Tuesday, November 30, 2010
Wednesday, November 17, 2010
Wednesday, November 10, 2010
Friday, October 29, 2010
My sister-in-law Alexandra sent this to me and I couldn't agree more so I thought I'd share.
Subject: A thought to share
a thought to share... I like this...
Someone had just finished taking an evening class at Stanford. The
last lecture was on the mind-body connection--the relationship between
stress and disease. The speaker (head of psychiatry at Stanford)
said, among other things, that one of the best things that a man could
do for his health is to be married to a woman whereas for a woman, one
of the best things she could do for her health was to nurture her
relationships with her girlfriends. At first everyone laughed, but he
Women connect with each other differently and provide support systems
that help each other to deal with stress and difficult life
experiences. Physically this quality "girlfriend time" helps us to
create more serotonin--a neurotransmitter that helps combat depression
and can create a general feeling of well being. Women share feelings
whereas men often form relationships around activities. They rarely
sit down with a buddy and talk about how they feel about certain
things or how their personal lives are going. Jobs? Yes. Sports?
Yes. Cars? Yes. Fishing, hunting, golf? Yes. But their
feelings?--rarely. Women do it all of the time. We share from our
souls with our sisters, and evidently that is very good for our
health. He said that spending time with a friend is just as important
to our general health as jogging or working out at a gym.
There's a tendency to think that when we are "exercising" we are doing
something good for our bodies, but when we are hanging out with
friends, we are wasting our time and should be more productively
engaged--not true. In fact, he said that failure to create and
maintain quality personal relationships with other humans is as
dangerous to our physical health as smoking! So every time you hang
out to schmooze with a gal pal or sister, just pat yourself on the back
and congratulate yourself for doing something good for your health!
We are indeed very very lucky.
Sooooo let's toast to our friendship with our girlfriends/sisters.
Evidently it's very good for our health.
Wednesday, October 27, 2010
Wednesday, October 20, 2010
Tuesday, October 12, 2010
Wednesday, October 6, 2010
Friday, September 24, 2010
Wednesday, September 15, 2010
Tuesday, September 14, 2010
Saturday, September 4, 2010
Friday, August 20, 2010
Monday, August 9, 2010
Wednesday, July 28, 2010
Saturday, July 24, 2010
Peritoneal dialysis differs from hemodialysis, a more common blood-filtering procedure. With peritoneal dialysis, you can give yourself treatments in the comfort of your own home, at work or while traveling. You may be able to use fewer medications and eat a less restrictive diet than you can with hemodialysis.
Hemodialysis is the most common way to treat advanced, permanent kidney failure. During hemodialysis, a machine does some of the work healthy kidneys normally perform by filtering harmful wastes, salts and fluid from your blood that would normally be eliminated in your urine. In hemodialysis, your blood is allowed to flow, a few ounces at a time, through a special filter that removes wastes and extra fluids. The clean blood is then returned to your body. Removing the harmful wastes and extra salt and fluids helps control your blood pressure and keep the proper balance of chemicals like potassium and sodium in your body.
One of the biggest adjustments you must make when you start hemodialysis treatments is following a strict schedule. Most patients go to a clinic—a dialysis center—three times a week for 3 to 5 or more hours each visit. For example, you may be on a Monday-Wednesday-Friday schedule or a Tuesday-Thursday-Saturday schedule. You may be asked to choose a morning, afternoon, or evening shift, depending on availability and capacity at the dialysis unit.
Researchers are exploring whether shorter daily sessions, or longer sessions performed overnight while the patient sleeps, are more effective in removing wastes. Newer dialysis machines make these alternatives more practical with home dialysis.
Several centers around the country teach people how to perform their own hemodialysis treatments at home. A family member or friend who will be your helper must also take the training, which usually takes at least 4 to 6 weeks. Home dialysis gives you more flexibility in your dialysis schedule. With home hemodialysis, the time for each session and the number of sessions per week may vary, but you must maintain a regular schedule by giving yourself dialysis treatments as often as you would receive them in a dialysis unit.
There is a lot more involved in this such as the different options for vascular access for hemodialysis and having a catheter installed in your abdomen for the peritoneal dialysis but I'll save all that for another time.
