8 Days after…still waiting…

image courtesy of http://www.artbywicks.com

I know I haven’t been posting as much as I usually do, and I haven’t been talking about my progress after my Cerebral Spinal Fluid patches, but I just haven’t felt all that different.

I wake up in the morning, and most mornings I feel pretty good.  (that’s not unusual)  I continue to feel a bit off balanced all the time.  As the day goes on I seem to start feeling a bit worse.  I don’t really know how to explain it.  It’s kind of like I’ve always felt, but different.  My head feels full, and I feel like if I moved my head too much I’d barf.  I feel slightly nauseous most of the time.  If I get hot, it gets so much worse.  I’m just not sure what it all means.  Stuart tells Dr. Gray and she seems content.  She says it’s good that I’m not having headaches.  I’m happy about that too.   I sure do wish I would see more improvement.

I do feel like my hearing is a bit better in my left ear, but I still have trouble hearing certain frequencies.  I don’t realize just how much I rely on closed captioning until I don’t have it.

So, my progress so far…not too much.  But I haven’t had any full blown Vertigo attacks!!  That says a lot.  One time I felt like I might start having one, I took a pill to reduce my pressure (like Dr. Gray advised) I was still having symptoms 30 mins later, so I took another one…and shortly afterward I couldn’t stand it any longer and took a Valium and Phenergan.  I started feeling better, but I’m not sure what caused it.

I had a Gastrointestinal CT scan on Thursday.  It was not a fun experience, but it wasn’t the worst I’ve had.  I think I had a reaction to the Contrast they had me drink before the scan.  I had horrible diarrhea starting before I started the 3rd cup.  (you have to drink 3 cups of this stuff, they tell you that, but they don’t tell you the cups are 20 oz.).  Well, they almost had a mess to clean off of their expensive machine.

The other bad thing about the test.  They were also supposed to put in an intravenous dye.  I told the nurse on the phone the day before that it is very hard to find my veins.   So she took me back in the very cold CT room and tried to start and IV, she looked at my arms and said, “Oh, yeah, you told me this would be a challenge.”  I said, “Yeah, I don’t know why people never seem to take me seriously.”  She said she did, she just forgot.  She then said she could see any veins, and she couldn’t even feel anything.  I said, well, it’s very cold in here, they had to use a hot pack last week to help out.  Well they didn’t have that.

So after 5 times of her trying to find a vein, and each time she would say something like, “I don’t feel confident about this, but I’m going to try.”  I felt that was not the thing to say to a patient.  She was very concerned for my comfort, but she was not confident in her job.  One time when she said that and was about to stick me (try number 4 I believe) I turned to her and said, “Honey, You need to get some confidence, you have to believe you are going to do this or you will never be able to do it.  Take control, tell that vein who is boss!  And just do it!  Don’t worry so much about hurting me, I’ve had much worse.”  She just said, “You are so funny.”

OK, well, I do believe, if you believe you are going to fail, you will fail.  It was obvious she believed she was not going to be able to do this and she never did.  Finally, she had to call the radiologist and tell him that she couldn’t do it, he said fine.  We just wouldn’t have that part, if they needed it later, they’d try again.  I said, “with someone else giving me the IV.”  : )

Luckily, it doesn’t seem to be a need for them to do that part of the scan.  Yay!

The results?  I have a Kidney stone!  Well, that was a surprise.  It’s small and not in a place where it’s causing any harm right now, but still, A Kidney Stone…crap.  I just wouldn’t think it possible with as much water as I drink.  Oh well.

The doctor also told me that I have a fatty liver, I don’t have liver disease though because my enzymes aren’t high.  So it’s just fat there because I’m over weight.  I told her, “Well that doesn’t surprise me since I gained 40 pounds in about 2 months, that is one of the reasons I came to see you.”  She said, “A low-fat diet….yadda, yadda….”  I told her that is what I was doing before all this started…she said I still needed to do the breath test to determine if I’m lactose or fructose intolerant.  And then come in for another office visit to reassess.   I told her I’m working with a nutritionist.  She was great!  (I thought, then why didn’t you suggest it?)  Can you tell, I’m not impressed by this digestive health office?

She just keeps telling me to take fiber.  Well, that didn’t work.  I tried.

