life is like........

....have you ever been stressed or upset and you find yourself doing something quite unexpected? Im talking about doing a Forrest Gump and running when you previously hated it, or baking cupcakes when you have never whipped up a batch in your life, or starting to doodle something having hated art at school, singing, dance, smoking, I dont know what, Im sure the list is endless.

Well, when I was getting divorced about 4  years ago I found myself having a Forrest moment.....running a LOT! It was therapeutic. When I got stressed about it all I'd throw on my trainers, hook up to the ipod and run. Now, Im no marathon runner, really, and I still have no ambition whatsoever to do one. This was just running wind, rain, sun and snow! and yes I got fit, slim and found that the natural endorphins were doing me the world of good!

A few years on, and another round of challenges, and Im running again. Well I say running, its more of a fast walk right now, given my bones and pain and all that stuff, but Im pounding the streets all the same. Im walking to and from work - 50 mins each way! Im hiking the streets again come rain or shine and its sort of strangely clearing the horrid fog in my head that has descended in the last year.  And yes -  in truth it is REALLY helping. Must be all those endorphins again! and the fact that Im actually able to walk and move this year in contrast to the complete disabled state of last!

You have to take control in order to stop feeling like the victim and as we all know we have a choice in everything, whether its sticking out a bad relationship, being nice/ nasty to someone, taking that job, quitting that job etc etc.......of course you cant control what others say or do to you, but you can control how you choose to react to them. That has been a tough one for me recently, having been ostracized by a bunch of friends on account of apparently being honest about how I felt about something that was in fact really upsetting me. I know we are English and therefore it is law that even if someone is rude, unkind or insensitive that apparently we absolutely come-what-may NEVER actually tell them how they are affecting us, we must keep that stiff up lip and simply zipit! I didnt do that and hence my issue -  I broke the law!

I was finding that I was increasingly upset and stressed, really upset and distraught. Increasingly  paranoid that in some way Im just some terrible person and Ive clearly done something awful to have been punished not only by a lifelong condition being thrown at me, but to then double up on finding people adding their own form of judgmental punishment on top  -  just to add cream to the pie! But as I said, it all comes down to how you choose to react to that, that and accepting that I had a  choice or not in the first place as to whether I tell the person how they were affecting me! I can (choose to) be the victim, and I was definitely feeling it. I can also decide that actually those that treat me like that are either so un-self aware, are very aware of what they are doing or simply not the friends I  thought they were, especially if tehy stop talking to me on account of that! (that last one is the toughest actually to deal with, and acknowledge -  especially when they are the people you spend the most time with and have shared private thoughts, time, holidays, weddings etc with) I can only hope that it isnt that last one! Really!

Anyway, I deviate, I was stressed and upset. My plug hole was sucking me down. I was circling rapidly towards an unspeakable place........just like when I was getting divorced and was starting my life again. I had left a home, all my belongings and had to start from scratch back then and I remember feeling the same sense of panic then as I have done of late. What will the future bring, can it get better, who, how, what would come along? And that was when I started running! My feet just carrying me along. This time its pacey walking! It clears my head, it lifts the fog, it raises me out of that navel gazing that we are all prone to doing when down in the dumps! The endorphins are going again and Im feeling more positive. There is no real change in the stuff that triggered this, but I can but hope that its a phase! Im choosing to get on with things, its the best I can do! actually its the only choice I want to make!

So I joined the gym -  Im swimming 3 x a week. Im walking and Im doing pilates! RPS has kicked in, the butt is being worked, the muscle memory is kicking back in! And Im pulling a Forrest Gump. so if you dont get an answer on my phone, Ill prob be out having a walk!

What was it that Forrest said?  "Life was like a box of chocolates ....You never know what you're gonna get......" In short -  you can always choose!

2 steps forward, 2 steps back - equilibrium?

My last posting was a rather impersonal summary of the 3 different types of pain. I posted it so as to raise more awareness to those who either suffer and will find it a way of clarifying or for those that need a better understanding of where Im at when I say Im in a constant state of pain. (ie persistent, as opposed to chronic or acute)

Its a concept for most that is hard to really grasp. I can also relate to that,  as I remember when my mother had constant back pain, when I  was a child, and I could never really fathom why she looked ok and yet insisted that she could barely stand or walk. That is the problem with pain -  its there, the person is suffering, but other than a grimace, or pale complexion, a few tears or so, there is no obvious outer sign of what is being endured.

Im now back in full swing of a more 'normal' life. I work everyday again, I try and see friends occasionally and have a bit of a social life now and then! I carry my own shopping, I even managed to do a bit of gardening last weekend, went for a walk, drive the car, take public transport etc. So all in all a pretty normal existence you might think.
The reality though is a bit more complex than all of that.
Yes, most mornings I stretch out in bed, greet the cat, and the first question that usually crosses my mind is what pain level today? Im normally around about a 1 or 2 first thing in the morning! A bumble and stumble with stiff limbs and sore joints into the bathroom and the baking hot shower usually serves to revive and warm me through to get me a bit more functional. I am challenged of course with the usual crisis that most women have every morning of course with what to wear and that provides something of a brief distraction, until I realise that due to lack of activity and eating a few too many naughty things, plus copious pills that have utterly disrupted my whole system, over the past year as way of comfort that I then despair that actually the dress I want to wear is now a bit tight! bleugh! That daily trauma over and Im generally in gear and out of the house quite soon.

I still have about 10 different pills every morning to take, magnesium citrate, calcuim, vit d, vit e, zinc and vit c combo, iron, my magic Chinese potion, co-enzyme q10 and Im off! should be too on that lot! but Im basically taking the magnesium, zinc and Iron cos Im knackered all the time. The magnesium is also meant to be good for bones and healing and bad sleep patterns. Co-enzyme is also good for immune and healing. vit e, hair and bones. You get the picture. And then there are the real drugs. Im still taking the naproxen anti inflamatory 1- 3 times a day. and then its a quick decision when I roll into the office as to whether its the 20mg codeine or the 30mg? I have a draw full of painkillers in the office or all types. If the tube journey has been bad of course Im on the 30mg. If Im having a better day its the 20. Naturally the lower the number the better in terms of side effects. I still get a nauseaous feeling with them and the higher dosages Im just a bit more fluffy headed! I still have to write nearly everything down all the time, but that's not such a bad practise in meetings and making decisions all the time anyway!