I was glad I had Matt with me because which ever option I choose will involve some help and I feel like it's important for him to understand what's involved. I don't regret the way we handled my being at Mayo but he wasn't there for any of the BMT and it put him at a disadvantage when I returned home because I think he was somewhat unprepared for how sick I still really was and how careful I needed to be regarding infection.
Matt was great and asked several questions but I know it was difficult for him. As I've said before, in some ways it's easier to be the one that is ill. You don't have a lot of choices in the sense that if you want to live you get treatment. Everyone handles things differently but in my case I accept that this may be something I have to do in the future while hoping I never get to that point. I really don't think I'll have start making these decisions until December when I finish my last velcade/dex session. At that point when I'm off the Dex (the steroid) we'll be able to see if my kidneys have been steroid dependent.
Transplant was also discussed but I have to go into complete response with the amyloidosis before that can be considered and again my kidneys aren't that bad off yet. So transplant. I am really uncomfortable with the idea of someone donating a kidney to me. I suppose if I get sick enough that may change but asking someone for a body part seems like too much. What if they suffer from an accident or illness where their one remaining kidney is damaged and they need the one they gave me? What if the amylodosis rears it's ugly head again and starts to attack the new kidney? There is the cadaver option which of course involves a waiting list but I think less guilt. I don't know. As I said I'm not there yet and if my kidneys continue to fail and I suffer more as a result I might find I change my mind. I know if I had healthy kidneys and someone I loved or cared about needed one I wouldn't hesitate to donate but that doesn't mean I'm comfortable accepting one.
I feel like I'm starting to ramble and this post is getting very long. I'm in a waiting pattern right now and I think that's my biggest frustration. I like a plan. I like answers and certainty. Amylodosis is too nebulous for me. Too many ifs.
Today I am at the lake. The rain has stopped and Kate and her boys are here along with Matt and all my guys so I will revel in the magic that is Green Lake, which unlike RUSH is the real thing.
Thursday, July 8, 2010
Saturday, July 3, 2010
Monday I had the port put in and generally it went well. The anesthesiologist told me I would be in a twilight state, not completely under but stronger than the level they use for a colonoscopy. I might be somewhat wakeful and notice blue draping over my head but more than likely I wouldn't remember any of it. Note to self, NEVER get a colonoscopy at RUSH. Not only was I more aware than I would have liked to have been, I still remember it. For a place that practically shoves morphine at you in the ER they are a bit stingy in the OR. Plus they sent me home without any prescription for pain medication, recommending Tylenol. I don't know about you but I might as well suck on a tic tac for all the good that was. Thankfully Ben was given a prescription for pain medication after his skateboarding debacle in Green Lake and there was some of that left so I was able to take the edge off that first night.
My chemo nurses were giddy with delight when they saw my port on Tuesday. I might be overstating the level of enthusiasm but I don't think so, they were pretty darn happy and we used it right away. Today is Saturday and it's still tender and sticks up more than I was expecting but we'll see how it goes.
Saturday, June 26, 2010
I didn't mention this is in my last blog but as my second visit to Dr. Wool's office was so similar to the first I can't resist. Hopefully he's too busy to read blogs or at least won't have time before Monday when he's cutting into me.
When I went in last Tuesday to make my consult appointment it took longer to set that up than it took to get my chemo. There are two doctors that I have seen working out of this tiny office. There are many more listed on the business card but as I say I only saw two. Each has their own receptionist/assistant and Dr. Wool's is a very sweet diminutive lady, Ruth. My mom and I have decided that they kind of look alike or they might even be married as you know sometimes when you spend enough time with someone that can happen. They have an interesting banter that implies they have been together in some capacity for a very long time.
Anyway, on my first visit there last Tuesday this tiny office was packed and when it's your turn to check in you walk back to Ruth's desk. Earlier when I was sitting in the waiting room with my mom I kept hearing this odd sound and finally figured out it was a typewriter! Go figure. Ruth types everything up on a typewriter. I don't know about you but the last time I saw a typewriter it was in a resale shop and no one was actually using it. So, When I step back to her desk sure enough there it is.