I’m glad my nutritionist doesn’t believe in a one size fits all philosophy.  She is working with me to figure out the best diet for me, and how to get me healthier.  One step at a time.   Already working with her, my diarrhea has gotten better.  I’m still having it sometimes, but not every day!  Isn’t that exciting??

I’m still hopeful that the patches will work.  Again, one step at a time.

Tomorrow is my hubby’s birthday.  I gave him a gift certificate for a 90 minute massage.  He had it yesterday.  It was so nice to be able to pamper him for a change.  And I’m going to watch the Super Bowl with him.  (I’m not a sports person)  We’ll have fun.  Gluten Free pizza.  Possibly wings. Oh, and Ice Cream from a local Dairy.  (I won’t be having the ice cream, I’m not eating sugar right now, but it’s a great treat for Stuart. Perhaps I’ll put a candle in it.)

Recovering..a little slower this time.

I was starting to get a little worried because I have been having some dizzy spells, and my hearing isn’t up to par.  Plus, I’m just really wiped out.

I knew Dr. Gray said to expect gradual improvements from these patches, instead of the instant improvement I had with the first patches, but I didn’t know how gradual.  Luckily, Dr. Gray called yesterday to check on me and she told Stuart it would take 7-10 days before I saw the same improvement I saw with the first patches.  (I thought it was kind of ironic that it may take 10 days before I see improvement this time, and last time I only had improvement for 10 days.)  I know it’s just coincidence , but I still thought it was kind of ironic.

So for now, still just resting.  Hardly any pain at all today, I feel like I’ve been getting over a pulled muscle.  Oh, and that cold I felt coming on…well, it doesn’t seem to be there any more.  I’ve been sniffling a little, and I’m very tired (but that could just be recovery, I think), that’s really it.

Yesterday I was so tired I got up around 10 or 10:30am, Stuart made me a lovely breakfast, and I was so tired that I laid down again by 12:30pm and didn’t wake up until 5pm!  I completely missed the only warm day we’ve had.

Stuart has been pampering me.  He’s been taking care of every meal.  Helping me with my every need, or want.  And we’ve been having the best time in the evening doing crossword puzzles.

Tonight, spaghetti and meatballs.  Yum.

A New Patch

I went in to Duke today at 10:30am, early for my 11am appointment, and was taken straight back to see Dr. Gray.  (Dr. Linda Gray Leithe, neuroradiologist at Duke University Hospital.)

At about 3:30pm I was finally on my way home….it was a long day.

Tisseel

First, we went over everything and I signed all my consent forms.  After talking Dr. Gray was pretty sure we’d find out that my pressure was again low, that the blood patches didn’t hold, and that she would be patching me up again today, but this time she was going to be using Tisseel, a surgical fibrin sealant indicated for hemostasis and tissue sealing.  It looks like epoxy.  It comes in a double tube plunger and it mixes when they insert it.   (kinda cool huh?)

So I went through the same thing I went though when I got the blood patches, but I didn’t have to have another myelogram.  They just used the information from the first one.  I don’t have to be as careful after this procedure because this sealant doesn’t have to clot around the leak, it is sealed now.  However, since they put less stuff in I will feel the results more gradually instead of feeling it as quickly as I did last time.

I have noticed I can tell that I am hearing better.  (the TV was too loud! hahaha)  I’m less dizzy that I have been, but I don’t think I’d risk closing my eyes and shaking my head around yet…maybe tomorrow.  : )

Dr. Gray said I could walk around some tomorrow, but as sore as I am right now, I don’t know if much of that is going to be happening.  It’s not horrible, but dang my back hurts.  I hate taking pain pills, but I think I will be taking a couple tonight.

There is still a risk that my pressure may spike tonight, but I have meds to take care of that if it happens.  So far, no headache, so no sign of increased pressure.

When I left Dr. Gray shook my hand and told me that she hoped she wouldn’t need to see me again!  I must say, as much as I like her, I also hope I don’t have to see her again either.  She is such a great doctor.  You rarely meet a doctor who is so up beat and genuinely loves her job.  When you are with her you can’t help but catch the enthusiasm and hope that just flows off of her.

Here’s Sandy coming to check on my recovery:

 

Sandy checking on me.

Tonight my darling husband went and picked up a gluten-free pizza from Mellow Mushroom.  (what a treat!)  Now I’m going to relax on the couch and watch cartoons.  Maybe, we’ll turn on a movie, but right now cartoons are making me happy!

