karenulijohn

As the year 2016 moves inexorably toward its end, I thought that I would be happy to put it in the past and move on to a fresh and new 2017.  2016 began positively enough, but took a distinctly negative turn in April, when Harvey was diagnosed with esophageal cancer.  Only three years earlier, he had been diagnosed with melanoma, the treatment of which had nearly killed him.  Now, we were facing weeks and months of chemotherapy, radiation, and surgery.  It was a grueling seven months during which time he struggled with lack of energy, no appetite, extreme weight loss, and general fatigue.  I accompanied him on every doctor visit, every chemo treatment, and every radiation treatment, doing my best to support and care for him, as well as advocate for him when needed.  In terms of his health, it was our “annus horribilis.”

But, as I reflect on the events of the year, I am surprised at the number of happy memories that come to mind.  First of all, we were fortunate to have had the most competent and compassionate doctors, nurses, and staff throughout Harvey’s treatment.  Both of us were the beneficiaries of so many kindhearted people.  Friends and family offered to help in so many ways, and the warm thoughts and sincere prayers lifted our spirits and sustained us through the darker days.  I have a box full of greeting cards, most for Harvey, but some for me as well as the caregiver.  I can’t even think about disposing of them.

We were disappointed to have to cancel all of our plans to celebrate our 50th wedding anniversary, including a trip to Maui with our daughter and her family.  Subsequent plans to spend a weekend at the Ritz Carlton in Half Moon Bay also had to be cancelled because Harvey just was not doing well.  In fact, we “celebrated” the actual anniversary day, August 13th, in the Emergency Room.  I cannot minimize how difficult that was, but in the overall scheme of things, we still achieved a significant milestone.

We stayed pretty close to home, but that made it possible for friends to drop by for a short visit now and again.  Though Harvey tired easily, those visits made a positive impact on his state of mind.  Friends and family played such an important role in his recovery.  In fact, we had friends from London, whom we had not seen in 30 years, visit us this past summer.  We enjoyed catching up with them, and showing them around our lovely surroundings.  We invited them to dinner on the patio at Meridians, and sat out well into the evening.  What fun it was to reminisce about our time in London.

We also enjoyed a special visit from Harvey’s sister, Hilma and her daughter, Lynda.  We have not seen Hilma here in California in some 20 years, since Dawn’s wedding.  What a pleasure it was to visit with them, talking about their parents, and funny stories growing up.  Shortly before their visit, Hilma lost her only son to lung cancer.  She and her family have also had several difficult years.  We were so blessed by their visit.

Dawn, Dirk, Claire, and Cole have been making trips to Lincoln to visit us, but the most special day was Thanksgiving this year, when I actually cooked a turkey for the first time in years.  The dinner turned out to be very tasty, and we enjoyed our time together, as always.  Of course, we were especially thankful this year for all of our blessings, and in particular, our husband, father, and grampa!

Through it all, I have continued to sing in the choir at church, and just recently have been named choir director, as our current director of worship and his wife have moved on to another church.  Members of the church, and most specifically, the choir, have been very supportive throughout, with prayers and cards and words of hope and comfort.  It will be an honor and a pleasure to work with all of them in the new year.

So, as I look back, I realize that 2016 has been a very special year; a year filled with friends, family, love, and friendship. To paraphrase a line from the movie, Its A Wonderful Life, we feel like “the richest [couple] in town!”  May the Light of the Christmas Season shine in you and through you now and always.  Merry Christmas and Happy New Year to all!

We received the best news ever yesterday during our visit with Dr. Graves.  We were directed into his office, and after shaking hands all round, and his commenting on how good Harvey looked, he sat down and began to interpret the pathology report relating to Harvey’s surgery.  He explained that the specimen showed features consistent with pre-operative treatment of chemotherapy and radiation, including ulceration and regression.  There was a small focus of residual adenocarcinoma, consisting of a single gland measuring less than 1.0 mm.  These findings correspond to a Tumor Regression Grade of 1.   TRG 1 was defined as complete regression (=fibrosis without detectable tissue of tumor).  Translating that into layman’s terms, He Is Cured!!!  Dr. Graves said that Harvey’s response to the radiation/chemo regimen was remarkable, and his recovery from the surgery is phenomenal.  He must have asked Harvey two or three times if he was really 80 years old.  He then said, “I ought to use you as my Poster Child.”  Dr. Graves checked the incisions and commented that he could eat whatever he wants, being aware that, if it doesn’t want to go down, stop eating it.  He even suggested having a glass of wine to celebrate.  The only follow up is a CAT scan four months hence.  Apart from that, Dr. Graves wished us a Happy Christmas with hand shakes all round.