Her desk is covered, and I mean covered with papers which are in turned covered with sticky notes. In the meantime the phone is ringing off the hook and this poor woman seems overwhelmed. I wanted to replace her with Kali, the goddess of time and change, you know the one depicted as having ten heads, ten arms, and ten legs but remarkably this darling little woman managed to get it all done and remain relatively unflustered. It took forever, but she did it.
When I went in yesterday I was curious to see if it would be a repeat from Tuesday. And sure enough Mr. Peabody, we stepped into the "way back machine" and the typewriter, papers and sticky notes were all still there albeit more organized.
It's easy to get spoiled by a place like Mayo which is almost beyond efficient. For my part, suffering with amyloidosis, a disease the medical profession is still learning about, that kind of efficiency is comforting. At the same time though this doctor and his office reminded me a little of the doctor Burt Lancaster played in Field of Dreams. Warm, real, a throwback and I found that oddly comforting as well. To them you are a person not an illness. I'm finding there is no "right way" to get treatment. It takes a team. My Mayo team gives me confidence. I know this disease is a priority and they are working towards treatment and cure. My Rush team, Dr. Gregory and all the chemo nurses manage my care and keep me as healthy as they can through treatment. As a result I don't find chemo frightening or depressing. And there are all the others like my nephrologist and cardiologist and Dr. Wool who step in at different times for different reasons or procedures. I am learning a lot about the medical profession. It can be incredibly frustrating for both the patients and doctors but is full of good caring people. While I feel it takes some managing on my part I feel like I have a great team. Unlike the Blackhawks, I feel no need to trade.
Wednesday, June 23, 2010
In general I still continue to feel well and was curious about how I would feel with the extra steroids (dex) that I take on Friday. I still had one day where I really ran out of gas but this time it was on Monday and I was still pretty wiped out for most of Tuesday until the steroids I take with the velcade kicked in. If my reactions continue in this way this is definitely something I can live with.
I think I mentioned in my earlier blog that I have some stenosis in the veins in my lower arms and other veins that roll. This has made putting in the IV difficult so yesterday after my chemo I had an ultra sound done on my neck, chest and upper arms in preparation for installing a port. Because I had a central line at Mayo the ultrasound was needed to see if my veins could handle a port.
A central line type of catheter is inserted into a vein at one location (neck in my case), and tunneled under the skin to a separate exit site, where it emerges from underneath the skin. It is held in place by a Dacron cuff, just underneath the skin at the exit site. The exit site is typically located in the chest, making the access ports less visible than if they were to directly protrude from the neck. Passing the catheter under the skin helps to prevent infection and provides stability. However because this device does exit the skin there is maintenance involved and it has to be cleaned regularly. It is also uncomfortable.
A port is a small medical appliance that is installed beneath the skin. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical "needle stick". This is much simpler that the central line which was partially under the skin.
So far it looks good. I consult with Dr. Wool (the surgeon) on Friday and the surgery should occur sometime on Monday. It was indicated to me the port could be used the next day for chemo. I'm not wild about having a device implanted under my skin but since we are hoping to complete 8 full sessions of velcade it makes more sense that digging around week after week for the next several months hoping to find a good IV vein.
As always I appreciate all your thought, prayers and good karma. Please keep my Aunt Barbara who is suffering with lung and bone cancer in your prayers as well. My mom and I went down to Indianapolis see her, my Uncle Karl (who just had a hip replacement) and my cousin Kaa last Wednesday. I am so glad we made the trip even though this is a sad and stressful time for them.
Monday, June 14, 2010
On Wednesday the Kahan and I made our way up and over to Rochester. We had a beautiful day for driving and arrived without incident. I love my doctors and the care I receive at Mayo but as Susan and I entered the downtown area we looked at each other and said "Ugh". Mayo is not our happy place. There are just too many yucky memories for both of us.
Thursday was a day for tests and doctor visits.
First Dr. Buadi. I love his smile. His picture on the Mayo website doesn't do him justice. He looks way too serious and this is a man with a sense of humor. He is so knowledgeable regarding amyloidosis that even if the news isn't great I feel like I'll be okay because I have him in my corner. Fortunately the news was good. All of the tests confirmed what Dr. Gregory also believes, and that is that the Velcade is making a difference. Hematologically I am having a positive response.
