Day 5 after stem cell transplant

Jonathan's autologous stem cell transplant was last week Thursday.  Originally I was not planning to be there but I got a call from Gabby around 10 am in which she was asking me if I was coming.  Apparently they had setup a lot of equipment in the event that Jonathan had a seizure or things didn't go well during the transplant.  I guess with all the 'extra' activity, Gabby got a little nervous and our previous expectation about the transplant being an easy process got thrown out the window.

Since I was still home - I decided to take the day off from work so I can be there during the transplant.  The actually transplant is really a similar procedure to when a patient is receiving blood and our initial expectation was that it would take just as long, about 3 hours.  The transplant itself started at 11 am but I didn't reach the hospital until 11:30 am.  By the time I arrived the most of the stem cells were already inside of Jonathan so I reached for the ending portion of the procedure with everything finishing about 5 minutes after I arrived.

The transplant procedure went well - and Jonathan didn't have any adverse effects.  What was interesting was that it was only the day before (Wednesday) that his counts finally got low enough for him to be classified as neutropenic, i.e. no white blood cells so no immune system to fight off any diseases.  So in Jonathan's case he was lucky that he was able to go out of his room for the first five to six days of his stay.  The doctors were expecting him to be neutropenic after the third day (for the least).  Of course I'm not complaining since it allowed Jonathan to have some more play time and fun but looking at him now - it's a big contrast.

I cannot remember clearly - but I believe by Thursday the sores in his mouth, throat and stomach got so bad that we already had Jonathan hooked up to receive pain medication all the time.  By Friday his fevers started and Jonathan has been spending his days having fevers and battling the pain in his digestive system.

On Friday morning I got a call from Gabby that she woke up with a sore throat and this was bummer news.  It meant that she couldn't stay with Jonathan and thus I had to extend my PTO until she recovered.  By Sunday, Gabby was beginning to feel better and by Monday we decided that she could spend Monday night with Jonathan and I could return to work.  This was a good thing too, because, besides the amount of PTO I was taking (which is always negative in my case), I was not getting much sleep in the hospital.  Every hour or so, Jonathan would be whimpering in pain and I would be needed to help him relieve the pain - either pushing the 'button' to get more pain medicines, helping him spit, rubbing vicks on his neck, etc...

By Monday I was completely exhausted.  Fortunately I was not cranky - just exhausted.  I was also fearing that I was getting sick but after a good nights rest - I woke up this morning feeling fine.  Of course I could have done with a bit more sleep - at least another two hours - but got to get to work today.

So ... the doctors estimate that Jonathan has another week of going through this terrible period and hopefully by the end of next week his stem cells will have taken root and his body will start back producing white and red blood cells and platelets.  Right now Jonathan is receiving a transfusion once a day.  One day he'll get platelets and the other day he'll get blood.  Since his body cannot produce any of it, i.e. because there is no bone marrow - he needs to get a supply while we wait for his stem cells to take root.

BMT Procedure - Day -1 or Day 6

After my journal entry on Saturday morning - Jonathan started to feel the effects of the chemo drugs.  On Saturday afternoon he had his first episode of vomiting and unfortunately it also included throwing up his NG tube.  So now we didn't have an easy way to give him his oral medications : (.  I think the NG tube was the biggest loss because Jonathan gets at least four medicines twice a day.  One for his blood pressure, another to (try and) protect his liver from damage from the chemo drugs, the third is an antibiotic and the fourth being a preventative medicine to reduce the amount of sores in his mouth and throat (another side effective of chemo).

On Monday - the BMT nurse practitioner and a couple other medical staff members saw (for the first time) how difficult it is to give Jonathan oral medicines.  For us - this was a normal thing because from the beginning Jonathan never wanted to take oral medicines.  He'll take everything else you throw at him but oral medicines was where he crossed the line.  Child life and child psychology were then brought in to work with him but I'm not sure how effective that has or will be.  On Tuesday they tried a couple of times to give / force the oral medicines but each time he threw up - probably because he worked himself up into a frenzy and it brought the nausea feeling back on.

On Tuesday afternoon they decided to put another NG tube - so right now he has a tube in and I'm hoping this one doesn't come out so at least we'll have easy access over the next two months or so.  Originally they said that if his first NG tube came out they wouldn't put another one back in - because with his mucusitis starting, i.e. the sores in his mouth and throat, putting the tube in may cause some slight injury to his throat and with him becoming nutroplenic they don't want to cause any unnecessary injury or sores.  But the decision was reversed because they saw how difficult Jonathan can be with taking oral medicine.

