Let's talk Steroid Induced Diabetes

 First off... This is just my opinion and how I changed it.

In 1999 and 2000, I was battling chronic rejection of my double lung transplant. Back then we got hit hard and fast with steroids and changed from Cyclosporine to Prograf to help control it.  All this caused me to be diagnosed with steroid induced diabetes.

I was put on insulin and began checking my blood sugar 4 times a day. My Primary Care at the time sent me to a three day Diabetes Management class that was extermely informative. First, we discovered that the insulin I was on wasn't what I should be using. I had serious side effects and it was recommended that I make a change to long acting insulin. Once changed, no more side effects. I learned to combine meals for effective control, drink tons of water, exercise even if minimally.

Through all of this, I had lost down to 90 lbs, on oxygen, in a wheelchair after 30 days hospitalized in Pittsburgh for Thymoglobulin. I was fighting to get out of that wheelchair and walk ! I had to walk to stay listed for a second lung transplant. I also had to lift 80% of my body weight with my legs. Once I was able to lift 100 pounds, there was no turning back for me. The Doctor said I could ease off.. Nope. not me. I had room to gain weight and it not afffect me  :)  This was a bit further down the road.

In all of this came the Diabetes. I felt this was one thing about my health that I could control. Yes, there were times I wanted to scream. Times I wondered if I could eat anything, without causing my blood sugar to rise. My blood sugar was so high at time of diagnosis that my vision was blurred. It had to be controlled quick. I was also so thin, there was no place the needle, no matter how small a gauge did not hurt. I was covered in bruises just from this alone.

As I started testing, I began to see a pattern. Certain foods affected me more than others. I'd already given up sweets. I never truly cared for them much anyway. I only wanted something sweet at rare times. 
I was walking very slow.. A turtle could outrun me with ease. After each meal, I began taking a short walk around my apartment building. I had to use a cane because my legs weren't strong enough yet, and my breathing was labored.  This one short walk, got my blood moving and my sugar dropping ! Eureka... could this be all there is to it? Bolstered, I began to push for more walking.

I had also given up potatoes, rice, noodles, anything fried and (my nemesis) bread. I became a control freak ! I thought if I can control this, it's my responsibility, that is one less prescription I have to take ! After a few days I felt better physically. After a month I said goodbye to the cane !  And after 10 years of being insulin free with good blood sugar readings, it isn't checked anymore when I go into the hospital. This was major elation for me !  I proved to the medical field that we as recipients do not have to accept that diabetes will happen, but if it should happen we are more than able to control it without medicines. 

Now, I can eat what I want, though I combine my meals. If I have this at breakfast, I don't have that at dinner. Life is a series of give and take. And. I. Walk. everyday, twice a day if possible. 

That three day Diabetes Management class was the best class I was ever sent to. I learned and now practice so much from it.

Control what you can, give the rest to your Team.. and remember.. Water...Water...Water.. drink it like a fountain !

Once again... This is my experience only. If it helps you, that's great. If not, don't shoot the messenger, please.

Photo from a bracelet I have, and the poem The Dash.

Struggles

 Everyone has obstacles in their life. For some, it's a  flat tire and late for work. For transplant recipients, it seems as though we are in a constant struggle to get healthy. We feel great. We get sick and have to start back at the beginning . Continually..

Immediately post transplant we want to go out and conquer the world. As years pass, our medicines take a toll and aging of our new organ creates some nasty side effects.

I'm at that cross roads. We're trying a new direction in treating my antibiotic resistant Pseudomonas.  I've stopped all nebulizer treatments.  Amikacin made it so I could barely get out of bed or make it through the day. Collistin tightened my airways so I could barely breathe.  I struggled with the known side effects of inhaled Tobramycin and lost. 

I now see a local Infectious Disease Specialist and Pulmonary physician. I was told the Tobramycin could cause hearing loss, what I was not told the loss is permanent.  Since it affects the inner ear, loss of balance is a huge problem. I was starting to notice that issue, as well as painful tinnitis.

Yesterdays walk was a little slower pace. Today was at a snails pace. Granted we had high humidity too. My low grade temperature is back which means it's time for IV antibiotics again. We're treating with antibiotics - only- right now.

Instead of letting all this get me down, I will keep trying that walk. Remember... accomplish one thing each day. If that's all you do, you accomplished that !  I Downed a few Tylenol and drank a little Root Beer to settle my stomach. Took a short nap and now feel ready to face the afternoon. 

