm facts:

1. The diagphragm is a muscle (rather a muscle-tendon-plate), its location depends on the breathing state. Its two surfaces stay in contact with the lungs and pericardium (thorax) and the inner organs (abdominal). Important vessels and nerves as well as the esophagus run through it.
2. It is the most important breathing muscle. When you breathe in, you tense it, the thorax expands and if you breathe out, you relax it, the thorax space decreases. Hence, breathing alone can mobilise the organs beneath the diaphragm.
3. Thus, one should treat fixated or immobile parts of the diaphragm via expanding it as the specific areas. It becomes more flexible and mobile and can again function better.
4. The nervus vagus lies inside the mediastinum and is affected by the diaphragm. For example, after surgeries it can be ‘glued’ with it and cause dysautonomia-like symptoms. It supplies the gut and pelvis, takes responsibility in the peristalsis of the bowel (parasympathic tasks) and affects the heart beat. A damaged one can cause nausea, reflux, diarrhea or constipation, headaches etc – generally speaking, it can put the body into a low- energy/functioning state.
5. Osteopathic treatment can cause some nausea when the epigastrium is pressed (that’s where you celiac plexus is).
6. Put your hands on your stomach and try to inhale into it. You chest will expand. Relax and repeat. Your breathing will increase the blood flow through the abdomen and mobilise the organs.
7. Try to breathe lower and lower into the abdomen. In my opinion, slow abdominal breathing should be administered to all patients with abdominal complaints. Think of Budai in his happiest state, that’s how your belly should look like! Put a hand on your chest, it shouldn’t rise during the inhalation, your belly should.
8. You can also lie down on your back, with a pillow under your lower back and repeat the breathing. Or underneath your legs, try it out. If you manage proper breathing, you can repeat it when laying on your stomach and breathe against the floor or over a chair with a pillow. Start with 5min three times a day.
9. Often, in patients with abdominal conditions the muscles don’t work properly. Their diaphragm contracts after food intake such that the upper abdomen relaxes which causes abdominal swelling and bloating (paradox breathing). Healthy: Belly expands during inhalation and contracts when breathing out.
10. The diaphragm plays an important role in the stability and mobility of your abdomen and back. Back pain and pain between the ribs are often caused by a weak or strangled diaphragm. Especially, low back pain can be the effect of a chronic high diaphragm i.e. caused by flattened breathing.
11. Similarly, it stabilises the spine in the cervical area and contains connecting nerves. Some studies show a correspondence between a dysfunctioning diaphragm and chronic headaches.
12. Even worse, it can be the cause of a range of common pains (shoulders, neck, general back pain, chest…). If you don’t move your diaphragm well enough because of daily habits such as smoking, stress, posture, lack of movement or it has been damaged in a surgery or accident, your whole abdomen won’t move well enough. Diaphragmatic breathing will open up your intercostals and you will feel much better.

Chronic Illness and Studying

Studying itself can be difficult. Managing a chronic illness whilst studying and managing studies whilst being chronically ill puts extra strain, both mentally and physically. It isn’t easy to adapt to a new life as a disabled or chronically ill student – whether you were born with it and have already developed coping strategies as a child or are faced with a completely new life in the mids of your studies. In the next posts I want to share my experience and give some advice on that topic. Some immediate tips:

1. Tell your school and university as much as they need or should know about your condition. Obviously, it is your decision and one might not want to share every detail. They should be aware about the difficulties you are facing every day, know about possible complications or emergency situations and how to react (e.g. meds, emergency contacts, doctors etc). Accept additional support that accommodates your daily needs, such as student services (disability, wellbeing, personal supervisors, extenuating circumstances) that might provide equipment, mental support, study support, extended deadlines or extra exam conditions (e.g. where you can lay down in between, have your own room, additional funding, more flexible arrangements, mobility and accessibility support etc). Build up a good relationship with your supervisor. In the UK they provide great pastoral support and can also help to access other support and communicate your needs in the department and university or school. You might even benefit from little things, let them know what you have in mind and don’t be afraid of mentioning ‘stupid’ idead, be confident and honest! In the end, it causes less stress and work for everyone.
2. Tell your friends and study mates what you want to share, they can support you and from my own experience it provides a lot of security, gratitude and improves your mindset. Whether it is sharing the material when you cannot attend the lessons, simple talking, accompanying you outside if you feel unwell or carrying the books. If you suffer from problems such as fainting you should let them know such that, if it becomes critical, they know what is happening. During events or activities let the people in charge know about your condition if appropriate (e.g. for sport societies). Many of us simply don’t look ill or disabled, so I can definitely recommend that you should be honest about your conditions.
3. Have an emergency note with you all the time. It should cover your details, conditions, doctors, emergency contact and meds (an updated list, including dosis and allergies!).
4. Find your own personal way of studying. How many breaks do you need? What is YOUR balance between studying itself, extracurricular activities and your personal (health) needs? Listen to your body and don’t force yourself to reach the goals you want to attain, but what your body is able to. I know that this is a very difficult decision, but it is better to aim for 80% of your daily goals than to override your limits yet again. It only causes stress and worsening of your symptoms. Give yourself enough time, don’t stress yourself. Think of alternatives on how to study. Sometimes it might be better to study at home, make sure that  you have access to all material and ask for further possibilities (recorded lectures, online sessions etc). Don’t reduce your interaction with other students and staff because of it, Covid proves how easy online correspondence is. Study smarter and not necessarily harder. For example, start your own planning strategies (include possible complications, breaks, your daily ‘health timetable’, appointments etc). Optimise your workspace and make yourself comfortable. You can also think about alternative study options such as part-time studies, interruptions, online studying and much more.
5. Also, find the best places to study. In the summer, one can study outside in the sun; make sure that you are warm and comfy in the winter; have your desk in the clinics; sit or lay down – whichever position doesn’t trigger your symptoms. In the class room it might be good to arange comfortable sitting possibilities, have a possibility to lay down or sit near the door when you have to leave the room. Have your medical supply with you.
6. Set priorities. There may be phases where your health worsens a lot and getting better should be the most important/only aim. Inform your school/university about it and simply concentrate on your health. It is ok. Also, be honest about it. If you cannot cope anymore, talk with other people and don’t play the role of the tough student that is doing well. If no one knows about your current state, no one can help you. I know how hard it is to ask for help or accept help – especially, if there is not much others can do – but isolation only increases the worries of everyone.
7. Don’t forget yourself, your goals and dreams. They might not come true or simply impossible, but keeping an optimistic and forward-looking mindset (that is still accepting changes) is the key for a good wellbeing. Mind and body are also connected by our studies or works as they obviously take up a big part of our life. For me, maths and physics have been the best medicine in the past years. In the months of hospital stays, the years of pain and nausea, only when when I was in very critical states I wouldn’t be working on my problems. Keep going, it will be worth it. I would also recommend to rather set weekly goals in your studies if your condition is a roller coaster as well.
8. Look for support groups (not only for your condition), local ones, at your university or school or near your institution. Talking with other people who face similar challenges can be so relieving, we can show each other empathy and sympathy, simply listen and give advice. You are not alone. So many students face their own smaller or bigger problems due to health reasons and we should be more open about it.
9. This brings me to the next point. Raise awareness, participate in wellbeing opportunities, help in improving support services. They can only help us if they know how to and our needs and get valuable feedback. For that, we need to communicate between each other and to the authorities, supervisors and other students.
10. Keep your privacy and only share what you want to share. There is no obligation to share all information. There is still the possibility for support access without going into detail. Your health data is very sensitive information, make sure that they are kept confidential and shared as you like and know about their function.
11. Don’t give up and listen to yourself. I stopped counting the number of times doctors told me to stop studying or interrupt my studies. But if things don’t improve on the long-term or I am constantly faced with new challenges, for how long should I stop doing what is still left for me? The unpredictability and uncertainty of your condition may make it difficult to plan ahead. But nonetheless, without trying, we don’t get anywhere. Be your own advocate, take responsibility, but also share parts of it where it is possible (or even necessary). Obviously, this requires trustworthy people around you.
12. Care about your general wellbeing. Studying needs attention, concentration, endurance and focus. Your symptoms or meds can affect those. Coping strategies such as meditation, mind-body exercises or efficient breaks can bring relief and shift you back into the right balance. Move in between study phases, lay down if you need to (even during lectures, it’s ok) and don’t force your body to keep going. Take your medical needs (meds, water, nutrition etc) with you. Know where you can rest at your study place. In some universities there are possibilities where you can sleep, calm spots in the common rooms, some have their own GP practice etc.
13. Choose a school or university (or job) that suits your needs. At least in the UK there is a huge difference in disability services and additional support networks between different institutions. Along with that you should make sure that the medical treatment is secured at your place and the accommodation possibilities suit your needs. Hence, depending on the severity and importance your illness takes in your life, it should be a criterion in finding the right place to study. I would recommend getting into contact with the wellbeing service before your application and if successful, ask for an appointment in which you can talk about your needs and plan possible support strategies before you start your course.
14. Enjoy your time. Well, try to enjoy it. I have talked to so many people that emphasise that their school/university time was the best time of their life so far. It is a time where you develop your academic and personal skills and values, collect many experiences that affect your future, bond life-long friendships and gain a larger part of the knowledge that will accompany you from now on. More freedom and independence also requires more responsibility and adapted planning.
15. Work. Rest. Repeat.