As we walked out into the hallway, we embraced and I got tearful.  I don’t think either of us was consciously awaiting the pathology report, but, nonetheless, we were relieved and elated.  We made our way to the car, and once on the road, put in a call to our daughter, Dawn.  Since it was her birthday yesterday, we were excited to give her this special gift.  As we explained the findings, I could hear in her voice that she was tearful also.  This has been a stressful time for all of us, and the relief that we feel is immeasurable.  We have so much to be thankful for this season, mainly family and friends who have kept us close in their thoughts and prayers.  How can we say “Thank You” enough?  Your cards and phone calls have inspired and encouraged us so that we were able to “keep it together.”

Our job now is to get back to normal.  That means eating properly and getting some exercise, and socializing a little bit more each day.  On our way home yesterday, we stopped at the Waffle Barn, our favorite “go to” restaurant, and had a great big waffle each, smothered in butter and syrup.  Harvey ate almost every bit of it, and I felt so proud of him.  Last night for dinner, he made it through a bowl of spaghetti.  His weight bottomed out last week at 163 lbs.  As of this morning, it is 165, which is the trajectory that we want.  I am determined to get my “chubby hubby” back!

It has been about ten days since last I posted to this site.  As I reflect on those ten days, each day has been much the same as the one before in regard to Harvey’s recovery, where daily changes are minimal.  We have been fortunate to have a visiting nurse attending him twice a week, as well as a physical therapist and a registered dietician.  I have continued in my role as CWN taking vitals each morning and giving injections twice a day.  I have a spreadsheet on which I record the data so that when the “real” nurse (RN) comes, she can be brought up to date on his progress.  Over this period, Harvey’s wounds have healed almost completely.  No dressings need to be changed, and he is able to shower without concern about getting those areas wet.

The Registered Dietician came to visit Thursday, a week ago.  I was very happy to see her and to get her input on how Harvey can eat nutritiously on a liquid diet.  His weight has dropped by ten pounds since leaving the hospital.  I realize he was well hydrated while in the hospital, but now, at 165 lbs, that is too low for a guy his size.  Before we even got started, I told her that we need to set realistic and achievable goals relating to calories and protein intake.  She agreed and gave us ideas on how to take in 1000 calories and 60g of protein a day.  We are now logging everything he eats, and I’m happy to say, he has exceeded his goals over the past five days.  Beginning on Friday, he will be transitioning to soft foods which will, hopefully, allow him to take in more calories and, subsequently, gain back some weight.  We will be meeting with the RD again tomorrow in order to educate ourselves on what constitutes “soft” foods, and how to build balanced, daily meal plans.

Last Wednesday, we had a follow up appointment with the Nurse Practitioner in our Primary Care Physician’s office.  Traci recommended that Harvey transition from Levonox injections to Eliquis tablets.  We decided to continue the injections until Harvey is eating soft foods to help with digestion of a tablet.  Not only that, but our copay was over $300 for a 30 day supply of Levonox, and I hate to see it go to waste.  We hope we will be able to give the three remaining boxes to some group who serves those who may be unable to afford Levonox.  This coming Monday, we will see Dr. Graves, the surgeon.  We are looking forward to that visit!

Not enough energy seems to be Harvey’s main complaint.  Of course, he forgets that it hasn’t even been two weeks since he was discharged from the hospital after major abdominal surgery.  In general, he is making very good progress; it just isn’t fast enough for him.  He has begun to receive visitors, and has ventured outside for short walks in the neighborhood.  Harvey attended church this past Sunday to support me in my new role conducting the church choir, and also to hear my trio sing during the service.  We did not stay for the entire service, and as we were leaving the sanctuary, Harvey seemed to be shuffling rather than walking.  I asked him if he was all right.  Under his breath, he whispered “I’m trying to keep my trousers up!”  Against his wishes, I went out today and bought him a new pair of dress slacks in a more suitable size.  He is confident that one pair of jeans and one pair of dress pants will be enough to serve him in the short term.

