CIDP And Me - Putting Things in Perspective

Every once in awhile it is good to take a step back and put things in perspective. So that's what I'm going to do with this post.

First I'll give a wee update as I have been mia for some time. I'm back on IVIG and, so far, so good. My neurologist decided against subcutaneous treatments for now and instead opted for what I call Plan A, Part 2. I now receive IVIG every four weeks with some new safeguards against reactions. The biggest change is that instead of taking 3 hours every day for 5 days, it now takes 7 hours each day. My IVIG week is now really just that - no physio, no occupational therapy, no choir, no lunches (sigh). It is exhausting but worth every minute and every drop of the goopy plasma as it really makes me feel so much better. If I am to be a vampire, sustained by the blood of others, there must be some limitations, no? 

Ok on to the reflective portion of the post...

Two years ago I was lying in a hospital bed with paralysed legs (one in a cast). I relied on nurses to help with the very basics of everything. Even at this, the lowest point of my experience with CIDP, I was not too down about things. I was, as my doctor put it, in 'fight mode.' I never really allowed myself to consider the possibility of not recovering. I knew that things would kick in and just needed time to do so. In retrospect I have no idea how I stayed so positive. What is even more amazing to me is how Scott stayed so positive. I can't imagine how difficult it was for him during that time. But we got through it and things did start slowly improving. 

Fast forward a year and things were quite different. I was home and able to take care of my own needs. I was in a wheelchair but seeing improvements. For one thing, I could stand up using my own steam as long as there was something to hang onto. I was starting to use the walker for transfers at home. I was battling fatigue and weak hands. I knew that I still had a long way to go and would get there but felt pretty good about how far I had come. When I look back at my journal from this time it is filled with excitement and hope. The highlight of November 3, 2016 was that I could undo the clips of my splints with one hand for the first time in months. I need to remember this when I complain about my hands now, I've really come a long way. My biggest goal in physio at this time was to walk with the walker without the wheelchair following me. 

The changes over the past year are really quite incredible. I haven't taken the wheelchair out of the house in months, for one thing. I'm even starting to walk around the house without the walker a little bit (as long as there is a wall or sturdy piece of furniture in reach). My hands are up and down in terms of pain and usefulness, but they have regained a baseline strength that is acceptable. Last night I held my music instead of using a music stand for the first time - just one of those little big things. I'm primarily focused on leg and core strength and making progress. I'm starting to be able to stand up without using my hands - as long as the seat is high and stable enough. This may not sound like much but it was a pipe dream not so long ago. I've gone from being the patient looking wistfully at others who can do so much more to being the patient that is looked up to! Last week, a new patient in  physiotherapy told me how he hoped he would be able to get on the treadmill like me one day. This comment gave me the warm fuzzies in a way that few could understand. Heck, I'm still amazed that I can use the treadmill - it's awesome!

My physiotherapist and I were chatting about this the other day. We've been working together for almost a year now and she is constantly impressed with my progress (not to toot my own horn, though she deserves as much of the credit as I do). She likes to remind me of how scared I was to let go of the walker or bars when standing when we first met. It took a lot of work, patience, guidance, and medication to get where I am now. Not that I'm done - nay nay, we're just getting started! 

Who knows what another year will bring. I'm sure there will be ups and downs. There may even be a plateau - there is bound to be eventually. I'm still a long way from where I was three years ago. I still hope to get back to work and have not given up hope that one day I will take the dog for a walk in the woods. These seemingly mundane goals keep me going and fuel my positive outlook. I refuse to get mired down in thinking about what has been lost or what I can no longer do. I still have everything that matters - an awesome husband, great friends, a supportive family, a goofy dog, a roof over my head, books to read, music to listen to and sing, and my own mind (it may scare you, but I like it just fine:)). If anything, I am more appreciative of these things than I was three years ago.

So there it is, a little perspective. Chronic illness is tricky. There is no clear path or knowable outcome. It doesn't go away (being chronic and all). All we can do is roll with the punches and make the most of each day. Man, that sounds lame. Yeesh. I think people experiencing chronic illness all find unique ways to help them deal with it. My way is to work on small goals and to celebrate the little things - to try to remember how far I've come without losing sight of where I want to be. In other words, to keep things in perspective. 

CIDP and Me - The Waiting Game

UPDATE: If you post it, they will call? I got a call within hours of posting this and have an actual plan... Still, enjoy the rant:)

Waiting. I hate waiting. There is nothing that makes one feel less in control of things than waiting. Especially when waiting for something that is truly out of one’s control. This is a little bit of a rant/vent that sums up my month. I am waiting, not always patiently, to find out what is happening with my treatment.

I met with my neurologist at the beginning of September and left with a shiny new plan of attack – subcutaneous IG (SCIG). This is the same blood plasma product that I received through IV for 2 years but, instead of IV, it will be given through needles into the skin. This may not sound appealing, but my tastes (and fear of needles) have changed over the past two years and it really isn’t so bad. The best part is that if this works I can eventually do it at home! But I’m getting ahead of myself...

SCIG is a relatively newly approved treatment for CIDP (oh the acronyms) and it seems that I will be the first person in Cape Breton to receive it. That is if I do receive it... It’s all still up in the air (the waiting). My neurologist wanted me to start right away (I met him on a Friday morning and he thought I should start the following Monday). I knew this was unrealistic, but we got the ball rolling. The idea is that my first treatment will be in the hospital in case of reactions. So I left it in their capable hands and started waiting.

As I mentioned, this is a new treatment to them so they had to do some research and talk to the people in Halifax who have experience with SCIG. Hence the waiting... I have had a few cryptic unofficial updates (waiting for call-backs, received call-back waiting to talk to neuro...). I have also left a couple messages asking for updates. My understanding is that they are worried about the timing of potential reactions as it could happen a day or two later. I did receive one official call about it last Friday, they told me there was more paperwork than anticipated and promised a call-back as soon as they 'know anything.' So I wait.

As I wait I go a little crazy. I am becoming far too hyper-aware of everything in my body. Is that ache or numbness new? Is that weakness or just fatigue? Are these tremors from medication or CIDP? So many questions festering and turning me into a self-obsessed hypochondriac. It’s not good. I try to distract myself but it’s tough. Meanwhile, I wait.

