Friday, February 28, 2014

Day 3 after the first chemo treatment-2/28/14

Three days after the first chemo treatment the pretty smile returned however my wife’s condition was up & down today.  Some sluggishness in the a.m. was replaced by afternoon nausea that has stuck around for most of today.  She struggled to get the proper nutrition however her mood was upbeat and her activity level was better than the last couple of days.   My understanding of chemotherapy is that the side effects have the potential of crippling an individual into such a horrific state that he or she cannot move for days.  Based on this description alone I would say that early score in the battle between Angela and cancer is 1-0 in the favor of Angela.   It will go the distance but she is a warrior & in the end she will come out on top.  I look forward to a good weekend with my wife & kids & then a repeat of her reaction to round two starting next Tuesday.   

Thursday, February 27, 2014

Day 2 condition after 1st chemo treatment 2/27/14

24 hours after chemo there were minimal side effects consisting of battles with nausea, sluggishness & acid reflux. Things started to deteriorate a bit as she slept or should I say attempted to sleep through the night. The acid reflux caused pain under her right shoulder blade which was so bad that she was up & down throughout the night. Finally she fell asleep around 4 a.m. only to awake around 11 a.m. feeling like she had been run over by a Mack truck. Since she has been awake she has been experiencing severe flu like symptoms that include body aches, sluggishness and the persistent acid reflux but thankfully the nausea is gone. Her appetite was not quite as good today as yesterday but she was able to stomach enough food to maintain at least a bit of strength. She is feeling bad today but still as beautiful as ever. When I look at her face I see the most beautiful woman in the world however when I look deep into her eyes I can tell she is in a battle. It was a tough one but we'll be better tomorrow.

Day 1 condition after 1st chemo treatment 2/26/14

We are holding our breath 24 hours after chemo the side effects have been limited to a few bouts with nausea, acid reflux and some mild sluggishness. The recommendations of others have been implemented which has helped her to be able to take in a good amount of food today as well.   If we're taking it day to day than today was a great one.

Tuesday, February 25, 2014

1st Chemo treatment

The drop off to the 1st chemo treatment could only be compared to the feelings of a mother & child at the time of the 1st kindergarten drop off. My wife did not want to go and I did not want her to go. At one point it was obvious that she was on the brink of tears but once she entered the treatment room & met her fellow patients she appeared to be more comfortable. Unfortunately the facility is small so it does not accommodate visitors so I had to leave. The good news is that the mood of the room itself was upbeat & the medical professional & the other woman were very nice. I had no communication with her until a reassuring mid-day afternoon email in which she declared that all was well. I responded back simply that I love her very much!!! The next contact came around 3 pm when she called worrying about how our boy would get to karate today. Just tells the whole story about how great of a mother she is. She has every right to be selfish yet she is still concerned about others. My message back to her is that it is time to let us take care of you! Since I could not be by her side today I plan to be home with her all day tomorrow. As it turns out it might be best that way since we were told side effects most likely won't come into play until then anyway.

February 23rd Facebook comment from my wife

A couple more days until chemo. I am scared to death. I don't want to feel sick, I don't want to be weak, have mouth sores, numbness in my feet and hands, have blood transfusions, be bloated, have the worse nausea and vomiting....blood work after blood work, testing after testing.....yepp...I am scared. I just want to get up and get my kids ready for school and go to work then pick them up to watch their sports and take them home afterwards....I am very sad : (

Saturday, February 22, 2014

Second Opinion Fiasco

Angela  and I went to M.D. Anderson-Cooper Hospital for a 2nd opinion on Tuesday February 18th. The first impression of the facility was that it was not that impressive. We were given wrong information about the location where we were to meet the doctor.  Originally we were scheduled to meet in Voorhees but when we arrived we were told that the doctor was in Willingboro.  Upon arrival at that facility there was some confusion about whether we were there for a consultation or an examination. Angela was very upset about the possibility of having somebody probe around her once again. Finally we met the doctor and and listened intently as she described the type of treatment that she would have prescribed.  There was some consistency amongst the drugs as she would have prescribed Taxon and Platinum however the third rug Avasten is not something that she normally prescribes. The major difference in the method of treatment is how the drugs would be introduced into the body.  Her current doctor—Dr. Whitney plans
to administer the drugs through a port inserted into a vein by her collarbone while this doctor claims that the most reliable method is to administer the drug directly into the abdomen.  The frequency of chemo is the same no matter the method however the side effects associated with the direct application are much worse than they would be if administered intravenously. No matter the method of treatment the likelihood of a recurrence is high however we were told that research indicates that it is more likely for cancer to be in recession for a longer period for patients who are administered chemo directly into the abdomen. Angela and I both believe that it is best for her to proceed with Whitney's method of treatment and if things do not progress as planned we can then inquire about the possibility of the direct abdomen application.
    It was a frustrating visit because my hope was that the 2nd opinion would include a method that would be easier for Angela to withstand & more effective.  The good news out of the visit is that I am not more confident than ever that Angela has the right doctor and she is going to the right facility.  In my heart I know that she is going to be fine.

