Go confidently in the direction of your dreams. Live the life you have imagined.

Henry David Thoreau

Day +10 – Sweets & Irritation levels

Thursday July 26, 2012
Quail Run Lot 15
Moffitt Cancer Center Room 3715

 

Since today is not a running day, I’m up early and determined to get to Moffitt earlier than usual given how badly David was feeling when I left last night.  I make some breakfast and eat it outside to the sounds of traffic and air conditioners.  No lawn mowers or blowers, it is too early for them.

 

the rain gauge

 

When I returned home last night, it was dark.  I usually look at my “rain gauge” but I just stuck my finger in the clay pot drain dish that I leave on the patio to let me know if and how much it rained during my day away.  It was empty.  No need to do the slide toppers in the morning. The weatherman had said only 20% chance of rain both yesterday and today. 

But when I get on line to post some comments and make some of my own, Karen says in her comment that they’d had a good storm in the afternoon.  Not sure why none of that water was in my makeshift rain gauge last night or this morning but I take my broom up on the roof and there it was, water on the bedroom slide topper,  I sweep it off.  My neighbor yells up and asks me if I want to use his blower for that.  I politely decline.  What’s with these folks?  Does a blower really do such a much better job than a broom or a rake?

 

Next, I walk up to check the mail and find a package slip inside the box.  I’m hoping they are open at 7:30 in the morning and they are.  It’s a pretty big box and HEAVY.  Now what could this be? 

Day  10 001 wearing my favorite shoes

 

I open  it up and am shocked to find that blog reader Betty has sent me a GIANT box full of Almond Joy.  Pounds of Almond Joys.  I’ve never seen such a big box full of so many almond joy candy bars.  This looks like a box they must use to FILL up the vending machines.

 

Day  10 007

I’m just overwhelmed with the generosity of my blog readers.  Thank you Betty!  Between the J-M-C ice cream and all these Almond Joys, I’m gong to be having all the sugar highs I need to get me through these days.  Wish David could enjoy eating as much as I’m going to enjoy these.  They should last me for a VERY long time.  This is a BIG box.  If I can keep from over doing, they will last long enough for David to share them.  He prefers dark chocolate so you’d think he’d like mounds but he’s also a serious nut lover so he enjoys both.  I REALLY WILL make sure there are some here for him when his appetite comes back.

 

I may have to up my running to daily in order to compensate for this drastic change in my diet which now includes an over abundance of ice cream and Almond Joy, nearly all my worst vices.  With the wonderful blog friends I have, I am one happy camper and actually don’t eat an Almond Joy right this minute.  But I do pack one with my lunch/dinner.   I am VERY proud of my will power.  LOL    Many many thanks Betty!!

 

Day  10 009

 

Not quite so happy when I get to David’s room.   I come in and find him asleep on his sofa.  He’s hooked up to a machine but it doesn’t seem to be dripping anything.  I look at the timer which shows zero.  So I assume that whatever he was getting has finished.   He’s deep in sleep and snoring when an hour later his nurse comes in.  He wakes up and is clearly more tired and has less energy even than yesterday.  

 

I tell her about the nothing dripping situation.  She looks and says “oh well the potassium didn’t finish.  I didn’t have time to come and check”.  I later find out from David that he was hooked to the machine an hour before I got there.  So now it’s two hours but nothing has been accomplished.

Day  10 017 

His platelets are, as I assumed, below 10 so she’s come to give him the platelet transfusion.  They are the yellowish looking fluid in the bag on the pole.  It will take about 45 minutes and then he has to have the rest of the potassium, an antibiotic and the saline drip.  In the past the saline drip has taken at least 3 hours.   I don’t see how he will possibly have time to do any of the things they have assigned him if he’s constantly hooked up to this machine.  Especially since with his fatigue he needs to take long rests between activities.

Again his white cells are inching up, his hemoglobin is inching down.  Only his platelets have fallen under the magic number which for them is 10.

Day  10 010

 

Day  10 037

 

He asks what time I arrived this morning and tells me that if I’d been 10 minutes earlier I could have seen him throw up.  I’m thinking poor him, lucky me.  He ate his breakfast and then lay down on the sofa in the sun to sleep.  Mark Honor is off rotation and another PA is now on who came in and woke him up to listen to his heart and lungs.  The sitting up apparently made him throw up his breakfast.   This is JUST the sort of thing I wanted to be here early enough to try to help him avoid. 