The Effect of Walking

Solvitur ambulando

After so much studying, why not go on a walk? 12 reasons for a healthy walk:

1. It brings relaxation.
2. Walking improves your mental state. It kicks off inner body pain killers and endorphins – probably the natural remedy.
3. It is healthy for the lungs, your cardio-vascular system and also good for bowel motility. There are countless studies that prove that it decreases hypertension, reduces the risk of strokes, unhealthy obesity and has a positive effect in psychological conditions, in illnesses such as arthritis, dementia, fibromyalgia and diabetes, it also prevents mental decline.
4. It strengthens the muscles and bones as well as it improves the endurance. – key after surgeries, stand up and try walking asap. It is good for people with osteoporosis.
5. Joints get nutrified by the fluid flowing through as we use them. It is a low-impact exercise as well (other than running).
6. Studies show also that it improves the immune system (especially walking in clean air in higher altitudes). If the sun is out it warms you up from the out- and inside, as soon as the sun shines, get your daily dose of vitamin D which we need in order to absorb calcium and phosphorus from food. Your skin produces it on its own from cholesterol under UV irradiation. (In the winter months, if you suffer from osteoporosis, absorption problems or any other condition that causes a lack of it, I would recommend getting vitamin D supplements/injections as you can’t possibly consume it via food.)
7. It betters your sleep quality and can even reduce insomnia. 
8. Whilst walking you can explore known and unknown places, find things you didn’t look for as well as use it as a routine exercise. Routine itself brings a lot of health benefits, for your physical and mental state. It can anchor us and help us with difficulties or changes in life.
9. Going on a walk can stimulate your senses, distract and give you a form of escape. It can also reduce stimulation/stress overflow and calm your senses. Try it out.
10. Walking is probably the easiest exercise there is, you don’t need anything else than your body and mind.

Tips: Wear comfortable clothes, not too tight and weather-proof. Wear proper shoes, in the summer (if safe) go barefoot over the grass. You can also mimic being barefoot. Swing your arms with you and lengthen your spine (which doesn’t mean to push your shoulders back).

Mindfulness – Walking Meditation

Walk. Walk in big circles, ideally without much distractions and where you feel at peace without focusing or concentrating on anything. Just walk and breathe at your own pace. Try to swing your arms with you at each step. In the Buddhist monastery, we used to do it in between sitting meditation and after lunch. It concentrates on the present moment of walking, without a destination ahead. Before you start walking, close your eyes and take a few deep breaths in and out. Do the same after walking. Make a body scan prior to make sure that your muscles are relaxed. Can you feel how firm and safe you stand on the ground? Do you literally feel grounded? Do it as long as you like, but I would recommend starting with daily 15 to 20min in the first few days. Be aware and mindful of your inner sensations and don’t let the outside distract you. If possible, open up and take a broader ‘view’ (in the sense of being aware) around. Be aware of each step. If your mind gets distracted, shift it back to the simple act of walking. I would recommend choosing a calm place you know due to security reasons: a park, your garden, on a wide field if possible, or streets that aren’t that busy (once I did it in Bloomsbury district between lectures and almost caused an accident, so be careful). You can also do it at home or in the hospitals (which are, depending on the time of the day, actually a good place due to the long corridors). When you are at home you can also listen to calming melodies or a walking meditation audio (e.g. from Headspace which I can also recommend for general meditation). Try to differentiate between going somewhere, walking the dog, do the Sunday walk from your daily relaxation walk. Running used to be my meditation a few years ago, I am grateful that I am still able to walk. Walking is such a gift.