Wednesday, February 12, 2014

Road to recovery 2/12/14

Today we received an inspiring visit from my cousin’s wife who is herself an ovarian cancer survivor.  She was generous enough to bring a batch of chicken noodle soup as a care package & kind enough to answer a few of our questions.   Her presence alone was uplifting and the information she shared was educational.

Angela’s recovery has continued down the right path over the last couple of days.  The pain associated with the surgical procedure has subsided to the point where she is only taking Percocet every 12 hours instead of every 4 hours as she was taking upon return home.  Swelling of the lower body continues but is slowly subsiding.  We had a bit of a scare over the last two days because she lost control of her bladder leading her to comment that she might have to wear depends the rest of her life.  We were told by the doctor that the bladder control problem is most likely the body’s way of releasing excess fluid and that it should only be a temporary condition.  There were no complaints of headache today however she did complain about back & leg aches.  At this time I just assume that the pain is associated with the healing process.

Angela confirmed through the hospital that the appointment to install her chemo port is at noon on 2/20 & she also made an appointment to be fitted for a wig.  The path forward to recovery is well on the way.

The big news of today is the pending snow storm which is expected to drop anywhere between 3-10” of snow in our area.  The news media again has sensationalized this event to the point where schools closed for the following day 16 hours in advance of the scheduled opening.


Quote for today is: “Run when you can, walk if you have to, crawl if you must; just never give up.”-Dean Karnazes, ultra-marathoner and author--This quote can also be applied to real life situations.

Tuesday, February 11, 2014

Thoughts, Emotions & Kyle's bad day

Managing my thoughts & resulting emotions has been quite difficult.  My chemical make-up is such that  I give little time to allow my brain to process information before reacting.  I know in my heart that all energy should be processed into positive emotions in order to get a positive result but I have trouble with this one. I have so much energy flowing through my body that it literally shakes while processing every thought into an emotion. Before my brain interjects my body & mouth are already reacting.   An example of channeling my energy into the wrong emotion was today’s “snap” at Angela using energy gained from my son’s explanation of his bad day.  See note below:

Mr. Pruitt,

The purpose of my note to you today is to make you aware of a family crisis that could impact the ability of my stepson, Kyle, to fully concentrate on his work.  Kyle’s mother, Angela, recently underwent a surgical procedure in which a full hysterectomy was performed along with the removal of a malignant mass.  The diagnosis delivered to our family yesterday is that Angela has stage 3A ovarian cancer which will require eighteen treatments of chemotherapy over the next 6 months.  While my wife and I are very confident that the treatments will eradicate the cancer we are concerned that the diagnosis and stress associated with the treatment could potentially impact Kyle’s ability to perform in school. 
While we understand that it is important to maintain consistent expectations as a class in whole I am asking that the teachers be sensitive to Kyle’s home situation when evaluating his performance as an individual.   Today, for example, after returning to school from a sick day,  Kyle did not bring in a binder for his Bio-tech class resulting in a deduction of 34 formative points.  Failure to meet this requirement is not consistent with Kyle’s normal behavior and I’m sure that if his teacher, who I’ve copied on this note to you, were aware of his home situation would have been more compassionate.  I feel, in this instance, some consideration should be given to allow him to have a second opportunity to report to school with the binder with only half credit being given. 
Kyle is a hardworking, sensitive child who thrives on proving himself through excellence of work.  Today, when I picked him up and saw tears running down his cheeks my heart was broken.  As he began to explain the reasons for his sadness the grief that I felt turned to anger.  The first event evoking Kyle’s dismay was the interaction with his bio tech teacher and the second was a routine dress code check that occurred at lunch time today which resulted in a code violation.  I am a Salesianum High School graduate so I fully understand dress code requirements however what concerns me most about today’s “check” is that the piece of clothing in question has been worn each and every school day without controversy.  At Salesianum dress code is clear & concise and checks are not random or inconsistent.  I’m certain that the clothing did not meet the specific criteria set by the school however being as though it is a coat and the temperature is well below normal again I think it could have been overlooked.   
My expectation from you is that either you or one of your staff will have a discussion with each of Kyle teachers providing enough information that will allow them to be aware of his special needs.  Also I would expect that you provide some confirmation of receipt of this note to you either by email reply or phone call.  Please feel free to contact me at home 302-xxx-xxxx or on my cell 302-xxx-xxxx.