As he’s telling me this I am not very happy with a PA who feels he has to listen RIGHT NOW to the lungs of someone who is barely sleeping at night while they are sleeping and I say so.  His nurse Michele gives me some snippy defensive business about how he has to do it.   My irritation is at level two.

The rounds group comes in about then and everyone but Dr. Perez is a different person.  She asks “how are you”.  David feels like shit, his eyes are at half mast, he is trying to get up the energy to reply, she is clearly in a hurry.   So I say “not so hot” and she begins telling me how he feels.  How well he’s doing, how in comparison to everyone else he isn’t sick, how this IS a transplant.  I mention the vomiting, she looks at David who explains and the PA has the audacity to say “Oh so it’s my fault”.   I want to smack him.   Irritation level has reached 5.  This is the level at which all desire to have pictures of these people and their “help” disappears.

 

Later, When I mention how dumbfounded I was at the PA’s response, David tells me he thinks the guy was kidding, perhaps, but if so, it’s a pretty poor joke.   It’s clear David feels terrible and yet Perez just goes on and on about how OK everything is even telling him that he has no pain since they have fixed the prostititis.   I ask him if this is so but she doesn’t even hear his slow and quiet response that it “seems a little better”.  Doesn’t sound quite the same as “fixed” to me.

His responses are slow and apparently she assumes he isn’t going to respond and just plows right on.  She looks in his mouth with a flashlight and begins talking about how his mouth is clear so he doesn’t have Mucusitis.  He tries several times to say something but she just runs right over him talking about how some people have terrible mucusitis and even sort throats.  I wonder if she even notices his attempts to say something or has forgotten that he DOES have a soar throat. 

My irritation is now at about stage 7,  so I say loudly looking at David, “IS THERE SOMETHING YOU WANTED TO SAY DAVID.” 

She actually shuts up and listens as he describes what is clearly a mild case of mucusitis.  He describes being  awakened by a mouthful of very salty mucus.  I ask him if his throat is STILL sore.  I’m trying to remind her that this IS a man who has had a sore throat for the past few days.  She looks at him and actually waits for him to reply  “it’s not AS sore”.  She looks at me with a smile. 

 

I ask if ice or ice water would help the build up of mucus.  She says they have a mouth wash for it.   Someone says they will get that for him.  My guess is that I will have to go out later and get it.

David is exhausted with all of this so instead of giving the two of them a piece of my mind, when she says “anything else”?  and he shakes his head no,  I say nothing.  Irritation level 9.  Amazing self control demonstrated here.

 

Day  10 020

 

His technician was taking his blood pressure just as they came in and it was 146 over I don’t remember what so she comes back after they have been gone for a while to do his vital signs again.  That pleases me.  Irritation lowering.  

 

 

 

 

 

His BP is down to 137.  Vital signs includes the little oxygen sensor on his finger  that I find so fascinating.

Day  10 023

 

Day  10 014

His nurse finished hooking up his platelet transfusion without explaining what is going on.  After the non drip hook up of two hours this morning I’m not so trusting.  I look at two lines going into one drip valve going into his central line.   Clearly the platelets are dripping, the saline is not.  So I go out and ask his technician Fadila so see  if she knows if that’s right.  She says she doesn’t but tells me his nurse is back at the desk in the other hallway.  I walk over there and ask her if they are both supposed to be dripping, she looks up with that look that people get when they think you are being too pushy and says no.   I wait for an explanation, she gives none, I leave.   I don’t want to make things worse with her for David.  So I bite my tongue AGAIN.

When I return to the room Fadila has sent another very nice nurse in to answer my question.  When I ask if the platelets dripping alone is right, she smiles, says yes and then explains that the saline is hooked up to flush the lines before and after the platelets.  Now how hard would that have been for Michele to do?  Perhaps she’s having a bad day or perhaps my questions are making it worse.  Or perhaps she’s over worked if paperwork, which is what she was doing, counts.

David is sleeping when the ding, ding, ding goes off.  The machine has shut down but the platelets are not all infused.  I go out into the hall.  No one is anywhere.  I come back in, buzz the nurse.  Go to the bathroom to get the urinal jug for David and when I come out, Michelle is setting the machine for another 11 minutes.

If all this is an effort to make at least me look forward to a Saturday discharge, it’s working.  I hope he is well enough to leave here.  The change in staff from Dr. Alsina to Dr. Perez, from Mark Honor to Mike, and the huge variation in nursing staff is wearing on me if not on David.  There is some very good medical care here at Moffitt but there are some attitudes of superiority that do not belong here.   Frankly I don’t care if he is less sick than anyone else on the floor.  His problems need to be taken seriously however small they seem to the staff and they need to be patient as he tries to respond to their questions and not assume they know how he feels.   Without exception, nearly everyone who talks to him today seems in a hurry and cannot wait for him to get all the words he’s trying to say out of his mouth.

