Emory update 4-29

I wanted to give you all an update from yesterday. By the way, those of you that are just interested in parts of the blog, for instance, you just have to see pics of Evalyn, don't forget on the right hand side there is an index.... just a a reminder.

MEDICAL UPDATE:  I'm going to bullet again :)
1. liver is normal, but they are still keeping off one pill for now
2. I have to increase my BP medication, one more pill
3. I have to start a new antibiotic so I dont get pneumonia, but just on Sat and Sun, weird
4. Cough is there, but better, inhairler changed to PRN!
5. Still on the same about of seroids, yuck
6. Been taking the sleeping pills I was order to take,  sleeping better, follow the rules heather
7. An icky part is that he has insisted that I use the rash cream 3 times a day before he will take me down on the steroids. I hate this cream. How can it not get on Evalyn... I don't know... I'm still trying to figure it out
8. Started the new study drug.... didn't get sick..... but it could be the sugar pill. It's a secret.
9. I had mentioned abormal bleeding before and that I do not beleive in taking hormones because when I do I have to be on a anti depresents, and yada yada.  Well, at the beginning of the week, they doubled it because it got so bad. Well, it's making me weeping. Not depressed, I'll just start crying. I could cry at a dog food commercial or just thinking of how much I love someone. He asked me to make an appt with the women doc an maybe there is something else going on. Please pray for me on that. I don't want to be infertile due to the radiation and I don't want to deal with all this other stuff either. Sorry to be so blunt, but you can tune out at any time.
10.  Knees are hurting, I need to take it a little easier, hard for me to do, but I'm trying today.
11. I had one scare yesterday. I went to do my EKG for the study drug, last thing on the list. My heart rate was crazy and the doc came in and said that usually if someone's is that high, they can't leave the hospital. Crap, I don't have my pillow, I thought. The issue is always communication. They are just sent down with orders to do one and don't know anything about the person. So I explained everything I'm on and why this is up and this is down but he still had to talk to Dr. K. I have spent hours waiting for the main man, as wonderful as he it.  Soon, I was out the door. Close call. What happens to people that don't know what is going on....it seems sad to me. I hope they have family members to help.
12. Best part for last, at this time I only have 1 Emory appt next week, god willing. I do have to schedule some appointments here in athens . Less gas for us, well my mom :)


UPDATE on Janet: I went to ICU to see Janet yesterday and followed my grandfathers rule that sometimes it's better to ask forgiveness than premission, ha ha. Don't worry, I was suited up. She was not concious, and this is acually the frist time I had seen her. We were usually not on the floor at the same times. I was able to pray for her. She was moving all around seeming uncomfortable but when I touched her forehead it's like the Lord calmed her. I said the prayer and got the heck out :)

I was also able to walk across the street to Children's healthcare to visit one of my favorite nurses that just transferred. She is a doll, I just love her. And her name is DORI. How cool!

My mom left to go back to Cville and my aunt Sherrie wasn't going to pick me up till 3pm. So I had some time to myself. I felt like such a big girl, ha ha. I have a rolly lap top bag now that makes it so easy to carry my snacks and toys. I met a man named John in the infusion center who was very nice and one lady just starting speaking blessings over me and it was so powerful, I forgot to get her name. The staff I see all the time are great, I love them, they call me VIP now. Hee Hee. I'm going to right up some good stuff about them and pass it on to the big wig. Wigs, ha ha ha.
           


   

Advocating for yourself!!!

I have not wrote a blog in a while about hospital protocols and advocating for yourselves.... so the next section is for those coming behind me in the future to help make there experience more smooth. Read on if you want but don't feel you have to :) This is a pick and choose blog. 

                I know I have said this before but let me reiterate that after the transplant things are far from over and you are shuffled though to the next teams and Emory protocols and lack of communication all over again. So just as you get your stuff together and get the team to start communicating with YOU, it starts all over. Thats ok, many years of advocating for my people on my caseload has prepared me to advocate for myself in a respectful way, most of the time. 