So far - Gabby has been the one bearing most of the burden of staying with Jonathan.  I've only stayed two nights - Friday and Tuesday.  Leading up to Jonathan's entry for BMT and his stay up till now - I've been in quite a 'funk'.  It was really difficult to get to work on Monday and Tuesday - although my working from home on Monday wasn't too bad.  I think my biggest deterrent right now is putting in the extra effort I have to do for my commute.  When I get to 'work from home' or I've reached into the office and started working - it's actually quite enjoyable.  It's definitely a topic I'll bring up with my boss but 'working from home' is a practice that is not encouraged so I'm not sure what decision will be made.

Another interesting thing that happened this weekend is that I got to spend time with Arielle.  On Sunday we drove to Fresno to see my brother (his wife) and their new baby daughter.  This was one of the few drives that Arielle stayed awake for more than 2/3 of the trip and it was interesting to hear all the 'talks' from her.  We got some good laughs out of it and it is amazing how much she hears and understand about what is going on around her.  With Arielle turning 3 a couple of days ago (on the 19th) I've come to a new appreciation of how much she is truly becoming a 'big girl' and is growing up.  I think, maybe part of my funk, is my shifting of responsibilities to start concentrating on Arielle a bit more, especially since I want her to start back at some sort of day care / preschool while she waits for the 2006 / 2007 school year to begin and join pre-K at Saint Lawrence.

So - tomorrow is going to be the big day.  Jonathan is going to get his stem cells back and hopefully all continues as planned with the stem cells taking root and starting to produce red and white blood cells and platelets.

BMT Procedure - Day 3 or Day -5

It's 5:30 am in the morning and this is my first night in the hospital since Jonathan started his preparation for his stem cell transplant.  I know I have trouble sleeping but I didn't think I was such a light sleeper until tonight.  Let me explain - as part of Jonathan regimen - he gets hydrated a lot so that the chemotherapy drugs gets flushed out of his system - at the same time they are giving him chemotherapy drugs.  Sounds confusing - huh?  Well, the consequence of getting so much hydration is that he has to urinate quite regularly - in this case between 100 to 150 cc every 30 to 60 minutes.  The only problem is that in the night - Jonathan does not get up to urinate so he wears diapers to try and prevent the bed from getting too wet.

Unlike the previous chemotherapy treatments when we could have changed his diaper every two hours - we have to check every hour and I've been getting up every hour to help the nurse.  The good thing is that the nurse really needed help because twice when Jonathan's diaper came off he tried to 'bless' the nurse : ) keeping in mind he is still asleep or at least half asleep.

So I've gotten up so many times - I've decided I ain't bothering to try and go back to sleep.  I tried doing some work but with a dial-up connection it's mightily difficult to get work done, i.e. it takes way to long.  Boy do I miss my broadband / DSL connection at home : (.  It's a pity the hospital doesn't offer some kind of network connectivity in the rooms - then I could really live here : ).

So today starts the third day of chemo or day -5 before day 0.  Day 0 being the day he gets his stem cell.  Luckily Jonathan has not begun feeling nauseous so we don't have to worry about his NG tube coming out.  So less fighting for us for having him to take his oral medications because it can still go through the tube.  Jonathan is also quite active but somewhat on the miserable side.  Being a little stubborn and not listening - so it will be interesting to see how things develop over the next couple of days.  This time we are being more firm with him - because if we don't he'll only get worse - and he's still a kid so I don't want him to think he can do whatever he wants and not listen when adults talk to him.  All in all the start has been good - I'm hoping the rest goes well : ).

On a side note - a special request to those of you that are following Jonathan's progress.  As he is in for a long haul / stay in a hospital environment it will be great if he can get mail.  Nice cards or letters.  For those of you that can, you can send mail to our home address:

Jonathan Seepersad
1035 Coleman Road, #7-117
San Jose, CA 95123

That's it for now - wish I had remembered to bring a movie so I could have watched it but I'll have to occupy myself with something else to do.