I am scheduled to go back to Mayo August 9th. and repeat the all the tests. If the immunofixation is negative then Dr. Buadi will order a bone marrow biopsy. Immunofixation permits the detection and typing of monoclonal antibodies or immunoglobulins in serum or urine. It is of great importance for the diagnosis and monitoring of certain blood related diseases such as myeloma and amyloidosis. A negative number would indicate CR as they call it, which in Mayo speak is complete response. (Because amyloidosis is chronic and not curable they don't use the term remission). The bone marrow biopsy would help to confirm that. If I am in complete response Dr. Buadi would still like me to continue the Velcade for a full 8 sessions just to be sure they really knock it back. I seem to be tolerating the Velcade well so far but the effects are cumulative so we'll have to see. If when I go back August 9th the immunofixation number is positive then I continue on the Velcade and we will assess from there.
So that's the good news. The not so good news is that my kidneys are not happy campers. My creatinine was up to 3.9. Dr. Leung, my nephrologist at Mayo however noticed a correlation between my creatinine number and the weeks I am off velcade and therefore also off dexamethasone (the steroid). Currently I only take the dex (dexamethasone) on the day I get my chemo. Dr. Leung has recommended that I take the dex twice a week (on Tuesday with the chemo and then again half as much on Friday). On the week I am off chemo he wants me to stay on the dex twice a week although on that Tuesday I won't take quite as much as I take on the Tuesdays I have chemo. He has found this to be helpful in some of his other amyloid patients that are having similar problems. He is hopeful this will help my kidneys recover a bit and settle at a reasonable creatinine number. There is no guarantee this will work or even once I go off the dex that the creatinine won't go up again but we're going to give it a try. If I go into complete response I would be eligable for a kidney transplant if it came to that but I'm getting ahead of myself. Best to just see what the added dex does and go from there.
I am feeling optimistic and hopeful.
Wednesday, June 2, 2010
I was under the impression from Dr. Buadi at Mayo that after two sessions we would be discussing the effectiveness of the current treatment. That was my expectation regarding my consult with Dr. Gregory as well. Unfortunately not all the tests results were in, most notably the 24 hour urine test. This test is important for measuring kidney function. My creatinine is still at 3.2 (stable) but my albumen level is low and has been for the last month. The albumen is a protein that is found in the blood. A low number in my case is just another indication that my kidneys are not working well. The results of the 24 hour urine test will show how much protein my kidneys are losing or spilling. I wasn't particularly surprised by the low albumen number as I have been feeling like I've been retaining more fluid primarily in my midsection. However without knowing how much protein I'm actually losing I don't know if it's something that would need to be treated.
I remember after the BMT I was given IV albumen along with lasix. Combining intravenous albumin with lasix is often used to treat accumulation of fluid in the abdomen or tissues. Albumin remains in the circulation for a while and increases the plasma osmotic pressure (pertaining to or of the nature of osmosis, the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent), helping to draw fluid back into the circulation from wherever it is accumulating. Lasix helps to get rid of the fluid in the urine.
So as a result, with some numbers in and others pending this consultation was much like my last one a month ago. I am tolerating the few side effects I am having with the Velcade and I have not been hospitalized with illness since starting on this protocol. All good and as far as Dr. Gregory is concerned worth continued treatment. When I indicated my dissatisfaction with not having something more definitive she told me I need to be patient. Clearly not one of my strong points.
While I feel the level of care I am receiving at Rush and from Dr. Gregory in particular is wonderful it was pretty obvious yesterday that I am being treated as one would treat someone with myeloma. Amyloidosis is rare and tricky and Mayo is a center for excellence in this disease. I am seeing Drs. Buadi and Leung at Mayo on June 10 and we should have all the results for the tests I had run yesterday as well as the results for the tests (pretty much the same ones) that they will have taken at Mayo on the 9th. I'm hoping that this consult will be more satisfying.
My "roid rage" apparently continues even when I am not taking the steroids. In must frustration at not getting a more concrete idea of how well or not the Velcade is working I lit into my poor father on an entirely different subject. While I have apologized already I still feel badly. I think because I was so frustrated in an area where I feel I have very little, if no control, this disease, my release was to go after something that I felt was controllable (deck issues at the lake). How wrong I was on so many levels. What I have discovered is that one of the few things I can control is my temper and I need to do a better job. I might be ill but I needn't be unpleasant as well.