This wee squirrel was my motivation on my walk.  He ran down the sidewalk right up to me before realizing I was real.  Looked twice and scampered off.  He gave me my morning laugh.

Find joy in each day.

Don't let negativity to rule you.

Take that walk. (Accomplish)

Lost In Life

 Wow! Has it been almost two years since my last post ?

I blink and life speeds by at the sound of light ! We can all attest that 2020 was pretty much a blur with a pandemic (darn Covid) and the ensuing panic. For Lung Transplant patients this has been more like another day at the office. We wear masks when in public,social distance and generally take it carefully 24/7.

I had four hospital admissions and five rounds of at home IV antibiotics from April through December. The Pseudomonas in my right lung was rearing its ugly head again, plus pneumonia taking up residence didn't help much either. The side effects of no appetite, no energy and the GI issues made life .... well to say the least.. it was interesting. 

Out of all that, I think the most unappealing was the way mask wearing was made political.  Wearing a mask is NOT political. We do it all our lives. Cancer patients undergoing chemotherapy do as well. So to hear others call me a sheep or tell me I'm wearing a face diaper is the height of ignorance. Remember the old saying. Never speak harshly of another unless you have walked a mile in his shoes. Well, it clearly applies here.

I digress. This blog post is about my push to regain the bit of health I can control. It has taken me three months to get back to where I was pre hospital admits.  My oxygen sats were dropping into the upper 80s. And my spiro was disappointing at best. I had almost convinced myself it truly was my time and I wasn't going to beat this again. 

I made an apppointment with my local Pulmonologist as Telehealth visits weren't working for me at this point. I was losing a pound every two days, getting weaker and the struggle to breathe, I hadn't experienced in decades. I. Was. Worried. My entire visit I wore a pulse Ox on my finger. She noticed right away that once I coughed and cleared my airways, my O2 sats skyrocketed to 97 ! I have been saying this for years. Clear my airways and esophagus and I can take control. A six minute walk was done. At two minutes my sats dropped to 86%. I put on oxygen and once again they went up.

I now have oxygen to sleep with at night. I breathe very shallowly when asleep,. Plus, I have a portable concentrator for outings just in case. The better I feel the less I need. So far, just sleeping with oxygen at night gives me the boost I need to make it through the day without additional oxygen.

So... now to the part that is up to me. And there is alwys a part that we must take in our health. The doctors and nurses can only take us so far.  I was walking around at a wishful 0.5 miles an hour for maybe  five minutes before I had to sit down. I didn't let it get me down. I did something, if only for five minutes. I kept telling myself, soon it will be more. My morning walks are now at 2.5-3 miles an hour continuous for 20-30 minutes plus I stay busy during the day, laundry, grilling and such. Even trmming shrubs ! 

Today, well my mind tried talking me out of that walk. Maybe take a short one it said. No I replied, I'll beat myself up all day if I do. But, you don't feel up to it my mind shot back. This played out in my head until I hit the  halfway point in my walk. At which point I told my mind to shut up,yes my sides ached from breathing, but I was doing this. 

My point is... It's mind over matter, but it doesn't always have to be. Even if you don't feel like that walk or whatever your facing, take that first step and try. Now, my day is brighter because I accomplished that one task my mind tried to defeat me on.

Have a wonderful day and enjoy the good things it has to offer.

Changing Outlook

     Today, driving home from yet another doctors appointment, I thought about my outlook on my life.  Many of you know, I choose to not always "update" or post about what my daily life is about on Social Media.   This is a conscious choice.
In the last 5 years, I've been more instrospective and not having anything to say on certain topics.  I realized that hearing my lung transplant team tell me there was nothing more they could do for me (5 years now), hit me mentally harder than I thought. Yes, I'm determined to prove them wrong, but it does take a toll on one hearing that kind of news.  A person never gets used to it.

     Why post about my daily struggles ? Because no one really needs any more to bring them down. Many choose to allow too much negativity in their daily lives already.
I see no need to be Social about my pain, and anything else that goes along with my many surgeries.
I would rather bear this Cross I've been handed with dignity, and allow you my friends to lift me emotionally throughout the day. That is what friends do, right ?

Plus my Momma always said, if you have nothing nice to say...... in the days of social media- keep scrolling. 