                 The example that I would like to give is that before the transplant, you have a transplant coordinator that is all up in your grill to get you through all the tests to get to the transplant. Then at the transplant, that person falls off the face of the earth and everything they did has to be done or redone by someone else who doesn't know you and doesn't it a different way. At this time, I have to say AGAIN, Emory is the best hospital around, I'm lucky to be treated there but I want to help those of you that are going to go through this because some of these things are the only thing you will have any control over in your life, and everyone has to have a little to stay sane. Some of this is funding because they really need to have coordinators that stay with you from beginning to end, kinda what I did for a job, and have 30 or so people. Well, when I win, or play, the lotto, I'm giving money for that reason only. 

         After the transplant is when you have to start coming the the clinic 2-3 a week. These appointments are sketcy. There is a plaza level lab in purgatory, I like to call it, they they have to use if they are drawing form a port, picc, or doing another special test. It's slow, slow, cramed, everyone is in a bad mood. Once my voice is back, I'm going to pop out my guitar and go at it....           Now, on the 2nd floor there is a nice quite lab, you get in quick and fast. The issue is that they only draw from the arm there. Hey, I have been in so much pain and picked, etc, that an arm pick is nothing. So when I have the choice, I advocate for myself to be at that lab and choose to get it taken from my arm. This is better also because you are not around the sick people down stairs that are coming to clinic as a walk in do to fevers, etc.  Sometimes you just have to go downstairs, but always go up and talk to Ramirez on the 2nd floor and ask him to ask the nurse if they can change it. It took me two weeks but I know have my nurse on board, the scheduling team, and myself that I always go to the 2nd floor lab unless otherwise noted, and I want to know why.

                Last week was a prime example of lack of communication, again lack of funding, They were trying to get me to go downstairs to get 19 tubes of blood from my picc for the research drug I was going to start on last Friday. However, everyone knew, Dr. K, nurse, the research coordinator, by Thurday, that I was not going to start the drug on Friday. No one bothered to call me. So we thought we were going to be at Emory all day, I had a ride set up to get back to Emory (mom goes home on fridays from Emory), and they were trying to take my blood that they didn't need. Well, we got that straighten out real quick, got my quick labs on the second floor, and thank God my cousin Andy, love you!, got out of bed to come and get me!

               This week went smoother but it still took some advocating on my behalf. On Wed, they said that I was going to start the study drug on Friday (all day thing). Dr. K asked the research coordinator to give me a road map asap because I wanted to know what what going to happen and when I would need a ride. Now, they can never guarantee anything, but I'll I ask for is common knowledge so I can be in charge of my medical care because it is my body. I emailed the RC (research coordinator) first thing on Thursday morning, never heard back all day. I finally called my nurse an expressed again that I wanted us to be on the same page and wanted to forward her the email. Instead, she found the RC, and got her on the road. Now this is were the some of the sweet talking came in, (more flies with honey) I said a lot of I's, very important. They are so busy,  over worked, they are there still 7 every night.  I calmly explained to her that it causes me more anxiety for me, my caregivers, my drivers, when we have no idea what is going on. That I have very little control over my life and I have to be able to advocate for myself. There was also the issues about eating. I have to eat about every 2.5 to 3 hours , small meals, at this time. With the amount of meds that I'm on if my tummy gets empty, I get sick.  I had to fast for so long before and after the medication. Now if the team is not on board with times, I could have ended up going 6 hours without eating instead of 4. This actually happened to me back in Nov in the hospital, I didn't get to eat all day because of a procedure that someone didn't do early enough. I'll have to find that blog and put a link here. The team got on board. She gave me a road map, and I bet I saw her five times throughout the day. She seemed to be very sorry, even though I continued to tell her that she is doing a great job and I understand. The day was long, but went smoothly. It was worth fighting for and so are you! 

           

Jan 8th Balloons,volcanoes and designer nails- 4th admission

              I’m here at my studio apartment, as my aunt Lisa likes to call it. I don’t really have the best room this time and was too tired yesterday to think about switching today, so I didn’t bother. I’m don’t have a fancy view this time, but I’m pretty close to the helicopter landing pad, so maybe I’ll catch a good glimpse. I’m debating on if I should try to talk someone into letting me go see the landing pad since it is right there. I’m so close that I can see dust blowing outside the window. Maybe I can use the news story to my advantage…. Maybe I could take a ride! Yea, right. Ha ha. I’m on the eighth floor this time, which is the bone marrow transplant floor. It’s good to see the balloons on the door which means that they just had the transplant. It’s nice to meet some of the staff up here and learn more about BMT’s.  I’m getting plenty of sunlight in this room. I think I might get a tan on the right side of my face, with the shade down. I’m pretty sure that sunscreen is not given in the welcome package. I decorated first thing with cards, pictures, and of course my little lamp. The I pod actually came out first and we listened to the Paper Route mix as we unpacked a little. Jonathan actually had to leave pretty soon after getting to the room because the day was long and traffic was going to start soon. I said my tearful goodbyes. I felt like crying all day, so it was good to just do it, you know? On a good note, I did get to use my fancy vintage luggage that I got for Christmas!

