What happened? Did you have a heart attack? Why did they have to do a bypass?
These are the questions I get most often about my 4 way Coronary Artery Bypass Graft (CABG) I received 10 weeks ago today.
No, I didn’t have a heart attack (whew)! They had to do a bypass because I had too many blockages for a stint to be effective.
So what did happen?
Well to start, my heat pump died.
It was late January when it was very cold. It was a very old system and it became clear that I needed to replace it. With some assistance I was able to arrange a replacement. But during the 5 or 6 days I had no heat, I started experiencing pain in my jaw that would come and go. I knew this could be the sign of something to do with my heart as my mother always told me my father complained of that pain in the weeks before he had a massive coronary at 57 years old. I also knew that it could be TMJ (Temporomandibular joint and muscle disorder). It’s a similar pain.
But once my Heat Pump was installed, and I started to get back to some normalcy, I ran into a musician friend at Food Lion on a Saturday night. We never see each other in there so it was an unusual encounter, but one I have come to be grateful for as I saw it as the universe sending me a message. It turns out my friend had recently had a heart attack which, fortunately, caused no damage to his heart and only required a stint to correct. But of course the entire time he was telling me his story, the awareness that I had been experiencing pain in my jaw and some other mild symptoms, was causing me to think maybe I’m getting a message here.
Well by the next afternoon I went on my first trip to the emergency room. They saw no evidence of a heart attack and, beyond the jaw pain, my other symptoms were somewhat vague and could be confused for other issues I deal with.
So they sent me home. I followed up with a cardiologist the following Thursday and we scheduled a stress test for the next Wednesday.
But that evening when I was carrying laundry to my laundry room, I felt what seemed to be a muscle cramp in my right pectoral muscle. It stayed tight while I was in motion but relaxed once I stopped. (I later was informed that this is “stable angina.”)
A similar experience happened the next day as I was walking into the grocery store. My right pectoral muscle tightened and then relaxed once I stopped.
Then on Saturday it happened again and I also experienced pain down my right arm.
Well certainly all this should have been happening on the left side. Right? But it wasn’t. I later found out this is called referred pain.
Well I talked myself into going back to the ER that Saturday night. Even though they found no evidence of a “heart event” they kept me over night to talk with a cardiologist the next day about doing either a stress test or a catheterization. The cardiologist cut to the chase. There was no reason for a stress test. The catheterization would tell me what I needed to know.
So on Monday we did the Catheterization. It wasn’t very long because as soon as they saw my arteries, they said, “There are too many blockages, and you’ll need heart surgery.”
The next day when I had a chance to talk to the cardiologist, I asked him “What caused this? I’ve never had high blood pressure or high cholesterol?” He said it was my genetics. Indeed, heart disease is in my family on both my mother and father’s side. I knew at some point I would face something in my life, but that I had so many blockages was baffling to me. He did confirm for me that I have a strong heart. So that was reassuring in having to face the upcoming surgery.
And then I spent the following days in the hospital waiting for confirmation of what day I would have the surgery. Of course there were numerous tests and personal matters to take care of.
So many of my friends were supporting me with prayers and well wishes on Facebook. Many friends came by to visit. This helped my determination to face this event.
I had every confidence in the doctors. I was in a nationally recognized heart hospital. Everyone answered my questions and gave me more reason to expect that it would go well. Of course there is always a fear with an operation like this. There is always a chance that things won’t go as intended. And I felt that. When I was taken to pre-op, I trusted I would be awakened in recovery. But I also had the thought that I may not. Fortunately all went well and I have a mountain of gratitude to all the doctors, nurses, and technicians who cared for me and repaired my heart.
But I know the strength received as I was lifted up by the power of prayer and good thought that came to my aid. Though it has it’s troublesome aspects, Facebook is an extraordinary vehicle for sending powerful energy to each other in times of crisis.
So at ten weeks post surgery I am driving again and many of the stresses of my life have come creeping back in. I drive and can do most things but still rely on a few friends to help me with heavy things. I am still on the restriction of not being allowed to lift more than 10 lbs. There are good days and rough ones. But I certainly feel a lot better now than I did when I came home 5 days after the surgery.
There is a lot I haven’t mentioned here. So many friends who stayed with me the first week and so many who just dropped by to check in on me, help me with chores, and brought food and meals. One can only feel blessed when that kind of energy comes to your aid. Thank you all.