     I find that instead of letting my life get me down, I try to find joy in the simple things- EVERY day.
While I was waiting for my 2nd lung transplant & on oxygen (again), my day started with sitting outside on the step, with a cup of coffee welcoming the sunrise. I could have hit FaceBook with "I didn't sleep again !" or "I'm so tired and exhausted "  instead I find that positive ray of sunshine to brighten my day.

When Nelson drops his tennis ball while I'm eating, I get up and play a few minutes of fetch. My food can wait. Time with Nelson cannot. He's happy, it warms my heart and makes me smile.

My morning is best spent sitting in a lounger outside watching him wait for squirrely or chase lizards.  The simple things can bring so much positive into our lives.

 A simple touch from Larry, or one of his practical jokes warms my heart. It means more than any store bought item he could ever give me. It reinforces our life together, & gives me that much needed boost to keep fighting.

Laughter and smiles- that's the key. So let's stop the name calling, finger pointing, and hatred- life can be negative enough, right?

Closing for the day- Nelson is unhappily on the couch alone & needs loving..

Finally Free !

I am finally back to a normal heart rhythm ! It only took 2 CardioVersions and 2 hospital stays, but hey whatever works right?

The last 6 months have been the worst, to say the least.
September was the start of the A-Fib and multiple testing for a Watchman, only to be told I was a perfect candidate, but the Board chose not to give me one. I was referred to Mt. Sinai in New York, but the Electrophysiologist office neglected to send the records.  I discovered this in January. Unbelievably I am still waiting to hear from them. I chose to contact Shands Cardiovascular since they are only 4 hours away in Gainesville, FL. They visited me while I was hospitalized in February and did another TEE as well as a CardioVersion. I had a wonderfully normal heart rate for all of one night. The pharmacy didn't send up the meds to help it stay that way, and you guessed it I coughed the next morning... Back in A-Fib.

Another admission was scheduled for March. I was put on Sotalol for 5 doses with an EKG 2 hours after each one. Yes even at 2AM  ... grrr.. This was to make certain there were no prolonged QT waves in my heart, which could eventually be fatal. I then got another Cardioversion and have been normal (well for me) ever since.

In all this time, I lost My Boy Ozzi. Two days before my birthday. My 26 year lung transplant anniversary breezed by in a cloud along with my birthday. I'm still not ready to write about how much I miss my fella. He was my heart, my soul, and my inspiration to keep going. We were a team.
As the days went by, I recognized the need for a reason to wake up every day. Larry was away working and this house was too empty.

A friend knew I was looking - slowly- for a furry, wet nosed companion and recommended us to someone she knew. Nelson flew (literally) into our lives. I will admit 16 years out of the puppy stage, and this fella has been a joy to behold. He is into everything, explores the world via his nose and mouth ! The first commands he learned were "drop it" & "leave it".

He isn't Ozzi. Nothing will ever take his place in my heart. Nelson is pushing hard though. He's loving, tenacious, and stubborn all at the same time.

He's earned the nicknames wiggle butt, waddle butt, & low rider. He is a Skye Terrier and I honestly never thought to own another. They are difficult to come by. Owning a Skye Terrier was on my Bucket List, though I did have an Oath with Ozzi, & he promised me he'd live forever.

Now, to the latest dilemma, health wise. All these shocks to my heart plus a dermatologist visit triggered a case of Shingles. Oh yay !  Well, it also triggered what is known as Grovers Disease. Never heard of it ? You don't want to. It makes Shingles feel like a picnic in the park. Little bumps all over your torso front & back that will drive you mad with itching. I tried 2 Benadryl, Hydrocortisone cream, SSD cream & finally resorted to soaking it all with alcohol and then applying baby powder.
The Dermatologist called in a big tub of cream to help out with it all. She did offer something to help me sleep. I declined.. after all what's better than getting up every 20-30 minutes wanting to rip your skin off by scratching? It seems to be helping, but from what I read this could last up to 12 months. Seriously ?!?  It's caused by Stress, Sweat, Sun & Heat.. Great for us Southerners. 

Honestly, if this lasts 12 months- the stress of wanting it gone will guarantee it stays for another 12.

At least I no longer feel intense pain when a soft T-shirt rubs my stomach.. 

Have a great day !! Oh ! and don't stress too much- we might end up Grovers buddies  😎😎

Chronic A-Fib Living with or Existing ?

     September 24,2017 I woke about 3AM with a choking cough, due to the chronic rejection. This time nothing would move. I honestly felt it was to be my last few breaths. I managed a slight intake of breath and blasted air out giving it my one last time.   Finally- relief, I could breathe. 