It's so beautiful, I can't put it in the closet. 

         So just a little bit about our day when I come back to Emory. Don’t think that I am not thankful for the amazing medical care that I am receiving but the truth is these days are so long that to ask anyone but close family to go through it with me is just wrong.  Jonathan will be at school on Fridays soon so that means we have to get a sitter and I have to get a ride. The ride can’t just drop me off because there is no where to put my stuff while I have all the appointments. So, we start with labs, and then have an appointment with Dr. Khoury, and then I have to wait for a bed to be admitted. This process takes about 5-6 hours and that doesn’t include the drive and then the admission process I have to do once I get to the room. I may get to start treatment by 10pm if the pharmacy has the chemo yet. The worst part of the whole thing is sitting there with a blue mask on, breathing my own air, and thinking about how much longer is it going to be.  It seems like I would be able to entertain myself, sometimes I can, and sometimes there is someone in the waiting room talking so loud, you can’t help but listen and wonder if an email should be sent out about waiting room etiquette.  I guess we need a splitter for headphones so we can just watch a movie when we get to that point.

My white stripes....

            I have a few new side effects from all this. This week, I noticed that my nails have these white stripes on them. So far I have two lines. I’m not sure which chemo is causing it or which cycle; I have an A and a B. I guess the lines will just keep going up the nail. It might end up looking pretty cool. I just hope they don’t get brittle. I have to pick my guitar with my nails. Ok, so this is super gross, and no I didn’t take a picture, but maybe I should have to go into the world record book. I’m here to record these things right now, there is no point of leaving this one out. When my white blood count starts to go back up, any place that is healing or needs to be healed can have an overflow of white blood cells and it can turn into a pus party. So, I ended up with a mountain of pus on top of my shoulder. I had always had a little bump there but never really knew what it was and it didn’t really do anything. So basically, this thing was too big to be called a zit. It was so gross. Anyone that saw it yesterday, docs, nurses, and Jonathan, wanted to get a hold of it. They were going to have to “lance” it today, but it took care of itself for the most part, unless my mom and my nurse decided that it was not done. I say this was too big to be a zit because I bet you never had to take pain medication for a zit. God, I hope nothing like this happens again. It’s so embarrassing. Some people have come in here because I was featured on the news story; some people have gotten off 85 to see the world biggest human volcano. I’m going start charging.

           I managed to walk a mile around the hall today, 21 laps, so boring, but I told myself I couldn't write this blog until I did it. I guess I still believe myself. I’m on cycle 2 B of the Hyper C-VAD A new hospital protocol has everyone getting a blood thinner shot in their stomach each day. Not really fun, it kind of hurts and now I have two dots on my stomach to go with my other skin issues. This round I will be getting two more Lumbar punctures, where they put the chemo in my spine to prevent it from spreading there and to my brain. A different person is doing it this time, which I’m nervous about but hopefully it will work out ok. Please pray that I don’t get a headache with these LP’s, they are so bad.  

My pretty pics are up!

             So I saved the good news for last. Dr. Khoury said that they have two possible leads for donors for me! They have to go through some more steps and are waiting. That is such wonderful news. Please continue to pray that one or both of them is a match for me. A please, donate if you have not already. There are so many people waiting for donors!  

Be The Match!

Dec 22nd Going home!