I actually developed my own breathing meditation walking which goes as follows. Do this either in a circle or if you are in a park/wide field simply walk where your body takes you.

1. Do the body scan and ground yourself for a few minutes whilst standing.
2. Start walking, rather slowly. Adapt your speed according to your emotional state.
3. Breathe in for a few steps, depending on your personal breathing duration (for me it is about 10 steps and I am a slow breather). 
4. Breathe out for the same amount of steps.
5. Repeat it a few times until it feels natural.
6. Now, when breathing in, think of the energy (qi) flowing through your whole body, centering at the celiac plexus.
7. Breathe out the energy, but keep it around you – as if you are walking through a foam of some energy which you are part of yourself.
8. Alter breathing as it feels energising (e.g. breathe in for a few steps, walk a few more and breathe out, not necessarily the same number of steps).

Actually, there is a science that studies walking in detail (strollogy) – indeed, one should differ between normal walking from A to B and strolling around. For example, one shouldn’t necessarily have a destination in mind, but simply strolling around because of its own benefits it brings. Strollogy covers reflexive walking i.e. being aware of the environmental influences whilst you are on your walk. It is the study of explorations, their motivations and effects, in urban areas and in the countryside. How can other factors such as culture, history and socio-economic conditions affect our perception about the arena we are walking through? Are there effects that work the other way around? In some sense, this differs from the walking meditation where you are aware of your inner self ‘only’.  The positive effect of walking has already be introduced by Aristotle who lectured whilst walking in the Peripatetic school (from peripatetikos, walk up and down) and the sophists gave lectures on their travel routes*, Darwin had his own ‘thinking path’, Kierkegaard went on his wellbeing walks and Dickens went on many miles through London (his routes I can recommend) which shaped his stories and characters. Indeed, walking improves creativity, new thoughts arise and old ones can be processed.

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

  Morning view from Waterloo Bridge.

• 

Walking poems and stories to give you some inspiration (and if you can only go on virtual walks):

• Alstonfield, Peter Riley
• Der Spaziergang, Friedrich Schiller
• Kore, Robert Creeley
• Desert Music, Steve Reich
• The Wood-Pile & Two Roads, Robert Frost
• Sweet was the Walk & The Excursion, Wordsworth
• Divina Commedia, Dante Alighieri
• Thus Spoke Zarathustra, Nietzsche 
• Mrs Dalloway, Virginia Woolf
• Wild, Cheryl Strayed
• Wuthering Heights, Emily Bronte
• Flâneuse, Lauren Elkin 
• Or in general any other books with lonely protagonists wandering and exploring the world or life (Of Walking in Ice by Herzog, The Miranda by Nicholson, As I Walked out one Midsummer Morning by Lee…)

Walking through space and time and beyond

Are you brave enough to take the first step? Are you brave enough to keep walking? Are you brave enough to turn walking into wandering and wondering? Translate your movements into the senses of the world around you and vice versa, become one with your senses, become one with the direct environment. Expand this out- and inflow towards the furthest possible. Walk into the world and not away from it. Walk into your feelings and thoughts, your sorrows and worries, walk into the unknown. Walk into your world. Be yourself the path you walk. When you stop, do you notice how your smooth flow of thoughts stops as well? Search for the unknown, out- and inside of you, find the unknown secrets of life and yourself. Sehnsucht. Sehnsucht into the unknown which will never be as we desire or imagine it to be. Whilst walking Fern- and Heimweh (wanderlust and homesickness) close the circle around you. Homesick for a place you have never been to and craving for a wonderful warming feeling of returning home. Coming home in the unknown and adventurous explorations at home.