But, I triggered my A-fib.  And it has stayed with me ever since, like a long lost enemy.  Believe me when I say - it is NOT a long lost friend.

All the other "episodes" would correct themselves within a few days. The one previous to this, I went to my Cardiologist and received an IV until it corrected back to my normal heart rhythm.

     If you follow this blog, you may remember I cannot take any anti-coagulants due to hemorrhaging from my right lung in 2014. A very scary summer I have no desire to repeat anytime soon.
However, I am again taking a chance.  October 6,  still having an erratic heart rate, I visited my Cardiologist. We had to stop the Multaq, not recommended for long term A-Fib. This has given my heart free reign on being all over the spectrum as to rhythm.  Metoprolol went from 12.5mg to 75 mg twice a day, started Digoxin, and Xarelto. Yes, I asked for a blood thinner until we can at least try ablation or anything to keep me from a stroke. Imagine feeling great and so well managed on minimal doses to having Saurons army of Orcs pounding inside your chest wanting out.
We also discussed me getting the Watchman implanted in my left Atrial appendage. This would mean no more blood thinners !

     In the middle of all this, I had other appointments, and did battle with my lung transplant team. They did not want me taking Xarelto or having ANY devices implanted at this time. My cardiologist called on the 6th, left them a message and we waited. Monday, I called them and did the one thing I most regret. I told them I was doing as my Cardiologist recommended as I had heard nothing from them. This is the culmination of a few mistakes that I question them making in dealing with my health.  My Cardiologist again called and finally got a return call.   What ensued between my transplant center may have them kicking me out of the program. I.E.  calling in a Rx for Levacquin (I cannot take) and then calling another Rx into a mail order for 3 tablets of Levacquin. Why would anyone call in an antibiotic a patient needs NOW, to a mail order that will take 2 weeks to get to you? Three tablets ??? Seriously ?!?  My right lung would laugh hysterically at that paltry defense, break out the catapults and gloriously defeat such a minute attack ! They also called in Gabapentin, to help with my cough, which is getting beyond controllable even with Tussionex. I can count on one hand the number of good nights sleep I've had in 5 years..  Once I read the side effects, I said nope, nada, no way. I am disappointed enough in how this is being handled, I refuse to take anything that could enhance that feeling. So, I am dealing with the cough. As usual.

     The 16th was an appointment for a CTA of my heart to see if I can be a candidate for the Watchman. We failed. I was too nauseaus and the contrast (which I had to get permission for from my kidney transplant team) would make me sicker.. Oh yay ! We tried again yesterday, after 3 tries they could not get an IV catheter to go in far enough to inject the dye, plus my heart beat was all over the spectrum.. 19-150-68-120-52-49-113  yep that was me...  Now we will try again on the 27th at the hospital where they will access my port instead of a vein.

       I am concerned. The contrast could damage my transplanted kidney. To insert the watchman they will have to create a small puncture through the septum wall between the Atrium chambers. The same wall that was repaired 26 years ago to end my Primary Pulmonary Hypertension along with my bilateral lung transplant. The electrophysiologist promised to plug that hole really well... Hopefully I can also get ablation done to correct this darned A-Fib.  My shortness of breath has increased 3-fold. AFib causes it as well as my chronic rejection. I need this corrected so I can tell when my rejection gets worse.

     It is a lovely sunny Saturday, me & Ozzi are delivering goodies to a local pet rescue and then me, him & the Orcs will relax outside and try to read an uplifting book.

I.Am.Still.Here.
I.Am.Alive
I.Got.This.


   

Comfort Zones

We all have them. Those places and people that we know we can trust with our lives. They know us there. They support us and often literally keep us alive.

This is extremely true for transplant recipients. Our Transplant Centers are our Comfort Zones. for many of us, this is where we found the physicians that have ever been able to answer our questions about our diagnosis.  I remember my first trip to University of Pittsburgh. I searched 28 years for answers to what my diagnosis actually was, and the cause.  Then as if by magic, I was overwhelmed with answers ! And the Coordinators- oh my ! if all health care staff could be just like them.  They were caring , positive, and so friendly.

Great flash back... and you know, even now at a different transplant center, this remains true.  We as patients literally put our lives and well being into their hands. No other doctors office runs like these do.  We talk to a live person, we get call backs, we get answers AND we do not have to wait 48 hours!  Many times I have said, "I wish all offices could be like my center."