I am especially grateful for the concern and care from my family: my brothers, sister in law, nephews, cousins who were there for me day of the surgery and so many who were sending me strength.
My brothers set up a GoFundMe account as I really lost a lot of work over the last three months. It’s times like these that being self-employed can be extremely difficult. It’s still going to take some time to get back into the full swing of work, but I’m certain I will be making a new start with the new energy I will receive from my repaired heart.
To help me make it through the time post surgery, my brothers set up a GoFundMe account. Being self-employed and not being able to work is tough at times like these. We’re more than halfway to the goal. Please consider helping out.
Halloween is one of my favorite holidays. It’s the October Country Ray Bradbury wrote about. Spooky and mysterious, it’s a time of shadows, ghost and goblins. I’m one of those people who enjoys a good scary movie. Not necessarily slasher films, but things that have the intensity of the unknown and unpredictable to them. The Exorcist is still one of the best movies to scare me. A good H.P Lovecraft story will also keep me engaged.
But perhaps the first writer I came across when I was a boy who really spoke to me and exposed me to a sense of the macabre, was Edgar Allan Poe.
So this Halloween I offer up my reading of Poe’s the “Haunted Palace.”
I hope you enjoy.
To all the readers of my blog, my apologies! I haven’t been ignoring you, but in the aftermath of my radiation and everything else that went on with the cancer, I found myself knee deep in getting back to work with my website business , acting, Voiceover and my music. These days, I think, time management is one of my biggest challenges.
So this is just a quick update to let you know I I am doing well. I have been returning to UVA every six months for follow-up visits and every six months getting excellent reports. There’s no sign of any return of cancer.
I have to keep returning every six months for five years. It’s hard to believe that this radiation therapy took place two years ago this past July and there’s approximately less than three years left on this journey.
So far I’m not necessarily experiencing the the blurring of the vision in my left eye that was predicted. I am trusting this is a good sign and that any ultimate damage from the radiation will hopefully be minimal – fingers crossed.
So many of you have been so helpful along the way and it’s been great to be back involved with the theater community, the music/songwriting community and all my business associates.
I look forward to adding more posts as things evolve
“How did you know there was something wrong with your eye?”
This is the most common question I have received.
The first signs were a small visual effect in the inner right corner of my left eye. I could only see it in certain lights. It was easily something I could ignore, as it wasn’t there all the time. It was a quivering, gelatinous spot mostly white & grey. This started probably as early as summer of 2009.
Gradually it became more common to see it in regular light. I remember at one point mentioning it to my ophthalmologist and he remarked he thought it was a visual affect from a cataract that was forming on the eye.
Almost suddenly in July or August of 2010 it became a shadow on my vision, geographic in shape with a white border. For some reason I didn’t feel alarmed and didn’t immediately call my doctor.
Then I started occasionally see white spots, like shooting stars and the white border was more pronounced. I went to the ophthalmologist. With a CRT scan they saw that there was swelling on the back of my retina. His first conclusion was this was a manifestation of my inflammatory disease, Reiter’s Syndrome that I have had for years and has often manifested as iritis or uveitis. The difference here was those always manifested in my right eye. This new issue was in my left.
The ophthalmologist decided to send me to a retinal specialist. Further tests and higher resolution pictures revealed a pocket of fluid raising the retina. It was near a “nevus” which is a mole on the eye.
The suspicion was it might be an internal scleritus and a regimen of oral prednisone was started. After two weeks there was no change and the conclusion was that the prednisone wasn’t having an effect (though I was told to stay on it for several more weeks).
At that point they ruled out a cancer. The Retinal Specialist told me there was there was too much fluid for it to be a melanoma and it didn’t fit as a lymphoma. But it was still a mystery. My specialist showed the pictures to his partner and her too was scratching his head.
In October 2010 my specialist sent me to University of Virginia’s eye clinic in Charlottesville. All of the same tests were run plus some and the doctor there was also uncertain of what was happening. Because the fluid appeared to be the primary manifestation he suggested that there was some sort of leakage of serum fluid from nearby blood vessels and suggested that trying a Cancer drug called Avastin may help.
A needle directly into the eye delivers Avastin. Currently it is used commonly for people with certain stages of macular degeneration.