It seems that the excitement of homecoming set Harvey’s heart all a’flutter: literally.  He had a restless night on Friday, tossing and turning, coughing, but no pain.  I went to my aerobics class at 8:00 AM and left a little early in order to be home when the visiting nurse was scheduled to arrive at 9:00 AM.  Trina settled in and began by having Harvey sign all of the usual “permission to treat” papers.  She then described all of the services available to him including Physical Therapy, and a Registered Dietician.  All of this took the better part of an hour.  Finally, she took his vital signs, and his heart rate exceeded 120 bpm.  Yes, his heart was in Atrial Fibrillation (Afib).  He took his Amiodarone, but the rate did not change over a couple of hours.  Trina telephoned Dr. Yadlapali’s office and was put through to the On Call Dr. Ebeneezer.  He was to call her back, and she remained here until about 11:30 AM with no call back.  She suggested that Dr. Ebeneezer would say one of two things; either go to the ER or pickup a prescription.  By 3:00 PM, we had still heard nothing, so Harvey called 911 and told the dispatcher that he needed a ride to the ER because he had “a little Afib.”

The ambulance and fire truck arrived within minutes, but, thankfully, no forestry service.  They hooked him up to the heart monitor, saw his heart rate, and began to get him ready to transport.  By the time I got to the ER in Carrrlo, he was in a cubicle and had another IV line in his poor, bruised arm.  Amber was his nurse during his stay, and Dr. Worth checked him over.  In consultation with Dr. Ebeneezer, they decided to “shock” his heart back into rhythm since he had not been in Afib for more than 24 hours.  I was happy to leave the area for this procedure, so I can only describe what I was told and then what I observed after it was over.  They put Harvey into a ‘twilight sleep” similar to that which is given for colonoscopy.  The drug has a very short half life, so it leaves the system fairly quickly.  He was unconscious for only about five minutes.  They shocked him three times, first with 100 joules, then 150 joules, and finally 200 joules.  Unfortunately, it was to no avail.  Dr. Worth came to get me and said that Harvey’s heart was being stubborn, and that the shock did not bring his heart into rhythm.  When first I saw him after the procedure, his eyes were open, but he was still not conscious. He started talking to the technician, but no sound was coming out.  Gradually he returned to himself, and was disappointed to find that he was still in Afib.  I think the doctors were at a loss as to what to do at this point, so they prescribed a Beta Blocker to slow his heart rate down, and hope that the rhythm would correct itself.  They sent us home at about 7:30 PM.

Having not eaten since early morning, to say that I was a “mean, hungry bitch” would be an understatement.  As we were driving down our street, Harvey suggested we stop and get the mail.  I told him that I didn’t give a crap about the mail (only not “crap”).  Obviously, he was happy to be home, having feared they would admit him to the hospital.  While I was happy to be home, the responsibility for all of this was once again placed on my shoulders.

I was assured that the prescription for Metoprolol had been called in to the Walgreen’s Pharmacy on Twelve Bridges.  Of course, it was closed last night, so I waited until 10:00 AM this morning to pick it up.  They had no record of the prescription at all.  He was to have taken the tablet by 8:00 AM this morning to fall into the every 12 hours cycle.  It was then up to me to track down the prescription.  Well, it had been called in to the Walmart here in Lincoln.  After several phone calls between Walgreen’s and me and Walmart and me, the pharmacist at Walmart said that he would fill the prescription, and register us there when I came to pick it up.  If I had been there, I would have kissed him on both cheeks.

Funnily  enough, when I finally got everything sorted out, I felt Harvey’s pulse, and then counted it for one minute (using a stopwatch).  Believe it or not, the rate was down to 77 bpm.  While it is still a little irregular, it seems to have slowed to a more normal rate.  Maybe having his “looney tune” wife out of the house for an hour made all of the difference.  I am happy to say that, as of now, 12:00 Noon, he is resting comfortably.

Years ago, when Harvey was traveling a lot for work, he would be gone for two or three weeks at a time.  Upon his return, I would be so excited and happy to see him.  Shortly after, a day or two, I would experience something of a letdown as he became introspective, quiet, and preoccupied.  I would try to engage him in conversation about the trip, asking who he had come in contact with, what were the outcomes, and did he manage to sell anything.  Invariably, weeks later, I would hear references to the trip that I had never heard before.  Similarly, today at the hospital, all of the discharge instructions were given to him before I got there.  He was given some paperwork which described his medication schedule, description of side effects, telephone numbers,  etc.  However, there was no information about diet.  I know that he had been given liquids, yogurt, juice, ice cream and pureed soups at the hospital.  I assumed that I would continue that, but for how long?  Should I begin introducing more solid foods?  When?  It wasn’t until late this afternoon that, out of the blue, Harvey said that he was told he should continue the liquid diet for two weeks.  I lost it!  “Thank you for letting me know,” I said.  “Why didn’t you tell me that when I asked earlier?”  His only reply was, “I’ve been sick!”  Ugh!!!