I don’t think I have regressed physically or functionally, which is good. I am definitely more fatigued and am experiencing more numbness and tingling. I feel hungover all the time without the pleasure that should precede it. Then there are the tremors. My hands have been shaky for months but it has now migrated to cover my whole body. I feel like a tuning fork. Scott was even able to see my stomach quivering through my shirt last night. Good times! Stress? Maybe. Lack of IG? Maybe. Too much Prednisone? Maybe. Who knows. I don’t like it. But I wait.

I know that I will hear when there is something to hear. I know that the powers that be are working on it and just want to make sure that things are done properly. I get that with any new drug there will be new protocols and procedures. I understand that these can take time to figure out. I also understand that calling me with no actual plan is unlikely. But it would be nice to get a little official word once in awhile – “Hi Gwen, we know this is taking a long time, hang in there we’re on it.” I say official, because I am getting unofficial messages like this when I run into people at the hospital and around town – and I do really appreciate these! I hate being a clanging gong and a pest. I hate calling and leaving messages every week. But, for my own sanity I need to. I refuse to fall through the cracks on this one. So I wait.

They say patience is a virtue. Heck, even I wrote a big long blog about patience a few months ago. Perhaps I need to revisit that post and follow my own advice. It will all come together eventually. Of this I have no doubt. Maybe I just need to spend a little more time practising yoga or meditation and a little less time stressing and obsessing. But until I hear, I wait.

CIDP and Me - Feeling Ambulatory

Time for a good news blog post I think! The past few weeks have been really good so I thought I'd share... I still don't know what the plan is for treatments now that IVIG is off the table, but in the meantime I'm making the most of my physical improvements and Prednisone-induced energy. I call it the 'Predni-Zone' (cue the music for Kenny Loggins 'Danger Zone').

I no longer need to take the wheelchair out of the house. Hopefully ever, but definitely for the foreseeable future. I still use it for a few things around the house (sweeping, middle of the night bathroom trips) but it is collecting dust and laundry much of the time. I can even manage to get around a little bit without the walker - as long as there is a counter, chair, wall, or Scott to hang on to. My new braces are no longer a hindrance and are really helping me learn to not stand with locked knees. Heck, I'm even getting some observable muscle tone back around my knees!

As a result of this new strength and confidence I have been checking off milestones both in and out of physiotherapy. In physio I have improved my score on the Berg Balance scale from 21-28 (in two months). This may not mean anything to my non-physiotherapist friends, but it's a pretty big jump (the scale is from 1-56 with 20-40 as the 'walking with assistance' range). In the spring I scored 17. She didn't tell me we were doing the test this time so I couldn't even 'study' (practice) ahead of time...

This is not the only milestone... I started using the treadmill this week! Yes, a moving sidewalk, and I didn't fall off! I have used it 3 times and am up to 8 minutes with a whopping 0.6 resistance (I'll be running in no time:)). My physiotherapist would not let me see the resistance or time the first day because I am apparently too competitive with myself... tee hee. So that's fun. The other new thing happened yesterday - I stood on the bosu ball for the first time. This is a half-exercise ball with a flat top used to improve balance and challenge every muscle in the legs and core. It kind of reminds me of pogo balls from when I was a kid. Course, I was never very good on those either. Anyway, it went better than expected (I did not end up in the ER or on the floor). I used the bars to stabilise myself and had 2 spotters hanging on to me. It will be awhile before I can stand on it without holding anything (let alone use it for squats). But still, I'm excited that we can even try it.

Our other main focus right now is slowing down my unassisted walking. I am a bit of an anomaly here as apparently she spends most of her time helping people walk faster. In my case, I go fast and rely on momentum to keep me up instead of my muscles, so we need to slow down and work on control. I can't get away with anything;)

Things are going well outside of physiotherapy too. I mentioned my outing to Louisbourg in my last post. This was a catalyst to get out more and more. I walked a kilometre or so with my brother and his girlfriend last week on the boardwalk at Dominion Beach. Two days later we all drove up the Cabot Trail to Ingonish and I did a little walking at the top of Smokey and Wreck Beach. I'm getting much more comfortable pushing my walker through gravel and up and down small hills. Last but not least, I reached a major milestone on Wednesday - I walked down the (steep) driveway and accompanied Scott and Barney on part of a dog walk! Walking the dog is one of my favourite things to do and I miss it terribly. It used to be how I cleared my head each morning and readied myself for the day. I can't handle the dog yet or go very far, but I'm getting there. I'm going to try to do this as often as possible to build up my stamina.

So there you have it. Only good news for a change:) Hopefully the improvements continue but I'm just taking things a day at a time and not stressing about what-ifs at the moment. I see my neurologist next week to figure out what's next for treatments and will post again once I know more about that.

Happy Labour Day Weekend!

CIDP and Me - Antibodies VS Antibodies....

I had a pretty crappy week. What a way to open a post, I know! But it's true. Remember 'the ugly' section of my last post? (Yes, I'm now assuming background reading...) I'll recap if you missed it. I have been having allergic reactions to my IVIG treatments periodically since March. Last month I had one despite a high dose of Prednisone, which was worrying as it is supposed to shut down the immune system enough to prevent reactions (along with other precautionary drugs and measures). Well, we changed brands (for the third time) this time around and I was hopeful. Alas, I had two reactions this week and have been told that IVIG is no longer a treatment option for me. My neurologist is worried about my kidneys - they are OK right now, but apparently it is a bit of a ticking time bomb if we continue. So, this sucks. IVIG, while no picnic, has played a big part in getting me where I am today. It is the first-line treatment for CIDP and has the fewest side effects. I had it every 2 weeks for a year and a half and then every 3 or 4 weeks for several months with no issues and figured that would continue indefinitely. It seems my body has other plans.

Basically what they think has happened is that over time my immune system (not my favourite part of me) has developed antibodies to fight the antibodies from IVIG. Well, I guess my arsenal is big enough now to launch counter attacks... At first Prednisone and Reactine/Benadryl were enough to stop the attack, but diplomacy has failed and war has been waged. I was pretty down on Wednesday when I had my second reaction in a week (first time that has happened). But such is life. There are other treatments and this does not take away from any of the awesome physical improvements I've made lately.

There are other options and no one has given up on me. My neurologist is going to discuss my case with a hemotologist in Halifax and we will go from there. For now I'll stick with Prednisone and hope it's enough to keep things in check. I should know more over the next few weeks. I keep telling myself that it took a long time to wind up in the chair the first time, I'm not going to end up back there again overnight. I was able to space out my IVIG infusions from every 2 to every 4 weeks without major issues, which is also hopeful.