 

Michelle comes back in and mumbles something about what she is doing. Is that her version of “be sure to tell the patient what you are doing”??  SPEAK UP WOMAN I want to yell at her.   I’m clearly going to need all that ice cream and candy comfort food.   When I am stressed my craving for sweets shoots sky high.  I think to myself “you’d be better off if your comfort food was macaroni and cheese or some other high starch rather than high sugars.”

 

Day  10 021

 

Thinking of “snacks”, I notice the peanuts still on his tray.  They have been there since he got them from the cute snack cart girl on Monday.   Carrie, and others who know David well, will see this and  understand even more clearly how badly he feels.  Otherwise, peanuts would never sit for 3 days now uneaten. 

 

It is almost noon and he has not been up at all today other than to move from sleeping on the sofa to lying on the bed and sleeping.  Each time someone comes in, I ask him if he’d like some water.  He says “not right now”.  And each time they leave he asks for the urinal.  He clearly has the strong urges with little result.

 

As lunch delivery time approaches,  he does get out of bed and move with the machine to his chair for the first time today.  He sits.  When I ask him what he’s thinking about, he says “that I should be doing something.”   So he takes up the kitchen menu for tomorrow and fills it out.   The kitchen has a nice variety of food and the food service person brings him both the regular and vegetarian menus each day.  He likes to have them both since there are often more side vegetable choices on the regular menu than on the vegetarian.  Vegetarian lasagna, veggie burger and black beans and rice are the routine entree choices for vegetarians.   There is also an ‘add on menu’ with pizza, burgers, shakes, fries and other “fast food” sorts of things.  He hasn’t used that much if at all.

Day  10 026

 

Michelle comes in to give him some lasix which has been ordered.  that is a surprise and we ask what it is for.  She says to speed up urination.  He’s going every 5 minutes as it is AND they are giving him saline.  This makes no sense. She says she doesn’t understand it either so she will check to see why Humorous Mike ordered it.  My irritation level lowers slightly.

 

She comes back to report that apparently Mike heard some crackling in David’s lungs, or thinks he did.  Is this when he woke David up this morning?  Michelle checks herself and says she’d call them clear.  I ask if we can opt out and she says it’s only a small amount and she wouldn’t.  So what do you do then?  David, of course, wants to be cooperative so the lasix is given.

By now it is nearly 1:00 and his lunch is delivered.  They’ve somehow gotten his request wrong for the first time in 12 days.  But we give them a pass since they have been so good.  Meals 3 times a day, always hot and from a nicely varied menu.  For hospital food, I’d give Moffitt high marks.  

 

He eats a good amount and while he’s working on his meal the Physical Therapist comes in and says she’ll come back later.  After eating, he goes back to sleep.  15 minutes later in comes Michelle with his neupogen shot.  She can not get the medical accounting system wand to work.

Day  10 031

So after fiddling and restarting it and beeping,  she double checks the order and the dose, gives it to him and takes the offending machine off to IT to see what’s up with it.  This is a subQ shot.  It cannot go in through the central line.  So once a day since Monday he has again been getting stuck.

Day  10 032

 

Let’s see now.  So far today he’s had potassium, an antibiotic, a saline drip, a platelet transfusion, lasix, and now neupogen. 

 Day  10 035

He goes back to sleep in his chair.   Fadila comes in to change his bed linens.  While she does, I check my email to post the comments on yesterday’s blog.  After Almond Joy, it is the most cheerful thing of my day. 

 

Thank you all so much for the time and interest you take to let us know you are following along.  His majesty Duke (remember his picture from yesterday) actually left a comment.  Now this is something even Scamper, my absolute smartest and cleverest and sneakiest beagle of all time could not do.  I don’t think.  But then I didn’t have a blog then so she didn’t really have a chance.  Who knows?  But Duke, you make me laugh out loud.  I know David will love this when he feels well enough to read the comments or to have them read aloud to him.  

 

Day  10 029

 

The lasix is working over time and wakes him up.  Fadila comes in with his mail.  It is a card from our wonderful neighbors Bob and Nancy whom we know follow the blog but do not comment.  Many many thanks Bob and Nancy!! 