I have to say that I thought that by now Id be 'more stable'. Im pretty level with the pain and its just a way of life now mostly, but its also a bit catch 22. I will turn into a total slug if I dont do more exercise and activity, but its really quite painful to do so. when I do,  I cease up, I get stiff, I have higher pain levels all which I have to keep pushing through to try and combat having no core muscles (which hold me upright) and arms and legs now like jelly rather than the more toned appendages that got me up a mountain a while back. So slug I am at the moment. Im not sure how many slugs grew muscles, some might argue they are just one slimy muscle that slopes about, but whilst I dont think Im so similar to one (at least I hope Im not there yet), it seems that my body is going that way. My back hurts all the time, as do my ribs still  -  I guess they are STILL healing,  I feel a bit without a spine frankly as sitting up sometimes is really quite painful. The muscles I do have stretch and hurt like hell too -  probably from extreme underuse!  Its a form of fibromyalgia I believe -  constant aches in your muscles and bones -  another condition to add to my list!

......the last 2 months has been something of a roller coaster again starting with all those test in January, the ups and downs and further uncertainty being lobbed over the fence at me  -  constantly questioning, what , why, how come and is there something more that is driving all this.......tumours, spine fractures, or just crappy genetics!?

I went away to the sun to get more vitamin d and warmth in my bones. A nice alternative to the usual skiing trips at this time of year! I thought that the sun would help the pain, but it didnt. I had pain every day. It was devastating. Actually it knocked me back a lot. I had it in my head that living in the heat would really help. Maybe I just need to move to a hot country, but it didnt seem that way even after 2 weeks of hot sun in the Caribbean (I peeled 3 times -  thats how brown I was and how much sun I got, and dont go starting on about skin cancer now........I used factor 30!!). That and getting back to my work schedule (no stamina still so constantly knackered, but I am improving day by day) and of course the daily struggle with my body not doing what I want it to do.

Pain as I have said before is knackering! yes yes, I keep going on about it. I have had a bad couple of months though. I get back from the sun, and BAM into the next downward spiral. In kicks in a round of drinking myself bonkers on a Friday night after a long week (not so uncommon I know),  total denial and utter misery. "Wits end" some people call it. Depression setting back in, feeling pretty wretched generally. I bit the dust again! by the time I got to Easter I was holding down a job and getting through the day and then just functioning through the evening to start the next day. I dont really talk about this stuff to anyone, I put on my face in the morning and get on with it all. You have to dont you!? but it doesnt really help. Actually it gets worse and worse. The more you feel the less you tell and externalise it. You think people are bored, you think people are disinterested -  actually mostly they are, they only ask out of politeness and then you see their faces cloud over.......so this thing grows inside you and starts to eat away........the big black cloud decends and there really doesnt feel like much of the silver lining  that everyone promises and goes on about!

So home I took myself. The lab puppy is now a beast and bounced like tigger when I arrived. Isnt it wonderful the way animals live so utterly in the present? I found myself wanting to take a leaf out of his book........I had a long chat with mum, who with her medical background helped explain that its actually very common to go through this when you have been diagnosed with a lifetime illness or disease. You get angry, resentful, depressed, feel like its not worth it any more. Its tough finding a way to come to terms with a condition that constantly seems to hurl crap at you and make every day a challenge to get through, and all on the outside looks well. Oh the irony! I know that cancer sufferers often beat the cancer and then get massively depressed because the thing they were fighting is gone and they feel a bit empty and goaless. Im just finding a way to deal with crap that goes on day after day, no treatment, no reprieve from the onslaught, no cure!

But I do know that the only person who can get through this all is me! Its my shit to deal with, its the challenge that I have been handed by some fateful signal out there in the ether that has set me this goal. Get on with it, pick myself up and find a way to actually function day to day and find a way of living that doesnt feel so compromised all the time. I do feel compromised. My whole life feels  at times like it has dropped down through a plug hole...... All the sports and activities I love to do -  the stuff that makes me me, or so I thought! I found my riding boots and chaps under the bed last weekend, the ski boots, the sailing gear and the windsurfing kit. I cant use them but I refuse to throw them away! Am I mad or just hopeful that one day maybe there is the slimmest chance I can use them again. Or do I just defy the doctors!?mmmm

I do know that my job, and my interests in art and culture, travelling and music are all still there, it hasnt all gone, but I have to focus on those things to find a lift! So its time to rehabilitate.

WHAT is PAIN?

“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage… Pain is always subjective. Each individual learns the application of the word through experience related to injury in early life...
It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore an emotional experience”. (International Association for the Study of Pain, 1979)

Importantly, this definition indicates that pain can occur without a recognised or obvious cause
and may also be influenced by our emotions.There are other ways of defining pain.




Acute pain
Acute pain is pain that lasts a short time and is clearly caused by tissue damage. This includes minor and major injuries, burns and surgery related pain. Acute pain usually improves within three months. If pain lasts longer
than three months it is considered to be persistent


Persistent pain
Persistent pain (also referred to as chronic pain) is pain that lasts longer than 3 months

It includes:
– pain that has an identifiable or obvious cause (an injury), and – pain that no longer has an identifiable cause
(i.e. the original injury has healed) Persistent pain with an obvious cause includes conditions like arthritis,
spinal stenosis, degenerative disc disease, or persistent leg ulcers. In persistent pain with no obvious cause, pain continues longer than you would expect (e.g. fibromyalgia, which is generalised muscle
soreness and stiffness). In these cases the nervous system misfires and continues to send pain signals even though there may be no damage.
Persistent pain can also be made worse by a lack of exercise that causes physical weakening.
Our thoughts and emotions can also affect how we respond to persistent pain.


When persistent pain becomes a problem

1. Reduced activity, Unhelpful beliefs & thoughts, Repeated treatment failures
2. Long term use of analgesic, sedative drugs, 
3. Physical deterioration(e.g. muscle wasting, joint stiffness)
4. Feelings of depression, helplessness, irritability 

Side effects
(e.g. stomach problems, lethargy, constipation)
Loss of job, financial difficulties, family stress,

Chronic Pain = Excessive Suffering
© MK Nicholas PhD, Pain Management & Research Centre, Royal North Shore Hospital


Because relieving persistent pain can be difficult, it can take time to get back to a fuller, more rewarding life. Managing persistent pain is about much more than just medicine. By being actively involved in a multidisciplinary approach to pain management, you can help your recovery and improve the quality of your life and how you live it, even though your pain persists.A multidisciplinary approach means you consult a number of healthcare professionals, including your GP and possibly a physiotherapist, pain specialist, social worker, nurse, occupational therapist and psychologist or counsellor to develop a range of strategies for you to use in managing your pain. It is important to follow your healthcare professional’s advice. Management
strategies are always individualised, because pain varies so much from person to person. Someone with arthritis may do well with occasional use of an over-the-counter pain reliever, whereas someone else with arthritis may need a prescription pain reliever and regular appropriate exercise to feel good.
When pain persists your role in managing it becomes really important. Remember, there are ways to take some control over your pain. A good way to start is to understand that what you think, feel and do on a
day-to-day basis will have an affect on your pain.