I allowed myself a rare pity party for a couple days but have decided enough is enough of that. Today we (Scott, my mother in law, Barney, and I ) got in the car and drove out to Louisbourg for the afternoon. Nothing beats a little fresh air and the ocean to improve my mood. I was even able to *hike* a little bit! Well, I took my walker and walked down the first few hundred feet of the well-groomed Lighthouse Trail. It was a really great day and a good boost for my ego. I found it easier than I expected to get around and, though I was tired, I didn't overdo it. Two years ago this week I heard about CIDP for the first time. A year ago I was happy that I could almost get up from my wheelchair unassisted, now I can walk a level gravel path by the ocean - not bad at all!

Here are some pics from our outing:

Ciao for now!

CIDP and Me - The Good, The Bad, And The Ugly

The Good

I am using my rollator more than my chair to get out and about, which is great. I still use the chair for longer treks like shopping, but most of the time I use the rollator. It's slow going (according to Scott I move at 'lazy old man' speed, which I figure is A-OK) and exhausting but very liberating. I even get to sit in real chairs at restaurants! My goal is to have enough stamina to drive to appointments and walk to and from the parking lot by September when Scott will be teaching and not so free to drive me all the time. I can get the rollator in and out of the car on my own, which is step one of this plan. The biggest challenge (other than stamina) is walking down hill. It's amazing how terrifying the slightest slope can be. I also recently discovered that my breaks don't work very well when the wheels get wet, so rollating in the rain is another challenge for me. I like challenges...

A benefit of walking and standing more is that my strength seems to be improving a little more quickly. My latest feat (achieved but 30 minutes ago) is lifting my heels off the ground while bridging. This may not seem like much but like all the little things, it's a big deal for me. Way back when (two+ years ago) it took not being able to stand on my toes for me to realise that something was seriously wrong. I can't do it while standing yet, but at least it is now a possibility! The strength gains are not just in my feet. My core and legs are getting better and better at supporting and holding me up - so yay!

In other news, I had a long-overdue visit with a very good friend. We even managed to spend an evening with a few 'old' friends who I had not seen in an age (or decade). It's always nice to reconnect and catch up. I really don't know how we are all so old now though!

I finally got my new custom AFOs on Friday! They look pretty cool (in a nerdy, mobility aidy kind of way). The background is a cross-section of a peripheral nerve and the foreground is the CIDP turtle. Here is a pic:

They are made of much heavier plastic than my over-the-counter AFOs and feel totally different. My centre of gravity has changed enough that I have trouble standing unsupported in the new ones. Apparently I have developed some bad habits by compensating for weak quads with locked knees and these new AFOs are designed to prevent that. My physiotherapist and I will have a lot of work to do when she gets back from vacation! In the meantime, these are a good inspiration for me to keep on top of my home exercises. I'm currently wearing them around the house and changing to the old ones when I go out. There will be a period of adjustment with some 'tweaking' trips to the Orthotist as we sort everything out in terms of comfort and function. Well, comfort maybe a strong term - but the aim is to make them as comfortable as wearing a plastic boot all the time can be.  

I recently decided to 'break up' with a particular medication and this definitely belongs in the 'good' category. Sometimes the side effects of medications outweigh the benefits. In this case the brain fog was just killing me. I could not think clearly or deeply and had a heck of a time concentrating on much more than reruns of Supernatural. Enough was enough. The fog has lifted and the world is sharper and clearer. I can complete thoughts and read books with a little more substance. I've been devouring literature and loving it. I have also managed to finish up some long overdue 'adulting'. 

Let's see, what else is good? Well, driving. Driving is good. And fun. Although, as with everything, there is a little hiccup. I'll relay the story while keeping it in the 'good' section because, ultimately, driving is good. So, we got the controls installed and I have been driving a little bit. I haven't gone out solo yet but more out of laziness than anything else. The annoyance is with Access Nova Scotia (the DMV). Shocking, I know. So the final step for legal driving is to get a note added to my license. I was told by the occupational therapist that once the controls were installed all I needed to do was go to Access Nova Scotia with my license and my prescription. He cautioned that they may make me do a driver's test but that it should pretty much be a rubber stamp. Great. We finally got around to this last week. Of course, the person we spoke to had no idea about hand controls or what to do. She went off with my license and prescription and talked to a few people. When she came back she told me that they faxed the information to Halifax and that I could expect a letter in the mail (!) within 1-3 weeks that would let me know what I need to do. Um... seriously!? She was not friendly nor did she have any interest in listening to my understanding of the situation. Sigh. Not much I could do though. I did not want to risk having my license revoked or anything else, so we left without making a scene. We'll see what this letter says I guess. 

The Bad

Carpal Tunnel. I have developed carpal tunnel in both hands/wrists. It's annoying and one of the main reasons I have not written in so long. Typing on the computer can be quite nasty and if I'm not careful can quickly lead to a week of uselessness for my hands. I have a new custom wrist brace, which helps and have to wear it pretty much all the time. If I overdo it I also find that I need to sleep with towels wrapped around my elbows (to prevent nerve-pinching through sleeping with bent arms). I am quite the dream at night these days - splints on feet and wrists and towels wrapped around my elbows... Maybe if I'm lucky I can acquire a neck brace or mouth guard to throw in the mix. The braces and towels help though and things seem to be improving. 

Fatigue. My old friend has decided to rear it's exhausting head again. I guess it is partially due to all the walking I am doing. It's frustrating. I've had to cancel plans and spent too many gorgeous days laid up on the recliner. Nothing I can do about it though. Pushing just tires me out more, and too much caffeine turns me into a jittery mess, so I listen to my body and do what I can when I can. I guess my body has adjusted to the high steroid doses as I no longer have the crazy Prednisone energy that used to get me through the day.

The Ugly

IVIG. Things were looking up here. I thought we had figured out how to prevent reactions, but alas 'tis not so. I had reactions to my last two treatments, which is very disheartening. I'm still going back for more though! We're changing brands (this will be the third one we've tried) and I need to get a bunch of blood work done to check whatever it is they want to check. I really hope this gets sorted out once and for all. The reactions have not been as intense, but they still suck and wipe me out for a week or so (possibly another contributing factor to the fatigue).I'm also trying to space out the treatments again - I went from every 2 weeks to every 3 without new weakness a few months ago. Now I'm trying every 4 weeks... Fingers crossed. If this works it will go a long way to giving me a little more time for life again.  I want to say that my nurses are awesome and have been excellent to take care of me and stay on top of this. They are great advocates and will even  follow up with my neurologist if I have trouble getting through. I spend a lot of time in this blog praising my physiotherapist and occupational therapist, but my nurses are just as important and praise-worthy! 

