Rest and Recovery

I am writing this Sunday, June 26, 2011.  Carl was discharged from the hospital just over one week ago on Saturday, June 18, 2011, after a Wednesday June 15, 2011 neck surgery that removed the remaining visible tumor from his neck.  [Actually, before the surgery, no tumor was visible.  (It was on the inside, ha ha)  But once the neck surgeon cut him open...  The surgeon looked around and removed all the tumor in the neck that was visible to the surgeon, and visible to the imaging (CT/MRI/X-ray?) equipment  in the operating room.]  

Froedtert's Operating Room used for Angiograms

The photo above and below shows the operating room used for Carl's two Angiogram procedures on Monday June 13, 2011 and Tuesday June 14, 2011.  Above, the large white structure with the large curved arm is an imaging machine that rotates and slides forward and back to takes images before, during and after the procedure.  A second curved arm in the center of the above photo takes images from the top and bottom of the surgery table.  Carl's bald head is visible on the far right.  Carl is still in the transport bed, and will be transferred to the operating table shortly.

The photo below shows the same operating room from a different angle.  This is the view of the operating room from the monitoring station, a room next to the operating room that has glass windows viewing the operating room.  I believe this is where the machine technicians operate the imaging machine from.  Carl is still on the transport bed.  The curved arms of the imaging machine are visible at the far left.

Froedtert's Operating Room used for Angiograms

Carl has spent the last week resting and recovering at home.  He did get lots of rest, hours of it a day, but there were still four children running to and fro - so not all of the hours in the day were 'restful'.  I estimating that Carl slept more then 12 hours a day, and Carl didn't move around too much.  He has started being a bit more active this weekend, and was exercising a little bit on a reclining exercise bike I bought at a rummage sale.  He went in to his work only for a short visit to say hi on one day.  Of course he didn't stay at home all of the time, though.  Probably once a day we/he left the house for some reason or other.

Carl came home from the hospital this time with a walker.  So now Carl has had a cane; crutches; a foot orthotic; and now a walker.  Today was one of the first days since the surgery that he has been able to move a bit without using either the walker or the crutches.  We went to church for the first time in weeks (with the walker). 

Carl on June 18, 2011

The photo above is from the day Carl was released from the hospital, Saturday, June 18, 2011.  Miranda came with me to pick Carl up from Froedtert hospital, and since it was a Saturday, we stopped at the Wauwatosa Farmer's Market.  Should we have?  Probably not, but Carl wanted to.  We did buy a couple of plants from local farmers for Carl's "earth box" garden.  One of the things accomplished this week was that Carl and the children planted tomatoes and cilantro and basil in two "earth box" gardens.  I can tell that Carl has lost weight in this photo. 

One of the highlights of this weekend has been a family film-festival viewing of the Lord of the Ring trilogy - tomorrow night we hope to watch third movie in the series, "The Return of the King".  We have decided that Nathan would make a good Frodo, the ring-bearer.


Thank you once again for your prayers.  We continue to welcome them. 

Click on any photo to see it larger. 7955 

June 15 Surgery update.

Carl's neck surgery at Froedtert on Wednesday June 15, 2011 went well according to the surgeon.  Now Carl has to recover, which is painful, but the hard part is (hopefully) over.  I don't want to jinx anything, but I want to give out an update. 


Monday June 13, 2011 Carl was in SICU (S=Surgical Intensive Care Unit) after a angiogram with embolization procedure, which was done under full anesthetic.  Carl did not eat at all on Monday.  He had to lay on his back from 9:00 AM until midnight.  

Tuesday June 14, 2011 Carl was in NICU (N=Nuerological Intensive Care Unit) after an angiogram procedure was done to balloon and block off his left vertebral artery.  This procedure had to be done with Carl fully awake, not even lightly sedated.  Carl didn't eat at all until past 9:30 PM, when I tempted him with whatever I could find from Froedtert's all night cafe, because he couldn't eat or drink anything after midnight.  He ate a sandwich, applesause, milk, a candy bar, 3/4 of a pear, and a blueberry muffin. 