Sincerely,
David M. Bursler

Monday, February 10, 2014

Treatment Plan

At today's appointment we discussed the type of cancer that has been identified & treatment plan to kill it off. First there was no cancer found in her lymph nodes meaning her type of cancer has been categorized as 3A.  Also what was originally thought to be a rare mucninex tumor ("evil stepsister") turned out to be a more common type of cancer called serous carcinoma.  As the more common type of ovarian cancer there is a well-defined treatment plan that will be utilized.  Next on the docket will baseline blood testing scheduled for tomorrow & then the insertion of a chemo port which is scheduled for next week. Chemotherapy is scheduled to start at Dr. Whitney's facility in Stanton on 2/25. The doctor stressed the importance of starting treatment within 28 days of surgery because there is research that indicates rapid cell growth within that time period. The medicines that will be used to treat the cancer are Taxon, Platinum & Avasten all with their own unique side effects. She will undergo a day of treatment one day a week for 3 weeks starting the 28th & then will rest on the 4th week.  After following this cycle for 3 months additional testing will take place to confirm progress has been made. If the analysis indicates no further growth or at least stability the cycle will continue for another 3 months.  All in all we both felt comfortable that we are on the right path to wellness.

Sunday, February 9, 2014

February 9, 2014 Recovery

2/9

Sunday is usually transition day in our home and today was no different.  Kyle returned home & Ian paid a visit which obviously lifted Angela’s spirits.  She was feeling so well she even made a comment that it is time for me to return to work.  By mid-week I might be ready to agree however it will depend on how well she is able to get around without assistance.  

Minor headaches still persist but those are expected in an anemic person with a 7.5 blood count.  The only other pain that she is experiencing is a result of the swelling of her legs which is more of an annoyance that an actual pain.   Her sleeping pattern has hindered our ability to stabilize her diet.  She did not rise until well after noon so her only two meals of the day were brunch & dinner.   


Tomorrow begins the second stage of recovery.  I expect that we will get clear direction from the Oncologist about the plan for treatment.  The unknown is scary, at least for me, but it will be nothing but forward motion once we know what to do.     

Today was a good day!

Saturday, February 8, 2014

February 8, 2014 Recovery

Today was a day of rest at our home. Angela didn't get up til well after 1 and I'm embarrassed to say that I fell asleep for an hour or so in the middle of the day.  The best sign of all that recovery is well underway is the fact that she is once again talking a mile a minute. The only benefit of anesthesia is that she talked slow enough that I could comprehend every word.


She is still overextending herself which ultimately comes back to haunt her in the evening hours.  We are doing a good job administering the pain medication before the onset of pain however she is still experiencing shortness of breath so I’m not sure that we’re out of the pneumonia woods just yet. The good news of the night is for the second night in a row her bowels were active.  Emotionally, she was upbeat & acting normal most of the day. She is a very strong, confident woman comparable to know one that I’ve ever met before. The most emotional days may yet to come but I have no doubt that we have the strength to carry each other through to the end and when we don't our wonderful family & friends will pick us up.    