Hey Everyone,
        I'm being discharged today! The treatment went well this trip and I'm so ready to be with my family. My sister, Jennifer, was already planning on coming to Athens today to see me so she is taking me home.
            **Medical MJ** We got the results back from the spinal test they did the other day when they did the LP, and it was negative, meaning I still don't have any cancer in my central nervous system. I never did, it is just usually the next place that it attacks. All these LP's (chemo in the spine) is hopefully preventing that from happening. I have another LP this morning and my favorite is doing it again so I'll be ok. Other treatment news is that after this A round I have a small round of chemo next Tuesday that will be done over at GA Cancer center. I will also have 4 days of steroids, not my favorite, but usually that would be the week that I'm super tired, so maybe I'll get some work done, ha ha.
           This week has been pretty good especially compared to the last treatment week. I have been pretty tired this week but I think that has to do with the anti nausea medication that they have been giving me. This is the round I had trouble with that first week, so I thought I should take it. I realized that I really don't like the way those meds make me feel, so I refused the medication yesterday during the day and felt so much better! I took it at night so ward off any nausea, but it was great not to feel like a zombie during the day. They warned me that I may be playing catch up if I got nauseous if I didn't take it, but hey they are experimenting on me, so why can't I. It ended up being a good choice.
                I'm on a different floor, 7E, due to 6E being full when I came in on Friday. Even though I miss the staff that I know on the other floor, I have met some great people up here. 7E is the medical oncology floor so there are a lot of different kinds of cancers being treated up here. My doctor this week is Dr. H, but I have not seen very much of him and I'm of course disappointed that I have not seen Dr. Khoury again, but it is the holidays and it is super busy here. I know that he is looking over my chart and would be up here in a heartbeat if anything was wrong. Dr. T is the medical doctor that sees me sometimes, and it is always good to see him. I live vicariously through him, gardening, since I can't do that for quite a while. I believe that I'm going to readmitted for treatment again around Jan. 7th. In the mean time, I hope that the migraines from the oral chemo do not come back. I have been on the meds since Sat and they usually hit between 1 to 1.5 weeks after I start the meds. I need the medication so we just keep trying. The other medication that I was hoping to try is not approved for the stage of cancer I'm in. No word yet on my donor status, till not sure how that works.
           **FLAGGED** I was flagged again this week by the food police. I very sweet girl, the new dietitian, came up here to check on me. I'm not sure who relays the news when I don't eat my food, but I have my hunches. I keep explaining that I bring food and have people bring me food and also pick and choose what I eat off my plate. See the food here is full of preservative, additives, and the meat, well, I don't think it is meat. I just can't eat most of it. I got a real flag this week, the flags here are little green slips of paper that they put on your plate to explain your type of diet. Mine is general, non restrictive. So the card basically says, "hey you, you can eat any of our delicious food so choose a well rounded diet, yada yada" I took a picture of it, I'll post it later.
           ** Visits** I had some nice visits this week. My brother came to visit on Sat, I think I wrote about that somewhere else. I think I will keep him :).  My cuz Shanna came to see me, always a treat, I didn't take a picture :(. I had planned for us to do some singing together but that stupid med was making me sleepy. I love the earrings that she brought me, they are super cute. My parents came to see me on Sunday and brought me some steam-able veggies and the green bolt house smoothie, yummy. I don't remember a lot from that visit, stupid medication. Again, now I know. A college friend of mine, Cristain came to see me. We have not seen each other in over 8 years, Crazy! It was just like we didn't skip a beat, he is such a great guy and I'm thankful that we met up again. He is teaching tennis here in Atlanta and is going to visit his family soon in Chilie. He recently got back from France where he saw my college boyfriend Camilo. Camilo

           It has been harder this week being away from Evalyn for some reason. Maybe because I'm at home 24/7 so we got closer after me being away for so long. I can't wait to see and kiss everyone. My poor puppy Chloe has something wrong with her eye and Jonathan took her to the vet yesterday. Just what we need, another medical bill, but hey she was my first baby girl. We had some help this week at the house to give Jonathan a break, he seems to be in good spirits. He is such a good Dad!! Wallace misses me the most of course, he is my snuggie puppy. And oh temperpedic, I didn't forget about you, I will be home soon.