Wednesday June 15, 2011 Carl was in NICU after the neck his third neck surgery in 2011 - this surgery debulked the tumor in his neck. (Carl got operating room # 13-sigh...).  This surgery was done under full anesthetic.  He didn't eat at all on Wednesday, and had to lay on his back the entire day, except for when he was being operated on, when they rolled him to his stomach and the surgeon worked from the back of his neck.  Really, though, I haven't figured out if Carl even remembers anything after they took him to surgery at 8:30 AM. Carl got heavy duty pain medication - including Morphine.  It seems almost wrong to type 'Morphine' - like it is a bad drug, and he shouldn't have gotten any, but I am glad that he was able to sleep with apparent comfort.

Thursday June 15, 2011 Carl graduated out of NICU to the Spine care 'floor', walked a tiny bit, had soup and a pastrami sandwich (from Benji's - a deli we both love), and ate several times, watched a movie. His pain medications are back to oxicodone and oxicontin. 

I will be happier once he is home.  Then I will be freaked out that he might get a fever, fall, etc.  That's just kind of the way it is.  Stress either way, but at least at home things are calmer.  

Neck Surgery Update - Try Again

Today is Saturday, February 12, 2011, and I am finally writing to bring this blog up to date. The last chaotic jumble of posts can be referred to or ignored, but I'll try to recap here.

Carl's Angiogram with embolization procedure done at Froedtert on Friday, Jan 21, 2011. It was a long day and a long procedure that attempted to kill off blood supply to the tumor in his neck, and the Doctors felt it went well. Carl remained in the hospital through the weekend, and on Monday, Jan 24, 2011 Carl had a surgery to de-bulk the tumor in his neck and to stabilize his neck. Monday was a long day and a long procedure, and the Doctors felt it went well. Carl stayed in the hospital a few more days and came home from the hospital late Wednesday, January 26, 2010.

Carl has been mostly staying at home and trying to recover from the surgery. He has been in a lot of pain at times, and takes a lot of pain medication. Carl takes 60mg of Oxicontin, (a long acting pain pill) twice a day, and he takes 10 mg of Oxicodone between these doses for break through pain. He takes a version of Valium to relax the muscles, up to four times a day.

Carl didn't have to return to the Medical complex until Monday February 7, 2011, when he had three appointments: 9:00AM with the Oncologist, 10:20AM with the Radiation Doctor, and 11:30AM with the wound check people. The wound check lady removed the stitches in the back of Carl's neck. The meetings with the Doctors were surprisingly unenlightening. (A friend once told me that with cancer you have to remember that every Dr. meeting is not going to answer all your questions, or even tell you a whole lot. There is no great answer at the next appointment.)

On Tuesday, February 8, 2011, Carl went to work for about four hours. He felt good about getting out of the house and going to work. (I drove him both ways. Carl won't be able to drive for weeks)

On Wednesday, February 9, 2011, Carl went to work in the morning, and then I drove him to a 1:10PM CT simulation appointment in radiation oncology.

On Thursday, February 10, 2011, Carl had a 9:00 AM MRI appointment in radiation oncology. Carl's pain, usually bad, was even worse today. It was wincingly bad, and so while Carl got his MRI I tried to get appointments to address the pain. The Oncologist could see him at 12:30 that day, but recommended we contact the surgeon. At around 10:00 AM I call the surgeon, and they made an appointment for Carl to see them at 12:00 noon the same day. We were in the surgeon's office at noon, and the surgeon reviewed the mornings MRI (which were taken from angles appropriate for Radiation planning, not the angle the surgeon was used to). The Surgeon then ordered an X-ray which Carl had 20 minutes later. At 12:40 we were back in the Surgeon's office. He studied the X-ray and indicated that the mechanical parts placed in Carl's neck were not in the right position, a plate had slipped and a screw was out of position. He said we should have that fixed in surgery on Monday, was that OK? Carl just kind of stared at the guy numbly. The surgeon was good. He said let's schedule the surgery time to hold the time slot and you can decide later whether or not to do the surgery. I said, Carl, your going to go along with this, right? (and probably some more things...) and Carl agreed he had no real choice. (We could edit that to "Carl agreed"... but I am not sure either edit defines the real moment)

So... Carl will once again undergo neck surgery, this time on Monday, February 14, 2011, Valentines Day. Sigh....

The rest of Thursday afternoon included a pre-op appointment and expediting a CAT scan through both insurance and the hospital, and we were home by 4:00PM. Carl went home in pain, (not really numb, was he?) and so both Carl and I will just keep going.

Carl is like a exotic sports car - He's finicky. He needs a custom tune-up.