Friday, February 7, 2014

Identified, diagnosed, treated Pt. 1

My oldest son rushed to me with the news the early afternoon on January 1, 2014 that mom was crawling on the floor in what appeared to be severe pain.  When I arrived in the house I found her crawling & crying in my direction mumbling unintelligible words. I first assumed that she was experiencing flu symptoms but soon found that the source of her pain was fear. Fear derived by the sensation of a lump that she felt in her abdomen releasing itself in the form of nausea.  Once calm I guided her to the car and away we went to the hospital emergency room.  As we traveled down the highway my wife continued to probe the area where she first felt the lump.  She appeared to become more calm as she moved her hand back and forth and side to side.  I was told to stop, turnaround and go home because the lump could no longer be found.  Rather than go home I made a deal with her in which we would bypass the ER & make a stop at the medical aid unit instead.  She agreed.
Exam #1 Medical Aid Unit
The exam at the medical aid unit would be the first of many each with their own unique diagnosis.  I found out quickly that the professionals staffed at a medical aid unit are not equipped with the tools, experience or knowledge to appropriately diagnose this type of condition.   It was confirmed that her stomach was distended which could a product of a blockage in an intestine or one of a million other reasons.  In order to rule out a blockage an X-ray of the abdomen was ordered but it did not reveal a blockage or abnormality. The consensus amongst the medical staff was that the distention of her stomach could be the result of constipation so we were sent home with instructions for her to take a laxative & wait.  As the day slowly progressed there were no results prompting my wife to make an appointment with her primary care physician for the following day. 
Exam #2 Primary Care Physician
Upon examination the tending physician showed some concern about what he felt so he ordered her to undergo an immediate CT scan & blood testing. There was no diagnosis at this time leaving me a bit shocked & bewildered that this particular medical professional allowed her to leave with the message that I’ve never seen anything like this before. 
Exam #3 OBGYN
The results of the blood test and CT scan were sent to her OBGYN and reviewed with my wife at appointment #3.  A preliminary diagnosis as a result of a physical examination & the diagnostic tests revealed the mass as uterine fibroids.  An ultrasound was ordered to confirm the diagnosis as well as to confirm the exact location of the structure.  A day later when the results of this test were returned we received a phone call from her OBGYN informing us of an inconsistent report delivered from the ultrasound as opposed to what was identified by the CT scan.  The conflict was significant in that the ultrasound indicated a mass on the ovary while the CT scan identified the mass as a uterine fibroid.  I’d been on the Internet long enough to know that a cancerous fibroid was less likely than a cancerous mass on the ovary.  After a night of worry we received another phone call from her OBGYN on the 8th of January confirming that the mass was indeed situated on the ovary.  The news that the mass could very well be cancer almost brought me to my knees.  In the coming days, when not in my wife’s presence there would be moments of sadness, times of fear & tears galore.  While my wife put on the strong front in my presence there were enough signs to indicate that she was experiencing the same emotional breakdowns.  I remember one night specifically when our eyes met & our thoughts became as one that I could no longer refrain from crying in her presence.  As the first tear dripped down my face my wife joined me in the longest, saddest cry that I’ve ever had in my life. 
Exam #4 Oncologist
Since visit #3 with the OBGYN an OVA test indicted the presence of cancer so an appointment was scheduled with an Oncologist to discuss his role in the surgery to remove the mass. The examination by the Oncologist as well as a review of the diagnostic tests & OVA blood test results produced a differing view point.  The doctor confidently informed my wife that there were more indicators identifying the mass as benign vs. the indicators that identified it as malignant.  The doctor was so sure of himself that he made the comment that he believed that his role in surgery would be less than ten minutes allowing him time to have his second cup of coffee before her surgery ended.  The news of this report was obviously received with open arms. Understanding that the mass could still be malignant I now had hope that the extent of the remedy would a full hysterectomy & the removal of the mass.