Dec 4th Medical MJ and 2nd discharge

         2nd discharge.....  For those that come behind me.....otherwise, skip down to medical MJ..First, I want to tell you about the 2nd discharge and what to expect, what not to expect, and hopefully save you some headaches, not literally :(, with medications. First, always, always make sure that your name is the name on what ever sheets of paper are being given to you. For real. Also, it is very important to stay organized and have someone check behind you.
        With discharge, any appointment, and when ever you ask for one, a list of medications that are ordered for you will be printed out. I dated the top of this sheet of paper from my first discharge, 11/22, to 2nd admission, 11/27. I then put beside the medications which ones are PRN, the common names for some of the meds I didn't know or are referenced differently often then written, and high light any must remembers such as only take for the next 4 days, etc. For the PRN meds, especially the anxiety meds and pain meds, I put a date down of when I took the PRN meds to be able to map out side effects. It is hard to remember with chemo brain so in doing a little documentation, I can see now that my migraines start about a week after being on the oral chemo again at 100 mg. I can also see that the pain medication didn't help much today and that there may also be something else going on as well. During my first week at home, I had 3 medications discontinued and 2 new ones start. I made notes on the same list and added the new medications to the bottom. Of course, then you have to come home and go through your fancy pill box and take meds out and put new ones in..... party.
             So when I was discharged yesterday, I got a new med sheet. Most of the meds were the same, some of the doses were different, and I had a new one for PRN nausea. It would be very easy to get confused and then purchase medications that you do not need, or do not need yet, and have tons of bottles of extra medication laying around. The discharge coordinator and I went through my previous list of medications and compared it to the new list. I decided not to get the prescription for the PRN nausea because I already had one and have not used it yet. I was only home for a week so I knew I had plenty of the other medications and would be back for the 3rd admission in 3 weeks. Out of all the medications, I ended up only having to get 1 refill. Again, I put needed info on the sheet and will start documenting the things that I want to remember. It's great to be able to give the docs clear info so they can make the best decision, well, so you both can make it. It's ok to ask why, how, when, and what the heck is this for?

           Medical MJ........Well, coming home, I'm sorry, recovering at home from chemo, has been a little harder than I thought it would be. This whole week has been harder than I was told or could image that it could be. I'm starting to have the migraines again from the oral chemo, just about the same time after starting it the first time, and I think I'm still having headaches from the LP's. It is killing me that I can't take care of myself or my daughter.
        See the first go around, they have to recover in the hospital, after that, they shoot you up and then ship you out. Luckily, I'm able to follow up with GA cancer in Athens for my lab work 2x this week, 1x the next, and then see Dr. K at Emory the 17th. We will decide then, what day I'm coming back, probably the Monday after Christmas. At the appointments this week, it is more likely that I will need to get platelets or a transfusion because this is the week that my counts will be super low. If that happens, I'll have to go to Athens regional and spend goodness knows how long, you wouldn't believe what it takes to just get blood. I thought they match your type and hook you up, nope. Note to self Heather, bring something to do and tell the person that takes you to bring something to do. Chit chat when you do not feel well is not fun and neither is staring at each other. I go on Monday at 10 am to GA cancer and hope that it is quick and easy!
         Not sure what I'm going to do tomorrow about the headaches. I may call in to see if I can stop the oral chemo, or reduce it, or just give up, just kidding, we will see how it goes tomorrow.

Nov. 23rd Discharge from Hospital- Wait I’m home… now I have to do what?

 

        

       This is for my own documentation, to help those of you that are newly diagnosed, and for those that are curious about what we are going through… let me tell you, it’s great to be home, but there is a lot of work to do.

        **HOSPITAL DISCHARGE** EVERY ONES DISCHARGE ORDERS are DIFFERENT- These are mine and ideas to help you get organized. Don’t do any silly.

        Days before we were discharged it made Jonathan and I feel so much better for him to go ahead and change the dressing in front of the nurse. It’s really not that hard, and it is only once a week.   I also requested to have the hypoallergenic dressings before I left the hospital. In my admissions blog I will write soon, and hopefully the packet Emory WILL have out to patients upon arrival, will mention that you can request the hypoallergenic dressing when your pic is put in, if you know that you have sensitive skin.

         WHEN AM I LEAVING: Because you don’t know what day you will be leaving due to your counts, it was best for me to set up rides for a two day period. It was better for us for me to find someone, besides Jonathan, so we didn’t have to find a sitter all day. So as soon as I found out about my discharge… mainly because I asked the nurse about my counts at 6:30 and know what the counts needed to be, I started setting up the day at 8am.