Tuesday, May 25, 2010
Chemo today and I'm off next week. Creatinine still at 3.2 like last week and as far as I'm concerned that's good. Anything below 3.5 makes me pretty happy. DTS (Desiree Tucker-Sorini) was my chemo pal today. Can you believe Kahan threw me over just because her mom is in town for George's graduation? I mean come on where are her priorities? I thought her mom really enjoyed Rush last week.
Traffic was horrendous! Is it really too much to ask that the state of Illinois leave us at least one route into the city that isn't under construction? We had seriously bad driving karma today on the way in but DTS was a saint because I was fretting over an appointment I thought had been moved from 10 to 9:30 (later found it hadn't been moved)and being a side seat driver. The ride home was much smoother. The chemo went pretty well except that towards the end I got really tired. Usually the steroids have kicked in by then but DTS said it looked like all the air (she did not say hot air thankfully) had gone out of me. We had made arrangements to meet Karen at the Grapevine in LaGrange for lunch and DTS thought maybe we should cancel. Are you kidding? I rallied in no time. My Tuesday reward lunch at the Grapevine was not going to be denied. Once again a fab meal and great conversation. A silver lining perhaps??
I don't know if I mentioned this in one of my last posts and I'm too lazy to try and find it so excuse me if I'm repeating myself. A few weeks ago when my mom was in town we met this darling man Francisco Mendoza and his nephew James. For privacy reasons I won't go into Mr. Mendozas reason for being at the clinic but suffice it to say he is amazing and I get strength from seeing him. The reason I mention him (maybe for the second time) is that he is an art teacher and muralist from the Pilsen neighborhood in Chicago. While obscure to most Chicagoans, he is well known to Pilsen residents who have seen his numerous student collaborations on murals at the old Orozco school and the Blue Line's 18th Street "L" station. He spent quite a bit of time explaining to DTS and me the process by which his mural are made. They are hand-set Venetian glass tiles and the 17 mosaic murals on the front of the new Orozco Community Academy are an ambitious addition to the Pilsen neighborhood's status as one of Chicago's best outdoor galleries. The mosaics, which can be viewed from Harrison Park across the street, represent perhaps the best work yet of Mendoza. For Chicago Public Schools, the artwork is "the most refined" of any mosaic mural in its 600 schools because of the professional work and materials. In all, the 2,100 square feet of mural panels--including six as big as 7 feet by 27 feet--pay homage to, among others, the Mexican neighborhood's character, the importance of education and Mexico's prominent muralists, namely Diego Rivera and Jose Clemente Orozco, after whom the middle school is named. Currently he is also being featured in an exhibit at the Mexican Fine Arts Museum called Translating Revolution: U.S. Artists Interpret Mexican Muralists. This unique exhibition examines the influence of Mexican muralists on U.S. visual culture and the subsequent re-invention of the mural movement in the U.S. I believe he said that exhibit would be open through August. He suggested that anyone interested should call the Mexican Fine Arts Museum and He said they set up walking tours of the mosaics in the neighborhood. As I start to feel better this is definitely on my to do list and DTS says she'd love to do it to.
Meeting this remarkable man is definitely a silver lining!!
Friday, May 21, 2010
When I have a good day, which usually involves relatively high energy, minimal shaking and a steady stomach, I try and accomplish as much in that day as I can. There is of course a part of me that worries I'll overdo it and pay a bit the next day but the next day is not guaranteed to be a good one so I push myself. I'm so glad in this case I did because I accomplished a lot and haven't had that feeling of satisfaction in a long time. I also felt way less guilty when I slept in this morning (Fox had a day off and slept in too and Matt got the other two to their trains).
It's pouring rain now but the weather people are promising a nice weekend and a sunny and hot next week as well. So if the weather had anything to do with my fabulous Wednesday I should be in great shape next week!
Tuesday, May 18, 2010
Today was chemo day and my creatinine is at 3.2. This is great news and I hope it continues to move in that direction. Dr. Gregory is afraid my achiness is a velcade side effect and we're going to watch it.