Yesterday, the chest tube was removed and all but one of the IV’s.  This morning at 7:00 AM, Dr. Meyers, the latest “Docling,” came in to remove the remaining drain.  Nurse Shastika, a lovely woman from Fiji, and Alisa, who sounded Swedish, removed the staples from both wounds.  Harvey said that it was a little uncomfortable, but not painful.  They placed tape strips over the wounds, and he is to let them fall off on their own.  Dr. Graves visited a couple of times this morning and told Harvey that he had recovered very well, and he was very happy with his progress.  He had told Harvey he would arrange for his discharge at 11:00 AM, and within a few minutes, that is what occurred.  On my visit yesterday, I had taken a duffel bag with all of the clothing he would need, including his Rotary pin on the collar of his shirt.  The Murdocks again came to our aid, and kindly volunteered to help me get Harvey home.  When we arrived at the hospital, Harvey was dressed and waiting for the wheelchair to transport him to the parking lot.  We were home just before Noon.

I will be adding another activity to my nursing experience.  Harvey will require an injection of Lovenox, a blood thinner, twice a day for the next thirty days.  Fortunately, they taught him how to give the injection as well, so the responsibility doesn’t fall solely on me.  I am happy to say that a Home Nurse has been assigned to Harvey’s case, and she has already contacted us to make an appointment.  She said that her first visit usually takes approximately two hours.  I will definitely be asking for nutrition advice.

Harvey’s sister, Hilma, emailed us to say that she had sent two quilted lap robes made by the women of her church.  As she and her husband, George, are snuggled under their quilts while watching Jeopardy, she will  be able to picture us sitting in our respective, side by side recliners, snuggling under our lap robes while watching Jeopardy.  Maybe we can send each other the answers through telepathy.  Thank you, Hilma.  They arrived today, and they are beautiful.  When Dawn is here on Wednesday, we will have her take a photo.

Not much has changed for Harvey since I reported this morning, except that he feels a little depressed.  Per our agreement yesterday, I did not go to visit him today, but we did speak over the phone.  According to him, not much is happening, certainly compared to the past couple of days.  That’s a good thing!  Compared to his room in the ICU, the room he currently occupies is very small, old, and dark.  It is a double room, and he is not on the window side.  He did have a roommate for a while last night, but the man was released early in the afternoon.  While Harvey still has the chest tube, he is not as tethered as he was in ICU, so he is able to get up on his own and walk around.  Dr. Graves visited with Harvey late this afternoon and told him that he was amazing in his recovery.  The chest tube will be removed tomorrow, but he will have to continue with the blood thinner, coumadin, at least until the blood clot has dissolved.  Dr. Graves did not seem to think he would need to take it for the rest of his life.  That is good news.  In other words, he is on target for discharge of Friday.

I enjoyed my own Recovery Day today with a little retail therapy.  My friend, Debbie, and I went to the Galleria for some shopping and lunch at Land and Ocean.  Early in the summer, I cleaned out my closet leaving me with a lot of empty hangers.  I needed to replace some of my tops with some that are warmer and have long sleeves.  At lunch, we chose the Halibut in a lemon caper sauce with rice and asparagus.  It was delicious.

As I consider all that has happened, health wise, in the past few years, I feel as though there should be some designation or certification that acknowledges all of the medical knowledge and experience I have gained.  RN, CNA, LVN, LPN, NP, all indicate a certain level of nursing training.  I propose a new designation: CWN, Certifiable Wife Nurse, or in order to remain politically correct, CSN, Certifiable Spouse Nurse.  I know there are a lot of us out there!

What a difference a day makes!  I arrived at the hospital yesterday at about 2:00 PM and was surprised to see Harvey sitting up in the bed reading a book on his iPad.  The nasogastric tube had been removed, but he still had the nasal cannula for oxygen.  He gave me a big smile and said that he had a very busy morning.  Clearly, he did.