Right now I’m not feeling all that great.  I think the meds aren’t sitting well, and I didn’t sleep very well last night.  I sure hope I start feeling better soon.

I’ll let you know how I’m feeling tomorrow.

Thank you, everyone, for being so very sweet and sending me wonderful wishes.  I really do appreciate all your thoughts and prayers.

*fingers are crossed*

Puncture Tomorrow – Cold Today

A Zen Moment. (a commissioned painting by Wendy Holcombe)

Tomorrow I go in to see Dr. Gray again for another lumbar puncture and possibly having some spinal fluid leaks patched.  They called today and moved my appointment up one hour so my lumbar puncture is at 11am tomorrow instead of at noon.  I need to be there at 10:30am.  Yay, that means I will be able to eat sooner!

Today, I woke up with a cold.  It’s not bad yet, a slight sore throat, nose is running, don’t want to stay awake, head hurts, all brain foggy, achy all over…you know.  I’m a little worried about tomorrow though.  You have to be very still on the table when you get a lumbar puncture (after all, they are inserting a needle between 2 of your lumbar vertebra), what if I sneeze?  Don’t know why I’m worried about that, I’ve only sneezed twice today.

I’m glad I have the appointment tomorrow.  I’m really ready to see if we can’t get this figured out, but I am a bit nervous about having a cold.  Even if I don’t sneeze or have the need to move, I am not going to be comfortable on that table, after all the table is hard and I already ache all over.  However, I do want you all to know that a lumbar puncture is not like it used to be, they do not hurt.  The only pain I really feel is the pain killer they inject first and it’s just a little sting.  Then I feel a little pressure.  But it’s not scary, and it doesn’t hurt.  So no worries.  I’m just a little apprehensive because I don’t feel good.

I will have to find a “Zen Moment” to keep myself calm and still.  (actually, I just didn’t have a perfect picture for this post, so I thought I would shamelessly post one of my own paintings.  *smile*)

I may be a tiny bit worried about having a cold during the procedure, but really, I’m mostly excited to get this over with.  (I really hope they are planning on doing patches tomorrow and not just doing a lumbar puncture.  Truthfully, I just don’t know.)

small update and Sauerkraut recipe

I have an appointment with Dr. Gray on January 28th at noon.

I don’t know why all of a sudden they were able to get me in sooner, but I’m glad.

We’ll find out what’s going on with the Cerebral Spinal Fluid Pressure.  Hopefully, she will be able to get something straight.  Even leveling things out a little would help a lot.  3-4 attacks a week are driving me crazy.  (as you all know.)

On a side note.  I made Sauerkraut today….well I started the making of Sauerkraut today.  I thought I had pictures of it from the last time I made it but I can’t find them.  : (  So I didn’t take any today.  But I will tell you what I did.  It is so easy!!  (especially if you have a food processor) *this recipe was inspired by the recipe for Raw Sauerkraut in the Whole Life Nutrition Cookbook.

Sauerkraut

  • 1 head of Cabbage
  • 1 – 2 Tablespoons of Sea Salt (I use 1, but the original recipe called for 2)

Peel off a few of the out leaves of the cabbage head.  Save these you will use them later.  Chop the head into small enough pieces to fit in your food processor. (be sure to remove and discard the stalk. I really like the center of the stalk, I always just gobble it up.)

Slice up the cabbage in your food processor with your slicing blade. (if you don’t have a food processor you can do this by hand, but it will take a while, you have to cut it up really small.)  Transfer the cabbage to a bowl and toss with the salt.

Here’s the really hard part if you don’t have a food processor.  Remove the slicing blade from the food processor and put in your little plastic blade.  Return cabbage to food processor in small batches just smashing it up and making it all juicy.  (if you don’t have a food processor you need to just keep smashing he cabbage with a mallet until you get a lot of the juice out.  Of course, this is a great way to get your frustrations out.)

Just spoon your juicy cabbage into a clean jar, and cover with those outer leaves you saved from the beginning.  Press the mixture down so the is some juice covering the leaves.  This won’t be hard.  Keep in a dark dry place for 3-7 days, I like to keep mine in my pantry.  (I do put the lid on the jar, but I don’t tighten it.)  Every day you need to press it down some more so even more juice will cover those leaves.  (eventually the leaves will start to just fall apart, don’t worry about it.)  The original recipe says to start tasting it after about 3 days, mine tastes nasty that soon.  Just smell it, if it smell like sauerkraut, then taste it.  If it taste like you like, then put it in the refrigerator the slow/stop the fermentation process.  If you get a funky scum on the top of your sauerkraut, just spoon it off.