Accepting Pain
Most people who are successful pain managers have learned to accept their pain. This means accepting that although you may not have caused it in the first place, it is now your pain. Pain may bring about feelings of anger, sadness, frustration and grief, and that is normal. However, if these negative emotions go on for long periods, they tend to make pain worse  Whilst you and your healthcare team may be involved in exploring strategies which help you with your pain, at the end of the day it is you who experiences it. Successful pain managers say that they choose a team (for example partner, doctor, counsellor, other healthcare professional) which helps them decide on the strategies that work for them, and they develop a tool kit which they use to manage their pain and which allows them to participate fully in important everyday activities.  Some examples of various tools you might choose are discussed in this booklet. Many people report they are helped by using exercise strategies, special relaxation techniques, choosing enjoyable activities that they pace well, and organising their lives so that there is less stress and worry

A bit of a 'curve' ball!

Happy New. Gosh well it seems a bit beyond that really now that we are at the end of January, but a new year it is and mean as you want to go on!

So, with the new year has come a whole new process, new hospital, more tests, ups and downs to go with it. I saw a new endocrinologist before Christmas -  Dr Cox. He's a totally different type of my doctor in my opinion. One that actually wants to know why and  how rather than just sticking at what! it seems something of a rarity these days to find a doctor who looks at the whole picture -  emotional, full history and even the smallest of things that may or may not have some sort of indicator towards what is really happening, and for anyone suffering from osteoporosis I strongly reccommend that you get your GP to refer you to one. They look fundamentally at the chemistry of your blood, how your body works and reacts to different things such as hormones and changes incurred in your body as a result of stress, changes in cortisol etc, immune issues and even imbalances in the various vitamins and minerals in the body. My specialist is one who focuses on osteoporosis, calcium and hormonal change. On my meeting him the week before christmas he set about scheduling me in for a raft more tests, 48 hour urine, 10 blood tests (what seemed like about 2 pints of blood to me!) and scans and spinal xrays. So the new year and a start back at work full time also yielded multiple visits to St Marys in Paddington, a vast and sprawling complex of buildings, corridors, rooms, machinery and hospital smells! on finally negotiating the maze that finding the Mint building was, I saw the wonderful endocrine nurses, Claire and Amu. Both experts it seems at taking blood, I managed not to pass out, go completely grey and wobbly and not go into panic attacks -  a long history of needle issues, multiple puncture marks in my arms hands and feet in the past, when blood has been drawn from veins, that seem to have some inate understanding of when a needle is coming within mm of them, and then disappearing into my arm deeper to hide from the trauma of that point! from there it was the scanners and xrays.
................and then the wait! until the 26th -  for the low down on what was really going on.
Now this all in and of itself does not sound so bad but that combined with the knowledge that they were testing my very specifically for something called Cushing syndrome/ disease, it was a bit of a shocker! Cushings is an awful condition that messes with the pituitary and or adrenal gland (the one just under the brain) that controls cortisol and other hormones. As one hormone goes mental its like dominoes and the rest go caput too, so this is just the start! when looking through the list of symtoms I seemed to have a rather alarming number of them! among which were severe bruising, sever headaches and migraine, hormonal changes, redness on the cheeks (face!), imune problems identified by multiple colds and viruses, weakness of joints and bones, multiple rib fractures, possible spinal fractures and tiredness. hmmmmmmm tick to all of those! yieks. the treatment for this disease is also really rather nasty so I really didnt want to start indulging in a mental hopscotch on this one, but Im afraid I really couldnt help it. The scenarios run through your head no matter what you try and do to disract yourself. Its a really rather nasty situation, and all I could do is wait for the results to come back. The urine needing to be cultured and tested about 10 different ways!

So I spent the best part of January in a further state of denial and avoidance like the proverbial ostritch! I managed about 15 days on the wagon and then fell off spectacularly by getting mashed on red wine! I put my head down at work, and got on with the job, had early nights, ate good food and tried to focus on the fact that whilst im still aching a great deal and have pain constantly, the level is more like 2 out of 10 rather than the previous 8 or so from september etc last year. Im still on painkillers! yes STILL! I tried to get off them again this week and managed 5 days without any, but by the end of that my back was in terrible spasm, I was struggling to sit up for long periods of time and worst of all I was in withdrawal again.......that addiction issue again. SO Im back on them and weaning off more slowly. It seems being so darstardly tired all the time is also a by-product of my withdrawals!

Right  -  back to the diagnosis. After a much expected sleepless night, which I might add is quite a change in my world of otherwise still needing at least 9 hours a night currently whilst I have no stamina at work, I met my mama at the hospital at 2.45 and up we went to the mint 3rd floor. A long day for the doctors, meant a 1.5 hr wait, and I was seen by the registrar and then Dr Cox himself.