His nurse, Rose, had him up walking at about 7:30 AM.  I commented that she must be a miracle worker.  He doesn’t get up much before 9:00 AM when he is at home.  Upon returning to his room, Dr. Graves appeared with a “brace of doclings” in tow.  He commented that all of Harvey’s vital signs were very good, and said the  nasogastric tube was to be removed.  He challenged Harvey with the goal of going home on Friday.  Whoopee!!  Harvey was then given the contrast drink to check for leaks in the esophagus, and happily, none were detected.  Rose brought him some chicken broth, applesauce, and jello, and while he tried each one, he said he really wasn’t that hungry.  I noticed that one of the bags hanging on “Howard” was glucose.  It seems that he has only lost one pound since being admitted, but that may be due to all of the fluids they are giving him.

He doesn’t seem to be suffering much pain even though the epidural catheter has been removed.  He did tell the doctors that he thought the PCA pump was really a placebo; “Just give the old boy a button to push and a flashing light, and he’ll think he is well medicated.”  Truly, he hasn’t bothered with it much.  By the way, I counted 20 staples on his chest, the incision he refers to as “the zipper.”  They have not removed the dressing on the incision on his back, so I don’t know about that one.

Another surprise for me was the mustache and beard that Harvey is cultivating.  It is very dark in comparison to the white hair on his head.  I wanted to take a photo, but he wouldn’t let me.  In fact, he asked me to bring in his razor, and he plans to shave it off before he comes home.  Even his nurse, Rose, commented on it.  Speaking of Rose, she told us that she is from the Placerville area and has two sons, five and one and a half.  She showed us a couple of pictures of two very handsome little boys.  She said she liked having Harvey as a patient, and she hoped they wouldn’t move him to “the floor” until her shift change.

Last night, he called to let me know that he has been moved out if ICU and into a semi-private room in the older part of the hospital.  We agreed that I would not visit today because I’m not sleeping very well, and I’m just exhausted.  He has promised to call me a couple of times during the day to let me know how he is doing.  I’m sure they will have him up and walking, maybe more than he wants.  I told him to do everything they tell him and then a little more.  I want him home on Friday!

In addition to the Afib yesterday which carried over into today and was finally controlled with IV amiodarone, the monitors showed that Harvey’s oxygen saturation had dropped to 80 percent. This is the fraction of oxygen-saturated hemoglobin relative to total hemoglobin  in the blood.  Normal blood oxygen levels in humans are considered 95-100 percent.  In addition, the nurses were hearing crackling in the lungs which is a sign of fluid collecting, and that can lead to pneumonia.  All of these things put together raised some red flags, and he was whisked to radiology for a CT Scan.  The scan showed a small blood clot in the lung.

Dr. Gregory Rossellini, a pulmonary specialist, recommended that Harvey be placed on a blood thinner such as Heparin.  The anesthesiologist disagreed because Harvey still has the epidural catheter.  In addition, the suggestion was made that they insert an IVC (Inferior Vena Cava) filter to capture any further blood clots that he may produce.  Fortunately, Dr. Graves has the final say on any treatment, and he arrived shortly after I left today.  Harvey called me a short time ago to let me know that, in the end, they removed the epidural catheter and are controlling his pain with a PCA (Patient Controlled Analgesia) Pump in which the patient presses a button to self-administer doses of pain relieving drugs.  He will be given blood thinner medication after twelve hours when the epidural drugs have cleared his system.  Best of all, absolutely no IVC filter.   Apparently, Dr. Graves was quite adamant about that.  His nurse today is Steve, and Harvey said that Steve got him up and had him walking around quite a bit.  He really sounded so much better this evening.

Tomorrow the nasogastric tube will be removed and the contrast drink will be administered to determine how well the internal stitches are holding the anastomosis.  I had planned to stay home tomorrow, but given the events today, I determined I just need to be with him.  When I told him I would be coming, he said he was secretly delighted.

I have to give special thanks to Bob and Carol Murdock, who drove me to the hospital today and stayed with me through all of the unsettling events and discussions.  I was so glad they were there, not only for moral support, but also to backup my understanding of the discourse.  I was sorry that I was not able to introduce them to Dr. Graves and Dr. Becker.  However, I did find out that Dr. Becker has moved on and a new “docling” (as Dr. Graves’ Residents are called) is working with him.  I wonder if he is as cute as Dr. Becker?