This is literally the best thing to happen for him all day so far and it cheers him up to the point that while I’m talking to my father on the phone to remind him that I’ve set up his transportation to the VA for a blood draw for tomorrow, David puts on his shoes and it’s clear he’s going for a walk.   I tell my dad it is time for a walk and say good by.  

 

The physical therapist comes back while we are walking.  She joins us and asks how he is feeling. “Like I have tired blood” is his response.   After a couple  of laps, she puts another one of those little finger things on his index finger to see about his pulse and the % of oxygen in his blood.   111 and 99.   She calls him a rock star. Wonder what Mick Jagger would think of that?   Isn’t he 69 sometime this month?  What these old men don’t do!

 

David wants to finish the walk and tells her I will help him with his PT exercises so she doesn’t have to come back again.   He’s been dropped back from the “hard” version done while holding on to the bed to the “moderate” version done sitting in a chair.   After 4 laps walking he comes back and sits in his chair, sleeping sitting up as in “church pose”.  I suggest he might sleep better if reclined and he says he’s been thinking about it.

 

Day  10 039

 

About 4:00 he wakes up to use the bathroom and then we do the three moderate PT exercises.  Just as he finishes,  the pharmacist comes in to go over his discharge medications.  I wonder if it has even occurred to these folks that when the patient is feeling his worst is not the time to do all these discharge things.  As she is going over his medications, Fadila comes in to do his vital signs again.  And the phone rings, his brother Roger is calling.  I answer and explain the situation to Roger.  David will call him back if he can stay awake and people stop bothering him.  Roger understands.  The pharmacist leaves, Fadila takes over and then Michelle comes in to take 2 vials of blood to check his platelets and electrolytes.

 

Finally the rush seems over and he wants to try the spirometer.  We agree that this time he will only do 5 at a time rather than all 10 since each one makes him a bit dizzy.  Last night he was exhausted and his teeth were chattering after doing 10 in a row.  He is able to get to at least 1700 each time and once to 2250.  But after 5 he is tired and cold so he lies back in his recliner with a pillow for warmth.  I suggest that I’ll get his blanket from his bed but he says no.   He wants to “get up in a little bit and do another walk” at 5:00 before his dinner comes.

I’m amazed that he is doing all these things after such a difficult morning and being as exhausted as he obviously is.  If this transplant doesn’t turn out to have a fabulous result, it won’t be for lack of effort his part to do everything asked of him.  I wonder how I would fare in his place.

 

Day  10

 

As I watch him sleep, I remember that unfortunately this transplant is not a cure.  Multiple Myeloma is a cancer for which there is no cure.  He will not “get over this” and back to his “normal” life.  There is now a totally new normal that will always include blood work and doctors every month.  This stem cell transplant, everything he is going through now and all the months of treatment leading up to it will hopefully give him a few years in remission before the disease returns.  No one as yet has been cured of the Multiple Myeloma and some have had multiple transplants.  Many people have 3 or 4 good years of life in remission, some have even more.  Some have transplants that don’t work at all like Pat Killingsworth who wrote the book about Multiple Myeloma Stem Cell Transplants.  Some are on drugs for follow up, some are not.  But all are tied to the medical system forever after, most taking medicines daily and all getting weekly/monthly/quarterly blood draws and treatments depending on their current situations.   Whether David will ever be able to travel full time in an RV with complete freedom and away from his specific hematologist is unknown.  His hope is that he can have a good enough quality of life and that better treatments/drugs or even a cure may arrive while he is in remission.

 

It’s just after 5:00 when Michelle comes in and announces that his platelet count is up from 6 to 36 due to the transfusion but she doesn’t have the electrolyte count yet.  Since he is now awake, I ask David if he wants to get up and he says “how about 5:15”.  “You got it”, I tell him and he goes back to sleep. At about 5:30 we set out for the 2nd walk.  After 2 laps he’s very cold so we come back and get him a third shirt and that hat he had me bring for his head.  He looks like he’s out for a walk in early winter.

 

Day  10 040

 

They bring his dinner just as we return, he’s eating it well, everything is fine and then says he’s too hot.  Shortly after that he vomits.  Michele brings him another shot of zofran but it’s clear he may have to switch to a different anti-nausea medication. 

After resting a while, he tries his dinner dinner again and is able to eat the remainder including a small bit of carrot cake.  He ends the evening by undertaking a shower.   This is a BIG deal and takes quite a long time when you have the central line and dressing that you have to keep dry.  We finally get his hair washed and get him into clean pajamas to go with his nice clean sheets but he’s exhausted.  It’s nearly dark when I leave him resting in his chair before brushing his teeth.