NO cushings. Phew! major sigh of relief. BUT, and of course there is always a but isnt there, good news and bad, part of lifes balancing act! The but is that I have a rather nasty curve in my spine in the upper region across my spine between my shoulders. The part that not surprisingly I have suffered a great deal of back pain in for a number of years! And in osteoporosis terms this is not good news. It indicates, although it is not completely clear if or not, that the vertebrae, at least 2-3 of them have possibly had fractures and are compressing/collapsing (for want of a better term!) and therefore creating a curve or early hunch in my spine. Think old people and hunches and you get the picture. There is not much they can do to fix this, only physio, weight bearing exercises and some specific shoulder and back muscle exercises that will try and keep me upright at best! So, no real surprise now when all pain of past few years is considered! I wasnt just slouching and being lazy! (the picture above shows how the spine starts to hunch! theres a link in the title bar if you want more information on this!)
I should expect to continue having aches in my ribs whilst they heal and strengthen, they will of course take 4-5 times longer to heal, so Im coming up to about stage 3 now, so only another 4 months of healing then!
Im not allowed to take any other medication, only what Im already on for pain management. Im now on increased calcium doses and vit d for next 6 months. magnesium citrate and the other supplements. And now to the scarey bit. They both sugested that having children was really of very great risk currently. They didnt say never, just definitely not now! specifically due to the fact that due to the advanced osteporosis state in my spine (worse than they had thought) I would not be able to carry the weight of a baby on my spine. All the calcium would be sucked from my bones further and weaken me more excessively! its not so much risk on the pelvis at birth, although that could be problematic, but my spine really is a bit of a mess, and carrying a baby would produce many other complications possibly! So a rather nasty shock after the somewhat brighter diagnoses of the previous two specialists later on last year, I seem to have gone full circle on that on. These doctors are focusing on getting my calcium levels back up again and to try and build me up so that possibly in the future I might still consider this. Its really a bit of a shock to think that this might be the blight that actually prevents me from bearing children, but Im focusing on being positive and that in time I can achieve this and with the right support I can have kids. They are also concluding that the depoprovera really has had a rather drastic and negative impact on my body. rare but possible on this contraceptive, so again I repeat please dont take it!

Im booked in for further tests, had more bloods for the red marking on my cheek and got 6 months of being terribly careful and managing pain ahead of me. Its not all doom and gloom at least. Im back at work, loving it, Ive got a close group of friends, Lei, Paul, soph and claudia in particular supporting me and a few special others (afar) keeping track and dropping me a note of word of much appreciated support. thank you. Really, you have no idea what it means. I know its boring dealing with people in pain or ill. I try not to moan!

So, more sun, more vitamins, a bit more sport and exercise is now possible, lots of red wine of course, and after a nice quiet January Im looking forward to Feb and the rest of the year hotting up. Its been a mild winter thankfully, the cold is a total bugger for my fractures and ribs, perhaps Ill move somewhere hot!!! ;-)

I really wish everyone good health and happiness in 2012, seems 2011 was pretty dismal for many!

xxx

A year of contrasts, contradiction and discovery

Well, its a funny thing this isnt it, its 5am, Im wide awake again, eating a chocolate snowman that santa gave me, in fact I just ate his head, and I find myself thinking back over the year as so many of us do as we see one rolling to a close.

Its truly been a year of discovery for me, and not really quite what I expected either this time last year, but nevertherless one of great learning and understanding of the human conditions.

Its also been a year of contradictions -  quite litterally:
1) approval and criticism - Ive been 'given approval', in fact actively encouraged to write this blog and on the flip side critisised for being too open, public and sharing all my 'private' matters with the world. So, it seems that people are divided on my sharing my illness in this way.

2) supported and abandoned/dropped - many have seen my illness and the pain Ive been in as something to share, help and hold my hand (some litterally, others verbally) on this journey, in fact a couple of old friends have shown their true colours and given me wonderful support, and even a group of new ones have been there too -  some conversely have decided that its not worth the bother and those that I thought were particularly close to me in the past couple of years have 'abandoned me'. (nb: moment of self pity whilst I peruse the list of 'close friends' who have barely spoken to me all year......I guess they werent so close after all and I was just dim for assuming that they even gave a s&*t about me, either that or they are those 'good time people' who only want to spend time with fit and healthy fun people(see earlier blog post)! -  thank god for REAL friends  -  you know, the ones who hold your hand through thick and thin, good and bad, illness and health .  And yes I am aware that in writing this Im even less likely to actually hear from some people as they take massive further offence at my public moanings......ho hum, I guess its what they call in meditation as 'cutting the cords' -  letting people go  -  although actually that is meant to be with sympathy and love and forgiveness. DO I forgive them  for hurting me?.......YES (although they probably think they should be the ones to forgive me and that Im being incredibly patronising by even suggesting that they hurt me!). I have to. Id be heart broken otherwise. Depression is hard enough to deal with without having to feel bad about all those people hating me as well. I have come to realise that some people just pass through your life -  REASON, SEASON, LIFETIME!. Some, conversely, stick around, and some love you no matter what!. As I mentioned in a previous blog -  its something to do with survival of the fittest - some people simply cant cope with sick people or those struggling with stuff. Those of us that have had to deal with those things perhaps are a bit more self aware and more able to be compassionate, understand and stick with it, and support and understand those who need it.

3) Ive liked and lost and learned. Back in June when I was diagnosed I was going out with a chap who all he wanted was a stable relationship and to settle down -  just not with someone who was sick! That one rocked my world as I contended with both a diagnosis and being 'dumped' for it -  on the same day!!!.......honestly, it made me feel utterly unlovable and like no one would ever want to spend time with someone as broken as I - and I thought love was supposed to overcome that stuff. Again, in counter to that I was told by a lovely man that I was like fine china and could still be loved and cared for, just a bit more delicate than the standard dishwasher fare that we use day to day! (I always knew I was the royal doulton stuff and not ikea ;-)

4) time flies, and can go SOO slowly. With months of staring at ceilings lying down, drugged out of my mind on painkillers, time has seemed to stop at times. I couldnt focus on the tv, reading a book, barely could a magazine hold my attention for more than 5 mins at a time, would forget what I was saying half way through a sentance. Time seemed to float and drift in a bubble of nothingness. And yet I have no idea where this year has gone. Its disappeared so fast, I feel as though I have lost whole months of my life (in fairness I lost 5 to severe painkillers and morphine!) I know as we get older, time seems to speed up. Im used to filling my life with events adventure, people and places to justify the speed at which time seems to pass. Its been a quiet year on at least 3 of those 4 for me this year!