In all this period I kept asking “Is this condition dangerous?” “Is this retinal detachment?” I was always being reassured it wasn’t. The impression I had was that what I was facing was an anomaly.
I waited to see if it mya pass on its own. The idea of getting a shot in my eye and the building costs without health insurance were weighing on me. I was also waiting for copies of test from UVA so I could consult with some other doctors.
The test information never came. The shadow seemed to settle down in to one spot and the lights calmed down so I focused on my life & business.
Suddenly just before Christmas I woke up one morning and the low frequencies in my right ear were gone, while the low frequencies in my left ear were enhanced and I felt like I had been hit by a truck.
I went to and Ear Nose & Throat doctor who suggested it may be Meniere’s disease. But Meniere’s is marked by severe Vertigo that I wasn’t having. He put me on Prednisone. Five days later I had to stop it as it was causing gastritis. About a week or so later I came down with full vertigo. I used the meclazine (Anti-vert) that helped a little but found better amelioration fro a remedy prescribed by my homeopath.
Near the end of this episode, the shadow in my eye suddenly moved to the center of my vision. Now it was extremely obnoxious. It was like having a smudge of soot on your glasses only you can’t get rid of it.
I went back to the Retinal specialist and elected to try the Avastin treatment.
In January of 2011 I had the first shot. Where it sounds difficult to have a shot in your eye, there is no pain involved and the procedure is so quick the worst thing that happens is there appears to be an oil spill suddenly floating to the top of your eye (which is really floating to the bottom, but because of the way the eye/brain interpret vision it seems to be going up.) We had a scheduled follow up for 4 weeks later.
Over the next ten days or so I had the impression that my vision was improving. A great sign. But it only lasted those ten days. Suddenly the shadow was just as prominent as before. On my follow up I reported this. My doctor’s scans could show no improvement, but because I was reporting some he elected to try a second shot with a quicker follow-up. I asked to wait to take the second shot as I was in the middle of the worst cold I had ever had in my life. It had drained my energy, ended up lasting four weeks and was deep in my chest with unpredictable coughing. I didn’t want a needle in my eye and all of sudden fall into a coughing fit.
So finally in March we had the follow-up to the second shot. He was again disappointed with the result and started to suspect maybe this was a lymphoma. He said he wanted an MRI and possibly a biopsy.
The biopsy he described involved cutting the eye open, draining the vitreous from the eye, very carefully taking a needle to the location of the swelling and getting a sample, then refilling the eye with a substitute fluid for the vitreous and sealing it up.
Needless to say I had a difficult time wrapping my brain around the idea of this biopsy. Not to mention the cost that would be involved. Just the idea of getting funds together for an MRI was creating more and more stress.
So I spent the next few weeks getting the prices from the area centers and hospitals for Mir’s. I finally had it and awaited my results. In the meantime, whether it was something from the MRI or a delayed response to the Avastin, the shadow in my eye moved. It went to the top of my vision.
When my retinal specialist reviewed the MRI with me at the end of March, he was encouraged that the shadow had moved. That it was appearing at the top of my vision meant the fluid had moved to the bottom of my eye and the scans were indicating the fluid was draining from the eye.
However, there was still a raised area beneath the retina. After a two-week follow-up, he was not as positive and suspected now that the fluid had been seated over a mass.
He recommended I go to the Will’s eye institute in Philadelphia for a one-day workup to seek a diagnosis.
At the beginning of April I finally had qualified for a group health policy and was able to schedule a trip to Wills at the beginning of May.
On May 3rd I road Amtrak up the night before and stayed in a hotel a few blocks away from Wills. The next morning I was to be there at 7 am. I didn’t leave until 3:30 that afternoon. Most of the time I spent there was waiting. I think I spent a total of maybe two hours in tests and talking to doctors.
Where all my previous doctors had been uncertain about what was happening with me the conclusion at wills that afternoon was immediate, “You have a Malignant Melanoma and it needs to be treated with radiation ASAP.” They actually wanted me to return that coming Thursday to have it done. I had no financial resources to do that and I wanted to talk to my retinal Specialist. But most importantly I was emotionally drained by this news. As the procedure was described it would also tae away the center part of my vision. Just the emotional drain of thinking of the conversations I must have with my friends and family were weighing on my as I made my way back to the Amtrak station and waited for two plus hours for my train back to Richmond.