I use a wooden pestle from a mortar and pestle that I have to press my mixture down every day.  Since I don’t use this mortar and pestle any more, I use it exclusively for this, now it smells like pickles.  : )  If you used a pestle made from a different material, or perhaps a mallet, you probably wouldn’t have this problem.

They do make crocks just for making sauerkraut, and I’ve seen much more complicated recipes, but I’ve never tasted better sauerkraut.

I may make it a different way some time, I may even get a fermenting crock so I can make more than one head of cabbage at a time.  But for now, this method does well for me, I just start a new jar before the one in the fridge gets empty.

(If I find those pictures, I’ll post one.  Maybe I will take a picture of the jar I have started at least so you can see what it looks like.)

I’m scared.

Snow falling in my back yard, December 4th, 2010

Last night I went to small Christmas gathering, I even drove myself!  I was very proud.  Unfortunately, during the party I started getting a pretty bad headache, and then I noticed my hearing dropped.  Dramatically dropped.

I came home and my stomach was killing me, something I ate at this gathering had caused me a lot of distress.  I ate half of a sandwich and was feeling much better.  Well, my stomach felt better….not my head, and the hearing was still way down.

I decided to take one of the pressure pills. (the pills Dr. Gray gave me that would reduce the spinal fluid pressure if it started building up too high.  She said to take one if I had a headache.)  My headache did not get better, I decided to take 1/2 of a pain pill and try to sleep.  I slept for 3 hours and woke up in horrible pain.  My neck, shoulders, and head all hurt.  Plus, my hands felt all tingly.  I took a couple of Tylenol, and tried to massage some areas and stretch and finally I was able to go back to sleep.

This morning when I woke up my hands were still tingling, and soon the headache started.  I’ve been fighting a headache all day.  Stuart and I went out for a while today,  we went to buy him a pair of jeans, then we went to the grocery store.  The grocery store was packed because it was snowing.  People in NC freak out when it calls for snow.  Unfortunately, we really had to get some groceries or I never would have braved that mob.

When we got home my head was about to pound off.  I again started with the pressure pill.  It didn’t help my head at all, and soon my neck and shoulders were cramping again, and my hands were all tingly.  I looked up the side effects of this medication.  It says that these are “Serious Side Effects – seek medical attention immediately”.  Well, I knew that it would wear off soon, so I didn’t seek medical attention immediately, but I won’t be taking any more of those pills.   Stuart is going to call Dr. Gray tomorrow.  (Yes, I know it will be Sunday, but that’s what she gave me her pager and cell phone number for, right?  She can always decide not to call me back until Monday.)

I’m so scared that the blood patch didn’t take, or maybe I was just starting to feel better because it was my time to start feeling better and now I’m starting to feel bad again.  Yesterday, I was so happy.  I had a long conversation with a friend on the phone, and I drove myself to a party…I actually went to a party, by my self, at night!   Today, I can’t talk on the phone, and I’m afraid to push it.  I’m really scared the procedure didn’t work.

Well, if it didn’t, we’ll figure out something.  It may not be the cure that this procedure was hoping for, but it will be something.  My doctors will have learned a lot more about this disease, and I will have had at least a small reprieve.  I will pick myself up, dust myself off, and find a way to have a life despite my illness.

"The most common way people give up their power is by thinking they don’t have any". Alice Walker

I saw this quote by Alice Walker, and I thought about how much I believed I had no power over anything in my life when the Meniere’s was bad.

I was so dependent on my husband for EVERYTHING!  From paying all the bills, to helping me get to the bathroom.  I had no choice for anything in my life…but that’s not exactly true is it?  I could have completely given up and just packed it all in.  I could have stopped trying to get out of bed.  I could have stopped caring that I had to be taken care of and just given in, but I fought it every step of the way.  Sometimes, it hurt my husband, but most of the time when I really needed him I let him help, but when I didn’t need help, I let him know in no uncertain terms.  (My biggest regret is that I wasn’t easier on him.)