BMT Procedure - Day 2

Today is the second day of the start of Jonathan's BMT (Blood Marrow Transplant) procedure.  The first seven days are the countdown to the actual stem cell transplant and then (hopefully) two weeks after that the stem cells would have taken root and white blood cell production would have begun.  So far, Jonathan is handling the chemotherapy drugs very well.  The drugs he is getting are in much higher quantities to what he has gotten in the past and the plan is for the chemo drugs to wipe out most of his bone marrow so Jonathan can start with a fresh bone marrow / immune system.

Jonathan had not experienced any nausea as yet and has been playing, eating and moving around just fine.  Although it is usual for kids on this type of treatment to have nausea - we are hoping he had a minimum amount of it because if he has to vomit to much his NG tube may come up and out.  At least for now, with his NG tube in, we don't have to battle him to take his oral medications and right now everything is put down his NG tube.

This morning was the first time I saw Jonathan and Gabby since he was admitted on Wednesday afternoon.  Gabby has been spending the last couple of days with him and I suspect she will be doing the next 8 days as well - at least until next weekend.  I think with all the 'noise' and fussing I made in preparation for the BMT procedure - Gabby has had a smooth and trouble-free experience at the hospital.  I'm glad and it takes the pressure off of us and also means I don't necessarily have to be there.  But I think I've gone totally on the other side, where I don't mind NOT being there at all.  The last two nights at home were nice - and since Arielle sleeps with me - one of us always have one of the kids with us.  I think part of my comfortableness with not having to go to the hospital is that I'm very tired and I can rest better at home - whereas Gabby is actually resting better at the hospital.  I'll be curious to see how the next couple of days go - because although I'm home - I've noticed I still have to take my sleeping pills to get me to go to sleep quickly.  The only time I don't need my sleeping pills is when I'm in the train : ).

Autologous stem cell transplant starts today

One of the things I've learnt over the weekend is to cherish every moment I have with the kids - even those moments when I want some time to myself : ).  This weekend was a good weekend - Gabby and I went on a 'date' on Saturday night and on Sunday we went to Big Basin Redwoods State Park.  The 'date' was to celebrate our 6 year anniversary of being married.  First we went to a comedy show - which was also being recorded because the comedian is making a DVD and then we went to the movies.  So we didn't reach home until 3:30 am - kind of reminded me of the 'ole' days when I used to go 'clubbing' and would stay out until 4 / 5 am in the morning.

So ... with only 4 hours sleep 'under my belt' we started to get ready for our trip to see the Redwoods.  The plan that day was to go to the state park and then head over to Carmel to do the 17 mile drive but we ended up spending the entire day at the park and by the time we were ready to leave it was almost 5 pm.  The kids enjoyed themselves immensely.  Partly because their cousins were there and partly because the trails to walk and explore were a lot of fun for them.  Jonathan enjoyed himself so much we had moments of him not listening and getting a frown or two - either because he was exerting himself too much, kicking up too much dust (which he shouldn't be breathing in) or doing something he shouldn't be doing.  All in all it was a fantastic day and a great way to end the weekend.

Jonathan's entry for his stem cell transplant got pushed again from Monday (15th) to Wednesday (17th).  The main reason is that Jonathan developed a serious cough Sunday night - probably with all that dust he was breathing in - and he coughed constantly throughout the night.  He did go into the hospital on Monday for his pre-admitting exams - because this time I wanted the doctor's to see for themselves instead of explaining over the phone what was going on and having them make a decision.  During his physical exam they saw that his throat was red (probably with all the coughing, etc...) so they swabbed his nose to make sure he didn't have one of the more serious viruses and did a chest x-ray to make sure his lungs were clear.

So today is the day.  The start of two months of the family getting broken up, i.e. one parent at Jonathan's bedside and the other parent at home (or in my case at work too).  It's also the start of renewing Jonathan's immune system and hopefully kicking this disease out of his system.  I cannot believe its been seven months since we've started treating Jonathan for cancer!  I know Gabby and I are maxed out.  If Jonathan's treatment takes another seven months as intense as the previous seven - I don't know if we will have the strength to continue.

BMT Procedure got pushed to next week

Wednesday morning and I'm on the train going to work.  Again I'm wishing I was staying at home - or at least working closer to home.  Fortunately yesterday wasn't a bad day - and like any days at the office - you have your good days and not so good days.  Over the weekend - Sunday to be exact - we had the birthday party for Gabby and Arielle.  It was very nice.  This is the first time we invited so many people to our place and we were pleasantly surprised that things were still comfortable.  If we didn't have our huge porch / patio then we would have been in some trouble - but I've noticed it sure does help to have a large patio.