There you have it. All in all things are progressing in the right direction and I'm happy about that. I have a lot to look forward to in August - visits from family and friends, day trips around the island, learning to stand (again), more walking and rollating (I made this word up, but I like it). Hope you are all having a great summer!

Ciao for now!

CIDP And Me - Baby I Can Drive My Car!

It has been quite the week over here! I have 2 major developments that warrant blog posts (and celebratory wine) to share with you.

The first is in the title of the post - driving! I can no longer drive a 'regular' car as I can't pump or feel my feet enough to safely use pedals. Instead, I need to use hand controls. Like everything else there is a process for getting hand controls. I have been working with the driving occupational therapist to make it all official over the past few weeks. Step one was a cognitive assessment. Believe it or not my cognitive faculties are in order (or good enough anyway). Step two was a driving assessment using the controls. No practice runs or anything, cause why be comfortable or have a sense of what's coming? The assessment involved driving the OT's car with both the OT and a driving instructor in the car. Scott was not allowed to come along. This happened Tuesday.

I felt a little bit like I was 16 again. It's not that I'm worried about my driving ability but 1. I haven't driven in 2 years 2. hand controls - big unknown there 3. Different car than I'm used to 4. Two strangers judging and evaluating me... Not my idea of fun. Turns out it was though. I've missed driving. And hand controls are kind of fun! They have a lever that goes on the left side of the steering wheel and is connected with rods to the pedals (a metal plate covers the pedals so I don't accidentally press them). You brake by pushing and pull to accelerate. The tricky part is getting the feel for how much strength to use (you really don't need much). There is also a knob-thing that attaches to the steering wheel to give full control when steering with one hand. It didn't take me too long to get the hang of it, though I did want to use my feet. The assessment itself was not that stressful - no parallel parking! We tooled around town a bit then went on the highway. I was grinning the whole time.

Step three would normally be to get the controls installed. The nice thing is that it is easy to switch between hand controls and 'regular' controls, so Scott will still be able to drive the car (when I let him:D). Unfortunately the controls cannot be installed with a standard transmission, which brings us to step four - my new car! Yup I get a new car out of this deal. We pick it up Monday. Hopefully I can get the installation done in the next week or so. Finally (step 5) I need to let the DMV know about the controls and have a note added to my license.

Exciting development #2 - wheelchair not required

This may not be new to all of you as I couldn't help posting it on Facebook, but I went out without my wheelchair for the first time this week! That's right, I finally took Rosie (my rollator) out for a spin in the real world. We went for lunch, cause that's what I do. It went perfectly and felt great. In fact it went so well that I keep repeating it. I even took Rosie to a new 'regular' yoga class this morning. My legs and butt are kind of annoyed with me (I feel like the day after squat-day at the gym) but it is totally worth it! Now, this doesn't mean I can relegate my chair to a dark corner yet, but it's definitely a step in the right direction.

I feel like I have been on the cusp of this outing for ages. It's been both a physical and psychological battle to get here. Luckily my physiotherapist is very good at reading me in both ways and prepared me well. I'm still terrified of falling and breaking something so I like to try everything new in a controlled environment (i.e with my physiotherapist holding my safety belt) first. Our little walks outside the hospital over the past couple weeks were what finally gave me the confidence to do this. She wants me to try walking from the car to my next session (with Scott there in case) to see how I manage a slightly longer distance.

I'm going keep going out with the rollator as much as possible to build up my stamina and confidence.
There are times that the chair is still needed though and that's OK. Nothing about CIDP happens instantaneously. I'm sure I will be double-wielding these devices for months to come while I work on my cane-walking skills. I've certainly reached a milestone with this though, and am going to celebrate this evening.

Ciao ciao

CIDP And Me - Life as a Lab Rat

It's been awhile since I posted an actual update, so this may be a little long and scattered.

I had my 3-month checkup with my neurologist last week and it went pretty well. He does makes me feel a little like a lab rat though. He was so happy my last IVIG treatment went well that he is changing things up again. Why risk getting comfortable after all? The name of the game now is to find the minimum dose of Prednisone needed for me to have IVIG without a reaction. We will be slowly weaning throughout the summer. We're also tinkering with some other medications (I'm losing track of what side effect belongs with which change). So much for only changing one thing at a time! However, I did leave the appointment with a plan and a schedule for the next 3 months, so that's good. I think my favourite part of the appointment was when the doctor and Scott started talking about how finding this magic number is like coming up with variables for a math equation... Then they thought they could write a paper about it... Oy. This is my first IVIG week with a lower dose and so far, so good...

I have made some good physical gains recently. We are working on walking outside in physiotherapy. We take the rollator to the hospital entrance and I walk down a slight hill (mountain) and across a crosswalk to the parking lot then back again. I've done this twice now and plan on doing it weekly - my apologies if you get stuck waiting for me to cross the road. The first time involved a lot of breaks and a lot of swearing and sweating as I conquered my fear of walking on a slope. Today was much better. I had one break and didn't swear at all! I was a little freaked out at one point but it will continue to get better. I am working on this at home by walking up and down sections of the ramp. I haven't done the whole ramp yet but am getting there. I hope to be able to get to the car sans-wheelchair in the very near future. The next thing will be to build up my stamina so that I can take the rollator to the shops without having to sit too much.

We are also working on walking with a quad cane (a cane with a 4-pronged claw for more stability), which is hard work and not what I would call fun. I'm not ready to take this out of physio yet, but it is good to have goals. My balance and ability to stand unassisted are getting much better. We even did a balance test a few weeks ago! My therapist laughed at me because I Googled the test ahead of time to know what I was in for (it's called the Berg balance scale - you can Google it too!). Scott was not willing to help me try it out at home - he has no spirit of adventure sometimes - so I didn't actually 'study' for it. I didn't ace it but we now have a benchmark, which is just awesome. The other big thing at physio these days is stairs. I go up and down a short stairway to nowhere every week and am getting pretty confident with it. As long as there is a sturdy rail, a cane and a spotter, I can safely manage a few steps. I may even try the stairs by the ramp at home one of these days.