Much planning had taken place leading up to the day of surgery including the travel plans of my wife’s parents from Eerie, Pa to Bear, De.  Funny thing happened the day before the scheduled surgery is that an unplanned snowstorm hit the area virtually shutting down the state of Delaware including the hospital.  I was stunned that a hospital would shut down amidst what I consider to be a nuisance and even more stunned that an administrator would be the one to make the decision to cancel forty plus surgeries without so much as consulting with a medical professional.  There were many emotions experience by me on this day including amazement that my 70+ year old in-laws traveled 400+ miles right through the meat of the storm to be by their daughter’s side but a basically every school, business & agency, including hospitals felt it necessary to shut down.  Anger aside I finally realized it was out of my control so I began to work hard to ensure that someone was working diligently to reschedule her surgery. As the in-laws packed to return to Eerie we badgered the scheduler until we were told that the new date would be eight days later on January 31. 
The mass had grown to such a size that my wife was feeling significant pressure from bloating.  While I could not feel her pain I was stressed & distressed knowing that she was uncomfortable and that there was nothing that I could do.  It was a grit your teeth & hold on situation for eight days but she made it.
When the day of surgery arrived my wife appeared to be relieved but I was stressed.  She was admitted into the hospital and almost immediately transitioned into the OR processing area where she would wait two hours before the start of the procedure.  My mother & I were joined for periods of time by my cousin and her husband as well as my brother for while surgery took place.  The scheduled 10 a.m. surgery started at 11:43 a.m. and ended three hours and thirty eight minutes later at 3:21 p.m.  I stared at the surgery status board, which had the characteristics of an airport flight status board, to make myself aware of when surgery was complete.  I fidgeted in my seat waiting for the news of my wife’s condition hoping & praying that cancer would not be found.  Finally the surgeon tapped me on the shoulder and walked me back to the consultation room where she reported that my wife was stable but cancer was found.  The Oncologist, who apparently did not get that second cup of coffee, was called in to remove the tissue & stage the cancer.  I can not even begin the describe the emotions running through my body at this time.  I cried, I was angry & I was sad for my wife.  I finally settled and made the phone calls to family & friends before being allowed to stand by my wife’s side in the recovery room. After thirty minutes or so in a semi-lucid condition the doctor, in my presence, reported the news to my wife.  Every inch of my body, mind & spirit wanted to hover over my wife to deflect, protect & buffer this pain from her but there was nothing I could do.  Amazingly enough Angela took this news in stride, barely batting & eyelash impressing the living daylights out of me. 
In the coming days I would watch Angela suffer in pain & overcome adversity while recovering from major surgery.  In my mind I could not help but compare her to my one and only hero who once traveled this world ignoring pain & anguish to function better than any other human & that would be my grandfather.  I’ve documented the six day ling struggle here
2/1
Angela had a difficult night last night.  Remnants of anesthesia are still impacting the functionality of her bowels & kidneys  & she is not getting enough oxygen into her blood without the use of a machine.  The nurse antipated  quicker progress so the breathing air tube  & catheter were removed during the daylight hours yesterday.  Monitoring throughout the night revealed fluid being produced  (a good sign) but not being released & insufficient O2 in her blood. As a result both the catheter & the air tube had to be reinserted early this morning to stabilize her condition.  Though her attitude remains positive I do sense that she is becoming frustrated because her body is not bouncing back like she expected.  I'm expecting a visit from the doctor this morning at which time I will ask her to set some clear expectations so Angela has a more accurate gauge for which to monitor her
progress.  Just as an FYI the anesthetic still has her feeling very groggy so if you call and she doesn't answer or get back right away try not to be too upset.  I know this is a long disertation but by doing this I get relief and I feel I'm helping everyone stay in tune. If you have any questions feel free to ask at any time.