The kids enjoyed themselves immensely and all in all it was a lot of fun.  I had over-estimated the amount of meet we would need and ended up grilling until the gas ran out and after changing the tank and finishing up the last batch decided that I'm not grilling anymore.  So one bowl of chicken got left behind (which went into storage for another day).

On Monday Gabby and I woke up with the cold.  I had (primarily) a low grade fever, while Gabby has a sore throat.  We both felt yucky.  Because we woke up not feeling well I called the BMT coordinator to let him know about our changed condition and whether Jonathan's appointment could be shifted to Wednesday instead?  After a couple phone calls it was decided that the best bet was for Gabby and I to get checked out by our PCP (primary care physician) to make sure nothing worse was going on based on that information they'll decided whether to start on Wednesday or push to the following week - on Monday.

By Tuesday morning Arielle's nose started to 'run' and we didn't know if Jonathan got the cold and the symptoms are not presenting themselves as yet - so the medical team decided to push everything off to next week Monday.  In a way this is good because it means we get one more weekend together as a family.  It also means that Gabby and I can use one day this weekend to celebrate our 6th year anniversary.  With our wedding anniversary being the 15th I'm thinking we can go out somewhere on Saturday night and make it special ;).  I know Gabby is looking forward to us doing something - since we don't often do anything - so hopefully I'll be able to surprise her this year : ).

With the delay for Jonathan starting - it also means that some of his tests have to be redone, including an audio cardiogram and various blood tests.  Once that gets done today - then it's a matter of resting (at home) and letting the healing begin.  Hopefully all goes well this week for a successful start of Jonathan's BMT procedure next week.

CT Scan

A picture of Jonathan next to the CT or CAT scan. He does the CT scan without getting any 'sleepy' medicine - especially since the scan itself takes a very short time.

The blank stare - lol

The famous 'Jonathan' stare. Jonathan has perfected the art of totally ignoring people or giving you the 'blank' stare : )

Preparing for the weekend

Wow - the weekend is finally here.  Probably our last weekend as a family in our home for at least two months.  I'm hoping the 'Jonathan factor' kicks in during his stem cell transplant and he continues to surprise everyone and recovers in record time.  The 'Jonathan factor' is a little joke we have with our primary oncologist - Dr. Twist.  Okay - so I've never said her name in my journal - but since my journal is not searching online - and I've checked many times - I feel it's okay to start using some names - especially since Dr. Twist is a good doctor.  So the 'Jonathan factor' is saying we have because at times Jonathan starts out being down and all of sudden he picks up and recovers very well.  Also - as various members of the medical team have said - when Jonathan is feeling well - you definitely know - because he is very loud, talkative and extremely active.

The unfortunate thing is that I have to work one day over the weekend - put in my eight hours (so to speak) - so I'm not looking forward to that - but hey - someone's gotta make the money - right?  The unfortunate thing is that this will be one of many weekends to come as we come closer and closer to our next release date.  I think this is the only downside to my present company right now - other than the looooong commute - but the positives have outweighed the negatives many times over.

So Sunday is the big day.  The 'big' party for Arielle and Gabby.  Unfortunately we couldn't invite everyone we wanted but at least we'll have a few friends over so it should be a grand event.  We kept expanding our list a little at a time as we remembered we 'forgot' someone but then we realize we have a small space I'm hoping that everyone on the current list can fit : ).  I'm hoping that next year - when Jonathan's immune system recovers - we can have a grand party and invite everyone who as touched our lives in some way.  But that is far off - I'll see how feasible that is closer to the time.

So on Monday - Jonathan has to go into Clinic E at Lucille Packard Children's Hospital (LPCH) at Stanford at 1:30 pm.  He'll get weighed, blood pressure and height taken.  They'll also draw some blood from his catheter and do a physical exam.  All of this is the pre-admitting exam for his admittance to the 2 North ward at LPCH.  The pre-admitting exam might probably take about two hours (with a lot of it being waiting) and I suspect that by around 5 pm / 6 pm he should be in his room.  This time Jonathan will be in an isolation room.  There are two sets of doors - the first door opens into a small room with a sink where incoming people can wash their hands and put on any gowns, gloves, etc...  Unless Jonathan contracts an infectious disease - incoming people will just have to wash their hands.