My parents came for a visit a week or so ago. It was a good weekend for many reasons as I had not seen them in too long. One unexpected bonus was the perspective it gave me about how far I have come. The progress I have seen has been so slow it is easy to diminish it or feel like it isn't really happening. I don't really feel like I am that much more mobile than I was in the fall, but I am. It was a good little ego boost to see this in their reactions as they watched my get around the house.

Finally, I went to get fitted for custom AFOs today. These are the lovely (and oh so sexy) braces that allow me to stand up and walk around without breaking anything. I've been wearing off the shelf AFOs for almost two years but decided to take the plunge into the custom market as I am likely to need them for a long time. The orthotist had me stand, checked my range of motion, and took fibreglass moulds of my feet and lower legs. The braces should be ready in 3-4 weeks. I'm pretty excited. I'm also experiencing a creative block. I can have a picture or pattern on the AFOs - I just need to send in a photo. Now, it seems rather boring to let such an opportunity pass, but what to do? These will be well hidden under my pant legs, so no need to be conservative. Do I go for a nice argyle or pattern? Do I immortalise Barney on plastic? Do I pull out a fun Mesopotamian image or seal impression? Perhaps I go with a bookish or musical theme? I feel like I'm deciding on a tattoo and am probably (definitely) overthinking it. I'm sure I'll figure something out. Suggestions?

That's it for now - covfefe everyone!

CIDP And Me - Awareness Month

May is CIDP Awareness Month and the week of May 7-13 is Peripheral Neuropathy Awareness Week. In recognition, this post will be more of a personalised public service bit than a regular update.

As you should know by now, I have a lovely little type of Peripheral Neuropathy called Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). My first symptoms appeared in March of 2015 and it has been quite the ride. I'm not usually one for ribbons or randomly assigned 'cause' months, but this one is personal. I'm not asking anything of you (if you know me at all you should know that fundraising is about as appealing to me as dental surgery) but spreading some information is never a bad thing. If you do want to donate, I'd recommend the GBS/CIDP Foundation (https://www.gbs-cidp.org/). You could also donate blood/plasma if you are so inclined as it is needed for the magic goop that courses through my veins - IVIG. There, that's over...

I wrote a post about CIDP back when I started the blog and have added the link to my main page. If you don't feel like reading you can always watch some of the many videos on YouTube. The following is a short little introduction to the disease. It does a nice job of pointing out that my case is outside of the norm, but I've always known I'm special;)

If you have been reading my posts you know that the focus of this blog is my slow path to recovery. I find that there is very little out there that goes into much detail about the recovery process. Saying that %90 of people with CIDP recover is incredibly vague and unhelpful. What does 'recover' mean? How long does it take? Do those who end up in wheelchairs have a lesser chance at a greater recovery?

Well, it means something different to each person, which is part of the problem. It is also a chronic condition that may come with relapses and regressions. It never fully goes away, so 'recovery' may not be the best word to use as it implies a finality once achieved. It may be better to think of this journey as one of rebuilding or rebounding but that's not quite right either. Semantics aside, the goal is to improve as much as possible and achieve a 'new normal' plateau that can hopefully be maintained with or without ongoing treatments.

I have stopped asking 'how long until I reach this plateau?' because I know it is impossible to answer the question. A lot is unknown about the disease and the experts aren't much help here. I try to follow stories of others with CIDP on Facebook groups and through other blogs, but there is so much variation, they hardly provide a road map for me. Though, it sure is comforting to read about and interact with other people in similar situations! At this point I'm happy that things are improving and will do all I can to make sure it continues as long as possible. I will do my best to keep on top of my treatments and exercises when I do plateau so that if and when a flare up happens it wont get the best of me.

Over the course of two years I have gone from being a fairly active able-bodied person to being all but paralysed from the hips down to being able to walk short distances with a walker (with a cane or nothing under close supervision of my physiotherapist). I'm rebuilding atrophied core and leg muscles and teaching my body to balance with numb feet and paralysed toes. I have weakness in my hands and wrists to boot. But I am getting better. I celebrate every new muscle movement and continue to push myself as much and as safely as I can. The doctors are happy and continue to be elusive with time-lines or giving any indication of how much more I will regain.

I've created a little graph to illustrate how my mobility has been affected. It is a somewhat arbitrary assessment, but I think it's kind of fun. The top line is for my hands and the bottom for my legs. I assigned a number (1-100) based on two month intervals. I keep a daily journal and used this to come up with the numbers in the graph.

I focus a lot more on my legs than my hands, but they have certainly been affected. I am pretty functional in my hands these days but I can't knit, crochet or write for more than a few minutes and my wrists are quite pathetic. My hands have really been up and down and seem to respond better to steroids than IVIG. Each dip on the chart has been followed with a course of steroids. I didn't catch the one last spring/summer fast enough and the damage was swift and severe. I now look at my hands as my barometer and am hyper-sensitive to any tingling or weakness that creeps in.

The real drop in the mobility of my legs happened before the treatments kicked in. I started IVIG in late August 2015 and it took a few treatments to take effect (we also had to play with the schedule to find a frequency that worked). In terms of the range for my legs, I figure that walking with AFOs alone is 85, walking with a cane and AFOs is 75, walking exclusively with a walker is 70, being able to stand without assistance is 50, etc.

I find it interesting that I am currently at around the same level of mobility as I was when I started IVIG in late August 2015. This is a good sign. It is also scary as I was not using a wheelchair back then  - I was stubbornly (and dangerously) plodding along with 1 or 2 canes. It's amazing I didn't break anything sooner. Of course, it is not exactly the same. I'm sure that my muscle atrophy has me weaker in some places right now. It's encouraging to see the curve going in the right direction -- I really have come a long way since the dark days in hospital and rehab. My current (realistic) goal is to get to 85 and be walking with AFOs alone. That will sure be nice.

There you have it, a little bit of a public service message about CIDP and how it has affected me. There is a lot more to it (the ups and downs of medication, nerve pain, residual health concerns, psychological effects, etc) that you can read about in my previous posts. This is really meant as an overview and I hope it was informative and not too long or boring. I'll get back to my regular style of updates next time (big things are on the horizon).

Ciao ciao ciao.

CIDP And Me - You Take The Good, You Take The Bad

Let me start by stating, for the record, that CIDP sucks. I do not like it and wish it would go away. I have had a rough few weeks. That said, it is certainly not all bad and I have a lot to be happy about. My mobility continues to improve and, at the end of the day, the more easily I can walk, the better. Independent walking (or walking with minimal aid) is the goal after all and I continue to get closer to it.