5)Highs and lows - god this one covers everything.
Firstly - diagnosis highs, followed by further opinions that disqualify previous theories or disagree with previous thoughts leading to lows of new things to deal with, more tests, more hospitals and more disagreement as to how, what and why!
Secondly, love and hate. I love my friends dearly and believe I am loyal and honest with them, perhaps my fault here is I say what I feel -  at least im what I say on the tin and not a bullshit artist specialising in hoodwinking and pandering to people. I find myself feeling constantly hurt and low by peoples actions, possibly I have bought this on myself and deserve it, but there seems such a willingness amongst some to just drop you at the first sign of disagreement, illness, sadness, weakness, disapproval. Maybe life is too fast now and we chuck away friends like we chuck away white goods -  we cant keep up with everyone so have to find the smallest reason to cull and cut back to make our worlds more manageable for our own shit to be dealt with! people are as disposable as broken gadets! hence there seems to be a lot of hate. that makes me sad.
Thirdly - kindness and bitterness - the highs and lows like sugar rushes from eating too many chocolate snowmen no doubt!  one seems to trade the other. like happiness and jealousy! if you are happy someone is always jealous. if you are kind or have experienced kindness, then someone will try and kill it with bitterness and nastiness. these are lifes balances and I guess we wouldnt appreaciate the good stuff it the bad didnt also happen.
fourthly - pain and no pain -  drug induced coma type bluriness of cotton wool and marshmallows and fluffy clouds, followed by the neausea of trying to stand up or roll over, stabbing pain, muscle spasm and feint head as you roll back in a screech of dismay.
fifthly -  work and no work, brain and no brain, engagement and boredom, productive and unproductive, tasks and teams and none of these. These are the contrasts and highs and lows of being off work incapacitated. Getting back to work, my team, my friends there has been a total joy. I never realised how important a nice job, good colleagues and getting stuff done and feeling needed by that was so important -  perhaps I took it for granted before, perhaps I didnt really like my job (I do now) and perhaps I didnt appreciate what I had  -  but I certainly do now.

And finally glass half full (never half empty!) -  I have certainly proved to myself that despite all the crap this year (and in previous others) that Im definitely a glass half full optimistic type of person. Ive endured some shitty stuff and come through it all -  I was attacked and beaten up living in Russia years ago, Im divorced, Ive dealt with alcoholism(not me but someone close to me who suffers), depression (family friends and self!), verbal and mental abuse and a lot of pain, sadness and illness around me and with me my family and friends. BUT what I do know is that I climbed a mountain last year despite back pain that I thought would destroy me. I did it against my own odds. I recovered from all the items above and have learnt from them. out of something shit always comes something good.
People are generally good, but often stressed, confused, hormonal, in pain, having a bad day, lost and therefore it might be something other than what you think, that is upsetting them and hence affecting you!
If you smile people cant help but smile back. If someone is having a bad day, ask them if they are and they will be surprised that you even noticed.
If you complain people are more likely to dismiss you.
Most people hate hearing the truth, so either dont tell them or know that if you do they will probably react badly to it, so accept your choice to tell them  unless of course you are telling them how fabulous and wonderful and important to you they are!
We have a choice with everything we do and everything we say, to whom and when and how. We dont have to be victims in our own little worlds, we can take control and do our best to combat everything that is thrown at us.

My new years reslolutions are to focus on compassion, health and wellbeing, and of course LOVE. I will forgive and forget and pray/ hope that others will overlook my shortcomings too.

a 3rd opinion - another a new diagnosis - were the others wrong!

So only a couple of weeks ago I was celebrating a diagnosis that in fact seemed like it was quite reasonable. However, this was from the osteoporosis specialist in rheumatology (bones and joints) -  and now I have seen an endocrinologist (hormones, blood chemistry and how the body reacts to stuff)!

Dr COx is a dream. ok so he is quite tall and good looking too, so that is a huge plus, but he is the first doctor to take such a full history, look at my tongue, pulse, reactions, backpain, skin condition, liver, kidneys  -  you name it he tested it! it was THE most reassuring medical interview of all. (and he spent 40 mins with me rather than the 10 or 15 I got in diagnosis from the other 2!)

Now, as I mentioned before -  Fogleman had said it was genetic, and not only that but when he wrote to me afterwards actually had the cheek to add that he thought I had been 'unlucky' with so many breaks and perhaps accident prone, and had no idea why I ahd had so many breaks and that it was unheard of in his experience!!!. So he dropped about 10 miles into the depths of the earth in my opinion. NO NORMAL PERSON breaks from a hug for gods sake!that is not just unlucky! thats a major problem in my opinion! SO the temporary excitment of a couple of weeks ago had descimated into no mans land of somewhat disgruntlement.

But, then I have a final appointment this year with Dr COX. After a VERY long wait to see him, he reviewed all my previous tests and as I said, looked in to all the other aspects of what might actually be CAUSING this problem and not just dismissed it as bad luck or unfortunate or even just low bone density all along.
SO what was the outcome!?

Where he did agree is that the depo provera is a likely catalyst for me in decreasing my bone density so rapidly. he also siad their is a small chance that I might have had low bone density all along, but given how robust I ahve been until more recently, with a lot of sports, adventures and exercise that he feels that is more unlikely. He is looking at the hormones, the blood quality, urine, the overall chemistry of how the body reacts to drugs, food, illness, stress, you name it, basically how the body is changing in these conditions.
He feels the long period of stress in my life over the past 10 years has been a factor, the depo is a factor, but he was VERY concerned about the bruising I have suffered all my life (not normal at all apparently!) the migraines are a factor, and previous breaks and illnesses such as obshgood schlater disease I got when I was growing (in my knees) are all indicators of something else going wrong in my body! It is a great comfort to me that this man actually wants to understand WHY and not just diagnose me with a problem and then brush me off!

He also agrees that there is no current relevent drug that will help me -  all the biphosphenates are horrid as mentioned before,and he says would be far too disruptive to my body in the immediate term, especially if I still want kids at any point in the next few years. the only option, should I continue to suffer breakages is to take a hyper parathyriod drug that helps increase bone density rapidly, but that I should have in high levels and only for a short time. but he said it would make me feel ill due to the dose levels -  there is always a trade off I guess. He does believe that my bone levels are significantly low to be greatly concerned and that I should be very careful and even expect more breaks -  so perhaps skiing is not such a great idea just yet.

Finally he does believe that now Im off the depo and that my cycle has returened that my body will start to regenerate some of my bone density on its own. Basically the depo shuts down the production of oestrogen, and s bone loss is caused by the calcuim being pulled from the bones to suport the hormone system in the meantime. With the return of oestrogen (and much to alls surprise - a significant increase in bra size!) my body can then focus on keeping the calcuim in my bones and even restoring it to more normal levels. by contiuning to take the K, magnesium and calcium this will be encouraged further. so 2 glasses of milk to be drunk a day and continue with my suplements and the Vitamin d now to be taken every 2 weeks instead.