Find more about Sehnsucht to the unknown and wandering mind here.

Best albums for long walks

• Geogaddi, Boards of Canada
• Hunky Dory, David Bowie
• If you are feeling sinister and others, Belle and Sebastian
• The Creek drank the cradle, Iron and Wine
• Sun Kil Moon, Benji
• Mezzanine, Massive Attack
• And Then Like Lions, Blind Pilot
• Selected Ambient Works Volume II, Aphex Twin
• Ambient 1: Music for Airports (and more), Brian Eno
• Yellow House, Grizzly Bear
• The Glow Pt. 2, The Microphones
• Hospice, The Antlers (probably the saddest I know of)
• The Dark Side of The Moon, Pink Floyd
• Gemini, Wild Nothing
• Basically all Zero 7 albums

Evening in a Buddhist monastery in the mountains of Taiwan.

Despite the weakness and symptoms you may face because of any conditions it is important to never stop exercising. Keep your body as mobile and stabile as possible. I know how hard it is and I am very fortunate to be a former athlete and life-long nature lover, so I always feel the need to move. Try to move every day, better go on a few short walks. If possible walk some stairs, but don’t overdo it. In the clinics don’t forget to wear your mask.

I want to share some tips for working with a balance board (mine has a spinning top form) and pull up bar.

A balance board (have a look at the different types) improves your balance and stability, posture and coordination. It strengthens core, back, legs and but and can easily be combined with further exercises e.g. stretching. You can strengthen your muscles after surgery and use it as rehab at home. I also felt some benefit for my joints. When you are a pro, you can also do other things during the following exercises (watching the news, wash the dishes etc).

My top exercises

1. Stand firm on it. Balance your body by slightly shifting your weight.
2. Start with the feet on the outer part of the board. Take little steps towards the centre.
3. Wobble around without falling down. Tilt back- and forward, to the left and right, but don’t lose your posture. Try touching the floor with the board’s edge. Do it slowly.
4. Stand on one foot. One can rest the other on the knee of the other leg or simply push it aside to the side, back and front.
5. Do a squat and stay in that position for a while, then move upward again. It is not about the quantity, but quality! Either hold your arms in front of you or hold some weights in your hands. Use them to balance your body.
6. Tilt again, but in a smooth and dynamic way, around the clock and in the opposite direction. 
7. Step down. Now combine with some stretching exercises. For example, put one knee on the board, kneel on the floor with the other and stretch.
8. Put both feet on the board whilst laying on your back, do a back arch. 
9. Hold the board with your hands and go into the push up position. Tilt the board with your arms to the left and right.
10. Go back onto the board and throw a ball, catch it and repeat.
11. Stand firm on it and close your eyes. Feel your sensations and be aware. Breathe in deeply.
12. Sit down on the board with crossed legs and try doing a meditation session on it. 
13. Don’t forget taking breaks in between.

It is a very progressive task and you will soon see how natural it becomes. I can stand on one leg, solve a difficult sudoku and pay attention that Einstein doesn’t eat away the cables and Bo doesn’t kill the neighbours. It also improves the mind-muscle connection and will definitely improve your daily activities.

Pull up bar – einfach mal abhängen. Use simple hanging as an exercise. With your own weight you can strengthen your spine. Whether for shoulder or back pain, lack of mobility, impingement syndrome, just hang in there (‘just’ – even that is almost impossible for me right now, but try it out for a few times a day, even if it is for a few seconds only). There is passive hanging: relax your shoulder plates & active hanging: you actively push your shoulders downwards & dynamical: do both alternating and smooth. It shouldn’t be painful or an intense exercise in the sense of building up muscles. Just be a monkey.  It can put your muscle dysbalance which often is the cause for blockages into balance again.

*have a look at the famous painting of Raphael’s School of Athens, where Plato and Aristotle are both walking whilst discussing.

Good Night.

Winter greetings from us!

Be brave. Take risks. Move forward. Close circles. Fly when you can. Play. Fight. Accept yourself. Accept your life. Breathe in the moment. Be curious.