1st Neck Surgery Day Over

On Monday, Jan 24, 2010 Carl had a surgery at Froedtert Hospital to de-bulk the tumor in his neck. The surgery goals were to remove as much of the tumor as is safely possible, stabilize the neck, and relieve the pain that Carl has been experiencing recently. The surgery and procedures went well, started about 7:30 AM, and ended about 3:30 PM. Carl went to the recovery room, and at about 6:00 PM he was wheeled into his hospital room on the 5th floor of Froedtert, where I first got to see him since 7:20 AM in the morning. He was groggy, in pain, and very still, but otherwise doing well. By 8:30 PM he had walked half the length of a hall, taken some steps and was back resting in his bed for the night.

Carl recovering

Below are the bloody details only for people interested. Don't read below if you are the sqeamish type, the summary above should tell you enough.

Carl was scheduled to show up at 5:30AM for a 7:15AM surgery. Carl was in the hospital already, recovering inpatient from Friday's angiogram with embolization procedure, so 'early arrival' was somewhat easy (for Carl). The surgery was scheduled to start at about 7:15AM, I left him at about 7:20 AM as they wheeled him in to surgery. Carl was out under general anesthetic at about 7:30AM.

First the surgery team "installed" multiple IV's (including one called an arterial line), a breathing tube and a foley catheter. At some point after the IV's and breathing tube and catheter were in, Carl had to be carefully lifted off the portable hospital bed (where he was laying on his back) and turned over and placed lying on his stomach on the surgery table, with his neck position immobilized the entire time. This procedure alone takes a fair amount of time (and coordinated teamwork between many people), because head can't be rotated independently from the body. (The operating team does this type of positioning roll with people with broken necks from accidents, so they are used to the procedure, but that doesn't mean it is easy.) The length and positioning of IV lines are carefully thought out in advance so that lines don't get crossed, pinched, or end up getting in the way of the surgery personnel or equipment. Carl hasn't been able to lay on his stomach for about a year because of his port, which sticks out from his chest. Padding and positioning of sponge like O-rings takes care of this, but again, it all has to be thought out in advance.

It is my understanding that the skull was locked into place with screws through Carl's skin into the bone of the skull, and X-ray imaging photos (and MRI?) were made so the surgeon could "see" precisely where the tumor lay before the first cut. I am guessing that these steps were done after Carl was rolled onto his stomach. Throughout the operation neurological functions where checked with monitoring impulse signals being sent and received from the head to the limbs, this functioning being entirely monitored by a neurological Doctor and his team. At points throughout the operation progress was checked with more X-rays.

This preparation, monitoring, imaging and other setup steps took until about 9:53 PM, when the first cut was made and the "surgery" officially began. The surgeon made an incision into the back of Carl's neck, 4 to 6 inches long, (I haven't seen it yet) and started the process of carefully removing the tumor through the back of Carl's neck. The surgeon did not try to remove all of the tumor, particularly the tumor that lay along Carl's main vertebral artery. Accidentally harming this artery could be fatal. The tumor that lay next to the spine seemed to neatly "peel away from the dura", which was a nice turn of events. It is my understanding that the surgeon cauterized the edges of the blood vessels that fed the tumor, hoping to prevent them from regrowing and resupplying tumor growth.

The tumor in Carl's neck had invaded and eaten away some bone in Carl's neck. There are 7 neck bones, called vertebrae, labeled C1 to C7 from top to bottom. The neck vertebrae C2 and C3 had lost bone material to the tumor, mostly the spiny pointed part on the the back of the neck bone. (The 'ring' portion of the vertebrae was still intact, but weakened). The tumor was removed here, along with some bone, and the neck was then fused with titanium metal hardware from the skull, through C1 to the intact C4 vertebrae. The fusing will stabilize the spine, but will result in some loss of movement in the neck. However, in the proceeding weeks, Carl has been in so much pain that he already stopped turning his head much. It is possible that he will have more movement (in several days) then he did immediately proceeding the surgery.

Carl received two units of blood, about 1000 ml, as blood transfusions throughout the surgery. (Thank you to all who have ever donated blood. Its not fun, but it is important.) The surgeon indicated that five years ago he would have expected Carl to lose about 5000 ml of blood in a surgery of this type, and he was surprised at how little blood was used. This was the reason that they did the angiogram with embolization procedure on Friday, and it was very successful in minimizing the blood loss. I expect it helps lower the surgeon's stress level as well - I looked at my pyrex measuring cup and thought of 500 ml of blood spilling all over my floor. Then I thought of 5000ml (more then a gallon of blood) spilling out of someone's neck as you are trying to do a careful job of identifying healthy cells from tumor cells, removing the tumor cells, and then building a superstructure of titanium in a living person's neck, and I was grateful for Friday's procedure.