In january I have to have a spine xray - he is concenred that the damage in my back is in fact due to fractures there too, so best to rule it out if possible. that would certainly explain an awful lot f the back pain I have had over the years!
I have to do 2 days of urine collection and tests, with a number of steroid and blood tests to test my bodies' reaction to various things and how it combats or not certain things like changing hormones.
It means January and the new year will be starting with a whole new round of hospital visits, needles and machines, as well as hours more in waiting rooms and so forth, but it is encouraging that this doctor really wants to know what is going on.

SO a final step towards actually finding out how in 18 months a person can endure 21 fractures and breaks in their ribs (and possibly now my spine too!)

onwards.........................................

some tips for living and dealing and managing OP naturally

Im am an advocate of trying where possible to stay off drugs that we dont really understand the long term effects of. Therefore I constantly look for articles and new and interesting research on how to live with this disease. Diet, exercise and general health and positivity are of course all major factors.

Jack Kruse is a physician who specialises in OP and says the following :

"Osteoporosis is conventionally thought of as a disease of aging.  That has to stop because it is old school conventional wisdom.  What is closer to the truth is the patients diet.  The worse the patients diet is the more likely osteoporosis will be present regardless of age.  The younger generation has massive unrecognized osteopenia present because they have lived surrounded by processed food.  This is due to the SAD which causes high inflammation levels, low vitamin D levels (from lack of D in the diet), pregnenolone steal syndrome (reducing formation of D in body) and liberal use of sunblock and lack of outdoor activity to gain sun exposure.




WHAT IS THE OSTEOPOROSIS RX TREATMENT:

1.  Cortisol must be neutralized after its elevation can be found.  The most common reason is LR today in the USA from a SAD loaded in carbohydrates.  LR nullifies Wolff’s law.  Diet modification to a high fat and high protein paleolithic diet is treatment option number one in most cases.  Renal osteodystrohy is one of the few causes where protein has to be limited, but fats can be used liberally to support bone mass.  Pastured butter (K2 source) and grass fed meats with eggs and bacon and coconut oil is preferred.  All the hormones that are anabolic for bone formation are derived from LDL cholesterol in our diet.  Vegans should pay close attention to those biologic facts.  PUFA’s and carbohydrates should be extremely limited during treatment to avoid future fractures because they generate inflammatory cytokines that favor disease progression.

2.  Age and weight are not completely indicative of real bone risk.  Inflammation is and it should be followed clinically to assess risk.  Bone density testing is worthless unless a wrist module is added to it.  I have had patients in their 20’s paralyzed from osteopenic fractures.

3.  Smoking carries a 100 fold risk of developing osteoporosis. It must cease for any treatment to work

4.  Excessive drinking also elevates the risk.  More than 4 oz a day is a problem.

5.  I personally avoid all conventional osteoporotic drugs because of side effect risks.  In surgical cases I now completely avoid the use of all synthetic derived bone morphogenic proteins in older patients with osteoporosis.  (InFuse by Medtronic)

6.  I use high dose Vitamin D3, K2, Magnesium, in doses based upon lab data and  on the severity of disease.

7.  I replace all sex steroid hormones to the top quartile found in young adults.  Bio-identical HRT are preferred.  I avoid synthetic hormones at all costs.  Often this is tough because many physicians are not aware of the organic chemistry of why synthetic hormones are suboptimal for the human steroid receptor.

8.  Exercise is an excellent treatment for osteoporosis.  But one must remember that if one has LR exercise exacerbates the risk of fracture because Wolff’s law is null and void.  The Exercise Rx (written below) requires Wolff’s law to be operational to work.  Too often it is not.  Exercise will increase growth hormone secretion which is very anabolic for bone mass accrual.  Most older people have horrendous GH levels measured by IGF-1 levels.  In people with IGF-1 levels below 100,  I recommend use of arginine, ornathine, turmeric and resveratrol because all increase bone mass.  Resveratrol increases bone morphogenic proteins directly.

9.  Walking is a great start for those who are debilitated..  I tell my patients to park far away from doors to facilitate walking.  I encourage water aerobics because of its low impact and its good skeletal effect’s even when Wolff’s law is null and void.  I also encourage yoga and meditation for endogenous control of cortisol.  Biofeedback is also a consideration if it is in the budget.

10.  Strict avoidance of NSAID’s and steroids for all osteopenics or spine fusions die to bone mass losses.  These medications also cause a leaky gut and gut dysbiosis is a major cause of persistent inflammation and bone loss.

11.  Any stressor should be aggressively treated.  I usually will double doses of D3, K2 and Mg during ICU or the preoperative times.

12.  In older patients I trim back all meds that cause osteoporosis and I advocate strongly for hormone replacement.  Progesterone is the critical for women and testosterone for men.  Estrogen and testosterone are added often to women’s treatment plan by their PCP’s or Ob/GYN’s

13.  I try to limit radiation exposure to all patients with osteopenia because of its effects on bone stock.

14.  I have all thoracic fracture patients follow up with their lung specialists because each fracture limits pulmonary functioning by 5-8% and is a major cause of disability.

15.  Any spine fracture should be aggressively treated surgically as soon as it is diagnosed on STIR MRI.

16.  I keep an open dialogue with patients and family about bone risks going forward and make sure they know what to discuss with their PCP’s going forward.

17.  An ounce of prevention really saves a point of cure with this disease. Mobiltity is the key to optimal recovery.  We want patients moving naturally as soon as possible to stimulate bone formation after the diet is optimized.

18.  I do not advocate any use of Calcium with this disease because I mandate a change of diet and this diet provides ample Calcium and there is no need for supplementation.

19.  In the severe cases I will ask for an endocrine consult to consider Forteo and PTH if it is warranted.  This is quite rare but can be a huge help in complicated spine fractures in older patients.

20.  I advocate sun exposure for natural Vitamin D production in patients with low 06/3 ratios.  This is outlined in my Vitamin D blog.

FALL PREVENTION AND THE EXERCISE RX:

After the diet is re tooled to a paleolithic diet and the underlying leptin resistance is dealt with everything should be done to prevent falls that can cause fractures.  This is where exercise comes in.  I am a major advocate of lifting weights for both men and women no matter their baseline condition with this condition.  If the patient is wheelchair bound they can lift dumbbells while they watch TV and wear weighted ankle and wrist bracelets.  The reason is simple.  This will restore bone faster than any single thing we can offer once the dietary problem is repaired.  Men and women with osteoporosis need to take care not to fall down. Falls can break bones and are a major source of disability.  Once mobility is limited the death rate can begin to grow exponentially.  The goal is to restore natural mobility as soon as possible in this disease."

its all in the genes!