2/2
Angela had another rough night last night. She sent me a text at 4:30 a.m.describing the pain she was experiencing.  I called her right back to get more info & to make sure that the staff was responding to her needs. Here main issues were nausea & headache. The nausea was remedied by a dose of Zofran & but the headache persisted despite a dose of Advil that she took from her own stash. When I got here at 8 I immediately noticed that Angela's mood had drastically changed from frustration the night before to pure anger now.  Insted of getting an update from her I spoke to the day nurse. She was surprised to hear that Angela had such a rough night because there were no documented events listed on the night notes nor was there a verbal given during face to face turnover. My discussion with the nurse prompted her to immediately observe Angela's condition to ensure that there were no abnormal
signs.  The observations that were made were 100% positive.  Her body temperature was back to normal, blood oxygen level @ 95% (normal) and obvious bowel activity wad heard. Oh and the biggest news of all is that she urinated on her own only two hours after the catheter was removed!  A gold star is in order. Emotionally she is angry, moody & frustrated but physically she has made dramatic improvement since last night.

2/3
I received a text from Angela this morning saying that she experienced another bad night. Pain, elevated temperature & bright red bleeding from  the vaginal area. What I was told by her  is that the doctors were meeting to discuss the possible cause(s) of her symptoms.  I was very stressed by the time I arrived this morning.  The ride in here was hard but I convinced myself not  to jump to conclusions without first talking to a nurse or a doctor. Luckily Dr. Glover's assistant was reviewing Angela's charts  when I arrived so I had a good source to answer my questions. Just as it was the case the last  3 days the report that I received from Angela was not consistent with the views of the medical staff.  The elevated temperature  is of some concern because it is an indicator that infection could exist however her white blood cell count is normal  so while not ruled out it is doubtful that
there is an infection. Also the staff did proactively pull blood & urine  samples last night for further analysis just to be sure that there is not an infection. It was explained to us that  the source of the bleeding is most likely the result of residual blood that still remains in the body cavity as  a result of the surgery. If it the bleeding persists Dr. Glover will check to ensure that there is no internal  bleeding but again there are no other signs indicating that this is a problem. It has been four long, hard nights  for Angela but every medical professional that I've spoken to ensures me that she is progressing however slow it may be and that we need to be patient. Angela is still frustrated but she is less moody today than yesterday. Still taking Dilodin & Zofran through IV and mostly sleeping this morning.
2/4
Angela is 100% better today. The fever broke late last night after a 2nd  dose of the antibiotic Rocephin & the introduction of a second antibiotic Azithromycin. It has become obvious that the source of the fever was a lower lung infection just as was suspected. The other big news of the night is that her bowels decided that it was time to wake up. It was because of this that she was treated with solid food this morning for the first time since being admitted. I'm hopeful yet doubtful that she will be discharged today.  Her pain medication was downgraded from an IV dose of Dilaudid to Percoset in pill form which she has accepted well. That being said she is still receiving IV fluids & the same  IV port is being used to introduce the antibiotics & the anti-nausea medicine.  I haven't been told formally but I would assume that she will remain in the hospital until enough antibiotic is
intrduced into her system to clear the infection. Obviously the turn of events has left her excited, bubbly & generally back to her norm'al self. On the docket for today is lots of walking, using the spirometer & thanking the nurses for their support.

2/5
I received my daily panic text from Angela around 3:45 this morning.  Apparently she had been denying herself the pain medication for fear that it might cause her to be constipated.  As a result she woke up around 1 a.m. in "horrific" pain.  She also suffered with bouts of nausea & severe gas pains. Coming to the realization that sleep was not in her future she became angry and started to rip off her clothes to be prepared to leave as soon as the discharge papers could be processed.  As Angela was in the act of changing her clothes the nurse asked her jokingly if she had planned to take a walk through the park.  Angela's anger became more intense when she found out that the clothes she intended to change into did not fit due to bloating.  The emotional outburst must of stimulated her bowels as it was not long after that she began passing gas "like crazy".   Once her body relieved itself she began to think more logically and found that the clothes that were given to her by Gary as a gift fit perfectly.  Now happy & content she layed in bed and rested until I arrived around 6:30.  The good news out of all of this activity is that every sign still pointed to a late morning, early afternoon discharge.  A visit was paid to her by the resident physician & also her primary doctor's assistant who both confirmed that Angela's condition was stable so release was in her near future.  As I write this note the discharge papers are being processed and we hope to be home by noon at the latest.

2/6
It was a good night &  day with Angela actively sleeping more than half the time. Keeping track of the different medications and how often they should be taken was a challenge however there were bigger obstacles to overcome on this day.  First & foremost I found it difficult to convince the now refreshed Angela that it was important to moderate her activity.  My understanding of her condition was that she should do no more than walk from room to room refraining from any activity that might result in undo stress to her body.  Apparently her understanding is that it is okay to bend down to scratch the dog’s belly & to do some light cleaning of the kitchen.
Though rested and energetic I still sensed frustration on her part.  Frustrated that her bowels were not as active as she thought they should be, frustrated because her temperature once again became elevated & frustrated because she was forced to take a dozen medications.  Regardless of her position she was making obvious progress toward a full recovery.  Her appetite is slowly recovering, her breathing is returning to normal & the swelling is her legs is significantly reduced allowing her to walk in less pain.  All & all this was a good day.

2/7
A long night’s sleep , the prospect of a good meal (more on this later) and the knowledge that her staples would be removed on this day left Angela in a good mood most of today.  Today’s challenges once again included reminding her that she needed to restrain from activity that could jeopardize her recovery (cleaning the house) & reminding her that her body will become more regular each & every day. (Continued frustration at the slow movement of her bowels)  Highlights of the day were the removal of her staples, a visit paid to us by my brother & his wife & finally a bowel movement.  The most gracious act on this day was delivered by my brother & his wife.  Platters full of excellent homemade food were given to us by them.  This will go a long way in helping us to bring some normalcy back to our lives when the kids return over the weekend.  Thank you Joe & Lucy!  All & all this was a good day.