He doesn’t do the last walk or the other 5 on the spirometer but he’s done as much as he can and that’s good enough.  Now that his platelets are moving up, we are hoping the rest of his numbers will begin to make bigger climbs and these numerous side effects will decrease.  Tomorrow is another day in which that could happen.

22 comments:

  1. Egads, what an ordeal. Here's hoping David starts feeling loads better soon.

    Enjoy those Almond Joys, you've earned them!

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  2. Fingers crossed for tomorrow!
    You are quite the patient advocate Sherry. Keep it up.

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  3. You restrained yourself really well. Can tell it was a stretch. But a patient needs someone like you watching out for them!!! Good job! Wish David well!!!

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  4. David has had quite a day, Sherry. Maybe you'd be better off staying over with him the next couple of days. It might ease your mind and his. Just a suggestion from someone who knows nothing about anything so take it from where it comes.

    The tension you've been through seems to be surfacing, and things for which you have no control are happening which may be the reason for your level of discontent.

    I know it does no good to know that David is doing better than a lot of other patients. He is yours and you hurt for him, and him alone. I never realized until my niece had Leukemia that it is, indeed, a life long tie to treatment, checks, doctors, all the things one doesn't want in their life.

    Maybe once you get into the housing and have more control minute by minute, you'll feel a little less apprehensive. You didn't get your run in today so I imagine your patience is wearing thin at this point.

    How nice of your blog reader to send you your favorite candy. If it does nothing else, it tells you how many people care and how many people have come to love David and you. You've seen him change for the worse almost over night, let's hope it changes direction just as fast in the next couple of nights.

    Not everyone is like us--perfectionists. To some, as you said once, what they do is just a job. To others it is a calling. There may come a time when you may want to find another doctor who will LISTEN--but that remains to be seen.

    So sorry for your bad day, and my sincerest hopes that things are better, tomorrow.

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  5. what an ordeal is right....I can 'feel' how miserable he feels in your writing..even tho he is still being such a trooper about all of this...We have spent what would probably equate to years, in time , in hospitals with one of our sons...like you I was his patient advocate...you have to be....its very hard to bite your tongue at times ..how well I remember...but sometimes you have to for the patients sake... thankfully David has you to avocate for him, where he feels so ill right now, there is no way he could do it for himself. Hang in there my heros I'm praying for improvement tomorrow...god bless you both...

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  6. I can only hope that I would be a strong as you in the position Sherry...I have all the admiration in the world for you. You are my heroine! Know that you both are in my prayers every night.

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  7. You should start calling Betty "Awesome Betty." Such a thoughtful gift!

    Poor David needs all the advocacy he can get; he's too tired to stick up for himself. I hope he feels better by Saturday, so he can get some rest.

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  8. You keep up your support of David! Don't let THEM get slack with his care. Nice to get some Almond Joy too!

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  9. What a day! I applaud David for continually trying to do above and beyond what is expected of him... even when he feels terrible. This is an ultimate challenge. It would be easier just to do nothing. I believe, though, that pushing through is in his best interest. Nobody loves a "patient" more than their own family members... and they need to be the "voice" at times. David is a quiet man, even when he is healthy. He is a gentle, loving spirit. Nice to see the platelets rising... please,,, please... let this bring more energy to his body and spirit... and to yours, Sherry. These are long and difficult days... the "rabbit hole" as you say. Obviously it takes a lot of strength just to get through EACH single day - physically and emotionally. So hoping that TODAY is the day he turns the corner and starts feeling better. Thank you for taking us along on this difficult journey... although we can do very little to ease the burden, it is so helpful to know how he is doing each day. Stay strong... both of you. Winnona is calling for a long journey to your favorite places.......

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  10. I'm frustrated for you after reading all that. I suppose health care workers need to be detached to a point, but it sounds like they were to the extreme yesterday. So good that you're there to stand up for David when he needs it most. You're doing an excellent job. We have so much admiration for the both of you in how you're doing what you have to do to get through this. And you WILL get through this! Prayers continuing.

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  11. Maybe the transfusion will have him feeling stronger today. Catherine felt the same way when everyone was telling her how "well" she was doing. She felt lucky not to be doing worse, but she still felt really bad and wanted someone to "hear" that. I am glad you are making them listen to David. I should have done more of that for Catherine.
    On the prognosis-remember, most of the folks who get this are older than David and in poorer health. We feel confident his good health will bode for a much longer, stronger remission-

    Let us know if we can help with anything over the next few days..