Well well well, I saw professor fogleman today. He is the leading specialist in Europe for Osteoporosis based at Guys Hospital in London Bridge. I have waited 3 months to see him in his clinic after my mother tracked down his details through references and a bit of research.

Fogleman has conducted many clinics and trials and has seen a broad number of people with this disease, of all ages. His appraoch and understanding seem pretty comprehensive and I have to say that having seen him now, I feel that it was definitely the right thing to push and find the time.

He reviewed my full history, breaks illnesses throughout my life, eating, drinking, smoking, you name it. THen he reviewed my scans and blood tests from September when I was in hospital.

The outcome -  its Genetic, and more surprisingly he thinks Ive had this ALL MY LIFE! Now theres a revelation! so after all the ummming and ahhing its a diagnosis. It is genetic -  thanks mum and dad -  its all your fault ;-) dud genes!
so what does this all mean. Its easier I think to list the points:
Ive always had low bone density issues.
I have broken lots of bones (yes we know!)
I have a good diet, never been anorexic or had other diseases that would bring this on.(chrones, hyperparathyroidism etc)
I am generally fit and slim and healthy - thanks but I reckon Im carrying a few extra pounds that need to GO, (but thats due to 21 breaks in 2 years and a complete lack of mobilitiy for the best part of 12 months!)
He cant understand why Ive ahd so many breaks in my ribs -  Im a total anomally and utterly unique -  in all the years hes been practising hes never seen anything like it
I can have children but just would need to be very closely monitored, have a good gyne, and possibly c section to avoid issues with pelvis.
(breastfeeding will increase my bone density issues and worsen them but they will recover in time once I stop)
I can lead a pretty normal life as I was before, but just a bit more caution in certain circimstances -  and yes that means I can still SKI!!! yipppeee. as long as I dont crash or get wiped out by some nutter snowboarder out of control! (so a relaxed and calm skiing trip then ! sounds like half days and plenty of apre to me!)
horse riding is not so recommended but a stroll about should be fine -  no cross country madness!
I can continue sport, healthy exercise and healthy eating with plenty of good stuff in my diet
continue taking vitamin d and the magnesium, k, c and calcium

so what is the but!!!!!?????

well yes there are drugs that would help but he conceeded that given my age and situation they are still too agressive would make me ill and affect other parts of my life -  so thats consistent with previous discussions, but he did say that the biphosphenates drug would help in the instance that I keep on breaking. that is a later discussion!

so a happy outcome after a traumatic year of inactivity, weight gain, massive pain and huge numbers of drugs, incapacitation, multiple breaks, a sore back, dislocated ribs and of course being off work for 5 months.

roll on 2012  -  its going to only get better from here.

xx

....like a seive!

.......and Im not just talking about my memory!

Another day another 20 accupunture needles! I feel like a pin cushion, or even, yes, you got it, a seive! Today the wangerama dealt with recent batch of sleepless nights, a fresh and snotty cold and sinus pain and finally a bunch more headaches -  the migraine variety! The number of those have increased since Ive got my hormones back, so more regular now on  the monthly cycle, but there are the random ones too!

Am back at work part time now, brain busy and feeling more positive, if somewhat tired. Body is getting a bit stronger on a daily basis though and my stamina is definitely improving. Only thing I seem to have noticed is that Ive normalised with my pain levels. It is constant in my ribs, and cold days I do notice it more, but Im pretty stuck on current level of pain killers, less and I cant do much, more and I do too much as cant actually feel any pain. I sort of need to be on the knife edge between pain and not , so that I can actually manage what level of activity is realistic and feasible.

Yes, Im starting too to fantasise about running again, doing some exercise, maybe even some pilates classes, as, with every day the ribs heal a tiny bit more, the stretch is less, the stamina is better and so life feels a tiny bit more normal. I read daily updates on Inspire about peoples' cases of OP and how they suffer and how they manage. I do weirdly seem to have a ridiculous record of breaks in a year.........21 seems to take the piss a bit in regards to others stories. 1 is bad, but 21 unreal......and thats my story. I feel the bubble ever more around me.......a sort of surreal and parallel universe.......where did this year go, how have the months slipped by, well I suppose the fog of killers and pain and spaciness from all the drugs is enough but it does all seem like it sort of happened to someone else. isnt it funny how the mind can trick the body. Im actually no better really than a few months ago. my spine readings are still horribly low (-3.2 T score -  thats pretty bad by the way as many with this disease have readings around -2.5! -4 is even worse and more rare!). My bone density is basically shocking still and the fact that you can squeeze me a few times and I break is pretty scary, however, the one HUGE difference for me now is that the pain of so many breaks is finally relieving itself. Assuming no more accidents, bear hugs or drunk colleagues fall on me then I should be alright. Im avoiding the rush hour traffic, got great at negtiating round pissed people, no bicycle action, horses, sports or wayward dancing! and all this alone is allowing me to feel a bit more 'normal' a bit more functional and like actually life might now beat me on this one.

A close friend recently compared me to a fine bone china......I like that comparison......a fine and somewhat fragile cup and saucer that is handled with love and care......and NOT left on the shelf just to look at but can still be used daily if you just handle with a little bit more thought and attention.......you dont bung it in the rucsack, picnic basket or jam it in the dishwasher......but there is no real reason not still to use it and enjoy the tea in! so a mental shift from humpty dumpty to fine china is I think a more positive and fitting approach.