I have returned to UVA for several follow-ups with the surgeon who did the radiation Brachytherapy. At this point my impression is he doesn’t really see any change to the tumor. He says it takes about 18 moths to shrivel. He will begin taking pictures of it again in February, which will be 8 months since the radiation, at which point we can see any size differences.
I still have a shadow on my vision caused by the tumor and the vision is warped on that side. Post surgery I also came down with iritis in the left eye that was managed with optical steroids. Unfortunately it also spread to the right eye and it took a couple of months to wean off of the medicine completely.
The prognosis is good according to the doctor. He says 2.5% – 5 years. Which means 2.5% of patients are likely to see it return in 5 years. For me those are great odds.
I have so much for which to be thankful. The support, thoughts and prayers I have received have provided me with fortitude in moving forward through seemingly unsolvable financial stresses. My goal is to get my business back to its former levels as soon as possible.
If anyone needs a website, knows of someone who needs a website, I would be glad to meet for a one hour free consultation. If you have a website and are not sure if it is doing all it should be for you, I also offer auditing services. Also, if anyone needs a voice over, I’m available.
Thanks to all who have supported me and who read this blog. I am still on a journey to restore balance to my life, and your help has been a great boon to me.
My friend Kevin Beale www.kevinbeale.com has offered to help by donating sales of his CD’s through September. I’m grateful for the help in managing the financial challenges I face. (See Some Not So Good News.)
You can purchase them at the Kevin’s itunes Store. Please give the samples a listen and consider purchasing or sharing Kevin’s work with your friends.
Here’s a quick demo of his three cd’s –
- the still small voice
- The Late, Great Barnabus Jones
the still, small voice – Kevin Beale
Split – Kevin Beale, Greg Ewan
Barnabus Jones – me, Jeff Down, BJ Kocen.
Kevin’s Music has been featured on George Maida’s “Electric Croude” on WCVE and he and I are part of the original The Electric Croude Band.
For more info, go to www.kevinbeale.com.
Thanks to Kevin for his generous help. I hope you enjoy.
Though my procedure to have the plaque removed wasn’t scheduled until 2 pm, we were called in a 9am and arrived at 8:30am.
Suddenly after four days of being by myself or with Holly, I was around an entire hospital of people of all ages. I was acutely aware that I was radioactive and had been told to avoid children and pregnant women.
Ended up in the elevator with a teenager. I assumed their exposure was minimal, otherwise the hospital would have taken more precautions to keep me away from people. But I still felt very self-conscious about it
When we checked into he surgery lounge we made them aware I was wearing radioactivity and they did put us in a separate room for a minute. Then someone came in and told us to check in at a different desk. I was asked to fill out a form and told to sit down in the general area. A few minutes later a nurse came out and said no we couldn’t sit there, then she told us to return to the room where we had originally been, away from the general population.
Holly & I sat from about 8:45 am until 2:05 pm when I was called up for surgery.
Holly had the chance to go get some breakfast and take care of a few things. I was allowed a glass of water since my scheduled 2pm surgery was 5 hours away
There was a challenging drilling type sound just outside or above the room. Some construction was ongoing.
Fortunately the hospital provides a wi fi and we both had laptops with us. Holly was able to connect to it, but I couldn’t. I was, however, able to connect through her Smart phone hotspot.
The first 3 hours actually passed quickly because we were both engaged with computer tasks. As 12:45 came I became concerned we had not been called up to pre-op. We were then told that the call would likely not come for another 45 minutes. We engaged in conversations about various things and when 1:30 arrived, I became concerned that the radioactive disk may end up being on my eye too long. We asked again. They then said they talked to the doctor and he said everything was OK and we would be called soon.
Finally around 2:05 we were taken up. I changed into the hospital gown and saw some of the doctors, new nurses and anaesthetists.
The Second Procedure
Finally I was taken back. This procedure, though similar to the one previously described, was much quicker.
The local anesthetic was applied which caused the temporary blindness though not as complete as during the procedure to attach the plaque four days before. I could see some shadows with the eye they were working on.
They quickly removed the plaque, removed sutures, did some cleansing, gave me a shot and added a new patch over the eye. Not more than 15-20 minutes.
Once again I had a bandage over my eye with instructions to remove it the next morning and begin a regimen of Prednisilone (optical prednisone) in the eye 4 time per day.