I am currently in a concerning dilemma.
I sense the chronic rejection/infection from my right lung has sneakily taken up residence in my left lung.  Now this devious organ has tried this before, many times.  We try to catch it early and make it move back home.  Let me give you a little history here. The right lung is from a double lung transplant almost 26 years ago (I know, Yay me !) while the left lung was re-transplanted at Shands Hospital almost 15 years ago (again Go Me !!). I am known for doing all possible to stay away from hospital admissions.

Through the years my transplant coordinator has always known that if I call and say there is an issue, we jump right on it.  We've shared many hospital admissions that took me years to get my strength and endurance back, and neither of us want a repeat.  Bette, happy and medically managed healthy is a wondrous thing to be !

I've noticed my cough ( part of right lung chronic rejection, and as Heddi would say "A real Bugger") has gotten more prominent. Pain in my right side tells me it's on the move. Pain on my left side screams "Get it out !"  My cough can be loose (preferably) or tight to the point of choking me (not fun). When you are woken up at 3AM choking and cannot get air in to make ANYTHING move- it is NOT a good thing. Both sides ache from muscles being strained to unbelievable levels. Been there. done that. Sadly it will happen again many times in my life.  My friends know, my biggest fear is suffocating, alone and no help.

This is where I am now.  Plus temperatures off and on  for the last 3 weeks.  Now comes the inevitable, walking across the room and I am struggling to breathe. This is NOT the Bette, who was walking and climbing in Maine just a few months ago ! This is NOT the Bette I want to be !
I coughed/ choked so long and hard on Sunday morning I went into A-Fib- today is Tuesday and I am still trying to get my heart rate back to normal.  I will, if not my cardiologist will bring me in and there is an IV that works - just an annoyance is all.

Now the real concern... There is not one physician or coordinator who remembers my past history. They are all NEW !  I was called in a prescription for Levacquin, 1 tablet a day for 7 days. Ha ! I laughed hysterically.. I know it has to be knocked out and fast. This infection will shore up the tower, bring out the seige enginges and merely enjoy the little attack on it's defenses. Plus, I cannot take it. Levacquin causes a prolonged QT wave in your heart. I already have that, plus it does not play nice with my heart medication Multaq. I had open heart surgery with the double lung transplant instead of a heart transplant as well.

I called up Monday and asked if there was availability for a Wednesday visit.  They were full & overbooked. Now, under different circumstances, this infection would have been long moved back to it's home with me being treated like we normally do.  Heavy duty antibiotics called in & if I don't feel better within 14 days, a visit to start IV meds.  I have repeated my history multiple times. I wonder if they are tired of hearing  "This is what Dr. Baz always did for me and it worked ?"  Maybe I should change it to Dr. Baz, Dr. Akindipe & Dr. Salgado ? In my defense, my previous physicians proved to me time and time again- they would keep me alive.  Those transplant coordinators deserve a universe of praise as well ! I admit, when I'm sick, I want to get well NOW.  I had all these transplants to embrace life and this is merely an interference with me getting on with life.
I guess what I'm saying is, after trial and error we found what works for me. I don't really want to go through trial and error again. Is it too much to ask, to have a physician who KNOWS me and a coordinator as well.

During this phone call, I spoke with Rita the transplant assistant. When I mentioned coming up, her response was, "You're one of our strongest patients, when you call we know you are serious." My response: "I know! right! You're the only one there who remotely remembers my history."  I did get an appointment, with a promise that I will be given nothing unless in conjunction with my Cardiologist approval. As long as he knows, and we are proactive, I'm OK with it.

My suggestion for hiring coordinators. Let's not look at qualifications, but more at longevity. My coordinator in Pittsburgh is still there 26 years later. How comforting that is. My original coordinator  at Shands, I had for many years & was heartbroken to lose her as well as my physician (happily married with gorgeous kids), but there was a long period of transition to Sonja. Sonja was moved to pre-transplant after a few years and I got Chad who after 2 visits took a promotion and I got Sherrie. I just barely knew her and she left. After a few talks with Ashley-Marie my new coordinator, she is trying her best to know me and be my advocate. I only hope she stays for a long time.. The foundation of my comfort zone has shaken just like out recent Hurricane. This appointment will be stressful as I fight for what I know I need from years of experience, as well as try to not bring up physicians of the past.