They were closing Carl's surgery from about 2:00PM on until the surgery ended about 3:20PM. Carl was then taken to the recovery room. I met with two anesthesiologists at around 3:40PM, after they had stopped the anesthetic and removed the breathing tube and left Carl in the recovery room, (where visitors are not allowed). At about 3:45 PM I talked to the neck surgeon on the phone briefly before he went in to his next surgery. The neck surgeon indicated the surgery went well and he was pleased with the results.

Carl was in the recovery room until about 5:45 PM, and before 6:00 PM he was wheeled into his hospital room on the 5th floor of Froedtert, 5 South East room 25, where I first got to see him since 7:20 AM in the morning. It felt great to see Carl after all that time. My brother Tom stopped by within 10 minutes of Carl arriving at 5 SE room 25, which is in the 'Spinal Injury' Center.

Carl was groggy, thirsty and in pain, able to talk but only in a pained whisper, and was occasionally quietly agitated and anxious. His eyelids were very puffy (from having been laying on his face for hours), and he used his fingers to open his eyelids now and then, but mostly kept his eyes closed. He was very thirsty. As soon as the nurse 'read his orders' (instructions from the doctors), I was allowed to feed him ice chips. Carl was mumbling about water rights, and how people should not steal water. (This may be funny in the future, but at the time it just told me he was still pretty out of it.) My brother Tom kept saying "what?" every time Carl made some remark, and I kept making weird eyes at Tom effectively saying "I have no idea". It was nice to have Tom there at that time. Tom recently helped my brother Paul after a spine surgery, and he saw some of the similarities of the situations.

The neck surgeon stopped in to 5 SE room 25, and answered a few questions before leaving to arrange for more pain medication for Carl. Eventually pain medications were given and Carl settled down into a barely alert dozing state, waking to try to turn and find a more comfortable position. Tom left around 8:00. Carl had a neck draining blood from his neck (ok, yuck...) and woke up at around 8:30 PM when they emptied it. He wanted tubes out. The catheter could come out after he walked, and this motivated Carl. At around 8:40 PM he had walked half the length of a hall flanked by 2 nurses, with me pushing his IV 'tree' behind him. The nurses had to keep telling Carl to open his eyes. As soon as he was back in bed, he was asking them to take out things. The catheter came out, and arterial IV was removed, and the pain medicines were kicking in, and Carl fell asleep by about 9:15 PM, (after numerous times of shifting around his position, and Carl having me and the nurse change the incline of the bed, and location of pillows, etc.) He fell asleep, and his pulse below 60, which tells me that he wasn't in pain. (Of course, I had to first go and checked with the nurse to make sure the pulse rate that low was OK.) Carl didn't stir at all after about 9:20, and I left a little after 10:00 PM to drive home to my sleeping children, who had been fed and cared for by a team of friends that day on Monday alone. Thank you all.

Please pray that Carl recovers quickly and well, and that the tumor is mortally damaged and unable to grow back.

Angiogram with Embolization Done!

Carl's Angiogram procedure was successful and ended about 8:10 PM, on Friday, Jan 21, 2011. This is the first time that Carl has been knocked out with a general anesthetic, unless maybe when he was a baby. All other procedures (2 biopsies, and the port placement, etc.) have always been done with local anesthetic. Carl came off the anesthetic and had a breathing tube removed around 8:30 PM. The procedure went very well according to the Doc.

More later.

Angiogram Day

(Please keep Carl in your prayers.)

Today Friday, Jan 20, 2011, is the day that Carl is having his Angiogram and procedure. And what a rough day the day has been already.

The children have no school today, just because -- I guess the reason given is that it is the end of the semester. (And Monday was a "holiday" as well.) So, ... I have to make arrangements for the children. This shouldn't be hard, but the children want to lounge around and play, not get up, shower, eat, etc. on any sort of (highly delayed) time schedule. I guess I thought that my children kind of understood that today, with their dad having a medical procedure, they might have some responsibilities beyond self gratification. The children kind of thought today would be "Saturday like" with the added bonus that there would be zero adult supervision. So, today I had children breaking all sorts of rules, well before the 'adults' (parents) even left. (The children don't consider that they have rules, they consider them "guidelines".) One rule/guideline - once you get up: Shower, get dressed, possibly eat breakfast, and if the Dog is barking for attention, put him outside. One "rule": Practise the piano before playing computer or "screen" games.