Not to be too happy-clappy, let me elaborate a bit on the rough stuff. My last post mentioned my first allergic reaction to IVIG. Unfortunately, that was not a one-off blip, as I had my third reaction in as many treatment weeks today. I will spare the details but assure you that I am fine and have the best nursing staff and neurologist on the case, not to mention the most supportive husband around. I left today with a new regimen and schedule that will hopefully work out and nip this in the bud. I am tired of the hippy hippy shakes and looking like a 'smurf' (as my nurses so poetically put it).

OK, happy clappy time, wherein I get a little preachy about the great outdoors... I managed to step onto the deck this past weekend! This is where the pic was taken. I am looking forward to spending a lot of time out there once the weather warms up a bit. I cannot stress how important it is for me to get outside whenever I can (and I recommend you do too). Whenever I am feeling down I try to get out for a breath of air and it is amazing how quickly my spirits lift. Friends of mine took me down the road for a dog walk following a really rough week recently and it was so uplifting! I wheeled myself one way with my friend there to push me off the road when traffic came along. She also wheeled me back when I got tired. We had so much fun that we started scheming about getting me an adult-sized running stroller and doing a 5k race. I had a smile all night and the following day. It doesn't really need to involve exercise, even sitting outside waiting for a ride can do the trick. Unfortunately my 4-wheeling adventures are on hold until things get a little less muddy, so I am finding new ways to get out and commune with good ole nature. You can't take the granola out of this girl!

So there you have it. The good, the bad, the ugly. No one ever said this would be an easy or straightforward journey. I will continue to roll with the punches, do what I'm told, and play outside as much as possible.

Cheers!

CIDP And Me - A New Enemy

I have a new enemy and it's name is Benadryl. Seriously, that stuff is just not cool. Now that that is out in the open, I'll take a few steps back and tell you about last week.

Last Monday was the first day of Spring, so there was a snow storm. The snow was coming down so heavily in the morning that we decided not to make the trek in for IVIG. I hated to cancel as it would mean a make-up day the following week, but it was the right thing to do. By Tuesday morning the snow had been replaced by a nice steady stream of freezing rain. However, the roads were ploughed and we have studded tires, so we decided to brave the elements. As an aside, it was so icy Scott had to wear cramp-ons to wheel me down the ramp (I was not in the mood to start my career in wheelchair luge). OK, I make it to IVIG and everything is great, until my first rate increase... (IVIG is a bottle of clear, goopy blood plasma that is given by IV. The drip rate increases throughout the infusion). I started to feel chilly and asked for a blanket (this in itself is rare). Within five minutes I was shivering uncontrollably and realized something was wrong. I rang the bell for the nurse and a kerfuffle ensued.

It seemed I was having an allergic reaction. It was dealt with quickly and skillfully and I am fine. I was given IV Benadryl and Steroids and then subjected to a number of tests and observations. Apparently this is not an uncommon occurrence as IVIG is a blood product and no two bottles are exactly the same. However, I now have to take precautions before each infusion. Enter my new enemy number 1 - Benadryl. I am very sensitive to the 'may cause drowsiness' warning on all drugs, so 2 Benadryl at 8 am does not make for a pleasant or alert day. IVIG is tiring enough, but I have now discovered a new level of foggy, groggy exhaustion. I do not recommend it. I'm really not sure how physio and ot are going to work out on IVIG weeks now, but I'll figure it out. My neurologist did say that we could try Reactine if Benadryl is too much - I am going to ask about this next week. I realize that many people who get IVIG have Benadryl beforehand but I don't know how they manage. It would be less annoying if I only had 1 infusion day, but I go for 5 days every two weeks... that is a lot of time to be down and out. No thank you. Course, it is what it is. I will adapt.

In other news physio continues to go really well and I am getting more and more mobile. I did something yesterday that I have not been able to do in over a year and a half - I stood up and hugged Scott. It may not sound like much, but we both thought it was pretty awesome.

On a more practical note, I'm using the rollator at home about %60-70 of the time. This is going really well and I'm figuring out how to get by (using the basket and seat to carry things). As of today I am cleared to try taking it into the world - possibly the grocery store where things are level and there is lots of room. This both excites and terrifies me. I'll be sure to blog about it next time...

Ciao for now.

CIDP and Me - Into the Wild

It has been a busy few weeks here in CIDP-land so I figure a blog post is in order.

This update begins with a bit of applied learning - brushing my teeth while standing. One day I decided to try something crazy - stand up at the bathroom sink. I thought about some of my activities at OT and PT and realized that brushing my teeth while standing (chair right behind me and one hand on the counter for balance) should be easy to manage. It was and I had a new home-mission. I now stand whenever and wherever I can. I stand to get into the car, stand to turn on an element on the stove, stand to put away dishes, stand to wash dishes. It's great and easily fills my daily sit-stand quota. I counted the other morning and found I stood 6 times in the course of making breakfast. Think about how many times you stand up in the run of a day. Now think of each of those stands like a squat at the gym. All this standing is a great workout for me. It is also exhausting.

I'm still not very good at standing without something for balance. I think my record at physio is about 25 seconds. But that involved intense concentration and was in an 'ideal' setting. The issue here is my weak core. I believe I mentioned this before, but my core is an almost worrying obsession of my physiotherapist. My upper legs are actually 'strong' now, which makes everyone very happy. It also means my only prescribed necessary daily exercises are for my core. Apparently I will have a great bathing suit body under all the medication-induced (really...) flab.

While my recovery is going well and things are improving, it hasn't all been roses. We had a bit of a reality check with the neurologist. He is very happy but says that I am not likely to get much more back in my feet and that I am looking at a lifetime of walking with afos (foot braces that wrap around my calves. Very sexy). I'm over the moon that walking is the prognosis but it did bring home the reality and permanence of this thing. I spend so much time focusing on getting through this acute phase that I forget that I will still have to deal with it in some form when things become 'normal' again. I realized that walking with afos may be limiting. Short distances, sure, but what about 3-hour hikes over rocky cliffs? I likely wont be able to run, so hopefully the zombie apocalypse holds off . No more sandals or shorts... I'll also not likely be able to drive a car normally - we'll need hand controls. This is actually kind of cool and we've been referred to a specific OT to start the process. I had a bit of a pity-party about all of this last week but have moved on. Seriously, after all the past 2 years have thrown at me, I will be so thrilled to walk and drive at all. I don't really care if I have to make some modifications.