Everything I am reporting today came second hand, but from a very reliable source.  Dawn and her son, Cole, drove up from San Mateo this morning to visit Harvey, and to give me a day to restore my energy.  Fortunately, Dawn has a good balance of my desire for details and Harvey’s unflappable composure.  Cole’s role is to verify her conclusions.

Harvey did not have a very good night.  He experienced a bout of Atrial Fibrillation (Afib), although the nurse reassured Dawn that this is often the case after chest surgery.  He has some fluid in his lungs, but it is not due to pneumonia.  Apparently, after this kind of surgery, the body produces a lot of fluids in general.  Both surgeons have been in to see him and have assured Dawn that everything is under control.  They prescribed Lasix, which is a diuretic to treat fluid retention.  Though I don’t know what drug, I am sure they have given him something to slow him down because his speech is very slurred, and he reports that he is unable to pull his thoughts together.  Of course, he also still has the nasogastric tube down his throat, making it very hard for him to speak.  Using Dawn’s mobile phone, I was able to talk to him, and believe me, he does not sound like himself.  He even admits that the minute his eyes close, he is asleep.  He did have a walk down the hall and back today.  His nurse is Gretchen, and she is amazed at how straight he is and how good his balance is.  So, the news today is mixed.  He will spend another day and night in ICU, but he is hoping to have nasogastric tube removed tomorrow.  I hope so too, for his sake.

I will be going to the hospital tomorrow, and will, hopefully, have only good news to report.  It turns out that his room does have a phone, and he telephoned me just moments ago.  It is difficult for him to have a conversation, but it was wonderful just to feel connected.

Since Dawn went home yesterday, I found myself really alone in a strange hotel in Sacramento anticipating all of the things that might happen on my way to the hospital this morning.  So, at 4:00 AM, I began to think about my route, which street would take me directly to the parking lot, and when it was time to leave the lot, which way must I turn to find my way to J Street and the freeway entrance.  I had been given complimentary parking tickets for Lot B, next to the hospital, so I proceeded to worry about how they were to be used, and if I had to pay in advance and then get reimbursed at the exit.  I checked my phone and found there were no emergency calls from the hospital, which was another worry.  Happily, all of the worst scenarios never came to fruition.  I found my way to the parking lot, found a perfect spot next to the exit, and when it was time to come home, four right turns and a left put me on the freeway. Whew!

Harvey was waiting for me when I arrived at 9:00 AM.  Again, I got there in time to see Dr. Graves, who was genuinely impressed by Harvey’s progress.  He had the nurse remove the bandage on his chest.  The incision is longer than I expected, but the stitches are very neat, and there is no sign of redness, heat, infection, or seepage.  These are all good signs.  He also had the urinary catheter removed.  Harvey is nothing if not persistent as he asked Dr. Graves if he could go home today.  Dr. Graves said that would be kind of unprecedented, and maybe he should wait a few more days.  Harvey then asked about the nasogastric tube.  Again, Dr. Graves didn’t promise anything, but suggested it might come out tomorrow.  He is still in ICU but will likely be moved in the next day or two depending on room availability on the prescribed floor.  A couple of hours later, Dr. Becker came in and checked all of the tubes, etc.  He is so cute!  Anyway, he said that on the fifth day after surgery, Harvey would be given a “contrast drink.”  This is used to determine if the Anastomosis is leaking or not.  The consequences of it leaking are somewhat dire, so we are praying for the sutures to hold fast.

Once the doctor visits were completed, Nurse Elise got Harvey unhooked so that he could get out of bed and sit on the chair.  I began reading email greetings and comments from friends and loved ones, and showed him photos of our grandson’s heroic football moments.  However, I could tell that he was getting tired.  He dozed in the chair for about half an hour, woke up, and said he wanted to go for his walk.  Not waiting for the nurse, he started to stand.  I panicked.  “Wait, wait for the nurse,” I said.  “I don’t know how to unhook all of these things.”  Fortunately, Elise walked in at that moment and sorted him out.  A short walk ensued after which he lay on the bed and went fast asleep.  It was a busy morning.  He was exhausted.  Sleep is the best thing for him now.

Dawn will visit tomorrow, and possibly Cole.  I will stay home and catch up on a few things here before going back on Monday.  As always, your thoughts and prayers are so much appreciated.  Our hearts are full to overflowing.