From the small room there is another door that opens into his room.  This time he gets his own room - which comes complete with its own bathroom / toilet and has way more space that a shared room.  The good thing is that we have already spent time in an isolation room so this is not new to us or Jonathan.  The air in Jonathan's room is filtered air and there are no windows that can open to the outside.  This means all the air coming into the room is cleaned / filtered and is sort of an isolated system.

Gabby even bought a new suitcase - to accommodate the amount of junk - sorry - stuff - that we'll be taking to the room with us.  Since the plan is for me to spend the nights and for Gabby to spend some nights and all the days we have to pack enough clothes for us (and Jonathan) and other things to make our stay feel somewhat at home.  I also want to print out some pictures of Jonathan and put it up to the entrance to the first door of his room.  I've seen some patients do this - and it's a cool way to personalize ones stay at the hospital.

Wow - two months in a hospital environment - about one month at LPCH and another month at the Ronald McDonald house.  It's going to be interesting.  I've already gotten approval from my doctor to increase the dosage of my anti-depressants - so now I'll be doubling up on what I take.  I'm going to start the increased dose tomorrow.  Hopefully that takes the edge off and also allows me to sleep in the night.  Lately, I've started back taking sleeping pills so I know I need to compensate by increasing the amount of anti-depressants I take.

Well ... I'm kind of glad I seem to be establishing a rhythm with my journaling.  I really want to journal at least once a week - but hopefully more and I seem to be keeping to this goal for the last couple of weeks.

Oh ... so I just thought of something I need to trash out.  My prayer life.  It still sucks!  I would have thought it would have improved but I guess since I didn't actively do anything to help it - it wouldn't improve!  But I'm not sure that this is necessarily a bad thing?  I remember my spiritual director saying that doing God's work can be done by doing God's work to those around me.  For example, in my relationship with Gabby, in taking care of Jonathan, in ensuring he gets the best care, being a good father to Arielle.  I know I'm definitely not a model 'child of God' but for some reason I'm not too alarm that my personal prayer life is not great!  I think my personal prayer life is one of spontaneous thoughts of God but nothing really formal or defined.  Maybe the 'extra' time in the hospital will help turn me around : ).

I am so in a writing mood tonight.  It's 8:42 PM and I'm still on the train to get home.  I took the super slow train - because I missed the faster ones.  After the 6:50 pm train from San Francisco - the rest of the trains are local trains, i.e. it stops at EVERY stop there is to make - or as I call it - the super slow train.  So instead of my commute taking 1 hour (if I took the bullet train) or 1.5 hours (with the limited local) it takes 1.75 hours instead.  At times it's not too bad - because sometimes I watch a movie on my laptop or I get to journal : ).

My thanks to all of you that continue to keep us in your thoughts and prayers.

Jonathan is not NED

We had a consult with our primary (oncologist) doctor yesterday around 11:30 am.  The main focus of the meeting was to review the tests that Jonathan went through to re-evaluate the tumor and cancer and make a decision on whether he will continue with his stem cell transplant.  So ... the news was good - in a relative kind of way - but there was a hiccup.  On the MIBG scan it showed some tumor cells around his knee on his left leg.  Also - the bone marrow tests returned with a couple cells being tumor cells.  What this means is that Jonathan's bone marrow is not clear but the amount of tumor remaining is very low.

The only unknown right now is whether the tumor cells are mature cells that cannot reproduce and will die or whether it is 'live' tumor cells which can replicate and grow.  Since we don't know either way - we have to assume that it's 'live' tumor cells that can replicate.  On the good side - nothing lit up on the MIBG scan around his abdomen area so there is no likelihood of Jonathan having a second surgery to do clean-up - at least one less thing to worry about now.

Since Jonathan's stem cell transplant is schedule to begin on Monday - 8th August - then the hope is with the high dosage of chemotherapy drugs he'll be getting to wipe out most of his bone marrow will also help with the eradication of the remaining about of tumor cells.  Of course we'll have another 8 weeks before we learn anymore but all we can do is hope for the best.