I think my children have only absolutes:

• If any sibling is breaking any sort of rule, then you should also.
• If the dog is barking to go outside, then someone else should put him outside.
• If the phone rings, (even if you are expecting a call) someone else should answer it.
• If mom starts to yell at ALL FOUR children to take a shower, you can gain bonus points by pushing others out of the way once you belatedly (1/2 hour later) decide it is time for you to comply with her request.
• If mom starts to "yell", then children should pre-emptively yell.
• If mom is yelling at any sibling, then other siblings should pre-emptively yell if she looks at them.
• When mom lowers her voice and says "Do it now", then mom is yelling. Pre-emptively yell. If you are feeling teen-like, swear as well.
• If an event is going to happen more then an hour in the future, you don't need to start getting ready.

I think I am probably being passive-aggressive here, but I hope that someday my children read this and think "That is SO UNFAIR". My Mom is not supposed to have any feelings other then a desire to make me ridiculously happy. My mom is not supposed to have any negative feelings at all. (Well, maybe at my siblings when they interfere with the world wide goal of me being ridiculously happy.) My mom is not supposed to require me to participate in any work required for the upkeep of the family, house, dog. (GOSH, isn't that what she is supposed to do? I mean, LIKE, isn't that her bleeping JOB?) 

I also hope that someday my children read this and think "That is SO UNFAIR". That is so unfair of my mom to use writing skills to vent her feelings. (We want writing to become obsolete, not used to remind our short term memories of negative things.) Writing is supposed to become obsolete, like hand-writing. Even the curriculum people know that. We keep telling mom that. OMG, DO I HAVE TO make MOM a power point? I'd TEXT her, but she won't even buy me a cell phone.) I know that the teachers have accepted that hand-writing is obsolete. The teachers don't even want to see our handwriting, because they can't read it. And neither can we. SO THERE.)


Well, I admit to my general audience here that I was stressed this morning, and my children did not come to my aid, but instead aggravated the situation. I know from personal experience that pre-emptive strikes do not work, and I know from personal experience that escalating hostilities are a natural human condition. 


Where was I. Oh yeah. Carl has a medical procedure today; children weren't cooperating; no-one wanted to walk the dog in the cold; dog poohed in the house; someone stepped in the pooh, no child wanted to find ground zero (Ground Zero here refers to the initial spot the dog poohed in.) Car stalled a couple of times; Car needed gas...

Oh, let's just fast forward to the hospital. 


The schedule we had been given was all geared for Monday's surgery. Not Friday's procedure. Where Friday's procedure is being done was not clear. Actually, since everything is computerized now, the computer printout had a column that says "Center". It has the Acronym "Radfec" Let's not spend any time helping the customer (patient) getting anything beyond a poor acronym. In fact, even the people filling out the computer form don't understand the acronym. And since the column heading 'center' doesn't really scream "Location", anyway, the data entry people will use the column 'Provider'. Perhaps that is the only field where they can type an entry. So, Provider will have "Ir 5 - FWC 2nd Fl". Yep, that will help our customer. No matter that it directly conflicts with Radfec.

You see, I have a four year engineering degree. (Not that I usually admit to it). I can speak (some) Acronym. So I know that ...

"Radfec" is probably Radiation or Radiology (two vastly different departments and locations) and fec is probably Froedtert East Clinic. (I know you readers recognized that right away.)

But everyone knows that Radiation wouldn't be located in Froedtert, it's in the connected building - the Cancer Center, so Rad can only be Radiology. Oh yeah, but not the X-Ray kind either, that is a TOTALLY different department, that's not really radiation anymore, that's, Oh never mind.

This then conflicts with "Ir 5 - FWC 2nd Fl" I believe Ir is Interventional Radiology. Well there, the customer (patient) should know right where that is. FWC (why the caps? Oh, punctuation, capitalization, all that stuff is obsolete or else it has a secret meaning that we won't bother you with...) FWC would (of course) be Froedtert West Clinic. And 2nd Fl - well second floor.