Fortunately post-op did not include the hard drugs they gave me after the first procedure. Once out of the hospital I was pretty much just feeling a mild sedative effect from Versed. On the way home I was able to go with Holly into the drug store and then we grabbed french fries again.
That evening I was quite energized and cooked dinner. I think my adrenaline was kicking in after feeling like a pariah for four days. I was also looking forward to getting back home the next day.
I slept well and in the morning, Holly removed the bandage. The immediate effect was extreme disorientation as I was struck with the fact I had a severe case of double vision. Not just double, but warped as well.
Squinting as I looked in the mirror, I could make out that my left eye was still dilated and there was only a little sliver of white along the pupil. The rest of the eye was deep blood red. As I tried to walk, I had trouble sensing the floor and where I should step. I went and sat for about ten minutes to try to get used to the double vision. At that time I began to become aware how to describe the manifestation.
If you were to take two copies of the same image and place them side by side. You would keep the horizon of the right image level. But the left image’s horizon would be on a tilt, the right side higher than the left. There would also be he sense that the right side was farther away and the left side was nearer – a sense of perspective. Plus the left image just did not fit over the right. They could not be brought in sync.
However, once I had this understanding, I was able to stand better.
I did all my packing and awaited the arrival of my friend Michael. Michael and I have known each other since we were tikes – about 5 years old. Though we’ve not seen each other in many years, he was in town this summer and graciously took care of driving me to Charlottesville on the previous Wednesday evening and was about to drive me back.
I was concerned that the double vision and the experience of being in a moving car might trigger some vertigo, but it didn’t. In fact the ride helped me to start getting used to the double vision.
Next installment: Back Home and allowing the eye to heal from the trauma of the surgeries.
One of the purposes in setting up this blog was to not only share my experience with my friends & family but also with others who may be facing a similar challenge. The following is written for all those audiences. I realize some of the material may not be of interest to all, but trust that each audience finds something of value.
I haven’t verified this statistic, but I am told approximately 25 people a year in Virginia are treated for ocular melanoma. That makes it an unusual occurrence.
I was anxious anticipating the procedure. Radiation Plaque Therapy is a process where a disk about the size of a quarter is attached by sutures to your eye. It is a custom-made disk designed to point radioactive seeds at your specific tumor.
Just wrapping my brain around the idea that something would be sewn to my eye took quite a bit of trust. I was never quite clear where on the eye it would be attached. As it happened in my case, it was attached to the back of the eye as that renders less pain since there are fewer nerves back there.
Throughout this process, my best friend Holly, gave me rides and provided the hospitality of her rural home in Gordonsville. A quiet, renovated stationmaster’s house about 20 yards from the railroad tracks.
The surgery was set for 7:30 am which meant we had to be at the hospital at 5:30 am. Consequently I had to be up be up by 3:30 am to get prepared and take the 40 minute ride in to Charlottesville. Being as I am a night owl, not going to bed usually between midnght and 2 am, this was a challenge. As it turned out I only got about 3 hours sleep.
I remember the drive into Charlottesville in the still dark of morning. We managed to make good time and Holly’s calm presence helped me to keep my anxiety in check.
Once we arrived we found our way to the Family Surgical Lounge around 5:40 am. Soon my name was called and we were guided to the second floor where I was instructed to change into a hospital gown and await the plethora of doctors, nurses & anesthetists I would see before going in to surgery.
Everyone was warm & friendly. It was clear they were looking out for me. The operating room nurse came to give me an overview of how the procedure would unfold. Finally the anesthetist proceeded to give me a sedative and take me to the Operating Room around 7:40.
Though I was sedated with versed, I was conscious throughout the entire procedure.
Because I have bad back and a soft tissue hump in my cervical area, it’s difficult for me to lay flat without pain, so the first order of business was to get me transferred from the pre-op bed to the operating table get me somewhat comfy with extra pillows strategically placed under various body parts. I was told I was also receiving some medicine for muscle relaxation. Despite these best efforts, by the time the procedure was over, my back was locked and I was feeling my usual back pain.
Though I don’t recall the entire sequence of events, here are things I do remember. Because I was sedated with versed, which can cause lapses in memory, there is a margin of error to my report.