The other news around here is that we have found a new 'horcrux' and will be bringing it home on Monday. The 'horcrux' (I call all of my mobility aids horcuxes) is a 4-wheeled walker, or rollator. It has 4 wheels(seriously), breaks, and a seat for when I get tired. I'm not quite ready to hit the mall with it, but I am cleared to use it at home. I believe this will mean we can put the 2-wheeled walker away for now. I have also successfully rid myself of  two other 'horcruxes' in the past month or so - my transfer board and grabber, so it is OK to bring in another. I'll try to post an action pic of the rollator next time.

I had a bit of fun this morning. I went 4-wheeling! (the ATV kind with a motor and big knobby tires, not the rollator kind). It is always good to have at least one friend with a farm, toys, and some imagination. Hiking is one of my favourite things to do and not getting out in the woods has really been hard for me... My friends knew this and decided to come up with a solution. We were originally supposed to go snowmobiling but the snow melted.  Hence the 4-wheeler. I drove the 'bike' while the other two walked. We headed into the back woods and fields with five dogs and one pygmy goat in tow - quite the crew. It was a blast. I think Barney would liken the experience to a trip to doggy-Disney. I found it pretty easy to control the 4-wheeler (though I stayed in first gear) and it was simple enough to get in and out of.  I hope to repeat it before the ground gets too muddy.

So there it is. Things are going pretty well in my recovery and I'm happy. More to come soon...

Meanwhile enjoy this pic of me and Barney on the 'bike'. Note: he did not actually ride with me for the hike.

CIDP And Me - I Am Patience

This is going to be more of a reflective post than you are used to reading - believe it or not, sometimes I get deep. Before I begin the reflection, I will let you know that things continue to go well with my recovery and that every week brings new little but significant improvements. Please don't read into this post that I am going through a particularly rough time. I assure you that life is good:)

Now to the reflection...

I've been thinking a lot lately about patience and what that means in terms of a chronic condition like mine. What brought this on? Well, partly thinking of intentions at yoga class, partly reading another blog post that was supposed to be about patience but wasn't, and partly because I have been reading "Man's Search For Meaning" by Viktor Frankl. If you have not read this book, you should. Finally, when I think about it doctors, physiotherapists and others are always telling me to have patience. But what do they mean? After almost two years I think I am beginning to understand.

Let's start by talking about what they don't mean. Patience in this case is not simply waiting quietly for an ultimate reward (like a kid who quietly sits on his hands and behaves in order to get an ice cream). There is no guaranteed ice cream or other outcome with a chronic condition. Passive patience like this will get me nowhere and is not helpful. There is no clear cause and effect - I can eat all the right things, do all of my exercises and take all of my medications as prescribed and still get weaker and have bad days.  In a very large way the patience required of me is the ability to acknowledge this and be OK with it. It is the acceptance that the rewards that are meaningful come along the way and are often so small one will not recognise them at first.

Patience for me is understanding that the mind does not control the body and the body does not control the mind. For example, my mind tells my body to wiggle my toes every day and every day my body refuses to comply. However, my mind continues to try and, one day, if the body is ready, it may prevail. Patience is when my mind continues to make the best of my situation regardless of the state of my body. Patience has prevented me from falling into a 'pit of despair' and giving up the fight. Actually, giving up has never been an option for me. I'm just not capable of dwelling on the negative.

Patience is accepting the long game. It is the realisation that improvements will come slowly and that the end is unknown. It is taking time to reflect on and celebrate the little successes and improvements along the way. It is knowing that goals are not set in stone and need to be flexible. It is allowing timelines to fluctuate.

Patience is the strength to get up each day and face whatever the day brings. It is also the strength to endure setbacks and frustrations. It is knowing that there is no magic pill, vitamin or food. It is accepting that the doctors don't have all the answers but knowing they are trying. It is allowing treatments time to take effect. Patience is the ability to stop oneself from jumping to conclusions or giving up too quickly.

Patience means taking the time to look inside oneself and find meaning. This meaning is what one looks forward to - be it a person or activity. I look forward to going for long walks with Scott and Barney again (among other things). This is a kind of long-term goal or hope and it doesn't really matter if I actually get there or not - the important thing is having something to look forward to. (Thanks Frankl!)

Patience is understanding that things take time but can get better. It is learning that you alone must figure out how to live in your new reality. It is allowing yourself the time and space to figure this out. It is the ability to admit when help is needed or when additional changes are required. Don’t put off getting the ramp because you want to walk again – get what you need to live as fully as possible.  Changes to lifestyle do not fundamentally change the person inside.

Finally, patience is attitude. This is a big one. Attitude can make all the difference in so many ways. I have maintained a fairly positive attitude throughout my ordeal and many people ask me how I do it. It is not the result of any conscious decision, it is simply how I am. I could be down and depressed and that would be perfectly understandable. But at the end of the day that will only make me miserable and drive away those close to me. I think ultimately it is patience that keeps my spirits up. I work hard – I stay informed about my condition, I stay as active as possible, I try to eat well, I keep a daily journal, I celebrate the little things. I guess that’s my secret. There have been bumps, there have been challenges, but such is life.

I think back to the words of my doctor – ‘you are going to need a lot of patience’ and they finally make sense. At first I thought he meant that I needed to wait quietly while the treatments kicked in and we figured out what the long-term picture would be. But I realise now that there is no definable long-term picture and that patience is required for so much more than a diagnosis. Patience is the strength and attitude required not to simply survive but to grow through one heck of a challenge.

So there you have it, a little (OK long) reflection for a Sunday night.

Namaste.

CIDP and Me - Let's Roll

I haven't posted an update in awhile and have a lot to report, so this may be a long post. Or not, we'll see how the muse works in me tonight...

When I last wrote I was on a much deserved 'holiday' from physiotherapy. Well, rest assured we were quick to get back to work kicking my butt and expanding my comfort zone. There was no easing back into things with nice little strolls with the walker. Nope, we picked up right where we left off - walking around with only hands to hold onto. This lasted a session or two. Then, lest I become complacent, we tried walking with only one hand to hold. This actually worked out fairly well and I was feeling pretty good about things. Imagine my surprise when I learned that this feat was not enough! A week or so later I found myself lurching around with my hands out front like the monster from Frankenstein or a zombie while two people held my safety belt. That's right, I walked (for 100 feet or so) with nothing to hold onto. We have repeated this a few times and I can now breathe more normally and relax my hands a bit. I would certainly topple without the people hanging on for dear life, but that will improve. I'm pretty happy about this. I still have a long way to go in terms of balance and holding myself up, but it's coming. Our other less scary activities work on this.