There were a few times when I thought it would easier just to give up and take a bottle of pills and stop being the burden that I felt like I was.  Those are the times I gave up all my power.  But then I’d realize that just because this disease had control of my body, it didn’t have control of my mind.  So, I worked as hard as I could to find a way to live a better life with Meniere’s.  I never thought that I would have the chance of getting rid of the vertigo, and living a mostly normal life again.

Getting on with my life…

I've been doing nothing for so long, I think I can cross it off my list.

 

So, now that the blood patch is over, and I’m feeling better….now what?

I still have a long way to go before I think I’m healthy.  So I think it’s time to buckle down and start paying attention to the title of this blog.

Questions I need to find the answers to:

  1. Why am I having lower GI issues every day for almost 4 months?
  2. Why am I hungry all the time?  (could it be because of Number 1.?)
  3. How can I start exercising with my hip problems?
  4. How can I lose some weight?
  5. How can I improve my diet?

Now, a list on how I’m working on the above list:

  1. I have an appointment with the Digestive Health specialist on Thursday to discuss Numbers 1, 2, 4, and 5
  2. I found a pool nearby that I can exercise in, I’ve added ankle weights and a flotation belt to my Christmas list to make it even easier to exercise in the water.
  3. If the people at Digestive Health can’t help me, then I’m going to make an appointment with the naturopath/dietitian that I found.  (since I had to cancel the last appointment I made with her because of a vertigo attack).

We also made a huge step tonight in starting to change our lives considerably.  For a long time my husband and I have talked about Fostering.  Unfortunately, with my health issues I was afraid I wouldn’t be able to give a needy child the attention he or she needs.  Now that things look like they may be changing, and I won’t have to worry about having a vertigo attack once or twice a week, we decided to take the first step.  We went to an orientation tonight to find out more about becoming foster parents.

We plan to start taking the classes starting January 4th.  I will take a month of classes (30 hours of training all together) before we can be considered to get a license.  We also have to have a background check, be finger printed, have a physical…..there are a lot of things to do, and I’m glad.  I’d hate to think they gave just anyone a license to be foster parents.

I’m pretty excited about getting my life started.  I hope I’m not jumping the gun, but I really think this worked.  My head just feels so much different.

I have a lot to do to the house to get it ready for a child.  Starting with just giving it a good cleaning.  I don’t know how so many people with Meniere’s can keep up a house, and a family, and some even work.  Well, I guess I managed for years, but when I went bilateral, my life as it was pretty much stopped.  I even started seeing a therapist to help me deal with it all.

I will say one thing about therapy, it really helped my husband and I be able to talk about our feelings about my disability in a safe environment.  Then we were able to talk about it all much easier when we were at home.  When I felt like a burden, when I felt like he just didn’t understand.  When he would feel like he really wanted to help, but just didn’t know how.  I simply didn’t think anyone could love me enough to put up with as much trouble as I felt like I was causing.  I felt like a prisoner in my own home.  I couldn’t work, I couldn’t drive, I often couldn’t even help clean house or cook.  Yes, my prison is lovely, and I have a wonderful husband who is here with me, but he’s free to leave at any time.  I was completely dependent on him, and his generosity.  I understand the phrase, “feeling like a bird in a gilded cage.”  No matter how nice a prison is, it’s still a prison.  I had to come to the understanding, that is was my disease that was keeping me a prisoner, not my husband, and I didn’t do anything to cause it.

I hope all of you know, this disease is not your fault!  You didn’t do anything to cause it.  Let the people who love you, care for you, it’s the only way they feel they can help.  My husband felt so helpless, but at least he could be here for me, and help care for me.  He told me he is just so grateful that he could be here to help me through this.  He will never know how grateful I am that he has been here, and continues to be there for me.  I hope he never needs the same kind of attention I have for the past couple of years, but I hope he knows that if he ever does, I will be more than happy to help him.

(I love you Stuart.  Thank you for being the best husband a woman could ever hope for.)

Pictures taken during the Blood Patch, for CSF leak.

During the Blood Patch Stuart asked if he could take some pictures.  They said it would be no problem as long as he didn’t show anyone but me, and as long as the screen showing my name wasn’t in any of the pictures.

In this photo you can see me in the CT Scan, they are lining up the next leak to patch.  You can see the screen on the left hand side that shows the pictures from the CT scan.