Susan forgot her mother was flying in today for George's graduation next week and both Ben and George have concerts. Thankfully she remembered in time to drop me at Rush, run to Midway to get her mom and then make it back to Rush. Susan's mom is great company and I bought us all lunch on the way home at the Grapevine in LaGrange (the least I could do since she sat through my chemo). If you haven't been there you must give it a try. I haven't found one thing on the menu I don't like. That's saying a lot because my appetite isn't always great and frequently I think I'm going to like something and then see it and don't.
Took Matt in to see the therapist with me today. I feel like we need to communicate better regarding this illness and our expectations. I could tell this is is not his comfort zone (is it in any mans) but he was a great sport and at least I came away feeling like it did some good and as DTS (Desiree Tucker-Sorini) would say, It's all about me!" I only hope I haven't scared him for life and then he'll need therapy for post traumatic stress disorder.
Monday, May 17, 2010
Then again maybe its the weather. I'm sick of spring. Its just a big tease and I want Summer now!
Good lord I'm crabby today. I'm going to go work out with Lewis and see if that improves my mood.:-)
Wednesday, May 12, 2010
I didn't feel great last week and sort of assumed this was just my body readjusting to the Velcade and IVIG after my week off. Now with the creatinine being lower I wonder if it was my body fighting a virus or infection. I think I probably was a little more stressed out than I realized by the whole dialysis discussion. That also probably effected the way I was feeling. I'm feeling like I have a little more breathing room now that the creatinine number is lower.
Feeling good today. Wishing the same for everyone else
Monday, May 10, 2010
It's more than just the physical me that I miss. I miss the me that had more days when I felt good than days when I feel ill. I miss the me that was spontaneous and adventurous and could stay up past ten.
In mentioning this recently to a couple of friends and family, all have reassured me that I am still here, I am still me. While that is somewhat true I have come to realize that the person I was is to some extent gone. I don't think you can have an illness like this and not have it change you in some way. It's not all bad but it's different, I'm different. You see while I hope for a time when I will have more good days than bad, when I can be more spontaneous and adventurous I now know those days are a gift, not the norm. I miss that norm. I miss me.
Wednesday, May 5, 2010
That's the good news. Unfortunately my creatinine jumped from 3.2 to 3.8 in one week, not good news. Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Approximately 2% of the body's creatine is converted to creatinine every day. Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out most of the creatinine and dispose of it in the urine. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired for any reason, the creatinine level in the blood will rise due to poor clearance by the kidneys. Abnormally high levels of creatinine thus warn of possible malfunction or failure of the kidneys. It is for this reason that standard blood tests routinely check the amount of creatinine in the blood. Prior to my BMT my creatinine level was 1.8. It needs to be below 2 for another transplant. Normal Creatinine levels are between 0.6 to 1.2. Once it gets up into the 4's and approaches the 5's one has to start considering dialysis.
Dr. Gregory's office had me call my nephrologist (Dr. William Whittier) to see if he wanted them to give me additional fluids. While the kidneys like to be wet it's a fine line and we don't want to overload them either. Dr. Whittier looked at the numbers and decided on no more additional fluids and said we would look at the numbers next week. Less than a half an hour later I look up and there's Dr. Whittier, what a guy! In looking at me he says I look like someone who has a creatinine level of 3.3 but the 3.8 level is of concern. I could be dehydrated, I could be fighting an infection or the amyloid could be winning over the kidneys. If the amyloids are winning I have to start thinking about my dialysis options. Ugh!
If the amyloid is getting the better of the kidneys does this mean I may have to add another chemo drug onto to the Velcade? That will be discussed (at Mayo and Rush) after this second round of treatments but I really hope that is not the case as I am feeling okay and can live with these current mild side effects.
Another thing that has concerned me lately is it seems since I've been getting these treatments I experience a feeling like my brain is like a record skipping. It's so hard to describe but it's like this little wave goes over my brain that makes me a little dizzy and then it passes. I refer to it as being lightheaded but it's different than that. It doesn't happen all the time and I think it occurs more when I am tired. I've mentioned it to my doctors and they don't really have any answers but they also don't seem overly concerned either.
So all in all I feel pretty well and it's still awaiting game. Keep your fingers crossed for a lower creatinine level.
Finally my Aunt Barbara is very ill. She is my mothers older sister and the only other living member of their immediate family. Please keep her in your thoughts and prayers she is a wonderful woman and we love her.