The interesting thing was that although the news was a little bit disappointing for both Gabby and myself - I was not taken by surprise.  Gabby actually expressed more emotion and was clearly not happy with the news - but I've learnt that with this disease - anything goes.  Granted Jonathan is doing very well - I don't take any present indicators as a sign of victory or defeat - we'll just see how it goes one day at a time and make the appropriate decisions as things occur.

I must say - more and more - I've been thinking about our 'Make a Wish' trip to Disney World and have been wishing it happens sooner rather than later.  Partly because the kids would have a great time and also because it would be a great break for Gabby and me.  I've come to realize that my stress levels are (unfortunately) starting to increase (again) and some mornings I wake up wishing I didn't have to go to work.  I've been putting it off - but I have to call my doctor and get her okay with increasing my meds to compensate for the extra stress levels.

Finishing up tests to re-evaluate cancer

One more day and Jonathan will be done with testing to re-evaluate his cancer.  We are hoping that the news is that he is free of disease or as they say on the neuroblastoma website - NED - no evidence of disease but somehow I think that will be too hopeful.  Today Jonathan has his bone scan done.  He is still in the hospital - recovering from the effects of the anaesthesia that he was under but hopefully he'll be done soon.  He should have been released already but his blood pressure is high (taken on his leg it is above 160) but Jonathan refuses to have the nurse take his pressure on his arm so Gabby is stuck there for the time being : (.  I know how stubborn Jonathan can be - bull headed is more like it - but I'm hoping by the time my train reaches Palo Alto he would have calm down enough for the nurse to take his pressure and it is low enough for them to release him.

Tomorrow - Jonathan has a CT Scan - and that lasts about 15 minutes so he doesn't need to get 'sleepy' medicine (as we fondly call it) so hopefully he'll be in and out of there real quick.  The problem with taking anesthesia is that Jonathan has to stop eating from 12 am the night before and his scans are normally in the afternoon so by lunch time he is very hungry and gets very irritable (what's new?).  Hopefully he stays quiet for the 15 minutes so he doesn't have to get the 'sleepy' medicine.

After tomorrow Jonathan has less than a week before he starts his stem cell transplant - initially targeted for Monday 8th August.  Originally I was going to object to the stem cell transplant if Jonathan still has evidence of disease but I think I'm going to go ahead with whatever our doctor recommends.  One of the interesting things she said during our consult last week is that some cancer treatments are not a cure but more of a way to prolong (the quality of) life.  It was an interesting statement because my expectation was that once things go well Jonathan will be cured.  Of course there is always the possibility of a remission occurring but I never thought of it as a way to prolong life and not a cure.  It does put an entire new twist to things but surprisingly I'm rather calm about it.

I think part of the reason I'm calm is that I've already started to consider comfort care for Jonathan.  Not that I am thinking of doing that now - but for the future.  It's an issue that Gabby and I disagree on but it's something we don't have to come to a decision on right away.  In brief, Gabby feels if Jonathan has a remission later on - we should fight as much as we can with as many treatments as can, whereas I feel there is a certain point in which I wouldn't want to fight and continue to subject Jonathan to the pain and discomfort of treatment.  Hence at some point I will prefer comfort care - in which Jonathan is made comfortable with pain management and allowed to die peacefully.  As I've said, Jonathan is doing fine now so these decisions are far from being made but I went through a period in May / June where his suffering really affected and thus started this train of thought.

So the big plan now is to enjoy this weekend.  Gabby's and Arielle's birthdays are at the end of August - the 23rd and 19th respectively - and since Jonathan will be in the middle of his stem cell transplant recovery he wouldn't be able to attend.  Instead we've decided to have a combine Gabby and Arielle birthday party this Sunday (7th August) similar to the combine Walter and Jonathan birthday party we had in the month of May.  We've definitely inviting more people this time but keeping the food simpler so it should be a blast!  I know the kids are looking forward to it - and the cool thing is that this will be Arielle's first birthday party.  She even has a princess outfit to wear which she is very proud of.  Of course I'll be taking lots of pictures and will hopefully post some up for our family and friends to see.

Work wise - things are going okay.  We are slowly getting to that time where we have to work weekends and I know this might by an issue of contention - since working weekends will be most difficult for me.  I'm curious to see how the next couple of months ago - since I can already feel my stress levels regarding Jonathan's care are increasing and the pressures and demands of work is also going up as well.  My hope is after all of this - somehow I'm a better, and stronger person.  The only thing now is for me to lose this weight!