I was given a local anesthetic which they called a “block”. It is like a lydocaine shot a dentist would administer only this time in my cheek just below my left eye. The OR nurse had warned me that it might hurt and she would be there to hold my hand. She jokingly said I could squeeze it hard if I needed, but, if it was too hard and broke it, I would have to pay for it.
One of the effects of this anesthesia is it affects the nerves to the eye in such a way as to cause temporary blindness in that eye. Thankfully I would not have to see the instruments and hands as they worked on my eye.
The doctor rubbed iodine around my eye, cheek & brow then some sort of plastic sheet was laid over me with my head poking through a hole in it.
Then another plastic layer was draped over my face. I had been warned about this as it may trigger my claustrophobia. I was grateful to have the versed running through the IV and that there was a tube with oxygen running under the sheet as well.
This sheet also had an opening for my left eye allowing the doctors access for the procedure but my good eye was blocked. Because of the big light above them in the operating room, I could make out blurred shadows from time to time.
Throughout the procedure I remember him asking me questions and talking back & forth at various moments. I also recall feeling his hands on my face and my brow and around the eye as he did his work.
A “dummy” version of the plaque was sutured to my eye. As far as I could tell this was a way to test how the plaque should fit and make necessary adjustments before applying the real plaque.
They removed the dummy and proceeded to apply the real disk.
The vision in my left eye was slowly coming back as they put the real thing on, I could see vague shadows, not too distinguishable, the big light above them causing a reflection on my eye.
I was aware that he was suturing and would use the ultrasound to confirm details. In the lower left hand corner of my eye I could feel a stinging like a stick poking it, the Doctor said that would improve by the next day.
By the end all plastic was removed and my eye fitted with a lead shield and taped. I transferred back to the bed with some difficulty because of my back.
My memory of the exact return to recovery is blurry. Holly arrived in recovery after 9:30.
I remember the nurse giving me pain medication intravenously and I accepted his offer of nausea meds. When they kicked in, however, I began to feel that drugged sleepiness that can just take you over and I wanted to resist it.
Back to Holly’s
The nurse got me to Holly’s car and on the way home we got french fries. I exclaimed how terrific the fries were because I was sooooooo hungry - best french fries ever!
I remember getting back home, into the house, being up for a bit, talking to Holly, then slept most of afternoon.
After my nap, the local anesthetics were beginning to really wear off and my eye ached as if someone had punched me in the face. I made phone calls to friends & family. My appetite was good and I had ham with fresh organic vegetables for lunch.
Later my heavy lead shield kept slipping out of its nested position on my eye and the tape came loose. Holly did a masterful job of re-taping. Later that evening we ate polenta for dinner outside.
That day was marked with letting all the drugs wear off. I’m not one who likes to take pain meds . My pain threshold has been tested many times over my life. I think one of the worst pains I have ever felt was pain caused by photophobia from an iritis – it can only be described as the feeling of a dagger being driven back into your head. So the pain from this procedure, while being bad, wasn’t anywhere near as bad as that. This was more of an unrelenting ache. I found Tylenol by itself was enough to keep it to a bothersome distraction the first day or so except for my first nights sleep. The pain awakened me about 5 am. I took some more Tylenol and was able to get back to sleep in about an hour.
On rising the day following the procedure, my eye ached and there was pressure along with drainage in my left nostril which kept up for most of the day. All of this quieted as the day went on. The second night’s sleep was much easier though parts of the day I had some queasiness which I think was from something I ate and eventually passed.
In general I was able to watch TV, read a little, work on this account at my computer and take naps in between. Except for the facts I was functioning with one eye, had the persistent ache and there were irritating itches underneath the shield, I was interested in staying occupied.
Of course it’s not over yet and there are still the concerns: will the removal of the plaque be as smooth? What will the after effects of the radiation be? I’ve been advised that I’ll have double vision for a few weeks after the procedure because of the pressure on the eye from the plaque. Over the next few years the center of my vision in my left eye will become permanently blurred and I won’t be able to read with that eye.
As I write this I have less than 24 hours before the second surgery where they take the plaque off. Once that’s done it still takes a few months for the tumor to shrivel.
So far, the procedure wasn’t anywhere as bad as I feared. Of course it’s something I would have preferred to not have experienced. The reasons for the procedure are still of great concern. I really had no choice. One way or another, it seems some form of sacrifice is called for when cancer shows up.
I’m just so grateful that I have such great support and seem to be ahead in the fight.