This photo shows how the CT scan has a laser light that shows them exactly where to put in the needle.

Here’s a better view of the laser light, it’s even shining off of the needle they have placed in my back.

Here you  can see the blood being put in.

This photo is very similar to the previous one, but you can see the needle in this one, and see just how very thin it is.

It’s all over at this point, except for the washing up with the nice warm wash cloths.   You can see where they marked my back, and the puncture marks.  You can’t see that each puncture is raised a bit.  The puncture the lowest on my back, almost out of the picture, is the sorest one.  That’s where they did the pressure test, put in the dye, and then patched that spot.  It’s still a little sore, but really only if I try to over do it.  This was not a hard procedure to go through.  The doctors made sure I was as comfortable as possible.  The pain afterward has not been hard to deal with.  The hardest thing was that I couldn’t get up and cook on Thanksgiving.   I love to cook, and I admit, I love to show that off on Thanksgiving.  : )

Thank you to everyone who sent me good wishes for going though this procedure.  I’m happy to say that I do think it has done some good.  I’ve been able to close my eyes and shake my head without getting dizzy….That was amazing.  This evening, I’m feeling a little off, but I over did it today.  I was supposed to do very little to nothing for 3 days.  Today, I went with my husband up to a little mall near here…NO we did not go Christmas Shopping.  He needed to look for something at the computer store, then we decided to get some lunch.  Well, I did run in one store and buy a Christmas present, but I had a coupon, and it didn’t take long.

Oh, who am I kidding, by the time we got back to the car and I sat down I was in enough pain that I wanted a pain pill.  (I’m not a big fan of pain pills.)

Still no headaches, no real dizziness (I don’t think I’d really count the fact that I feel a little off this evening, I think I just wore myself out.)  I’m hearing better out of my left ear.  I still can’t hear from my right ear, I still have tinnitus, and I still have that full feeling (mostly in the right ear).

Right now, I’m feeling good about things.

The Spinal Fluid Leaks are patched….

I’m here on the couch trying to figure out if I feel different.  I can say I don’t have the disequilibrium as much as I usually do, I can turn my head around and around real fast and I don’t start getting sick!

The hearing in my right ear doesn’t seem to have changed much, but the left ear seems better.  However, it is the ear that fluctuates any way.  Also, it’s over cast today, I didn’t sleep well at all last night, and I still don’t have a headache.  (that is very unusual.)

Now ….What did they do?

First, they had to insert an IV, to give me a sedative and so they could take blood out of it.  Finding a good vein on me and getting an IV started took close to 30 minutes.  I do not have good veins, especially if I haven’t had anything to eat or drink for about 11 hours.  But she only stuck me twice, and she did a good job.  I do have a big bruise today, but that’s not unusual.

Dr. Gray took another opening fluid pressure check.  My pressure was higher, 17.75.  I think she was surprised about that, I know I was.  That is pretty high in the “normal” range.  But, she said, “maybe you need more.”

They inserted the dye, it causes an ache on one side until they move you around and get it moving, then the ache goes away, but it did give me a headache.

I was put on my stomach on the CT scan, all I could see was the “bed” below me.  I had to have my arms up over my head, this wasn’t the most comfortable I’ve been, but it isn’t the least comfortable I’ve been either.

They then started putting me through the CT scan to look for leaks.  They found a few.  She said she didn’t want to over patch me, because she was afraid my body wouldn’t be used to the higher pressure and would start feeling worse, especially the headaches.

They did 4 Blood Patches.  I’m very sore today.  Dr. Gray called me this morning to check on me, and she said she would call again tomorrow.

I think I may have tried to do a little too much in the kitchen, I just hate not being in charge in the kitchen.  I love to cook, and leaving it to someone else is hard, especially on Thanksgiving.  But, I did get everything started, so I hope Stuart won’t have too much trouble.

I will be posting some pictures of my procedure as soon as I can get them off my husband’s phone.  I think they are very interesting.   I will also give you more information on the procedure when you can see the photos.

I’m really tired now, and think I should rest.  Perhaps another pain pill soon.  (I’m only taking 1/2 at a pill at a time, I don’t like feeling dopey.)

I hope everyone is having a wonderful Thanksgiving.

We will just have to give this some time to see if it worked.

Thank you all for checking on me, sending me notes….  You have no idea how much it meant to me.