            I met with the discharge planner, a wonderful lady, and she let me know what all had to occur. I requested a reasonable discharge for no later than 3 pm because hello, Atlanta traffic is horrible. I politely let them know that if I was not out before Atlanta traffic, I was calling off my ride until traffic was over and they could then have this beautiful room that someone needed. I asked her to make my 2 day follow up appointment for the clinic so I could have that today. I call it a heads of states meeting because we are going to map out the big plan. I wanted my aunt, mom, and husband there.  I also went ahead and asked her if she could have my prescriptions for medical supplies, dressing kits and hefren for the pic line, sent down to the Emory pharmacy and I would go ahead and get that during the day. My ride and I got lunch from downstairs and I got the medical supplies. I requested that she fax my prescriptions to my home pharmacy because it is a huge order and I knew it would take a while. Now, any pain medications cannot be faxed in, so that one has to be taken in with the original prescription.  Many insurance companies make you use a specialty pharmacy for oral chemo. The discharge person is usually taking care of pre authorizing weeks before you leave the hospital, but if any changes have to be made, they are able to overnight the medication to you. In my case, we have to change the dose or the meds due to migraines.  Luckily all went well, and we were able to leave by 3:30. FYI, you can call Valet parking from the room and let them know you have a patient and to go ahead and bring the car around. It’s worth the extra money on the day your leave, believe me!

**Pharmacy Trip and needed supplies**

       Even thought we had sent the prescriptions hours ahead of time, poor Jonathan was probably at the pharmacy for an hour and a half. Make sure that you have someone to do this for you, once your home; you just need to stay there and rest. If I had it to do over again I would have called the pharmacy myself and explained the situation- cancer, mom, 1^st day home, need husband.  The pharmacy had to double check everything and did a good job spelling things out for us. For example, one of my meds I can’t take with the calcium. One of them is only M,W,F. Then there are a lot of PRN meds. It is very important to get at least an am/pm mediation dispenser. I could not even imagine trying to figure this out every day.  Jonathan and I had a little med party. We put on gloves and put the meds in for the next week. Do yourself a favor; don’t stop your Colace cold turkey. You have been on it for weeks. Trust me.  I think it is very important to have someone do this with you and help you do it in case there is a time that you cannot do it yourself. Plus, it is very confusing and I have chemo brain right now and may be on medication that affects my judgment. We separated the PRN meds from the meds that I will take every day. Sometime this week, we are planning on going through the entire medication cabinet we have and getting rid of unneeded medications and even moving it to a higher place to go ahead and baby proof that part of the house. We keep Evalyn’s baby medical supplies separate from ours for the sitters.

                      As for the medical supplies, I was given a good tip by another person that “press and seal” made by Glade is better than the aqua guard for covering your pic in the shower. It is must easier on your skin. If you can’t stand the “magic mouth wash” they gave you in the hospital. (Swish and swallow), no the bio tech, the same person gave me a recipe that they use at the children’s hospital. You can make a batch of it and store it in the fridge. It is equal parts of sterile water (boil it), Mylanta, and children’s Benadryl. She said that it works just as well and she has not had any sores in her mouth yet. She is on month five.

**UNPACKING**  We did the the second day home. One thing at a time, remember you need to rest and play with your children J Well some of you will not have to do anymore extended stays at the hospital, but most with ALL or AML will be returning within 4-6 days of leaving to start the next round of chemo and will have many of these small trips away. It is important to make the process as simple as possible. Jonathan and I started unpacking and listed out things that I would need to take back with me each time, some necessities like my own toilet paper, to some things I want there like my own blanket. Then we packed everything back up and bought two of something’s that would be easy to forget…. Toothbrush, face wash,  etc.  These things will just stay packed up. I even have hospital slippers that just stay in a plastic bag for that time away. The things I did take out, we have that main list and will go over it again before we leave. Also in the admissions blog I will write soon, I’m going to include my list that you may be interested in looking at. You may not care about a decorative pillow or a fake plant, but it makes me feel better. You will find things that make you feel better and I hope you do!

My little med/dressings central 

        It made me feel better to have everything organized so that I didn’t have to think about it. I also wrote out what I needed to do when- Meds AM, weigh myself, take temp, drink water: Meds PM, take temp, clean and flush pic line, drink water. Dressing change and med refill day-Sunday. It also helps to document side effects- how often, pain 1-10, etc. Always call about anything new that they don't know about. 

         There are other little things about the first day home you might relate to.  It’s under Nov.23 rd Loving Life and is coming tomorrow.

Shoot me an email at heather.cape@yahoo.com if you have anything you feel that should be added to this that could help someone else.

Welcome home!