Wangerama (Dr Wang my chinese doctor and accupuncturist) is funny. He told me I look young and vibrant today and he thinks Im very 'powerful'  -  his words not mine! he basically said that he thinks the fact that Im getting on with work, that Im still living life, that Im out there and not being a victim is the best thing possible. If you sit and moan and feel sorry for yourself instead of just getting on with it, not only is it all a bit depressing, and an ever decreasing downward spiral but its a negative state of mind that will never help -  (I know it all sounds a bit obvious, but its not always the easiest thing to do!). He told me the fact that Im back at work is massive as many of his clients with ME/ MS/ stroke victims, bone cancer and disease and even fertility issues, just give up and allow themselves the excuse of the illness/disease to sit about and feel sorry for themselves. His belief that positive mind = positive body and thus faster progress and recovery is the key. Its reassuring to hear this from him of course and I dont think Ive ever really allowed myself to be a victim. Yes I still have spectacularly bad days where its all a bit beyond the pale of actually getting my head round this thing, or dealing with the constant aches and pains, or the random shittyness that I can feel, either emotional or physical and vomitty. Ive just had to accept that this happens and this is just the way it is. No big deal its just part of how it is now........and when I do that it somehow doesnt feel so bad. I think I do have an occasional moan Im sure (apologies now if you are the one that gets it!), but Im also quite bored of sounding like I moan all the time in my own head, so Id rather just not comment and talk about the other persons stuff where possible! PLEASE JUST SHOOT ME OR TELL ME IF IM MOANING A LOT! apart from anything else, its just not a good state of mind for me to get better and through the day with. AND YES, when Im having a bad one, I turn on the cheesiest tune I can as loud as possible (when Im at home) and have a sodding good sing along......it works a treat! that or kicking a huge pile of leaves in the park is working too!

so my friends, life is rolling on and the tick of time continues in its consistent and unrelenting way of plodding forward..........but with it eases pain and boredom, and health and positivity return! Time heals......of course it does, but so it seems do a few needles and a bit of encouragement!

denial and a good cry!

Over the past few weeks I have been trying to really confront, research and learn what osteoporosis really is and what it actually means for me and my future. Frankly it all looks a little bleak, and its been something of a shock to really get under the hood of what it all means.

Ive joined a number of sites the best of which seems to be the inspire site that helps bring sufferers together to discuss and share and support each other. As well as people sharing their stories (more on that in a bit) it has diet, nutrition, drug and all sorts of personal and direct experience info on it that provides the greatest insight into what can and cant be done proactively and from research and side effects of many of the drugs.

Im not currently being treated with any of the known and recognised OP drugs as they are deemed too severe, nasty, aggressive, horrid side effects such as bone cancer and infertility -  all a bit bleak, and predominantly only for post menopausal women or much older people. So where does that leave me (and my fellow sufferes wiht this thing at such a 'young' age? Well Im taking 20000units a week of Vitamin d as we know. Thats it and a bunch of other supplements to try and help that absorb into my bones. Without the Vitamin D, K doesnt absorb, C doesnt absorb and neither does calcium, so they are all linked. I also referred to the fact that Im bruising a lot and it seems this is an outward sign of these deficiencies too!

The site though gives a lot of advice from people taking a number of of the drugs, their bone status, pain, conditions. To summararise a few of the cases and people on there:
28 yr old girl in SA who has -4 T scores, several broken hip issues, ops, and little support, medication etc. shes pretty incapacitated and also wants kids but being given no advice by her doctors on how viable this even is.
chap of 30 diagnosed with OP. lot of pain, again incapacitated. no treatment either
people in mobility scooters in their 30s and 40s (as well as much older) breaking bones hitting lumps in the street. people bending over in a chair and breaking bones, carrying heavy things and breaking, spines shortening and people loosing several cm and inches in height........33 yr old male with 2 breaks in his spine (readings are -3.6  -  mine are -3.2) requiring critical ops on his spine and not being elligable due to his condition.......!!!
These stories go on and on. Its pretty dire if Im honest. I only feel thankful that Im not dealing with all that, just a bunch of broken ribs and a lot of pain!
BUT - there are the success stories of course too. cases of very careful diet mangement, cuting out red meat, keeping diet more alkaline (acid erodes bone density) special cook books, and fitness balls that help increase bone density in the lowest impact way so as to avoid breaking. Some people are maintaining lifestyles, running and still playing some sport like tennis and even one lady still skiis, but that is after years of building back up her bone density. its a risk, but then I guess crossing the street is too.
I know of a lady who died on impact in a car accident recently. There is much debate about how much her osteoporosis contributed to her injuries, but the facts arent encouraging! its a shock to lose someone anyway, but knowing that a disease like this exacerbated the situation only makes it worse! my thoughts are wit the family.

So where am I? Well in all honesty i tip back and forth between super positive, fighty and strong, to an utter emotional wreck. Putting a brave face on and just getting on with things is sometimes just utterly exhausting, but its the only way I seem able to cope. But I also have days where I pretend that none of this is happening and have a day/ night off from being me. I drink and party and do too much and pretend that Im fine. Its a lifeline in small doses as it lets me feel normal, but the fall out the following day is huge. Physicall vomitting and sickness, cant get out of bed, shaking, sweats, pain and aching. Its all pretty grim. So you ask is it worth it? WEll at the moment I believe yes. To be able to go out and chat and be ' normal' and have fun and socialise like before is good for my sanity.(even if its not best for my body and my health!) It makes me feel better and strong and like I can get through it all. I need that. But I do also recognise that its a strong vein in me of utter denial and not really wanting to face up to it all. WIth knowledge comes power, but so also often comes pain, worry, understanding and of course denial!

I dont let this out very often, my modus operandi is to just get on with it all despite being tired or a bit overwhelmed, I dont want to go on about it all the time, I get bored talking about it. I get bored of being ill and being me. and I hear in my own head how shallow it can seem to others, that this is a disease that might not instantly kill me like cancer could, but it is a long running, debillitating disease and somehow because Im fine on the outside (right now), I cant really complain. Ive got plenty of good stuff to celebrate after all.

I have wonderful family and friends who are looking after me. I have a supportive job and company helping me get through this so I can find a way to keep working and be effective in my job and still be independent. I have a big bubbly personality and a glass half full approach to most things so that all keeps me going.

And then I have moments where I just explode and cry, usually I might add on my own in the privacy of my own home -  the cat looking on! People say crying is good. Its an important way of healing, of getting the stress out, of just deflating a bit. Its cathartic and therapeutic. I think in the past 4 or 5 months since I was diagnosed I have had a good cry only maybe 3 or 4 times. Something usually triggers me. A friend not being supportive and feeling dissapointed by it, or someone being truly kind and thoughtful and holding my hand, or even just watching some crap rom com on tv. it just comes out. But that is good I guess. Im not really a cryer I dont think, but maybe I should do more......maybe its also a form of acceptance I guess too. Another step in the process.

I mentioned the cat. Well he really does have a 6th sense and a remarkable capacity to just know when Im feeling bad. My baby bear is just there right beside me when Im wobbly or having a low day, or the pain is bad. Animals truely are healers. I cant think what life would be like with out my little bear. He is my shadow, and sticks like glue. Thank you Louie.