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  12. Whew- what a long, hard, day. I hope that the sun starts shining soon and that good days are right around the corner!

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  13. Oh man - how difficult this is getting. It seems that as he gets closer to discharge, Moffitt sort of drops the ball or becomes more 'detached' as 'Mike and Terry' said. It's made more difficult by the fact that Dad just doesn't have the strength to be an advocate for himself or have the stamina to be irritated as you are. He is just going step by step and trying to motivate himself - which I must say is very impressive. I wish I could lend him strength or lessen this load - my goodness do I. It is heartbreaking that there is no cure for this disease - it seems so incredibly unfair. Mama, you are doing a tremendous job attempting to be a voice for him and figuring out what to say and what not to say to make it easiest on him. Dad and I both thank you more than either of us can express. I hope today brings improvement - less pain and more energy - there will be better days ahead - I just know it - I can't wait to be there to share them. Stay strong - one day at a time. I am with you in spirit each and everyday.

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  14. Sherry and David, let's hope that it will be an uphill climb now instead of a downhill slide. You are both holding up remarkably well. Sherry, you are doing the right thing in expecting and advocating for good medical care and respect for David's voice. When I read Carrie's blog I can feel how hard it is for her not to be there with both of you and my heart goes out to her too.
    Please tell David that he looks as handsome as ever and that will be true no matter whether he has hair or not. Truthfully and sincerely, he looks amazing for everything he is going through. You are a wonderful caregiver, Sherry. Judy Weltman

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  15. I got very angry reading your post at the hospital staff, I can just imagine how hot you must have felt. You are doing a great job being David's voice, it is good that you are there by his side. Even with all David is going through, it is amazing that he can stand up at all, let alone walk the halls. He has great strength deep down inside and it is doing well for him now.

    Go ahead and have an Almond Joy, you deserve it after all the grief and aggrivation you've been through. A little sugar high is just the thing fo a pick-me-up.

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  16. Still and again, you show such strength! We never know how we will cope until we're in the middle of a crisis. David is very lucky to have you for support; I'm sure I'd be a ball of jelly (or some such analogy ;-)).

    All I know is that you'd better put those Almond Joys in the freezer to make them harder to eat! LOL That's where I keep my dark chocolate to avoid too rapid consumption.

    Good luck to you and David today. Sure hope he makes some positive gains so he can be discharged. There's no place like home.

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  17. The Duke of HuntingtonshireJuly 27, 2012 at 1:32 PM

    Scamper, eh? If memory serves, my cousin and best mate during the collegiate years at Oxford was affianced to a lovely young maiden nick-named Scamper. What a fine beagle she was! Fair of face, witty of tongue, clever as the dickens. Ah, and what a nose had she…
    But the Family disapproved of the courtship, claiming that the Beagles of the Lombard Duchies must take only nobility as spouse. Our lineage dates back to 571, the reign of Zotto, Duke of Benevento, yet few are aware that the reins of power were held by his #1 advisor and loyal companion, Zippo Beagleoni.
    Ah, but history is in the past.
    Let us look forward, always forward.
    Fondly,
    The Duke

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  18. Just a thought. Could it be that this is part of the weaning process in preparation for the move on Saturday? Seems like they have everything down to a science--perhaps it's so you and David and aren't frightened out of the hospital scene. As I said, just a thought. Just seems a little too sudden that they aren't being as attentive.

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  19. Sherry, I'm really at a loss for words. I want to say something intelligent to show that I'm still here, still supporting you and David. It's tough to come up with the right words, especially when so many before me have said it all. I don't have the wit of the The Duke to say something funny either. Just know that we're all here to support you guys through these difficult times. I know you're stressed and that makes your frazzled nerves more prone to take offense at things that might not be intended in that way at all. (I speak from experience.) Take a deep breath, close your eyes, and go away to to the sanctuary in your mind for a few brief moments to refresh. Remember, it's uphill from here; and that's not always easy.

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  20. Okay, Mama Wolf, you and I will take them all on! I do know how it feels to want to savage them all. I have made waves when my child was not listened to and I can sympathize with you over David's travails. It's the most painful part of the whole situation.

    So now, when you snap off their little heads with your teeth, remember that I will gladly bite their butts for you.
    Pat Floersch

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  21. Wish there was something we could say to make things better for you both. It all sounds like a bad dream. Hope you have much better days ahead.

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  22. I love your favorite shoes

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