Well, F (Froedtert, for those not thinking acronym) is a big place, so the big people (administrators) labeled all the parts with East Clinics and West Clinics, even though it is a hospital, and an overnight hospital at that, so that there are a lot more then just clinics, but that's just... never mind. Anyway, (I think) Clinics are where you meet and greet your Dr, and Procedures are done elsewhere, (keep them doctors walking, it's part of our health care plan for them) but whatever....

I'm not conversant enough in acronym to know what the 5 means. I don't have advanced degrees. (Although I suspect it is the Ir room Carl is scheduled to have the procedure done in.)

Really, I should scan in our schedule. Oh well. We got lost, parked in the wrong area, walked back and forth, a lot, etc. Got Carl to where he should be. That's when we figured out that Friday's "procedure" is probably and almost bigger than Monday's surgery. Actually, an angiogram with an embolization procedure in the neck will require possibly more time than the surgery will. And Carl will need a general anesthetic, and ... But that can be for another post. Tah! (One of my friends uses Tah! instead of saying good bye...)

I hope all is going well with Carl's thing (angiogram with an embolization). They are hopefully about 2 hours into a four hour procedure.

Signed, Jeanne (Mistress of Laundry, Evil Mom).

Happy New Year, Neck Surgery Next

Happy New Year, 2011!

Carl and I and the children ended 2010 as we have been ending the Year for over a decade now - welcoming in the new year with some college friends and our eight assorted children, all born within 5 years of each other. (I think Carl and I visited each child in the hospital when they were born.)


It was a good way to close out the decade - We have been getting together for New Years Eve with these friends every year since before the turn of the millenium. (Photo above from Dec 31, 2000.)

January ushered in cold weather and more pain in Carl's neck. Multiple Doctors reviewed Carl's case, and are now recommending that Carl has a surgery to de-bulk the tumor in his neck. They considered this surgery before (in April 2010), and decided not to operate, (and at the time we were glad!). Now that the neck is giving him more trouble, the plan is that Carl will have surgery on his neck near the end of January 2011. [Update: The Surgery was on January 24, 2011] (Keep Carl in your prayers, PLEASE!)


First a special Doctor will do a procedure called an angiogram a day or two before the surgery. They will do an angiogram with embolization. Embolization is kind of the opposite of an angioplasty - the Doctors will attempt to kill and destroy the blood vessels that are supplying the tumor. [Update: The angiogram with embolization was on January 21, 2011]


On surgery day a neck surgeon will carefully remove as much of the tumor in Carl's neck as he safely can, approximately 90-95%. The surgeon will not try to remove it all, there are important nerves, blood vessels and spine stuff he doesn't want to get too close to. (The neck is a pretty important part of the body.) The surgeon will also try to cauterize (kind of burn to a crisp?) the blood vessels that are looking like they might want to supply the tumor area. A downside of removing the tumor is that the surgeon will then have to fuse several of Carl's neck vertebrae (C1 to C4, for those curious). An upside of this fusing procedure is that Carl may (with luck) actually have more neck mobility then he currently has now. Carl is in enough pain that he really turns his head very little at the moment. Carl will hopefully stay in the hospital for only a couple of days, stabilize, and then go home to recover. He will not be able to drive for 6 weeks.

I was glad the doctors didn't recommend this procedure in April of 2010, but now I really want the days to pass quickly until the surgery is over and done with. Carl has not bounced back from the last chemotherapy (which ended Dec 30, 2010) like he has from previous chemotherapies. Carl's pain is barely controlled by the medication he is taking - daily Oxicodone, with Oxicontin and Tylenol for 'break through' pain, of which there is a lot. The pain drains him of a lot of energy. It's hard to watch someone in pain and be unable to help in any meaningful way. Carl has lost weight for the first time in a year. Through this month he has been dragging himself to and from work as well, and I don't know whether to encourage or discourage this. (He probably wouldn't take my suggestions, anyway.) He basically comes home and collapses, sleeping an incredible amount, leaving me to wonder if I should wake him up to encourage him to eat, or let him sleep. I don't know the answer. When you get married they don't give you a book that tells you what do do in situations like this. I actually pray that I am not messing it up too badly.

I'm glad we made it to this weekend, (Jan 15 and 16), where Carl can rest, eat, and rest more. Next week the children have off Monday and Friday, and the two in high school have "exam week", and then we will tackle the medical procedures. Hopefully all will go well.

May your 2011 be healthy.