Safe to say, I will get through this. I am not ready to check out yet, even with continual coughing for 5 years and lack of sleep from said coughing.. This is still my life and I intend to check out when I am ready. My goal to be back in Maine next summer and walking those inclines again !  Oh, and the lobster and Haddock are a great enticement too   :)

Be safe... Be a Donor.... Lives depend on you .

Being Thankful

Never forget... Things could always be worse...
Be thankful... you woke up
Be thankful... You are Alive...

 Obstacles are just that.. A minor bump in your journey that makes you stronger.

Finally News I can Smile About !

As I mentioned in a previous blog post, I've been bleeding internally since 2013, in 2014 we found it was from my right lung. Yeah the bad one from my 1st transplant 24 years ago..
I guess after all this time, it has a right to protest the captivity :)

While my transplant team also sent me home in 2014 with the statement, there's really nothing more we can do, and I accepted it to a degree, I also decided this was my fight.  That being said after 3 long years of becoming thoroughly exhausted from that long 3.5 hour one way drive to Shands and waking at 2AM to do the drive......  My PFTs  have risen !!!  My lung function is better, not where I'd love it to be,but better. We lungers will happily take any good news we can get..I watched as  my lung function has steadily declined over the past years but three months ago it stabilized...   Insert brief hope here :)

This visit they are up a bit ! I'm feeling better, not where I would like to be , but enough to get housework, yard work, etc done at my own pace without massive fatigue and continual naps.
Ozzi may not be happy with me skipping an afternoon nap here and there, but I will certainly  make it up to him somehow.

I have stopped all nebulizers. The excruciating ear pain causing the worst case scenario of vertigo imaginable brought on that decision.  It will also save me close to $400 a month. I know I will go back on it sometime soon,, just not now. I also recognize that the summer months June, July & August are my "magical" months.. You know, the ones where I end up in the hospital and have to claw my way out. I am preparing for those months, and this year am determined they will be my friend- no hospital.After all, what is 3 measley months out of 12 anyway?

We transplant patients don't "bounce back" like healthy folks, mine took 3 years..

All my other issues are still with me, but this I had to shout. I have worked hard for this glimmer and I intend to celebrate !

Oh, and the best yet ! Kidney and Lung Transplant told me, they didn't know what I was doing- just KEEP DOING IT ...


Be someone's Miracle- Become and Organ and Tissue Donor

It's Just Me Again !

     I have been regularly berating myself for not posting, however once again why post if it's negative. I've been in that mood of "just nothing to say" for awhile now. The day to day struggle can wear a person down, and reminding myself to just get up and do it, doesn't always work.  The mind is a powerful thing when it does not want to budge.
     After discovering I was experiencing every side effect from long term use of Colistin, I have been changed to a different inhaled antibiotic. I am now using Amikacin, and it was amazing the first 3 weeks ! I had no cough, I was sleeping ALL night and my energy returned. Sadly so did an excruciating earache. Not just the ear, this extended all the way down my neck - ear canal- type of ache. Nothing worked. I then discovered in rare circumstances it can cause hearing loss....
Hmmmm choose between hearing or having my lungs.. Difficult choice huh? I stopped the Amikacin for a week,, and the cough returned with a vengeance. Yes , even to coughing so voraciously I lost my breakfast in the mornings. We decided to try once a day and see if kept the infection at bay. It did.. Well until December, when the nebulizer paralyzed my vocal cords... Yes ... completely.. I had no .. NO voice.. and it was painful to try and talk.
      Eleven days in the Florida Keys in relative quiet. I guess my husband handled it quite well ;)
It was still the best and warmest Christmas to date. We played with a family of Manatee that were residents in the marina, and basically enjoyed the sunshine. My neice and her family came to visit for a day, being stationed in Key West, made Christmas away from family, better because there was family. Went into Key West for a day and Ozzi discovered the famous Key West Roosters !  We tried to visit again and after finding NO parking chose to go back to the campground.. Money saved-right ?
      Ten days on Cipro for Diverticulitis caused me to once again stop the Amikacin. I had severe Vertigo and didn't need to give it anymore help. Now it is with regret, that I go back on schedule with the nebulizer, I feel the need to fight this infection once again. I will admit, the freedom of being away has been such a heavenly relief..
For now.... Back to the grindstone....  Well until the earache retuns again anyway..

Life is a series of things we simply don't want to do... Do them anyway.. It matters ..