The other major new thing at physio is the rollator. A rollator is a four-wheeled walker with hand brakes and a seat that can be used if one gets tired. You see a lot of older people tooling around with these. They make more sense than a traditional walker for outdoor use but are a little trickier. Anyway, the current thinking is that I am not too far off (whatever that means) from being able to use one of these babies when I go to the mall (cause I do that?...) or the hospital, etc. Using a rollator is weird. At first I felt like it was constantly trying to get away from me, so I held on for dear life and put a lot more weight through my shoulders than I probably needed to. This is getting better and it is becoming a little more comfortable. Updates as events warrant.

In my last post I mentioned that I was to start seeing an occupational therapist for my hands. This is also going well, though it doesn't look like my career in calligraphy will ever get off the ground. We spend our time standing at a table and doing 'functional' things like putting pegs in and out of a peg board and stacking cups. I also have a bunch of stretches and exercises to work on at home. I see her once a week or so.

That was a lot of text so here is a picture that I will explain in a paragraph or 2.

Being the keener that I am, I have been doing lots of extra-curricular activities this month. The first is yoga. I finally got my act together and started going to a yoga class. It's a restorative class and is almost more of a meditation class than yoga. All of the poses are on the mat and supported with blocks and bolsters. These are held for several minutes for a glorious easy stretch and opportunity to breathe and let go. I only needed to modify one pose as I cannot sit back on my heels. It was great.

The picture above was taken this afternoon during my newest activity - a walking track. There is a 200 meter proper walking track at a hockey arena near the hospital. It's free and accessible so my friend and I decided to give it a go. We lugged my walker and her two kids (it was a rain/snow day) through the deluge into the arena and up to the track. I do not think I have walked 200m in one session but was feeling pretty confident. I strapped on my safety belt and assigned the kids to follow me with the chair while my friend would walk beside me. It became quickly apparent that having the kids follow was not a good plan. We sent them a little ahead and had them wait at the corner. And so it went. I made it around on my own steam with 3 breaks. The kids found the breaks boring so decided to spend them running around the track. Thus we managed to tire me and the kids in one go:) I had a nice long nap this afternoon and hope I can move enough for physio tomorrow (haven't seized up yet but will definitely stretch tonight).

I'll leave you with this lovely shot of my back - note the children making off with my wheelchair in the background. And yes, I have tennis balls on my walker - I have fuzzy dice too but left those at home.

Ciao for now!

CIDP And Me - Happy New Year!

Well it's 2017,  I hope everyone enjoyed the holidays and wish you all a healthy and happy new year. Today marks one year since I wrote my first blog post on here (though I didn't publish it right away). It is hard to believe that a year has gone by. 2016 was certainly not what I imagined it would be. The outside world lost it's mind and went crazy while my little personal world started to regain shape and order out of the chaos left in the wake of 2015.

I was going to write a reflection on the year that was, but I decided against it. Much of it is already here in my other posts. I don't want to go back to the uncertainty and frustrations of the first half of the year, nor do I really want to go into the ever increasing minor and major improvements of the latter half. Suffice it to say I am happy to close the chapter that is 2016 and begin a new one for 2017.

I have some updates from the past few weeks that I have neglected to share. It's nothing personal. I just got caught up in the holidays and, if I'm totally honest, became too obsessed with jigsaw puzzles to spend any time on the computer. My life is so exciting:)

Anyway, I made more progress in physio recently. I can now walk without the walker! Instead of the walker I hold onto the hand of my physiotherapist and the hand of one of the physio assistants. I used the hands more for balance than anything else and was able to complete a 200ft loop. Pretty exciting really. I was also able to do a few squats like that (though I needed the hands for a little more than balance). It's all in an attempt to force me to use my leg muscles more. I'm now halfway through a 2 week break from physio and staying active with my home program. Hope I can still work all these miracles when I return Monday.

Monday also marks the start of a new addition to my treatment regime - Occupational Therapy. I know I've mentioned it before, but my hands are pretty pathetically weak. They have improved a lot over the past 4 months or so, but there is a long way to go. I didn't really mind (especially once I regained the ability to drink 1-handed) so did not push for extra therapy in this area. This changed a little over a month ago with my new physiotherapist. She assessed my hand strength and was shocked that I get by as well as I do. She submitted an OT referral and I received the call today. It will be another regular appointment to contend with, but it can be scheduled to always follow physio and so will not mean an extra trip. Plus, maybe I can convince her that I once had beautiful penmanship and then perhaps she could miraculously teach me to write nicely:)  Updates as events warrant.

We now move to my life outside physio - in a wheelchair. I never imagined I would need the chair for so long. I also never imagined that I would start to feel normal in it. I have been forcing myself to go out as often as possible over the past six months and somewhere along the line I got over my extreme self-consciousness. I'm not sure when this happened but it struck me the other day that it no longer bothers me. I mean, it still bothers me when places are not accessible and I get frustrated with the limitations, but I no longer feel like the elephant in the room.

I met new people through a friend last week and my situation never came up - we just chatted about random things. I know they noticed the chair and were probably curious, but it did not come up and I felt no awkwardness. It was refreshing. I sometimes worry that I am becoming a one-topic person who can only talk about my health. I am careful not to dwell on it too much, but it is an unavoidable part of the conversation whenever I run into people I know. It was nice to know that I can still make small talk and carry on conversations with new people outside of the healthcare system.

With all of this, I am certainly not allowing myself to become complacent or resolved to life in a chair. The sooner I can walk and drive around, the better! That said, I am not rushing anything or putting any timelines out there. If nothing else, 2016 has taught me patience. If progress has to be slow and steady, so be it. If there are set-backs and bumps, I'll deal with it. I have accepted that there will be no 'eureka' moment when things just snap back together. I will not just suddenly be able to get up and walk around. I will get there in time. One nerve re-connection and muscle rebuild at a time. Meanwhile I will perfect my wheelies and chair-shovelling (I hear a nor-easter is brewing for the weekend).

Cheers and Happy New Year!